Childhood Obesity among Socioeconomically Vulnerable Families: A Path Model Using Parenting Behavior and Its Associates

Background@#Using path analysis, we aimed to examine whether parenting self-efficacy and parenting styles would be significant associates with parenting behavior, and the parenting behavior would be significantly associated with the obesity status of children from socioeconomically vulnerable families. @*Methods@#A cross-sectional study was conducted with 61 parents and their children enrolled in public welfare systems in a community in Seoul, South Korea. Parenting behavior was defined as encouraging a child’s healthy eating habits and was measured using the Child Feeding Questionnaire. @*Results@#In the path model, higher levels of parenting self-efficacy and lower levels of authoritarian parenting were significantly associated with a higher level of parenting behavior, which was significantly associated with lower child body mass index z-scores. @*Conclusions@#Community health nurses need to provide intervention strategies for increasing parenting self-efficacy and decreasing authoritarian parenting styles to promote parenting behaviors and childhood obesity prevention among socioeconomically vulnerable families.

Job Analysis of Visiting Nurses in the Process of Change Using FGI and DACUM

Purpose@#This study conducted a job analysis of visiting nurses in the process of change. @*Methods@#Participants were the visiting nurses working for the Seoul Metropolitan city. On the basis of the Public Health Intervention Wheel model, two times of the focus group interview (FGI) with seven visiting nurses and one time of the Developing a Curriculum (DACUM) with 34 visiting nurses were performed. A questionnaire survey of 380 visiting nurses was conducted to examine the frequency, importance and difficulty levels of the tasks created by using the FGI and DACUM. @*Results@#Visiting nurses’ job was derived as the theme of present versus transitional roles. The present role was categorized as ‘providing individual- and group-focused services’ and ‘conducting organization management’, while the transitional role was categorized as ‘providing district-focused services’ and ‘responding to new health issues’. The job generated 13 duties, 28 tasks, and 73task elements. The tasks showed the levels of frequency (3.65 scores), importance (4.27 scores), and difficulty (3.81 scores). All the tasks were determined as important, exceeding the average 4.00 scores. The group- and district-focused services of the tasks were recognized as more difficult but less frequent tasks. @*Conclusion@#The visiting nurses exert both present and transitional roles. The transitional roles identified in the present study should be recognized as an extended role of visiting nurses in accordance with the current changing healthcare needs in South Korea. Finally, the educational curriculum for visiting nurses that reflects the transitional roles from the present study is needed.

The Association between Social Support and Health Behaviors for Metabolic Syndrome Prevention among University Students: The Mediating Effect of Perceived Stress

Purpose@#Health behaviors for metabolic syndrome (MetS) prevention should be emphasized from early adulthood. There is little information on psychosocial factors associated with health behaviors for MetS prevention. The aim of this study was to determine whether there would be a mediating effect of perceived stress on the association between social support and health behaviors for MetS prevention among university students. @*Methods@#This cross-sectional and correlation study was conducted with 502 university students in South Korea. Social support, perceived stress, and lifestyle evaluation for metabolic syndrome scales were used. Online questionnaire survey was conducted between November and December 2019. The mediating effect of social support on health behaviors for MetS prevention was analyzed using PROCESS macro program with bootstrapping method to test our hypotheses. @*Results@#Social support directly influenced perceived stress (β=-.35, p<.001) and health behaviors for MetS prevention (β=.14, p=.002). Health behaviors for MetS prevention was indirectly influenced by perceived stress (β=-.25, p<.001). The size of indirect effect of social support on health behaviors for MetS prevention was 0.06. @*Conclusions@#The association of social support and health behaviors for MetS prevention was partially mediated by perceived stress among university students. Therefore, a university-based nursing intervention should comprise social support strategies with stress management to promote health behaviors for MetS prevention.

University Freshmen's Problem Drinking: Its Individual- and Family-Level Factors

Background@#University students have been known as having a higher rate of problem drinking than the general population in South Korea. In particular, the university freshmen may experience problem drinking from increased occasions of frequent social gatherings at the first school year as they have increased time to freely use compared to the high school days. Problem drinking among university freshmen may be influenced by multiple factors. The present study aimed to examine the prevalence of problem drinking and to identify individualand family-level factors associated with university freshmen's problem drinking. @*Methods@#A cross-sectional, correlation study was conducted. Participants were 227 university freshmen (70 men and 157 women) under the parenting of mother and father from 10 universities in Seoul. The problem drinking was evaluated by using the Alcohol Use Disorder Identification Test. Alcohol Abstinence Self-Efficacy Scale and Parental Authority Questionnaire for parenting behaviors were used. @*Results@#The prevalence of problem drinking was 58.6% among university freshmen. An individual-level factor of alcohol abstinence self-efficacy was significantly associated with the prevalence of problem drinking (odds ratio, 0.94; 95% confidence interval, 0.91-0.96) among university freshmen. However, any of family-level factors including types of parenting behaviors were not significantly associated with the prevalence of problem drinking. @*Conclusions@#Alcohol abstinence self-efficacy may be a strong protective factor against university freshmen's problem drinking. University-based alcohol abstinence programs should comprise of nursing strategies including the enhancement of abstinence self-efficacy at the first school year.

Associations between Depressive Symptoms and Work-Related Musculoskeletal Symptoms, and Health-Promoting Behaviors among Korean Coast Guards

Background@#The purpose of the study was to examine associations between depressive symptoms and work-related musculoskeletal symptoms, and health-promoting behaviors in Korean Coast Guards who are exposed to a vulnerable working environment. @*Methods@#A cross-sectional correlational study was conducted with 271 Korean Coast Guards in Gangwon-do. Depressive symptoms were measured using the Korean version of Center for Epidemiologic Studies Depressive Scale-Revised. Work-related musculoskeletal symptoms were measured using the KOSHA (Korea Occupational Safety and Health Agency) GUIDE H-9-2012. Health-promoting behaviors were measured using the Health Promoting Lifestyle Profile-II. @*Results@#Of all the Korean Coast Guards, 17.3% represents the risk of clinical depression, and 43.5% reported work-related musculoskeletal symptoms in any body parts. The average score of health-promoting behaviors were 2.4 (range, 1-4 scores). Depressive symptoms and work-related musculoskeletal symptoms were significantly negatively associated with health-promoting behaviors, respectively. Depressive symptoms were significantly negatively associated with the spiritual growth, interpersonal relationship, physical activity, and stress management in subscales of the Health Promoting Lifestyle Profile-II. Work-related musculoskeletal symptoms were significantly negatively associated with the physical activity and stress management in subscales of the Health Promoting Lifestyle Profile-II. @*Conclusions@#Among Korean Coast Guards, health-promoting behaviors were significantly associated with depressive symptoms and work-related musculoskeletal symptoms. Therefore, nursing strategies to promote health-promoting behaviors may be enhanced psychological health and physical health outcome of Korean Coast Guards.

University Freshmen's Problem Drinking: Its Individual- and Family-Level Factors

Background@#University students have been known as having a higher rate of problem drinking than the general population in South Korea. In particular, the university freshmen may experience problem drinking from increased occasions of frequent social gatherings at the first school year as they have increased time to freely use compared to the high school days. Problem drinking among university freshmen may be influenced by multiple factors. The present study aimed to examine the prevalence of problem drinking and to identify individualand family-level factors associated with university freshmen's problem drinking. @*Methods@#A cross-sectional, correlation study was conducted. Participants were 227 university freshmen (70 men and 157 women) under the parenting of mother and father from 10 universities in Seoul. The problem drinking was evaluated by using the Alcohol Use Disorder Identification Test. Alcohol Abstinence Self-Efficacy Scale and Parental Authority Questionnaire for parenting behaviors were used. @*Results@#The prevalence of problem drinking was 58.6% among university freshmen. An individual-level factor of alcohol abstinence self-efficacy was significantly associated with the prevalence of problem drinking (odds ratio, 0.94; 95% confidence interval, 0.91-0.96) among university freshmen. However, any of family-level factors including types of parenting behaviors were not significantly associated with the prevalence of problem drinking. @*Conclusions@#Alcohol abstinence self-efficacy may be a strong protective factor against university freshmen's problem drinking. University-based alcohol abstinence programs should comprise of nursing strategies including the enhancement of abstinence self-efficacy at the first school year.

Associations between Depressive Symptoms and Work-Related Musculoskeletal Symptoms, and Health-Promoting Behaviors among Korean Coast Guards

Background@#The purpose of the study was to examine associations between depressive symptoms and work-related musculoskeletal symptoms, and health-promoting behaviors in Korean Coast Guards who are exposed to a vulnerable working environment. @*Methods@#A cross-sectional correlational study was conducted with 271 Korean Coast Guards in Gangwon-do. Depressive symptoms were measured using the Korean version of Center for Epidemiologic Studies Depressive Scale-Revised. Work-related musculoskeletal symptoms were measured using the KOSHA (Korea Occupational Safety and Health Agency) GUIDE H-9-2012. Health-promoting behaviors were measured using the Health Promoting Lifestyle Profile-II. @*Results@#Of all the Korean Coast Guards, 17.3% represents the risk of clinical depression, and 43.5% reported work-related musculoskeletal symptoms in any body parts. The average score of health-promoting behaviors were 2.4 (range, 1-4 scores). Depressive symptoms and work-related musculoskeletal symptoms were significantly negatively associated with health-promoting behaviors, respectively. Depressive symptoms were significantly negatively associated with the spiritual growth, interpersonal relationship, physical activity, and stress management in subscales of the Health Promoting Lifestyle Profile-II. Work-related musculoskeletal symptoms were significantly negatively associated with the physical activity and stress management in subscales of the Health Promoting Lifestyle Profile-II. @*Conclusions@#Among Korean Coast Guards, health-promoting behaviors were significantly associated with depressive symptoms and work-related musculoskeletal symptoms. Therefore, nursing strategies to promote health-promoting behaviors may be enhanced psychological health and physical health outcome of Korean Coast Guards.

Ecological Factors and Strategies for Childhood Obesity Prevention Targeting Vulnerable Children: Using Community-Based Participatory Research

Purpose@#This study aimed to explore ecological factors and strategies for childhood obesity prevention targeting vulnerable children using a community-based participatory research (CBPR) methodology. @*Methods@#The CBPR was conducted by following basic process steps. Participants were 12 community stakeholders such as community child center directors (n=4), vulnerable children’s mothers (n=3), community health center officials (n=2), and lay health advisors (n=4); they were purposively sampled from K municipal county in Seoul, South Korea. The qualitative content analysis was performed to explore main themes of the ecological factors and strategies by using data obtained from 5 times of focus group interview. @*Results@#Twelve ecological factors associated with childhood obesity prevention were identified: Intrapersonal factors including emotional overeating; interpersonal factors including permissive parenting style of children’s eating behaviors; organizational factors including social workers’ less educational opportunities; and community/policy factors including less government financial support. Four ecological strategies for childhood obesity prevention were addressed: Developing obesity prevention programs targeting vulnerable children’ lifestyles; promoting parents’ active participation in education; building healthy meal service environments through empowering social workers; and building supportive community environment and securing community resources for child obesity prevention. @*Conclusion@#Our findings may be informative in terms of providing a comprehensive understanding of multi-level ecological barriers against vulnerable children’ obesity prevention and, moreover, guiding multi-level strategies for preventing childhood obesity targeting children enrolled in community child centers.

Ecological Factors and Strategies for Childhood Obesity Prevention Targeting Vulnerable Children: Using Community-Based Participatory Research

Purpose@#This study aimed to explore ecological factors and strategies for childhood obesity prevention targeting vulnerable children using a community-based participatory research (CBPR) methodology. @*Methods@#The CBPR was conducted by following basic process steps. Participants were 12 community stakeholders such as community child center directors (n=4), vulnerable children’s mothers (n=3), community health center officials (n=2), and lay health advisors (n=4); they were purposively sampled from K municipal county in Seoul, South Korea. The qualitative content analysis was performed to explore main themes of the ecological factors and strategies by using data obtained from 5 times of focus group interview. @*Results@#Twelve ecological factors associated with childhood obesity prevention were identified: Intrapersonal factors including emotional overeating; interpersonal factors including permissive parenting style of children’s eating behaviors; organizational factors including social workers’ less educational opportunities; and community/policy factors including less government financial support. Four ecological strategies for childhood obesity prevention were addressed: Developing obesity prevention programs targeting vulnerable children’ lifestyles; promoting parents’ active participation in education; building healthy meal service environments through empowering social workers; and building supportive community environment and securing community resources for child obesity prevention. @*Conclusion@#Our findings may be informative in terms of providing a comprehensive understanding of multi-level ecological barriers against vulnerable children’ obesity prevention and, moreover, guiding multi-level strategies for preventing childhood obesity targeting children enrolled in community child centers.

Gender-Specific Association between Emotional Labor and Health-Promoting Behavior in Call Center Workers

Background@#This study aimed to examine whether emotional labor was significantly associated with health-promoting behaviors among both women and men at call center workers. @*Methods@#A cross-sectional, correlational study was conducted among 709 workers (470 women and 239 men) at K call center workplace in Seoul, South Korea. Emotional labor and health-promoting behaviors were measured using the Emotional Labor and Health Promoting Lifestyle Profile-II (HPLP-II). @*Results@#Of all the call center workers, the average score of emotional labor was 3.5 out of 5.0. Women had a higher average emotional labor score (3.6 points) than men (3.5 points). The average score of health-promoting behaviors was 2.0 out of 4.0 in the overall workers and each group of women and men workers, respectively. Emotional labor was significantly associated with health-promoting behaviors among each group of women and men. Among women workers, emotional labor was significantly negatively associated with the spiritual growth and stress management subscales of the HPLP-II, while among men workers, it was significantly negatively associated with all HPLP-II subscales. @*Conclusions@#Emotional labor may be associated with health-promoting behaviors and its associations with the subscales of health-promoting behaviors may differ by gender. Therefore, nursing strategies for reducing emotional labor should be concerned in the context of gender-specific associations with emotional labor.

Effects of an Experiential Learning Activities-Focused Smoking Prevention Program in Elementary School Students: On the Basis of the Attitude-Social Influence-Efficacy Model

BACKGROUND: We aimed to examine the effects of an experiential learning activities-focused smoking prevention (ELSP) program on the basis of the Attitude-Social Influence-Efficacy (ASE) model in elementary school students. METHODS: A non-equivalent control group pre-test and post-test design was conducted with 84 participants who were in the fifth grade of two elementary schools in Seongnam city, South Korea. The two schools were allocated into either the ELSP (n=42) or control (n=42) group. The ELSP group completed five ELSP classes, while the control group completed five traditional lecture-based classes during the 5 weeks. Both groups were examined before and after 5 weeks, using ASE measures of smoking attitude, social influence, self-efficacy for the refusal of smoking temptation, and intention not to smoke. Data were collected from August to September 2017. RESULTS: The ELSP group had significant changes in the scores of smoking attitude (t=4.75, P<0.001) and social influences (t=3.73, P<0.001), compared to those in the control group. However, the ELSP group had non-significant changes in the scores of self-efficacy for the refusal of smoking temptation and intention not to smoke, compared to those in the control group. CONCLUSIONS: The ELSP program may be effective in improving smoking attitude and perceived social influence of smoking among those in upper grades of elementary schools. However, the duration and intensity of the ELSP program must be revised to effectively enhance smoking refusal self-efficacy and non-smoking intentions.

Effects of Isometric Handgrip Exercise versus Aerobic Exercise on Arterial Stiffness and Brachial Artery Flow-Mediated Dilation in Older Hypertensive Patients / 대한스포츠의학회지

PURPOSE: Isometric handgrip exercise (IHE) is an easy and accessible form of exercise that has beneficial effects on blood pressure (BP). However, it remains unclear whether IHE is similar benefits on arterial stiffness and endothelial function compared with aerobic exercise (AE) in elderly hypertensive patients. The aim of this study was to compare the effects of IHE versus AE on arterial stiffness and endothelial function in elderly hypertensive patients.METHODS: We conducted a randomized controlled trial with a three-arm design. Fifty-four elderly hypertensive patients (15 men; mean age, 69±6 years; systolic blood pressure, 131.2±14.7; diastolic blood pressure, 80.2±7.9 mm Hg) were randomized to IHE training (n=18), AE training (n=21), or non-exercise control group (n=21) for 12 weeks. Bilateral IHE training was performed four times of 2 minutes at 30% of maximal voluntary contraction with three times per week. AE training was performed brisk walking for 30 minutes at moderate intensity with three times per week. Carotid-femoral pulse wave velocity (PWV), augmentation index heart rate corrected (AIx@75 bpm) and brachial artery flow-mediated vasodilation (FMD) as indices of arterial stiffness and endothelial function were measured at baseline and after the intervention.RESULTS: Following 12-week intervention, resting BP was significantly decreased in both IHE (p=0.001) and AE groups (p=0.002). AIx@75 bpm and FMD were unchanged in the all groups. However, PWV was significantly decreased in both IHE and AE groups (IHE, 10.9±2.3 to 9.9±2.1 m/s [p<0.001]; AE, 10.5±2.0 to 9.4±1.6 m/s [p=0.001]), without any change in the control group.CONCLUSION: These findings suggest that both IHE and AE trainings were comparable effect in improving arterial stiffness in elderly hypertensive patients.

Effects of an Experiential Learning Activities-Focused Smoking Prevention Program in Elementary School Students: On the Basis of the Attitude-Social Influence-Efficacy Model

BACKGROUND@#We aimed to examine the effects of an experiential learning activities-focused smoking prevention (ELSP) program on the basis of the Attitude-Social Influence-Efficacy (ASE) model in elementary school students.@*METHODS@#A non-equivalent control group pre-test and post-test design was conducted with 84 participants who were in the fifth grade of two elementary schools in Seongnam city, South Korea. The two schools were allocated into either the ELSP (n=42) or control (n=42) group. The ELSP group completed five ELSP classes, while the control group completed five traditional lecture-based classes during the 5 weeks. Both groups were examined before and after 5 weeks, using ASE measures of smoking attitude, social influence, self-efficacy for the refusal of smoking temptation, and intention not to smoke. Data were collected from August to September 2017.@*RESULTS@#The ELSP group had significant changes in the scores of smoking attitude (t=4.75, P<0.001) and social influences (t=3.73, P<0.001), compared to those in the control group. However, the ELSP group had non-significant changes in the scores of self-efficacy for the refusal of smoking temptation and intention not to smoke, compared to those in the control group.@*CONCLUSIONS@#The ELSP program may be effective in improving smoking attitude and perceived social influence of smoking among those in upper grades of elementary schools. However, the duration and intensity of the ELSP program must be revised to effectively enhance smoking refusal self-efficacy and non-smoking intentions.

Effects of an Integrated Physical Activity Program for Physically Inactive Workers: Based on the PRECEDE-PROCEED Model

PURPOSE: We aimed to examine the effects of an integrated physical activity (PA) program developed for physically inactive workers on the theoretical basis of the PRECEDE-PROCEED model. METHODS: Participants were 268 workers in three departments of L manufacturing unit in South Korea. The three departments were randomly allocated into integration (n=86) (INT), education (n=94) (ED), and control (n=88) (CT) groups. The INT group received self-regulation, support, and policy-environmental strategies of a 12-week integrated PA program, the ED group received self-regulation strategies only, and the CT group did not receive any strategies. After 12 weeks, process evaluation was conducted by using the measures of self-regulation (autonomous vs. controlled regulation), autonomy support, and resource availability; impact evaluation by using PA measures of sitting time, PA expenditure, and compliance; and outcome evaluation by using the measures of cardiometabolic/musculoskeletal health and presenteeism. RESULTS: Among process measures, autonomous regulation did not differ by group, but significantly decreased in the CT group (p=.006). Among impact measures, PA compliance significantly increased in the INT group compared to the CT group (p=.003). Among outcome measures, the changes in cardiometabolic/musculoskeletal health and presenteeism did not differ by group; however, systolic blood pressure (p=.012) and a presenteeism variable (p=.041) significantly decreased only in the INT group. CONCLUSION: The integrated PA program may have a significant effect on increases in PA compliance and significant tendencies toward improvements in a part of cardiometabolic health and presenteeism for physically inactive workers. Therefore, occupational health nurses may modify and use it as a workplace PA program.

Health-Promoting Behavior and Quality of Life among Community-Dwelling, Middle-Aged Women: A Comparative Study between Overweight and Normal-Weight Groups

BACKGROUND: Strategically improving health-related quality of life (HRQOL) should be discussed among overweight middle-aged women who are vulnerable to low HRQOL. We examined firstly if overweight middle-aged women would have significantly lower levels of HRQOL and health-promoting behaviors than normal-weight middle-aged women, and to examine secondly if health-promoting behaviors would be significantly associated with generic and obesity-specific HRQOLs within the overweight middle-aged women. METHODS: We conducted a cross-sectional, comparative study. Participants were 119 women aged 30–49 years who were recruited from a community in Seoul, South Korea; 63 women for the overweight group who were recruited from a baseline sample of the Community-Based Heart and Weight Management Trial, while 56 for the normal-weight group who were recruited separetely. Health Promoting Lifestyle Profile II (HPLP II), World Health Organization Quality of Life-brief version (WHOQOL-BREF) of a generic HRQOL measure, and Impact of Weight on Quality of Life-Lite (IWQOL-Lite) of an obesity-specific HRQOL measure were used. RESULTS: Compared to the normal-weight group, the overweight group showed significantly lower scores of total WHOQOL-BREF as well as some HPLP II subscales including stress management (P=0.029). Among the HPLP II subscales, stress management was significantly and positively associated with total WHOQOL-BREF (β=1.58, P=0.003) and self-esteem IWQOL-Lite (β=11.58, P=0.034) among the overweight group. CONCLUSIONS: Among middle-aged overweight women, low levels of health-promoting behavior for stress management were shown, which should be strategically increased for improving their generic and obesity-specific HRQOLs.

Health-Promoting Behavior and Quality of Life among Community-Dwelling, Middle-Aged Women: A Comparative Study between Overweight and Normal-Weight Groups

BACKGROUND@#Strategically improving health-related quality of life (HRQOL) should be discussed among overweight middle-aged women who are vulnerable to low HRQOL. We examined firstly if overweight middle-aged women would have significantly lower levels of HRQOL and health-promoting behaviors than normal-weight middle-aged women, and to examine secondly if health-promoting behaviors would be significantly associated with generic and obesity-specific HRQOLs within the overweight middle-aged women.@*METHODS@#We conducted a cross-sectional, comparative study. Participants were 119 women aged 30–49 years who were recruited from a community in Seoul, South Korea; 63 women for the overweight group who were recruited from a baseline sample of the Community-Based Heart and Weight Management Trial, while 56 for the normal-weight group who were recruited separetely. Health Promoting Lifestyle Profile II (HPLP II), World Health Organization Quality of Life-brief version (WHOQOL-BREF) of a generic HRQOL measure, and Impact of Weight on Quality of Life-Lite (IWQOL-Lite) of an obesity-specific HRQOL measure were used.@*RESULTS@#Compared to the normal-weight group, the overweight group showed significantly lower scores of total WHOQOL-BREF as well as some HPLP II subscales including stress management (P=0.029). Among the HPLP II subscales, stress management was significantly and positively associated with total WHOQOL-BREF (β=1.58, P=0.003) and self-esteem IWQOL-Lite (β=11.58, P=0.034) among the overweight group.@*CONCLUSIONS@#Among middle-aged overweight women, low levels of health-promoting behavior for stress management were shown, which should be strategically increased for improving their generic and obesity-specific HRQOLs.

Effect of an Exergaming on Postprandial Endothelial Dysfunction Following a High Fat Meal in Individuals with Spinal Cord Injury / 대한스포츠의학회지

Endothelial dysfunction induced with a high-fat meal may be attenuated with an exercise in abled bodies individuals. Exergaming may be an exercise type applicable for disabled bodied individuals. We tested the hypothesis that an acute bout of exergaming following a high-fat meal would decrease postprandial lipemia, and endothelial dysfunction among individuals with spinal cord injury. Forty participants (age, 41±8 years; 24 males) were randomly assigned to either an exergaming group (n=20) or control group with seated rest (n=20) following a high-fat meal. Hemodynamic and blood parameters and flow-mediated vasodilation (FMD) as an index of endothelial function were measured at baseline and 4 hours after a high-fat meal. In half an hour following a high-fat meal, the exergaming group performed 50 minutes of moderate intensity active video games (Nintendo Wii Sports: boxing, tennis). Levels of blood triglycerides increased in both group (p<0.05) following high-fat meal. FMD significantly decreased in the control group (10.4%±4.9% to 7.9%±4.4%) but significantly increased in the exergaming group (10.9%±5.3% to 12.3%±5.3%), with a significant interaction (p=0.004). These results show that a high-fat meal causes endothelial dysfunction in persons with spinal cord injury, but endothelial dysfunction following a high-fat meal was attenuated by an acute bout of exergaming regardless of postprandial lipemia. Therefore, exergaming for individuals with spinal cord injury may have a cardioprotective effect from postprandial endothelial dysfunction induced with an exposure of a high-fat meal.

Childhood Obesity and Cardiovascular Health: Using 2010-2012 Data of the Korea National Health and Nutrition Examination Survey

BACKGROUND: Abdominal obesity as measured by waist-to-height ratio (WHtR) may have stronger and inverse associations with cardiovascular (CV) health than overall obesity as measured by body mass index (BMI). However, there was some challenges for controversies. We aimed to examine the associations of WHtR and BMI with CV health among Korean children using data of the 2010-2012 Korea National Health and Nutrition Examination Survey. METHODS: A cross-sectional study was conducted with the sample of 2,363 children by analyzing by gender and two-age groups (10-12 and 13-18 years). Overall obesity was categorized into 3 groups by BMI percentile: non-overweight (<85), overweight (≥85), and obesity groups (≥95). Abdominal obesity was categorized into 2 groups by WHtR: normal (<0.5) and abdominal obesity groups (≥0.5). The CV health score was defined as a z-score by calculating the sum of 7 CV factors. RESULTS: The overweight/obesity groups had significantly lower CV health scores than the normal group (P<0.05) in boys and girls aged either 10-12 years or 13-18 years after adjusting for covariates. The abdominal obesity group also showed significantly lower CV health scores than the normal group (P<0.05) in all the groups; this significant association remained significant in boys aged 13-18 years even after further adjusting for BMI category (P<0.01). CONCLUSIONS: Among boys aged 13-18 years, abdominal obesity as measured by WHtR was significantly and inversely associated with CV health, independent of BMI category. Therefore, it should be considered to assess the level of abdominal obesity as a measure of CV health in late adolescent boys.

Comparison of Physical Activity and Health-related Quality of Life in Adolescents with and without Congenital Heart Disease: A Propensity Matched Comparison / 대한스포츠의학회지

Physical activity and health-related quality of life (HRQOL) are associated with overall health outcomes in adolescents with congenital heart disease (CHD). The purpose of this study was to compare the levels of physical activity and HRQOL in adolescents with CHD and healthy controls. In addition, we compared these variables using a propensity score matching to reduce the confounding effects. Participants were divided into three groups with simple CHD (n=55), complex CHD (n=173), and healthy controls (n=181). Self-reported physical activity levels (metabolic equivalent of task [MET]-hr/wk) were obtained using the Global Physical Activity Questionnaire. HRQOL was evaluated using the Pediatric Quality of Life Inventory questionnaire. Total scores of HRQOL in adolescents with complex CHD were significantly lower than those with simple CHD (p=0.022) and healthy controls (p<0.001), respectively; however, there was no significant difference in total scores of HRQOL between adolescents with simple CHD and healthy controls. Levels of physical activity in adolescents with complex CHD were significantly lower than those with simple CHD (p=0.001) and healthy controls (p<0.001). After propensity matched analysis (44 pairs), the results were consistent with the above results. In conclusion, HRQOL scores and physical activity levels are significantly lower in adolescents with complex CHD, but not in adolescents with simple CHD, than in healthy adolescents.

Health Behaviors and Health-related Quality of Life among Vulnerable Children in a Community

PURPOSE: The purpose of this study was to examine the association between health behaviors and health-related quality of life (HRQOL) among vulnerable children in a community. METHODS: Using data from 'The Obesity Prevention Framework for Vulnerable Children', a secondary analysis was conducted for 165 children (ages 8~12 years) and their parents who were recruited from 16 K-gu Community Child Centers in Seoul. Six types of health behaviors related to eating and activity were assessed. Each behavior was categorized into the non-recommended vs. recommended levels. The scores of the recommended levels of the six health behaviors were summed up for the composite score of health behaviors. HRQOL was measured by KIDSCREEN-52. RESULTS: The groups with a non-recommended level of fast food intake and sedentary behavior had a significantly lower total score of KIDSCREEN-52 than those with a recommended level. Moreover, the lower composite score of health behaviors was significantly associated with the lower total score of KIDSCREEN-52. CONCLUSION: Among the vulnerable children, the six recommended health behaviors and their composite score were in significant positive associations with the HRQOL levels. Therefore, nursing strategies for enhancing the recommended levels of health behaviors are needed for vulnerable children.