Prenatal Exposure to Per- and Polyfluoroalkyl Substances, Maternal Thyroid Dysfunction, and Child Autism Spectrum Disorder

Autism spectrum disorder (ASD), with its high economic and societal costs, is a growing public health concern whose prevalence has risen steadily over the last two decades. Although actual increased incidence versus improved diagnosis remains controversial, the increased prevalence of ASD suggests non-inherited factors as likely contributors. There is increasing epidemiologic evidence that abnormal maternal thyroid function during pregnancy is associated with increased risk of child ASD and other neurodevelopmental disorders. Prenatal exposure to endocrine-disrupting chemicals such as per- and polyfluoroalkyl substances (PFAS) is known to disrupt thyroid function and can affect early brain development; thus, thyroid dysfunction is hypothesized to mediate this relationship. The concept of a potential pathway from prenatal PFAS exposure through thyroid dysfunction to ASD etiology is not new; however, the extant literature on this topic is scant. The aim of this review is to evaluate and summarize reports with regard to potential mechanisms in this pathway.

Relationship between Sugar-sweetened Beverages Consumption and Sleep Duration and Quality in Korean Adolescents: Based on Korea Youth’s Risk Behavior Survey

Background@#The purpose of this study was to examine the association between the consumption frequency of sugar-sweetened beverages including soda and sweet drinks and sleep duration and quality among Korean adolescents. @*Methods@#Data on 137,101 boys and 130,806 girls of students in middle and high school were obtained from the 2014-2017 Korean Youth Risk Behavior Web-based Survey, a national-wide cross-sectional school-based survey. Respondents self-reported soda and sweet drinks consumption, sleep hours, and sleep quality. The associations between these variables were analyzed by complex sampling multivariate logistic regression analysis. @*Results@#76.4% and 84.7% of respondents consumed soda and sweet drinks at least one time per week. Sleep deprivation (<8 hours/day) was associated with higher soda and sweet drinks consumption (adjusted odds ratio [aOR], 95% confidence interval [CI]) for 5 times a week for soda 1.44 (1.33-1.59) in boys and 1.25 (1.12-1.40) in girls: and sweet drinks 1.54 (1.43-1.66) in boys and 1.41 (1.28-1.55) in girls. Similarly, unsatisfactory sleep quality was also associated with higher soda and sweet drinks consumption (aOR, 95% CI) for 5 times a week for soda 1.19 (1.13-1.26) in boys and 1.27 (1.19-1.35) in girls: and sweet drinks 1.36 (1.29-1.44) in boys and 1.34 (1.28-1.41) in girls. @*Conclusions@#Both sleep deprivation and poor sleep quality was associated with higher consumption of soda and sweet drinks among Korean adolescents.

Effects of Nurse Navigators During the Transition from Cancer Screening to the First Treatment Phase: A Systematic Review and Meta-analysis

Purpose@#Implementation of nurse navigators during cancer screening to the first treatment visit may facilitate early diagnosis and treatment. This study aims to demonstrate the evidence of the effects of nurse navigators during cancer screening in the first treatment phase. @*Methods@#Eleven electronic databases were searched, including PubMed, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Web of Science, ScienceDirect, PsycINFO, KoreaMed, KISS, RISS, and DBPIA. The final search was completed in August 2021. Two reviewers independently screened and selected studies, extracted data, and conducted a quality assessment. Data to evaluate the effects of nurse navigators was analyzed through meta-analysis and narrative summary. Subgroup analyses were performed. @*Results@#A total of 16 studies was included. With low to moderate quality of evidence, nurse navigators had favorable effects on improving the timeliness of care during screening during the first treatment visits (MD = 20.42, 95% CI = 8.74 to 32.10, p = .001). Additionally, 13.0% to 45.0% of nurse navigated patients were more likely to complete cancer care services, although insignificant effects were observed. Study participants from individual studies reported a high satisfaction to the nurse navigators. Subgroup analyses indicated that nurse navigators working as key members in multidisciplinary programs had the greatest effect on reducing waiting times. @*Conclusion@#Nurse navigators improve cancer patient outcomes by providing more timely care. Additionally, nurse navigators have the substantial potential to increase completion rates to cancer care services and patient satisfaction. For facilitating multidisciplinary care, the use of nurse navigators is highly recommended in the future.

Energy Drink Consumption and Dietary-, Lifestyle-, and Mental Health-Related Behaviors in Korean Adolescents: Based on the 10th–13th Korea Youth Risk Behavior Web-Based Survey

BACKGROUND@#Energy drinks (EDs), functional beverages with high concentrations of caffeine, can cause health risks. This study examined the frequency of ED consumption and related factors in Korean adolescents.@*METHODS@#Data from the 10th-13th Korea Youth Risk Behavior Web-based Survey was used, and a total of 137,101 boys and 130,806 girls were included in the final analyses. Differences in ED consumption and associated factors were analyzed using the Rao-Scott chi-square test and a multivariate logistic regression analysis, reflecting of the complex sample design.@*RESULTS@#In total, 17.3% boys and 12.9% girls consumed EDs more than once a week (P<0.001). In particular, 24.2% of all high-school students in the 12th grade consumed more than three EDs a week. After adjusting for confounding factors, a multivariate logistic regression analysis indicated that higher ED consumption was significantly associated with a higher soda, sweet-drink, and fast food intake; skipping breakfast; a lower vegetable intake; depression; suicidal thoughts; sleep deprivation; and increased smoking and alcohol drinking.@*CONCLUSIONS@#ED consumption is associated with undesirable dietary-, lifestyle-, and mental health-related behaviors, suggesting the need for appropriate nutrition education in adolescents.

Pregnant Women's Antenatal Depression and Influencing Factors / 여성건강간호학회지

PURPOSE: The objective of this study was to investigate the prevalence of antenatal depression in pregnant women and its influencing factors. METHODS: With a cross-sectional survey design, a total of 396 pregnant women were recruited from a local obstetrics and gynecology clinic. Measurements included antenatal depression, perceived stress, predictors of depression during pregnancy, and demographic and obstetric characteristics. RESULTS: Mean antenatal depression score was 8.20 (standard deviation=4.95) out of 30, falling into its normal range. However, the prevalence of antenatal depression was 35.9% when cut-point of 9/10 was used. The prevalence of antenatal depression among women in the first trimester was 31.4%. It was slightly increased to 34.9% in the second trimester but significantly increased to 40.5% in the third trimester. In multiple logistic regression analysis, experiencing prenatal anxiety (odds ratio [OR], 4.16), having no job (OR, 2.90), lower self-esteem (OR, 1.62), and higher perceived stress (OR, 1.32) were significant factors influencing antenatal depression. CONCLUSION: Negative feeling such as feeling anxious, lower self-esteem, and higher perceived stress during pregnancy are key factors affecting antenatal depression. Thus, antenatal nursing intervention focusing on pregnant women's feeling upon their job status is necessary to improve their antenatal psychological well-being.

Energy Drink Consumption and Dietary-, Lifestyle-, and Mental Health-Related Behaviors in Korean Adolescents: Based on the 10th–13th Korea Youth Risk Behavior Web-Based Survey

BACKGROUND: Energy drinks (EDs), functional beverages with high concentrations of caffeine, can cause health risks. This study examined the frequency of ED consumption and related factors in Korean adolescents. METHODS: Data from the 10th-13th Korea Youth Risk Behavior Web-based Survey was used, and a total of 137,101 boys and 130,806 girls were included in the final analyses. Differences in ED consumption and associated factors were analyzed using the Rao-Scott chi-square test and a multivariate logistic regression analysis, reflecting of the complex sample design. RESULTS: In total, 17.3% boys and 12.9% girls consumed EDs more than once a week (P<0.001). In particular, 24.2% of all high-school students in the 12th grade consumed more than three EDs a week. After adjusting for confounding factors, a multivariate logistic regression analysis indicated that higher ED consumption was significantly associated with a higher soda, sweet-drink, and fast food intake; skipping breakfast; a lower vegetable intake; depression; suicidal thoughts; sleep deprivation; and increased smoking and alcohol drinking. CONCLUSIONS: ED consumption is associated with undesirable dietary-, lifestyle-, and mental health-related behaviors, suggesting the need for appropriate nutrition education in adolescents.

Relationships among Knowledge, Self-efficacy, and Health Behavior of Osteoporosis and Fall Prevention in Old Aged Women

PURPOSE: This study was conducted among older women to (1) identify their levels of knowledge, self-efficacy, and health behavior in dealing with osteoporosis and falls and (2) explore the relationships between the study variables based on a health-beliefs model. METHODS: With a cross-sectional survey design, we recruited 94 older women of ages from 65 to 74 at a community setting via convenience sampling. The study participants completed two sets of structured questionnaires (on osteoporosis and fall prevention). RESULTS: The general characteristics of the study participants demonstrated that the women were at high risk for osteoporosis and falls. Overall, the levels of knowledge about osteoporosis and falls, their self-efficacy, and their preventive behaviors were average or slightly above. The relationships between the study variables showed that self-efficacy and healthy behavior, such as doing osteoporosis exercise, eating an osteoporosis diet, and avoiding falls, were related (r=38, p < .001; r=.33, p < .05; r=.26, p < .05). In addition, there were statistically significant relationships between osteoporosis and fall prevention knowledge (r=.37~.46, p < .001), self-efficacy (r=.50~.53, p < .001), and preventive behaviors (r=.50, p < .001). CONCLUSION: The women's scores on osteoporosis and fall knowledge, self-efficacy, and preventive behaviors suggest an urgent need for the implementation of educational programs for older women. A close relationship between self-efficacy and health behaviors implies a need for transformation of a traditional one-way lecture form.