Validation of the physical activity classification table for Korean youth and assessment of total energy expenditure, estimated energy requirement and physical activity in Korean children and adolescents / 한국영양학회지

Purpose@#The purpose of the first part of this study was to evaluate the validity of the physical activity classification table for youth (Youth-PACT). The second part of this study was aimed at comparing the estimated energy requirement (EER) with the total energy expenditure (TEE) and evaluating the physical activity patterns of Korean children and adolescents. @*Methods@#The subjects of the first part of the study were 17 children aged 10 to 12 years, and their total energy expenditure (TEE DLW ) was measured using the double labeled water (DLW) method. A total of 166 children and adolescents aged 6-18 years participated in the second part of this study. Their resting energy expenditure (REE) was measured using indirect calorimetry and the TEE Youth-PACT and physical activity level were calculated by applying the Youth-PACT to the physical activity diary prepared by the subjects. @*Results@#In the first part of this study, there were no significant differences between theTEE DLW and the TEE Youth-PACT. The TEE Youth-PACT accurately predicted TEE DLW in 37.5% of the subjects. In the second part of the study, the rates at which EER accurately predicted TEE Youth-PACT and overestimated TEE Youth-PACT were 29.6% and 47.3%, respectively. The time spent based on intensity of physical activity and the physical activity categories which were obtained using Youth-PACT showed different patterns according to sex and age group. Age showed significant positive correlations with REE, TEE, and the time spent in sedentary behavior, but age was significantly negatively correlated with REE/body weight, TEE/body weight, and the time spent in low-intensity and high-intensity activities. @*Conclusion@#The results of this study showed that the Youth-PACT can be used to evaluate the TEE and PAL of children and adolescents. However, further studies are needed to validate the TEE Youth-PACT and to set the EER for children and adolescents.

Awareness and Intake of Caffeine-Containing Foods among High School Students in Seoul

The high caffeine intake by adolescents has been a concern. The purpose of this study was to examine the awareness and consumption of caffeine-containing foods among 443 high school students using a questionnaire. An analysis of the spending patterns of the students’ weekly allowance showed that the amounts spent on purchasing caffeine-containing foods were higher for female students than male students (P ＜0.001). The scoring of the perception of caffeine was 3.1 out of 5, interest in the caffeine content of food was 2.6, consumption of caffeine-containing foods was 2.6, and usefulness of caffeine-containing foods was 2.7. The awareness of caffeine content in food was significantly higher in females (7.3 out of 11) than male students (6.7) (P＜0.01). Approximately 59% of students perceived that the relationship between caffeine-containing foods and health, was harmful, and the experience of side effects after taking caffeine was significantly higher in female students than males. These side effects include heartburn (P＜0.001), headache or dizziness (P＜0.001), irregular heartbeat (P＜0.05), and hands and feet shake (P＜0.01). Caffeine-containing foods were purchased at convenience stores (62.1%). The factor considered when purchasing caffeine-containing foods was taste (72.2%), and the use of nutrition labeling for caffeine-containing foods scored 2.0 out of 5 points. When assessing the intake of caffeine-containing foods, the foods consumed more than once a week were in the order of coke, chocolate, chocolate milk, chocolate pie, and chocolate bars. These results suggest that it is necessary to prepare a caffeine-related nutrition guide improvement by sales management, and strengthen food labeling standards for the desirable recognition of caffeine and its safe intake by adolescents.

Awareness and Intake of Caffeine-Containing Foods among High School Students in Seoul

The high caffeine intake by adolescents has been a concern. The purpose of this study was to examine the awareness and consumption of caffeine-containing foods among 443 high school students using a questionnaire. An analysis of the spending patterns of the students’ weekly allowance showed that the amounts spent on purchasing caffeine-containing foods were higher for female students than male students (P ＜0.001). The scoring of the perception of caffeine was 3.1 out of 5, interest in the caffeine content of food was 2.6, consumption of caffeine-containing foods was 2.6, and usefulness of caffeine-containing foods was 2.7. The awareness of caffeine content in food was significantly higher in females (7.3 out of 11) than male students (6.7) (P＜0.01). Approximately 59% of students perceived that the relationship between caffeine-containing foods and health, was harmful, and the experience of side effects after taking caffeine was significantly higher in female students than males. These side effects include heartburn (P＜0.001), headache or dizziness (P＜0.001), irregular heartbeat (P＜0.05), and hands and feet shake (P＜0.01). Caffeine-containing foods were purchased at convenience stores (62.1%). The factor considered when purchasing caffeine-containing foods was taste (72.2%), and the use of nutrition labeling for caffeine-containing foods scored 2.0 out of 5 points. When assessing the intake of caffeine-containing foods, the foods consumed more than once a week were in the order of coke, chocolate, chocolate milk, chocolate pie, and chocolate bars. These results suggest that it is necessary to prepare a caffeine-related nutrition guide improvement by sales management, and strengthen food labeling standards for the desirable recognition of caffeine and its safe intake by adolescents.

Recognition of Nutritional Labeling and Intake Status of Processed Foods and Snacks among High School Students in Incheon

This study sought to analyze the need for nutritional education to enhance the selection of desirable foods by adolescents. A total of 480 high school students in Incheon were surveyed and their responses were analyzed for the recognition of nutrition labeling and their consumption of processed foods and snacks. Almost all the students (93.1%) recognized nutrition labeling, but 54.6% rarely checked the nutrition labeling. The nutrients recognized as important in the nutrition label of processed foods were total fat/saturated fat/trans fat (3.75 out of 5), calories (3.68), and sodium (3.67) in that order. The recognition of the importance of calories was significantly higher in female students compared to male students (3.78 vs. 3.58, P＜0.05). The information identified as important were the date of manufacture and expiration (4.21 out of 5), price (4.14), and the nutrition label (3.15). The preference for processed foods was highest in the order of beverages (4.03 out of 5), noodles (4.02), and frozen desserts (3.97), and the preference of females for processed foods was significantly higher than males (P＜0.001). The time when snacks were most frequently consumed were before going to the academy (21.0%), after school (19.4%), and after attending private institutes (15.0%). The main reasons for using processed foods as snacks were taste (44.4%), ‘no time to eat a meal’ (26.4%), and low price (17.7%). In conclusion, while students mostly recognized nutrition labeling, the actual usage rate was low, and snacks were selected and consumed instead of meals for reasons such as attending academic institutes after school. Thus, to encourage the choice of proper processed foods and snacks for adolescents, practical nutrition education using nutrition labeling is needed.

Postoperative Pain Management Status led by Nurse of Acute Pain Service / 임상간호연구

Purpose@#This study was conducted to demonstrate objective stability of postoperative pain management status managed by nurse-based, anesthesiologist-supervised Acute Pain Service (APS). @*Methods@#A retrospective descriptive review was conducted with 5,748 patients who had used intravenous Patient Controlled Analgesia (PCA) from January to December 2017. Data were analyzed using descriptive statics, Frequency analysis, ANOVA, Cross tabulation with X2 test, and Correlation coefficient. @*Results@#As the APS nurse's education date increased, the period of using PCA was statistically significantly longer, and the period of stopping PCA while using it became shorter (p<.001). Statistically significant, the most painful operations were extremities, spine, upper abdomen, and thorax, while the least painful surgery was lower abdomen (p<.001). Lower abdominal surgery used the highest amount of PCA (p<.001), and extremities and spinal surgery, the lowest amount of PCA and frequently stop using it (p<.001). The most common side effects were nausea and vomiting after surgery, with an incidence of 16.0% within 24 hours and 9.8% within 48 hours. The overall error caused by PCA was 1.5%, with 84.3% being caused by human errors. @*Conclusion@#With the pain management effect of APS nurses, patients used PCA more effectively. There were also fewer side effects and error rates compared to prior studies.Therefore, it is suggested that this system is safe and effective for pain management.

Postoperative Pain Management Status led by Nurse of Acute Pain Service / 임상간호연구

Purpose@#This study was conducted to demonstrate objective stability of postoperative pain management status managed by nurse-based, anesthesiologist-supervised Acute Pain Service (APS). @*Methods@#A retrospective descriptive review was conducted with 5,748 patients who had used intravenous Patient Controlled Analgesia (PCA) from January to December 2017. Data were analyzed using descriptive statics, Frequency analysis, ANOVA, Cross tabulation with X2 test, and Correlation coefficient. @*Results@#As the APS nurse's education date increased, the period of using PCA was statistically significantly longer, and the period of stopping PCA while using it became shorter (p<.001). Statistically significant, the most painful operations were extremities, spine, upper abdomen, and thorax, while the least painful surgery was lower abdomen (p<.001). Lower abdominal surgery used the highest amount of PCA (p<.001), and extremities and spinal surgery, the lowest amount of PCA and frequently stop using it (p<.001). The most common side effects were nausea and vomiting after surgery, with an incidence of 16.0% within 24 hours and 9.8% within 48 hours. The overall error caused by PCA was 1.5%, with 84.3% being caused by human errors. @*Conclusion@#With the pain management effect of APS nurses, patients used PCA more effectively. There were also fewer side effects and error rates compared to prior studies.Therefore, it is suggested that this system is safe and effective for pain management.

Refractory Hepatic Hydrothorax in Chronic Hepatitis C Controlled by Direct-acting Antivirals / 대한소화기학회지

Hepatic hydrothorax is a transudative pleural effusion that complicates advanced liver cirrhosis. Patients refractory to medical treatment plus salt restriction and diuretics are considered to have refractory hepatic hydrothorax and may require transjugular intrahepatic portosystemic shunt (TIPS) or liver transplant. Successful antiviral therapy reduces the incidence of some complications of cirrhosis secondary to HCV infection. We report a case of hepatic hydrothorax in a 55-year-old female patient with HCV cirrhosis, which exhibited a spontaneous decrease in pleural effusion after direct antiviral agent (DAA) therapy. In cases of HCV cirrhosis, DAAs are worth administering before treatment by TIPS or liver transplantation.

Ethical and legal consideration on medical realities and ethical debates about withholding or withdrawing treatment in end-of-life care

It is natural for all human beings to die; hence, death is an inevitable event. However, advances in medical technology are changing the meaning of natural death. These advanced treatments provide the capability to intervene at the time of death and to reshape the circumstances around natural death, by sustaining human life. However, it is extremely difficult to judge when treatment is futile for the patient's best interests. It is therefore recommended to make time to discuss the concept of medical futility during the course of caring for a critically ill patient. Despite the expectations and efforts of the patient, the patient's family, and medical staff, the patient will eventually, have a ‘hopeless’ medical condition. Most discussions about decision-making in end-of-life treatment have neen ethical debates focused on the patient's self-determination and best interest in the context of concepts such as euthanasia or death with dignity. However, such discussions are insufficient for resolving the wide variety of circumstances that occur in clinical settings. Instead, the various ethical dilemmas inherent to end-of-life care should be approached by educating medical teams, patients, and their families about how to recognize medical futility. Furthermore, it is important to optimize the balance between the rights of patients and the responsibility of physicians.

Evaluation of Sanitary Education and Performance of Sanitary Management among School Food Service Employees in Sejong

This study examined sanitary education and performance of sanitary management among employees related to cooking in school food services in Sejong. A total of 193 subjects (19.2% for kindergarten, 42.5% for elementary school, and 38.3% for middle and high school) participated in this questionnaire survey. The frequency of sanitary education was highest at 63.7% once a month, and it was higher in the order of middle and high school, elementary school, and kindergarten (P < 0.001). The most important contents of sanitary education were personal sanitary management (43.5%), food material management (25.9%), and sanitary and safety management of equipment and utensils (17.6%). The necessity of sanitary education recognized by the subjects was absolutely necessary at 69.9% and necessary at 28.0%. The application of knowledge from sanitary education is high in proper application at 50.8% and absolute application at 40.4%. The improvement effect after sanitary education was higher in kindergarten than in elementary school and middle and high school (P < 0.01). The performance of sanitary management was high at 4.7 out of 5. In particular, personal sanitary management was the highest in elementary school at 4.8 followed in order by middle and high school (4.7) and kindergarten (4.6) (P < 0.01). The necessity of sanitary education and the application of knowledge obtained from sanitary education to the food service showed a significant and positive correlation with the sanitary management performance (P < 0.05, P < 0.001). These results highlight that the need for customized sanitary education for institution types and an awareness of sanitary education by employees will enhance sanitary management in school food service.

Ethical and legal consideration on medical realities and ethical debates about withholding or withdrawing treatment in end-of-life care

It is natural for all human beings to die; hence, death is an inevitable event. However, advances in medical technology are changing the meaning of natural death. These advanced treatments provide the capability to intervene at the time of death and to reshape the circumstances around natural death, by sustaining human life. However, it is extremely difficult to judge when treatment is futile for the patient's best interests. It is therefore recommended to make time to discuss the concept of medical futility during the course of caring for a critically ill patient. Despite the expectations and efforts of the patient, the patient's family, and medical staff, the patient will eventually, have a ‘hopeless’ medical condition. Most discussions about decision-making in end-of-life treatment have neen ethical debates focused on the patient's self-determination and best interest in the context of concepts such as euthanasia or death with dignity. However, such discussions are insufficient for resolving the wide variety of circumstances that occur in clinical settings. Instead, the various ethical dilemmas inherent to end-of-life care should be approached by educating medical teams, patients, and their families about how to recognize medical futility. Furthermore, it is important to optimize the balance between the rights of patients and the responsibility of physicians.

Effects of Active Mandibular Exercise for Mouth Opening Limitation Patients after Maxillomandibular Fixation Release: A Non-Randomized Controlled Trial / 간호학회지

PURPOSE: The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release. METHODS: The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth. RESULTS: The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p < .001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p < .001), discomfort score (F=9.38, p < .001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group. CONCLUSION: The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

Perceptions of Food Allergen Labeling in School Meal Service among Middle School Girls in Incheon

The purpose of this study was to suggest strategies for effective food allergen labeling in order to prevent food allergies in school meal service. Food allergy experience, eating behavior, and perceptions of food allergen labeling in school meal service were surveyed and compared according to the food allergy experiences of middle school girls in Incheon. Seventy-eight students (17% of total subjects) experienced food allergies. For eating behaviors, students with food allergy experience had significantly higher scores for using nutritional knowledge in their life than inexperienced subjects. For the perception of food allergen labeling in school meal service, girls who had experienced food allergies more often checked labeling of school meals for allergenic foods than those who had no experience of food allergies (P < 0.001). The most desirable method for displaying allergenic foods was an indication of the allergenic food name among students who had experienced food allergies and allergenic food number of the current method for students who had not experienced food allergies (P < 0.001). Students who had not experienced food allergies showed significantly lower interest in food allergen labeling than subjects who had experienced food allergies (P < 0.001). For the importance score of information items in nutrition labeling, allergenic food score was significantly higher in students who had experienced food allergies (3.9 vs. 3.4 points, P < 0.001). These results indicate that students who have experienced food allergies are more interested in food allergen labeling of school meals and that they are more aware. Efforts to improve labeling method such as directly labeling allergenic food name and a more visible indication are required for efficient utilization of food allergen labeling in school meal service.

Perception of Sugar Reduction and Added Sugar Use among Dietitians or Nutrition Teachers in Gyeonggi and Incheon

The purpose of this study was to investigate dietitians or nutrition teachers' perception of sugar reduction and usage of sugars in school meal service. A survey was conducted for dietitians or nutrition teachers at elementary, middle, and high schools in Gyeonggi and Incheon. Survey data were analyzed according to the experience period and school types of dietitians or nutrition teachers. The numbers of subjects according to work experience period were 134 (44.2%) for < 5 years, 68 (22.4%) for ≥5 and < 10 years, and 101 (33.3%) for ≥10 years. Among the subjects, 168 (55.4%) were nutrition teachers at kindergarten/elementary schools, and 135 (44.6%) were at middle/high/special schools. Perceptions of sugar reduction programs were higher in kindergarten/elementary schools than in middle/high/special schools. The perception of added sugar use increased with more work experience, and interest in sugar reduction was higher in kindergarten/elementary schools than in middle/high/special schools. Practice for added sugar reduction increased with more work experience, and the most common method for reducing sugar was use of natural sugars. The main reason for not reducing added sugars in school meals was due to preference. Nutritional education for students increased with more work experience and was higher in kindergarten/elementary schools than in middle/high/special schools. The major nutritional education methods were using school homepage (37.4%), sending family letters (37.4%), and using principle's discretion time (18.4%). Organic sugar and rice taffy were used more at kindergarten/elementary schools, and white sugar, brown sugar, and white syrup were used more at middle/high/special schools. The most common menu using added sugars was stir-fried dishes (stir-fried pork, chicken, and vegetables).

Perception of Use of Environment-friendly Agricultural Products during School Foodservice of Mothers of Elementary School Students in Gyeonggi / 대한지역사회영양학회지

OBJECTIVES: This study was to investigate the perception of mothers of elementary school students regarding environment-friendly agricultural products in school foodservice. METHODS: A total of 282 mothers whose children were receiving environment-friendly agricultural products during elementary school foodservice in Gyeonggi participated in this questionnaire survey. The survey was conducted to investigate respondents perception and satisfaction with environment-friendly agricultural products in their children's school meals from May 29 to June 9, 2017. RESULTS: About 79% of the subjects were satisfied with school foodservice. The most important aspects of school foodservice were nutrition (35.8%) and sanitation (34.8%). Over 80% of the subjects were aware of environment-friendly agricultural products and about 54% of the subjects checked for a certification mark when purchasing environment-friendly agricultural products. Additionally, 72.3% of the subjects knew that environment-friendly agricultural products were used at school. The advantages of using environment-friendly agricultural products in school foodservice were safety (75.5%) and high food quality (16.3%). About 66% of the mothers knew the school was receiving support from the city or education office for using environment-friendly agricultural products. Additionally, 74.5% of the mothers responded that they are willing to pay for use of environment-friendly agricultural products when subsidies were not supported. CONCLUSIONS: The positive perception and high support for use of environment-friendly agricultural products in school foodservice among elementary students' mothers can be used as basic data for expansion of the use of environment-friendly agricultural products in school foodservice.

Perception of Use of Environment-friendly Agricultural Products during School Foodservice of Mothers of Elementary School Students in Gyeonggi / 대한지역사회영양학회지

OBJECTIVES: This study was to investigate the perception of mothers of elementary school students regarding environment-friendly agricultural products in school foodservice. METHODS: A total of 282 mothers whose children were receiving environment-friendly agricultural products during elementary school foodservice in Gyeonggi participated in this questionnaire survey. The survey was conducted to investigate respondents perception and satisfaction with environment-friendly agricultural products in their children's school meals from May 29 to June 9, 2017. RESULTS: About 79% of the subjects were satisfied with school foodservice. The most important aspects of school foodservice were nutrition (35.8%) and sanitation (34.8%). Over 80% of the subjects were aware of environment-friendly agricultural products and about 54% of the subjects checked for a certification mark when purchasing environment-friendly agricultural products. Additionally, 72.3% of the subjects knew that environment-friendly agricultural products were used at school. The advantages of using environment-friendly agricultural products in school foodservice were safety (75.5%) and high food quality (16.3%). About 66% of the mothers knew the school was receiving support from the city or education office for using environment-friendly agricultural products. Additionally, 74.5% of the mothers responded that they are willing to pay for use of environment-friendly agricultural products when subsidies were not supported. CONCLUSIONS: The positive perception and high support for use of environment-friendly agricultural products in school foodservice among elementary students' mothers can be used as basic data for expansion of the use of environment-friendly agricultural products in school foodservice.

The Effects of Hand Massage in Patients Who Underwent Transradial Percutaneous Coronary Intervention

PURPOSE: This study aimed to determine the effect of hand massage in patients who underwent transradial percutaneous coronary intervention. METHODS: This was a quasi-experimental study with a nonequivalent control group and non-synchronized design. The study included 30 patients in the experimental group and 30 in the control group. Hand massage was performed 2 times for 5 minutes each in the experimental group and the control group only received usual nursing interventions. Pain, level of discomfort, and vital signs were defined as key outcome measures, and the data were analyzed using the chi-square test, an independent t-test, Mann-Whitney U test, repeated-measures analysis of variance, and Friedman test. RESULTS: Significant differences were observed between the 2 groups in the pain score (F=7.91, p=.003), discomfort score (F=18.15, p < .001), pulse (F=12.92, p < .001), and respiration rate (χ2=19.35, p < .001). CONCLUSION: Hand massage can be a helpful nursing intervention for transradial percutaneous coronary intervention by reducing pain and discomfort to a considerable degree.

Knowledge of and Compliance with Neutropenic Diet in Patients with Hematologic Malignancy undergoing Chemotherapy

PURPOSE: This study aimed to investigate knowledge of and compliance with the neutropenic diet in hemato-oncology patients undergoing chemotherapy. METHODS: 123 hemato-oncology patients who had more than one chemotherapy participated in this study. Data were collected with a self-administered questionnaire from July 21 to September 26, 2014, and analyzed with SPSS 21.0 program using descriptive statistics, t-test, ANOVA and Pearson's correlation. RESULTS: The average of score for the neutropenic diet was 60.9 out of 100 points and mean compliance score was 69.5 out of 100 percent scale. For preventing infection, patients were found to be stricter in their intake of restricted foods than acceptable foods during neutropenia. There were significant correlations between the knowledge of and compliance with the neutropenic diet in patients receiving chemotherapy (r=.53, p<.001). CONCLUSION: It is necessary to nursing assessment and education should include a periodic assessment of nutritional status and risk evaluation of neutropenia and bacterial infections. This study recommended nursing research to establish a recommendation criterion for a restrictive neutropenic diet and less restrictive food safety education programs for cancer patients.

Effects of Active Mandibular Exercise for Mouth Opening Limitation Patients after Maxillomandibular Fixation Release: A Non-Randomized Controlled Trial

PURPOSE@#The aim of this study was to evaluate the effects of active mandibular exercise (AME) in patients with limited mouth opening after maxillomandibular fixation (MMF) release.@*METHODS@#The study used a quasi-experimental, nonequivalent control group and a pre test-post test design. Sixty-two patients with Maxillomandibular Fixation Release were assigned to the experimental (n=31) or control group (n=31). The AME was performed in the experimental group for 4 weeks. The exercise AME consisted of maximal mouth opening, lateral excursion and protrusive movement. These movements were repeated ten times a day. After the final exercise of the day, the number of tongue blades used for mouth opening was noted. The effect of AME was evaluated after MMF release at different time intervals: a) immediately, b) after 1 week, c) after 2 weeks, d) after 4 weeks, and e) after 12 weeks. The exercise was assessed using the following criteria: a) mandibular movements, b) pain scores associated with maximal mouth opening, c) discomfort scores associated with range of movement, and d) daily life activities that involve opening the mouth.@*RESULTS@#The experimental group showed significant improvement regarding the range of mandibular movements (maximal mouth opening (F=23.60, p < .001), lateral excursion to the right side (F=5.25, p=.002), lateral excursion to the left side (F=5.97, p=.001), protrusive movement (F=5.51, p=.001)), pain score (F=39.59, p < .001), discomfort score (F=9.38, p < .001). Daily life activities that involve opening the mouth were more favorable compared to those in the control group.@*CONCLUSION@#The AME in patients after MMF release is helpful for increasing mandibular movement range, decreasing pain and discomfort, and improving day life activities that involve opening the mouth. Therefore, AME is highly recommended as an effective nursing intervention.

Parents' Knowledge and Attitudes Regarding a Screening Test for and Subsequent Management of Students' Emotional and Behavioral Problems

PURPOSE: The purpose of this study was to investigate parents' perceptions and attitudes regarding a screening test for and subsequent management of students' emotional and behavioral problems. METHODS: A descriptive research design was used, and included disproportional stratified and cluster random sampling. The sample comprised 223 parents of elementary, middle, and high school students. Data were analyzed using descriptive statistics, Chi-squared test, and ANOVA with SPSS/WIN 21.0. RESULTS: Overall, parents responded that they knew of the goals, types, and tools of screening tests for students' emotional and behavioral problems. In total, 64.6% of parents reported having information for the screening test in advance. Only 13.5%(n=30) of students had emotional and behavioral problems in the last year. Among these students, 56.7%(n=17) were referred to mental health facilities but only 29.4%(n=5) of them received ongoing management from these facilities. CONCLUSION: These findings suggest that parents should receive information about the screening test for and subsequent management of students' emotional and behavioral problems. Health professionals need to build strategies to provide ongoing management for students who have emotional and behavioral problems.

Comparing the effects of vecuronium and cisatracurium on electrophysiologic monitoring during neurosurgery: a randomized controlled study

BACKGROUND: The differences between neuromuscular blocking (NMB) drugs on the efficacy of intraoperative motor-evoked potential (MEP) monitoring have not been established through clinical study. We compared the effects of vecuronium and cisatracurium on the efficacy of intraoperative MEP monitoring. METHODS: We enrolled 72 patients who had undergone neurosurgery with MEP monitoring. We randomly allocated the subjects into one of two groups, in whom we maintained continuous intravenous vecuronium (Group V) or cisatracurium (Group C) infusion during the surgeries; the target partial NMB for maintenance was T1/Tc 50% (T1, first twitch of TOF response; Tc, control response of T1 before NMB drug injection). We compared the means and coefficients of variation (CV, %) of all measured MEP amplitudes and the frequencies of NMB drug dose changes. RESULTS: The means and CVs of MEP amplitude and latency in all four limbs did not differ significantly between the groups, although we did change the continuous NMB drug doses in group V significantly less often than in group C. CONCLUSIONS: There were no significant differences between vecuronium and cisatracurium on the MEP variability and mean amplitudes. However, cisatracurium needed more frequent dose changes to maintain T1/Tc 50%.