Colonoscopic Screening and Risk of All-Cause and Colorectal Cancer Mortality in Young and Older Individuals / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The incidence of early-onset colorectal cancer (CRC) and associated mortality have been increasing. However, the potential benefits of CRC screening are largely unknown in young individuals. We aimed to evaluate the effect of CRC screening with colonoscopy on all-cause and CRC mortality among young (aged < 45 years) and older (aged ≥ 45 years) individuals. @*Materials and Methods@#This cohort study included 528,046 Korean adults free of cancer at baseline who underwent a comprehensive health examination. The colonoscopic screening group was defined as those who reported undergoing colonoscopy for CRC screening. Mortality follow-up until December 31, 2019 was ascertained based on nationwide death certificate data from the Korea National Statistical Office. @*Results@#Colonoscopic screening was associated with a lower risk of all-cause mortality in both young and older individuals. Multivariable-adjusted time-dependent hazard ratios (95% confidence intervals) for all-cause mortality comparing ever- to never-screening were 0.86 (0.75-0.99) for young individuals and 0.71 (0.65-0.78) for older individuals. Colonoscopic screenings were also associated with a reduced risk of CRC mortality without significant interaction by age, although this association was significant only among participants aged ≥ 45 years, with corresponding time-dependent hazard ratios of 0.47 (0.15-1.44) for young individuals and 0.52 (0.31-0.87) for those aged ≥ 45 years. @*Conclusion@#Colonoscopic CRC screening decreased all-cause mortality among both young and older individuals, while significantly decreased CRC mortality was observed only in those aged ≥ 45 years. Screening initiation at an earlier age warrants more rigorous confirmatory studies.

The Korean Version of the Fugl-Meyer Assessment: Reliability and Validity Evaluation

Objective@#To systematically translate the Fugl-Meyer Assessment (FMA) into a Korean version of the FMA (K-FMA). @*Methods@#We translated the original FMA into the Korean version with three translators and a translation committee, which included physiatrists, physical therapists, and occupational therapists. Based on a test-retest method, each of 31 patients with stroke was assessed by two evaluators twice, once on recruitment, and again after a week. Analysis of intra- and inter-rater reliabilities was performed using the intra-class correlation coefficient, whereas validity was analysed using Pearson correlation test along with the Motricity Index (MI), Motor Assessment Scale (MAS), and Berg Balance Scale (BBS). @*Results@#The intra- and inter-rater reliabilities were significant for the total score, and good to excellent reliability was noted in all domains except for the joint range of motion of the lower extremity domain of the K-FMA. The MI and MAS scores were significantly correlated with all domains, all with p<0.01. The results for the MI ranged from r=0.639 to r=0.891 and those for the MAS from r=0.339 to r=0.555. However, the BBS was not significantly correlated with any domain, as the K-FMA lacks balance evaluation items. @*Conclusion@#The K-FMA was found to have high reliability and validity. Additionally, the newly developed manual for the K-FMA may help minimise errors that can occur during evaluation and improve the reliability of motor function evaluation.

The Korean Version of the Fugl-Meyer Assessment: Reliability and Validity Evaluation

Objective@#To systematically translate the Fugl-Meyer Assessment (FMA) into a Korean version of the FMA (K-FMA). @*Methods@#We translated the original FMA into the Korean version with three translators and a translation committee, which included physiatrists, physical therapists, and occupational therapists. Based on a test-retest method, each of 31 patients with stroke was assessed by two evaluators twice, once on recruitment, and again after a week. Analysis of intra- and inter-rater reliabilities was performed using the intra-class correlation coefficient, whereas validity was analysed using Pearson correlation test along with the Motricity Index (MI), Motor Assessment Scale (MAS), and Berg Balance Scale (BBS). @*Results@#The intra- and inter-rater reliabilities were significant for the total score, and good to excellent reliability was noted in all domains except for the joint range of motion of the lower extremity domain of the K-FMA. The MI and MAS scores were significantly correlated with all domains, all with p<0.01. The results for the MI ranged from r=0.639 to r=0.891 and those for the MAS from r=0.339 to r=0.555. However, the BBS was not significantly correlated with any domain, as the K-FMA lacks balance evaluation items. @*Conclusion@#The K-FMA was found to have high reliability and validity. Additionally, the newly developed manual for the K-FMA may help minimise errors that can occur during evaluation and improve the reliability of motor function evaluation.

Spousal Concordance regarding Lifestyle Factors and Chronic Diseases among Couples Visiting Primary Care Providers in Korea / 가정의학회지

Background@#Few studies have been conducted in Korea on concordance regarding chronic diseases and lifestyle factors among couples. We, therefore, evaluated spousal concordance regarding lifestyle factors and chronic diseases among Korean couples. @*Methods@#A total 1,040 participants (520 couples) who visited family physicians were recruited from 22 hospitals. All participants were aged ≥40 years. Participants completed questionnaires on smoking, drinking, physical activity, and irregular eating habits, including skipping breakfast. We estimated the spousal concordance regarding lifestyle factors and chronic diseases using McNemar tests and logistic regression analysis. @*Results@#The concordance rate was high among couples who shared unhealthy behaviors, such as low physical activity, irregular diet, and skipping breakfast (P<0.05). When cardiovascular risk factors such as overweight (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.14–2.63), hypertension (OR, 1.88; 95% CI, 1.23–2.86), or hyperlipidemia (OR, 2.41; 95% CI, 1.60–3.64) were prevalent among husbands, the odds that their wives also had the same risk factors at the same time was significantly high. The odds of being depressed when the spouse was depressed were also significantly high in both men (OR, 5.54; 95% CI, 2.19–13.96) and women (OR, 4.52; 95% CI, 1.77–11.53). @*Conclusion@#There was a high level of concordance regarding lifestyle factors among couples, which could lead to an increase in the prevalence of chronic diseases among couples. In addition, if a spouse has depression, the odds of their partner also having depression was high.

Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury

Objective@#To compare the energy efficiency of gait with knee-ankle-foot orthosis (KAFO) and robot-assisted gait and to develop a usability questionnaire to evaluate the satisfaction of walking devices in paraplegic patients with spinal cord injuries. @*Methods@#Thirteen patients with complete paraplegia participated and 10 completed the evaluation. They were trained to walk with KAFO (KAFO-gait) or a ReWalk robot (ReWalk-gait) for 4 weeks (20 sessions). After a 2-week wash-out period, they switched walking devices and underwent 4 additional weeks of training. Two evaluations were performed (after 2 and 4 weeks) following the training periods for each walking device, using the 6-minute walking test (6MWT) and 30-minute walking test (30MWT). The spatiotemporal variables (walking distance, velocity, and cadence) and energy expenditure (heart rate, maximal heart rate, the physiologic cost index, oxygen consumption, metabolic equivalents, and energy efficiency) were evaluated duringthe 6MWT and 30MWT. A usability evaluation questionnaire for walking devices was developed based on the International Organization for Standardization/International Electrotechnical Commission guidelines through expert consultation. @*Results@#The ReWalk-gait presented significant advantages in energy efficiency compared to KAFO-gait in the 6MWT and 30MWT; however, there were no differences in walking distance or speed in the 30MWT between ReWalk-gait and KAFOgait. The usability test demonstrated that ReWalk-gait was not superior to KAFO-gait in terms of safety, efficacy, efficiency, or patient satisfaction. @*Conclusion@#The robot (ReWalk) enabled patients with paraplegia to walk with lower energy consumption compared to KAFO, but the ReWalk-gait was not superior to KAFO-gaitin terms of patient satisfaction.

Quality of Life and Associated Factor among Cancer Survivors in Korea

BACKGROUND: New and more effective treatments for cancer have resulted in individuals living longer with a better quality of life. Thus, the Quality of life (QoL) is now a major concern of cancer survivors. This study tried to identify the factors affecting the quality of life among cancer survivors. METHODS: Data was collected from the sixth (2013-2015) National Health and Nutrition Survey. Among total 16,522 participants aged 19 years old or more, 721 cancer survivors who had any previous history of cancer were included in the analysis. QoL was measured using EuroQoL-5D which evaluated 5 domains including the problem of mobility, self-care, usual activity, pain, and anxiety. RESULTS: Cancer survivors had lower QoL than the general population and participants with other chronic disease. Among cancer survivors, age had the strongest association with mobility. The problem of self-care was affected by age, female, income state, and comorbidity. More income had an impact on better self-care. The problem of usual activity was affected by job state, stress and comorbidity. There was a positive association between job status and the problem of usual activity. The problem of pain was related with female, education state, and stress. Higher education was associated with lower problem of pain. The problem of anxiety was in relation with age, female, and stress. CONCLUSIONS: To improve the QoL of cancer survivors, the appropriate intervention is needed for effective management considering the different factors which affect the QoL of the cancer survivors.

Factors Affecting Adherence to Antihypertensive Medication / 가정의학회지

BACKGROUND: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. METHODS: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. RESULTS: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ≥65 years, exercise, treatment in a metropolitan-located hospital, being on ≥2 classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. CONCLUSION: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.

Quality of Life and Associated Factor among Cancer Survivors in Korea

BACKGROUND@#New and more effective treatments for cancer have resulted in individuals living longer with a better quality of life. Thus, the Quality of life (QoL) is now a major concern of cancer survivors. This study tried to identify the factors affecting the quality of life among cancer survivors.@*METHODS@#Data was collected from the sixth (2013-2015) National Health and Nutrition Survey. Among total 16,522 participants aged 19 years old or more, 721 cancer survivors who had any previous history of cancer were included in the analysis. QoL was measured using EuroQoL-5D which evaluated 5 domains including the problem of mobility, self-care, usual activity, pain, and anxiety.@*RESULTS@#Cancer survivors had lower QoL than the general population and participants with other chronic disease. Among cancer survivors, age had the strongest association with mobility. The problem of self-care was affected by age, female, income state, and comorbidity. More income had an impact on better self-care. The problem of usual activity was affected by job state, stress and comorbidity. There was a positive association between job status and the problem of usual activity. The problem of pain was related with female, education state, and stress. Higher education was associated with lower problem of pain. The problem of anxiety was in relation with age, female, and stress.@*CONCLUSIONS@#To improve the QoL of cancer survivors, the appropriate intervention is needed for effective management considering the different factors which affect the QoL of the cancer survivors.

Experience of Smoking Cessation Treatment Program in Korea: Results from a Qualitative Study / 보건행정학회지

BACKGROUND: The objectives of this study were to identify the reasons of quitting smoking, to determine the factors that make it difficult or helpful to maintain smoking cessation and to confirm the changes after the smoking cessation. METHODS: This study was conducted an in-depth interview with people who participated in the smoking cessation treatment program. There were 10 participants and they were interviewed thoroughly for 14 times. Using the directed content analysis, we analyzed the transcript which was written by recording the interview and the researchers' note. RESULTS: The results of this study are summarized as ‘the experience while at the verge of smoking cessation and stepping over the verge of smoking cessation,’ ‘the changing experience due to smoking cessation,’ and ‘maintaining the changes through overcoming re-smoking.’ The smoking cessation treatment program induced the smokers to quit smoking. Participants mentioned drinking alcohol was the major obstacle to maintain smoking cessation. Also, they noted that the money and the time that were already spent to quit smoking helped their smoking cessation as well as the social relations which helped to prevent re-smoking. Participants felt well-cared through the smoking cessation treatment program and that it helped them to maintain smoking cessation. CONCLUSION: Smoking cessation treatment program has a positive effect on the smoking cessation trial and maintenance. In order for smokers to overcome re-smoking, educations regarding drinking problem, formation of supportive social relationship, and the applications for smoking cessation will be beneficial.

National health examination expansion policy

The Korean national health examination provides a tremendous amount of medical services in comparison with other countries. The first national health examination plan from 2011 to 2015 led to a remarkable growth in the number of examinees, the institutions that participate in the program, and financing for health examinations, and the national health examination will be expanded and reinforced through the upcoming second national health examination plan. Primary medical institutions should carry out health examinations related to chronic diseases, evaluate the lifestyles of examinees, counsel them about the results, and simultaneously offer follow-up management, so that the health examination and medical treatment function as parts of a cohesive continuum. For personalized health promotion integrated with information and communication technology, the health risk assessment program should be standardized in the Korean population. This will be a cost-effective strategy for managing overall health risks in comparison to the previous separate management of individual risk factors. Furthermore, whenever scientific evidence for items assessed in the national health examinations is lacking, the items should immediately be revised in accordance with appropriate validation studies, and quaternary prevention should be implemented in health examinations in order to avoid overdiagnosis and overtreatment. Finally, aid for vulnerable social classes should be expanded in order to improve the overall national health status and to address health inequalities.

Usages of Computers and Smartphones to Develop Dementia Care Education Program for Asian American Family Caregivers / 대한의료정보학회지

OBJECTIVES: Families of ethnic minority persons with dementia often seek help at later stages of the disease. Little is known about the effectiveness of various methods in supporting ethnic minority dementia patients' caregivers. The objective of the study was to identify smartphone and computer usage among family caregivers of dementia patients (i.e., Korean and Vietnamese Americans) to develop dementia-care education programs for them. METHODS: Participants were asked various questions related to their computer or smartphone usage in conjunction with needs-assessment interviews. Flyers were distributed at two ethnic minority community centers in Southern California. Snowball recruitment was also utilized to reach out to the families of dementia patients dwelling in the community. RESULTS: Thirty-five family caregivers, including 20 Vietnamese and 15 Korean individuals, participated in this survey. Thirty participants (30 of 35, 85.7%) were computer users. Among those, 76.7% (23 of 30) reported daily usage and 53% (16 of 30) claimed to use social media. A majority of the participants (31 of 35, 88.6%) reported that they owned smartphones. More than half of smartphone users (18 of 29, 62%) claimed to use social media applications. Many participants claimed that they could not attend in-class education due to caregiving and/or transportation issues. CONCLUSIONS: Most family caregivers of dementia patients use smartphones more often than computers, and more than half of those caregivers communicate with others through social media apps. A smartphone-app-based caregiver intervention may serve as a more effective approach compared to the conventional in-class method. Multiple modalities for the development of caregiver interventions should be considered.

Examinees' Knowledge of the Result Form of Korean National Health Examination

BACKGROUND: Cardiovascular diseases related mortality attributes to approximately one fourth of mortality in Korea, and management of chronic diseases is essential for the prevention of cardiovascular diseases. Through the health screening program, early detection and prevention of chronic disease are made possible, and this will improve the health status of examinees. In the current national health examination (NHE), counseling and continuous management after NHE have not been properly made. We aimed to investigate examinees' knowledge of the result form of NHE in order to find the ways of improvement. METHODS: We recruited 120 examinees, who have undergone general health examination and life turning point health examination (LTPHE), and conducted survey from January 7, 2016 to January 26, 2016. Participants answered questionnaires regarding demographic characteristics, health screening related factors, and their knowledge and attitude towards NHE. Answers were converted to Likert scale, and student t-test, one-way ANOVA, and linear regression models were used for the analyses. RESULTS: Examinees' knowledge of the result form was lowest in the blood test category. When age and type of institution were adjusted, the examinees in their 60s had significantly lower knowledge of all the categories of result forms except urine test in comparison to the younger examinees. When type of institutions were compared, examinees, who had undergone NHE in health screening clinics, had significantly lower knowledge of several categories of result forms in comparison to those who had undergone NHE in private clinics and general hospitals. Examinees' knowledge of the LTPHE result form was lowest in categories of “mild cognitive impairment and dementia” and “fall down and voiding difficulty.” CONCLUSIONS: The result form of NHE should be revised so that examinees in old age can easily understand. Examinees' knowledge of the result form was lower in health screening clinic; thus, quality of health screening clinic should be improved for continuous care after NHE.

Correction: The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients / 가정의학회지

We would like to replace Table 3 of the original paper with a revised version. We sincerely apologized to the readers.

Family Functioning and Communication in Spouses of Patients with Parkinsonism / 가정의학회지

BACKGROUND: Patients with parkinsonism exhibit motor symptoms, cognitive impairment, and neuropsychiatric changes, and these symptoms increase caregiver burden. Family dynamics can be influenced by the presence of comorbidities, which is especially important in diseases causing caregiver burden. We investigated the effects of spousal parkinsonism on family functioning and communication. METHODS: Couples without parkinsonism, who visited hospital-based family practices, were recruited by 28 family physicians from 22 hospitals between April 2009 and June 2011; patients with parkinsonism and their spouses were recruited from a single institution. The participants completed questionnaires on demographic characteristics, lifestyle factors, family functioning (the Korean version of the Family Adaptation and Cohesion Evaluation Scale [FACES] III), and family communication (the Family Communication Scale of the FACES-IV). We compared family functioning and communication between spouses of the patients with and without parkinsonism. RESULTS: The mean family adaptability and cohesion scores of the spouses of the patients with parkinsonism were 23.09±6.48 and 32.40±8.43, respectively, whereas those of the control group were 23.84±5.88 and 34.89±7.59, respectively. Family functioning and family communication were significantly different between the spouses of individuals with and without parkinsonism. After adjusting for age, sex, income, and cardiovascular disease in the logistic regression analysis, family functioning was found to significantly deteriorate in the spouses of patients with parkinsonism but not the control group. Family communication decreased significantly in spouses of patients with parkinsonism. CONCLUSION: Family functioning and family communication significantly deteriorated in spouses of patients with parkinsonism.

Knowledge and Attitude of Health Care Providers for Korean National Health Examination

BACKGROUND: Current National Health Examination (NHE) in Korea provides health examination to the public throughout the entire life course; however, management after NHE is not sufficiently delivered. In this study, we investigated knowledge and attitude of health care providers in order to revise result forms and counseling manual of NHE. METHODS: We recruited 30 doctors, who undergo NHE, and conducted survey from January 7, 2016 to January 26, 2016. Participants answered questionnaires regarding difficulty of explaining each items of result forms, difficulty of counseling each items of NHE, and ways of improvement. Furthermore, we conducted in-depth interview regarding pros and cons of NHE and improvements needed. RESULTS: The average Likert score for difficulty of explaining items of result forms was lowest (3.8/5.0 points) for blood test due to its graphic format. Difficult counseling items were mental health, mild cognitive impairment and dementia, and healthcare for the elderly. The proportions of doctors, who often counsel these items, were less than 40%. In the in-depth interview, health care providers suggested that examinees' knowledge for result forms decreases because it is hard to interpret, and management after NHE should be improved by undertaking NHE in primary health care facilities. CONCLUSIONS: The graphic format of blood test result form should be revised into readable format, and contents of counseling manual for mental health, mild cognitive impairment and dementia, and healthcare for the elderly should be improved. Financial support for doctors should be provided, and NHE should ultimately be reinforced in primary health care facilities.

The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients / 가정의학회지

BACKGROUND: Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents. METHODS: This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic. RESULTS: Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control. CONCLUSION: Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.

The Effect of Sleep Quality on the Development of Type 2 Diabetes in Primary Care Patients

Sleep has important effects on physical and mental health, and sleep disorders are associated with increased mortality and morbidity. This study was conducted to evaluate the relationship between sleep duration or sleep quality and the risk of type 2 diabetes. The FACTS (FAmily CohorT Study in primary care) was established to investigate the relations between familial environment and health which was conducted at 22 family medicine outpatient clinics in general hospitals. Total 563 patients without diabetes who received > or =1 year follow-up examination were included in the analysis. We used the Pittsburgh Sleep Quality Index to determine sleep quality, and a score of > or =5 was considered to define poor sleep quality. Patients taking oral hypoglycemic agents, having a fasting glucose level of >126 mg/dL, or diagnosed with diabetes by physicians were classified as having diabetes. The median follow-up period was 2.5 years. Poor sleep quality was associated with a higher risk of diabetes after adjusting for age, sex, body mass index, income, physical activity, and family history of diabetes (relative risk=2.64; 95% confidence interval, 1.03-6.78). As a risk factor for the development of diabetes, poor sleep quality may independently increase the incidence of diabetes.

Relationship Between Cognitive Perceptual Abilities and Accident and Penalty Histories Among Elderly Korean Drivers

OBJECTIVE: To investigate the relationship between cognitive perceptual abilities of elderly drivers based on the Cognitive Perceptual Assessment for Driving (CPAD) test and their accident and penalty histories. METHODS: A total of 168 elderly drivers (aged ≥65 years) participated in the study. Participant data included CPAD scores and incidents of traffic accidents and penalties, attained from the Korea Road Traffic Authority and Korea National Police Agency, respectively. RESULTS: Drivers' mean age was 70.25±4.1 years and the mean CPAD score was 52.75±4.72. Elderly drivers' age was negatively related to the CPAD score (p<0.001). The accident history group had marginally lower CPAD scores, as compared to the non-accident group (p=0.051). However, incidence rates for traffic fines did not differ significantly between the two groups. Additionally, the group that passed the CPAD test had experienced fewer traffic accidents (3.6%), as compared to the group that failed (10.6%). The older age group (12.0%) had also experienced more traffic accidents, as compared to the younger group (2.4%). CONCLUSION: Overall, elderly drivers who experienced driving accidents had lower CPAD scores than those who did not, without statistical significance. Thus, driving-related cognitive abilities of elderly drivers with insufficient cognitive ability need to be further evaluated to prevent traffic accidents.

The Impact of a Spouse's Depression on Family Functioning and Communication

BACKGROUND: Depression is known to affect family function and communication. However, the distress experienced by those who have spouse with depression has not been properly assessed to date. This study attempted to examine the effect of depression on family function and communication as reported by the spouses of the depressed patients. METHODS: The participants of this study were 445 couples who visited 28 family doctors from April 2009 to June 2011. The Family Adaptability and Cohesion Evaluation Scale III (FACES-III) was used to evaluate the family function, and the family communication scale in FACES-IV was used to evaluate communication among family members. A score of more than 21 points on the CES-D scale was used to indicate depression. The relationships between family type, family communication, and the depression of one's spouse were analyzed using the chi-square test and logistic regression. RESULTS: The odds ratios, indicating how the family is heading towards an extreme level, were statistically significant in all male and female respondents (male: odds ratio [OR] 3.08, 95% confidence interval [CI] 1.73-5.48; female: OR 2.09, 95% CI 1.02-4.27). On the other hand, only female respondents with depressed spouses reported their family communication not to be good (male: OR 1.65, 95% CI 0.88-3.07; female: OR 2.48, 95% CI, 1.25-4.93). CONCLUSIONS: This study revealed people perceive their family function and communication not good when they have spouses with depression. There was no gender difference in the evaluation of their family function, but the perception on their family communication were different by gender.

Augmented immune responses in pigs immunized with an inactivated porcine reproductive and respiratory syndrome virus containing the deglycosylated glycoprotein 5 under field conditions

PURPOSE: Porcine reproductive and respiratory syndrome virus (PRRSV) leads to major economic losses in the swine industry. Vaccination is the most effective method to control the disease by PRRSV. MATERIALS AND METHODS: In this study, the efficacy of a glycoprotein (GP) 5-modified inactivated vaccine was investigated in pigs. The study was performed in three farms: farm A, which was porcine reproductive and respiratory syndrome (PRRS)-negative, farm B (PRRS-active), which showed clinical signs of PRRS but had not used vaccines, and farm C (PRRS-stable), which had a history of endemic PRRS over the past years, but showed no more clinical signs after periodic administration of modified live virus vaccine. RESULTS: The inactivated vaccine induced great enhancement in serum neutralizing antibody titer, which was sufficient to protect pigs from further infections of PRRSV in a farm where pre-existing virus was circulating. CONCLUSION: These results indicated that vaccination with the inactivated vaccine composed of viruses possessing deglycosylated GP5 would provide enhanced protection to pigs from farms suffering from endemic PRRSV.