Association between Eating Alone Patterns and Mental Health Conditions by Region among Korean Adults / 대한지역사회영양학회지

Objectives@#This study investigated the association between the frequency and pattern of eating alone and the mental health status according to region in Korean adults. @*Methods@#The data of 10,040 Korean adults aged ≥ 19 years from the Korea National Health and Nutrition Examination Survey (KNHANES) 2017 and 2019 were used.Participants were divided into 4 groups based on their frequency of eating alone: none (all meals together), 1, 2, and 3 meals/day alone. The regions were divided into urban and rural areas. Mental health status was assessed by stress recognition, depressive symptoms, and suicidal ideation. Multivariable logistic regressions were conducted to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) on the association of the frequency and pattern of eating alone with poor mental health after controlling for covariates. @*Results@#Among Korean adults, 74.1% ate more than one meal a day alone. Individuals having 3 meals a day alone tended to be less educated, single, single person households, or living in urban areas (all P < 0.05). In rural areas, those having 3 meals/ day alone had higher odds of stress recognition (AOR: 1.55, 95% CI: 1.02-2.35) than those having all meals together. In urban areas, individuals eating alone 3 times/day had higher odds of stress recognition (AOR: 1.60, 95% CI: 1.31-1.96), depressive symptoms (AOR: 1.61, 95% CI: 1.23-2.12), and suicidal ideation (AOR: 2.14, 95% CI: 1.42-3.22) compared to those having all meals together. Urban residents having dinner alone had higher odds of depressive symptoms (AOR: 1.29, 95% CI: 1.05-1.58) and suicidal ideation (AOR: 1.66, 95% CI: 1.19-2.33) than those having dinner with others. @*Conclusions@#Our findings showed that the frequency and patterns of eating alone were differentially associated with increased odds of poor mental health according to region of residence. Nutrition education is needed for those frequently eating alone, particularly those living in urban areas, to highlight the advantages of eating together and to ensure that they have balanced and healthy meals even if they eat alone.

Clinical analysis of direct medical oversight for the national pilot program of expanding scope of firefighter emergency medical services providers in a Korean metropolitan city

Objective@#The fire department-based emergency medical services (EMS) system and centralized direct medical oversight (DMO) system are well-established in Korea. In 2019, the government launched a national pilot program for expanding the scope of work of EMS providers. This study was undertaken to clinically examine DMO for the ‘specialized EMS squad’ in the Seoul Metropolitan City. @*Methods@#This is a descriptive analysis of the current status of the EMS of the city and DMO. The basic statistics of firefighter EMS providers and the DMO physicians, as well as the number of ambulance runs, were investigated during the study period (July to December 2019). Records of the DMO physicians were also reviewed, to assess intervention of the ‘specialized EMS squad’. @*Results@#Totally, 1,109 patients transferred to hospitals by the ‘specialized EMS squad’ were provided DMO (out-of-hospital cardiac arrest 833, chest pain 229, multiple injured trauma 21, anaphylaxis 17, unplanned out-of-hospital birth 4.; excluding 5 cases of insufficient records). In out-of-hospital cardiac arrest, intravenous epinephrine was implemented by 538 cases (64.6%). Single dose of intravenous epinephrine was used in 218 cases (40.5%), whereas two doses were administered in 163 cases (30.3%). In patients with chest pain, 12-lead electrocardiography was achieved in 226 cases (98.7%). The epinephrine autoinjector (0.3 mg) was applied for 10 cases of anaphylaxis (61.1%). Umbilical cord cutting was executed during 2 births (50%). @*Conclusion@#The national pilot program to expand the scope of firefighter EMS providers was successfully implemented in the Seoul Metropolitan City. Emergency physicians played critical roles for the application. The firefighter EMS providers were able to accomplish advanced life support level practices in the prehospital setting by DMO.

Usefulness of CT-Guided Percutaneous TransthoracicNeedle Lung Biopsies in Patients with SuspectedPulmonary Infection

Objective@#This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection. @*Materials and Methods@#This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range,17–91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient’s treatment were measured. Multivariateanalyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured. @*Results@#CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1–2.7; p = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2–3.5; p = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1–5.8; p = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient’s treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0–3.7; p = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5–3.8; p < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0–2.8; p = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351). @*Conclusion@#In patients with suspected pulmonary infection, approximately 30–40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.

The First Case of Ochrobactrum pseudogrignonense Bacteremia in Korea

No abstract available.

Clinical Significance of Pleural Attachment and Indentation of Subsolid Nodule Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Lung cancers presenting as subsolid nodule commonly have peripheral location, making the cancer-pleura relationship noteworthy. We aimed to evaluate the effect of pleural attachment and/or indentation on visceral pleural invasion (VPI) and recurrence-free survival. MATERIALS AND METHODS: Patients who underwent curative resection of lung cancer as subsolid nodules from April 2007 to January 2016 were retrospectively evaluated. They were divided into four groups according to their relationship with the pleura. Clinical, radiographical, and pathological findings were analyzed. RESULTS: Among 404 patients with malignant subsolid nodule, 120 (29.7%) had neither pleural attachment nor indentation, 26 (6.4%) had attachment only, 117 (29.0%) had indentation only, and 141 (34.9%) had both. VPI was observed in nodules of 36 patients (8.9%), but absent in nonsolid nodules and in those without pleural attachment and/or indentation. Compared to subsolid nodules with concurrent pleural attachment and indentation, those with attachment only (odds ratio, 0.12; 95% confidence interval [CI], 0.02 to 0.98) and indentation only (odds ratio, 0.10; 95% CI, 0.03 to 0.31) revealed lower odds of VPI. On subgroup analysis, the size of the solid portion was associated with VPI among those with pleural attachment and indentation (p=0.021). Such high-risk features for VPI were associated with earlier lung cancer recurrence (adjusted hazard ratio, 3.31; 95% CI, 1.58 to 6.91). CONCLUSION: Concurrent pleural attachment and indentation are risk factors for VPI, and the odds increase with larger solid portion in subsolid nodules. Considering the risk of recurrence, early surgical resection could be encouraged in these patients.

Diameter of the Solid Component in Subsolid Nodules on Low-Dose Unenhanced Chest Computed Tomography: Measurement Accuracy for the Prediction of Invasive Component in Lung Adenocarcinoma

OBJECTIVE: To determine if measurement of the diameter of the solid component in subsolid nodules (SSNs) on low-dose unenhanced chest computed tomography (CT) is as accurate as on standard-dose enhanced CT in prediction of pathological size of invasive component of lung adenocarcinoma. MATERIALS AND METHODS: From February 2012 to October 2015, 114 SSNs were identified in 105 patients that underwent low-dose unenhanced and standard-dose enhanced CT pre-operatively. Three radiologists independently measured the largest diameter of the solid component. Intraclass correlation coefficients (ICCs) were used to assess inter-reader agreement. We estimated measurement differences between the size of solid component and that of invasive component. We measured diagnostic accuracy of the prediction of invasive adenocarcinoma using a size criterion of a solid component ≥ 6 mm, and compared them using a generalized linear mixed model. RESULTS: Inter-reader agreement was excellent (ICC, 0.84.0.89). The mean ± standard deviation of absolute measurement differences between the solid component and invasive component was 4 ± 4 mm in low-dose unenhanced CT and 5 ± 4 mm in standard-dose enhanced CT. Diagnostic accuracy was 81.3% (95% confidence interval, 76.7.85.3%) in low-dose unenhanced CT and 76.6% (71.8.81.0%) in standard-dose enhanced CT, with no statistically significant difference (p = 0.130). CONCLUSION: Measurement of the diameter of the solid component of SSNs on low-dose unenhanced chest CT was as accurate as on standard-dose enhanced CT for predicting the invasive component. Thus, low-dose unenhanced CT may be used safely in the evaluation of patients with SSNs.

Prevention and improved responses to workplace violence against healthcare provider in the emergency department

Recently, a violent incident in which a drunken patient attacked an emergency physician at a general hospital emergency department (ED) shocked the entire country of Korea. According to a study published in the Journal of the Korean Society of Emergency Medicine and a recent survey conducted by the Korean Society of Emergency Medicine, workplace violence (WPV) against healthcare providers in the ED is common in Korea. Most of the violent offenders were males and between the ages of 30 and 40 years old. However, many of the victims were nurses. WPV against healthcare providers in the ED most often occurred during the night shift, and 77.4% to 88.1% of cases involved verbal insults and threats. Diverse efforts should be made to prevent WPV against healthcare providers in the ED and to improve the responses to cases of WPV. A national reporting system should be established. Current laws must be strictly enforced, and further amendments to the law are also needed. The Governmental Emergency Medical Basic Plan should include an improvement plan for WPV against healthcare providers in the ED every 5 years. It is necessary to establish and enforce a national standard police protocol for preventing and responding to WPV against healthcare providers in the ED. Support for resources, such as an ED police program, security personnel, and equipment such as closed-circuit television, is needed. Most of all, it is important to advance the culture of people's use of the ED and to promote safety culture.

Delphi study to achieve consensus for the development strategies of emergency medical services system preparing for reunification of Korea

OBJECTIVE: This study aimed to achieve expert consensus for the development of strategies emergency medical services system (EMSS) after reunification of Korean using the Delphi method. METHODS: The Delphi study was performed through several rounds from January to February in 2017. Experts who have experiences of emergency medical support in North Korea and developing countries participated in the study. Respondents were asked to express their level of agreement following 7 categories: (1) emergency medical manpower, (2) communication system, (3) emergency facilities, (4) patient transfer system, (5) consumer participation and public education, (6) insurance system, (7) disaster planning. Score 1–3 was classified as disagreement, 4–6 as medium agreement, and 7–9 as agreement and consensus was considered being achieved when more than two thirds of respondents agreed in each question. RESULTS: Response rate were 80% in the first round and 75% in the second round. Consensus was achieved in emergency medical manpower, communication system, emergency facilities, patient transfer system, and disaster planning for the important factors immediately after reunification within 5 years. Consensus was achieved in emergency medical manpower, communication system, emergency facilities, patient transfer system, consumer participation and public education, and disaster planning for the prior factors when the reunification would happen rapidly without enough preparation. CONCLUSION: Consensus was achieved in emergency medical manpower, communication system, emergency facilities, patient transfer system, disaster planning for the essential EMSS elements. The consensus was expected to utilize as a basic data for the development of EMSS preparing for reunification.

Multimodality Imaging in Patients with Secondary Hypertension: With a Focus on Appropriate Imaging Approaches Depending on the Etiologies

Although the causes of hypertension are usually unknown, about 10% of the cases occur secondary to specific etiologies, which are often treatable. Common categories of secondary hypertension include renal parenchymal disease, renovascular stenosis, vascular and endocrinologic disorders. For diseases involving the renal parenchyma and adrenal glands, ultrasonography (US), computed tomography (CT) or magnetic resonance (MR) imaging is recommended. For renovascular stenosis and vascular disorders, Doppler US, conventional or noninvasive (CT or MR) angiography is an appropriate modality. Nuclear imaging can be useful in the differential diagnosis of endocrine causes. Radiologists should understand the role of each imaging modality and its typical findings in various causes of secondary hypertension. This article focuses on appropriate imaging approaches in accordance with the categorized etiologies leading to hypertension.

Prevention and improved responses to workplace violence against healthcare provider in the emergency department

Recently, a violent incident in which a drunken patient attacked an emergency physician at a general hospital emergency department (ED) shocked the entire country of Korea. According to a study published in the Journal of the Korean Society of Emergency Medicine and a recent survey conducted by the Korean Society of Emergency Medicine, workplace violence (WPV) against healthcare providers in the ED is common in Korea. Most of the violent offenders were males and between the ages of 30 and 40 years old. However, many of the victims were nurses. WPV against healthcare providers in the ED most often occurred during the night shift, and 77.4% to 88.1% of cases involved verbal insults and threats. Diverse efforts should be made to prevent WPV against healthcare providers in the ED and to improve the responses to cases of WPV. A national reporting system should be established. Current laws must be strictly enforced, and further amendments to the law are also needed. The Governmental Emergency Medical Basic Plan should include an improvement plan for WPV against healthcare providers in the ED every 5 years. It is necessary to establish and enforce a national standard police protocol for preventing and responding to WPV against healthcare providers in the ED. Support for resources, such as an ED police program, security personnel, and equipment such as closed-circuit television, is needed. Most of all, it is important to advance the culture of people's use of the ED and to promote safety culture.

Nodule Classification on Low-Dose Unenhanced CT and Standard-Dose Enhanced CT: Inter-Protocol Agreement and Analysis of Interchangeability

OBJECTIVE: To measure inter-protocol agreement and analyze interchangeability on nodule classification between low-dose unenhanced CT and standard-dose enhanced CT. MATERIALS AND METHODS: From nodule libraries containing both low-dose unenhanced and standard-dose enhanced CT, 80 solid and 80 subsolid (40 part-solid, 40 non-solid) nodules of 135 patients were selected. Five thoracic radiologists categorized each nodule into solid, part-solid or non-solid. Inter-protocol agreement between low-dose unenhanced and standard-dose enhanced images was measured by pooling κ values for classification into two (solid, subsolid) and three (solid, part-solid, non-solid) categories. Interchangeability between low-dose unenhanced and standard-dose enhanced CT for the classification into two categories was assessed using a pre-defined equivalence limit of 8 percent. RESULTS: Inter-protocol agreement for the classification into two categories {κ, 0.96 (95% confidence interval [CI], 0.94–0.98)} and that into three categories (κ, 0.88 [95% CI, 0.85–0.92]) was considerably high. The probability of agreement between readers with standard-dose enhanced CT was 95.6% (95% CI, 94.5–96.6%), and that between low-dose unenhanced and standard–dose enhanced CT was 95.4% (95% CI, 94.7–96.0%). The difference between the two proportions was 0.25% (95% CI, −0.85–1.5%), wherein the upper bound CI was markedly below 8 percent. CONCLUSION: Inter-protocol agreement for nodule classification was considerably high. Low-dose unenhanced CT can be used interchangeably with standard-dose enhanced CT for nodule classification.

Effect of Critical Care Transport on Patients' Survival after Inter-Hospital Transport of Critically Ill Patients

PURPOSE: Critical care transport (CCT) has been known to be beneficial for inter-hospital transport of critically ill patients. Seoul Mobile Intensive Care Unit (SMICU) has been established and provided CCT in Seoul Metropolitan City since 2015. We tested the association between SMICU transport and hospital outcome for critically ill patients. METHODS: This is a before and after intervention study. SMICU group with cardiac arrest, acute myocardial infarction, acute stroke, major trauma, respiratory failure, and shock who were transported by SMICU from January to July 2016 were collected as an intervention group. Non-SMICU group with the same above diagnosis criteria who were transported by private ambulance services during same period in 2015. By National Emergency Department Information System (NEDIS), demographics were compared for original data and sampling data. Multivariable logistic regression analysis was done to calculate the adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) adjusting for potential confounders. RESULTS: Total 1,837 patients (128 SMICU and 1,709 non-SMICU group) for original dataset and 180 patients (60 SMICU and 120 non-SMICU group) for sampling dataset were finally analyzed. Hospital mortality rates are 22.7% in SMICU and 11.8% in non-SMICU in original dataset (p<0.001), 26.7% in SMICU and 31.7% in non-SMICU in sampling dataset (p=0.490), respectively. AOR (95% CIs) for hospital mortality by SMICU in original and sampling dataset were 0.80 (0.48-1.35) and 0.71 (0.33-1.51), respectively. CONCLUSION: The CCT for critically ill patients did not show significantly better hospital mortality in the pilot study.

CT Features of Vasculitides Based on the 2012 International Chapel Hill Consensus Conference Revised Classification

Vasculitis, characterized by inflammation of vessel walls, is comprised of heterogeneous clinicopathological entities, and thus poses a diagnostic challenge. The most widely used approach for classifying vasculitides is based on the International Chapel Hill Consensus Conference (CHCC) nomenclature system. Based on the recently revised CHCC 2012, we propose computed tomography (CT) features of vasculitides and a differential diagnosis based on location and morphological characteristics. Finally, vasculitis mimics should be differentiated, because erroneous application of immunosuppressive drugs on vasculitis mimics may be ineffective, even deteriorating. This article presents the utility of CT in the diagnosis and differential diagnosis of vasculitides.

Clinical Analysis of Direct Medical Oversight in a Korean Metropolitan City

PURPOSE: In Korea, the EMS system is a municipal governmental fire-based system. Since 2012, an EMS medical director has been appointed in all fire stations by legislation. This study examined the direct medical oversight (DMO) clinically in a Korean metropolitan city. METHODS: This is a descriptive analysis of the fire-based centralized DMO in a metropolitan city. The current status of the ambulance crew of a fire station including certification, EMS experience, the number of requested DMO, and the statistics of DMO, and the DMO physicians of a fire department dispatch center, was studied. The ambulance run sheets of a fire station were reviewed to survey the assessment and intervention of ambulance-receiving DMO. RESULTS: Although it is increasing every year, the ratio of ambulance runs receiving DMO was 2.5–11.1% in a fire station. The fire station has 45 ambulance crew, half of which were level 1 emergency medical technicians and registered nurses. In a fire department dispatch center, most (70%) of the DMO physicians were emergency physicians. The ratio of prehospital assessment, including consciousness (100%), full vital sign (78.8–91.2%), oxygen saturation (86.5–100%), blood sugar test (31.3–94.4%), and ECG (16.7–48.5%), was higher than the ratio of prehospital intervention, including advanced airway (1.9–21.15), bag mask ventilation (3.0–63.2%), IV dextrose water (55.6%), nitroglycerin subligual (42.9%), cervical immobilization (57.7%), and wound dressing (53.85) in an ambulance run receiving DMO in a fire station. CONCLUSION: The ratio of patients transported by ambulance receiving DMO is still low in a metropolitan city. The DMO should be strengthened to improve the patient safety and quality of EMS in Korea.

Erratum: Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea

On page 545, the fifth author's name has been incorrectly spelled as Jin Mo Koo. The correct spelling is Jin Mo Goo.

Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea

OBJECTIVE: To compare the multidetector CT (MDCT) features of malignant pleural mesothelioma (MPM) and metastatic pleural disease (MPD). MATERIALS AND METHODS: The authors reviewed the MDCT images of 167 patients, 103 patients with MPM and 64 patients with MPD. All 167 cases were pathologically confirmed by sonography-guided needle biopsy of pleura, thoracoscopic pleural biopsy, or open thoracotomy. CT features were evaluated with respect to pleural effusion, pleural thickening, invasion of other organs, lung abnormality, lymphadenopathy, mediastinal shifting, thoracic volume decrease, asbestosis, and the presence of pleural plaque. RESULTS: Pleural thickening was the most common CT finding in MPM (96.1%) and MPD (93.8%). Circumferential pleural thickening (31.1% vs. 10.9%, odds ratio [OR] 3.670), thickening of fissural pleura (83.5% vs. 67.2%, OR 2.471), thickening of diaphragmatic pleura (90.3% vs. 73.4%, OR 3.364), pleural mass (38.8% vs. 23.4%, OR 2.074), pericardial involvement (56.3% vs. 20.3%, OR 5.056), and pleural plaque (66.0% vs. 21.9%, OR 6.939) were more frequently seen in MPM than in MPD. On the other hand, nodular pleural thickening (59.2% vs. 76.6%, OR 0.445), hilar lymph node metastasis (5.8% vs. 20.3%, OR 0.243), mediastinal lymph node metastasis (10.7% vs. 37.5%, OR 0.199), and hematogenous lung metastasis (9.7% vs. 29.2%, OR 0.261) were less frequent in MPM than in MPD. When we analyzed MPD from extrathoracic malignancy (EMPD) separately and compared them to MPM, circumferential pleural thickening, thickening of interlobar fissure, pericardial involvement and presence of pleural plaque were significant findings indicating MPM than EMPD. MPM had significantly lower occurrence of hematogenous lung metastasis, as compared with EMPD. CONCLUSION: Awareness of frequent and infrequent CT findings could aid in distinguishing MPM from MPD.

Dietary quality differs by consumption of meals prepared at home vs. outside in Korean adults

BACKGROUND/OBJECTIVES: Eating out has been reported to have negative effects on nutritional status. However, eating out can include meals prepared at home and eaten outside. Conversely, meals eaten at home can be brought from outside, as take-out and home deliveries have become common in Korea. Thus, we tested whether or not meal preparation location influences daily diet quality. SUBJECTS/METHODS: From the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2009, 4,915 Korean adults (20-64 years) were classified into two groups: home-made meal group (HMG), who ate ≥ 2 meals per day prepared at home (n = 4,146), and non-home-made meal group (NHMG), who ate ≥ 2 meals per day prepared outside home (n = 769). Daily diet quality was determined by energy intake, nutrient intake, Dietary Variety Score (DVS), and Diet Diversity Score (DDS). RESULTS: Compared to the HMG, the NHMG was more likely to consist of men, single, employed, educated and of a higher economic status (all, P < 0.01). The NHMG showed higher energy intakes (1,776 vs. 2,116 kcal/day) with higher percentages of energy from protein (15 vs. 23%) and fat (14 vs. 16%) and lower intakes of dietary fiber, phosphorus, potassium, niacin, and vitamin C (all, P < 0.01) than the HMG, with some variations among age groups. The NHMG tended to consume foods prepared by frying and grilling and had more one-dish meals such as bibimbap, noodles, and dumplings but also showed higher dietary diversity. CONCLUSIONS: It should be noted that home-made meals do not necessarily guarantee a healthy diet, and the effects of meal preparation location on nutritional status might vary depending on socio-demographic characteristics.

Dietary quality differs by consumption of meals prepared at home vs. outside in Korean adults

BACKGROUND/OBJECTIVES: Eating out has been reported to have negative effects on nutritional status. However, eating out can include meals prepared at home and eaten outside. Conversely, meals eaten at home can be brought from outside, as take-out and home deliveries have become common in Korea. Thus, we tested whether or not meal preparation location influences daily diet quality. SUBJECTS/METHODS: From the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2009, 4,915 Korean adults (20-64 years) were classified into two groups: home-made meal group (HMG), who ate ≥ 2 meals per day prepared at home (n = 4,146), and non-home-made meal group (NHMG), who ate ≥ 2 meals per day prepared outside home (n = 769). Daily diet quality was determined by energy intake, nutrient intake, Dietary Variety Score (DVS), and Diet Diversity Score (DDS). RESULTS: Compared to the HMG, the NHMG was more likely to consist of men, single, employed, educated and of a higher economic status (all, P < 0.01). The NHMG showed higher energy intakes (1,776 vs. 2,116 kcal/day) with higher percentages of energy from protein (15 vs. 23%) and fat (14 vs. 16%) and lower intakes of dietary fiber, phosphorus, potassium, niacin, and vitamin C (all, P < 0.01) than the HMG, with some variations among age groups. The NHMG tended to consume foods prepared by frying and grilling and had more one-dish meals such as bibimbap, noodles, and dumplings but also showed higher dietary diversity. CONCLUSIONS: It should be noted that home-made meals do not necessarily guarantee a healthy diet, and the effects of meal preparation location on nutritional status might vary depending on socio-demographic characteristics.

Genotypes of Clinical and Environmental Isolates of Cryptococcus neoformans and Cryptococcus gattii in Korea

Multilocus sequence typing analysis was applied to determine the genotypes of 147 (137 clinical and 10 environmental) Cryptococcus neoformans and three clinical Cryptococcus gattii isolates from 1993 to 2014 in Korea. Among the 137 clinical isolates of C. neoformans, the most prevalent genotype was ST5 (n = 131), followed by ST31 (n = 5) and ST127 (n = 1). Three C. gattii strains were identified as ST57, ST7, and ST113. All environmental isolates were identified as C. neoformans with two genotypes, ST5 (n = 7) and ST31 (n = 3). Our results show that C. neoformans isolates in Korea are genetically homogeneous, and represent a close genetic relationship between clinical and environmental isolates.

Nutritional and health consequences are associated with food insecurity among Korean elderly: Based on the fifth (2010) Korea National Health and Nutrition Examination Survey (KNHANES V-1) / 한국영양학회지

PURPOSE: The purpose of this study was to examine the prevalence of food insecurity in Korean elderly and to analyze the health status as well as food and nutrient intakes according to food insecurity status. METHODS: A total of 939 elderly subjects (over 65 years old) were used in our analysis from the fifth 2010 Korean National Health and Nutrition Examination Survey (KNHANES V-1). The variables consisted of general characteristics, physical and mental health, nutrient intake, rate of deficient intake of energy and nutrients compared with Dietary Reference Intakes for Koreans (KDRIs) and food quality and diversity according to the status of food insecurity. Food insecurity status was measured using a self-reported food security questionnaire on the dietary situation in the previous year, and participants were classified according to three groups: food secure group, mildly food insecure group, and moderately/severely food insecure group. RESULTS: The proportion of the food insecure group was approximately 67% and the food insecure group had lower income and educational status than the food secure group. Food insecurity was associated with worse physical and mental health status after adjusting potentially confounding variables. The results showed that food insecurity in Korean elderly significantly affected mental health (including stress cognition, depression experience, and suicide thoughts) which exceeded stages of physical health. In addition, food insecurity showed significant association with low nutrient intake and high rate of deficient intakes of energy and nutrients compared with KDRIs, and a reduction of dietary quality and diversity was indicated in the food insecure group. CONCLUSION: This study concludes that the prevalence of food insecurity may affect the physical and mental health as well as dietary intake of the elderly Korean population. Therefore, food insecurity should be considered as an important public health issue in Korea.