Development of Nutritional Biochemistry Learning Goals and Core Competencies in the Dental Hygiene Curriculum / 치위생과학회지

Background@#In the dental hygiene curriculum, efforts are being made to introduce an integrated curriculum based on the competency of a dental hygienist. Because there is a connection and overlap in learning contents between Dental Nutrition and Oral Biochemistry, which are basic dental hygiene subjects, it is possible to integrate these two subjects. This study aims to derive Nutritional Biochemistry as an integrated curriculum for Dental Nutrition and Oral Biochemistry, and to develop learning goals and competencies for Dental Nutritional Biochemistry. @*Methods@#The learning contents of the integrated curriculum were composed by referring to the contents of the Dental Nutrition and Oral Biochemistry textbooks, and learning goals were derived from the learning contents. Moreover, competency was developed by analyzing the duties of a dental hygienist that can be performed through the learning goals. The Delphi survey was conducted twice to verify the content validity ratio (CVR) of the competence and the learning goal of the integrated curriculum. @*Results@#In the first Delphi survey, the CVR for two competencies was 0.56 or higher. Moreover, it was revised based on expert’s opinions, and as a result of the second Delphi survey after the revision, the CVR was either increased or maintained. Eighty-five learning goals were derived by referring to the textbook. According to CVR and expert opinions, after the first Delphi survey, the number of learning goals was reduced to 69. After the second Delphi survey, 68 learning goals were finally derived. @*Conclusion@#The development process of the integrated curriculum conducted in this study can be utilized for integration between subjects in basic dental hygiene.

The financial estimate of dental implant treatment about the National Health Insurance coverage for the Korean young adults / 대한구강보건학회지

Objectives@#The purpose of this study is to review the condition of young adults’ teeth loss and dental prostheses and obtain the financial estimate which was needed for National Health Insurance Coverage for Korean young adults’ dental implant treatment. @*Methods@#This study analyzed young adults between 20 years and 29 years old using the data from the 7th Korea National Health and Nutrition Examination Survey. The KNHANES data were used to generate indicators related to teeth loss and dental prostheses. In addition, this study estimated the financial data of dental implants for young adults by using the number of population covered by National Health Insurance, the number of dental implants insurance fee, and the number of dental teeth loss per person. @*Results@#Korean young adults have 20.4% of tooth loss holders and 2.1% of them require a tooth extraction. Also, dental implant holders were 2.3%. The estimated finance of dental implant treatment for the Korean young adults was confirmed from a minimum of 55.9 billion to a maximum of 233.0 billion. @*Conclusions@#In order to prevent early deterioration of oral health due to teeth loss held by young adults, attention is needed to the National health insurance coverage of implant for young adults.

A study on Korean workers’ practice of brushing teeth after lunch / 대한구강보건학회지

Objectives@#The purpose of this study was to investigate Korean workers’ practice of brushing teeth after lunch, and to provide basic data for the formulation of oral health promotion policies for the Korean workers. @*Methods@#We performed a cross-sectional study using the data from the Sixth (2013-2015) Korea National Health and Nutrition Examination Survey (KNHANES, VI-1,2,3). The variables included oral health behavior (i.e., tooth brushing after lunch), demographic factors, and socioeconomic factors. The study analyzed 8,800 workers from Korea. Complex samples were analyzed through chi-square analysis and logistic regression. @*Results@#The rate of practice of brushing teeth after lunch among Korean workers was 51.6%. Among managers, experts, and office workers, it was the highest at 66.4%, while simple laborers had the lowest rate of 23.6%. The odds ratio of not brushing teeth after lunch was 3.0 times higher among agriculture, fishery workers, and simple laborers than that of managers, experts, and office workers. In addition, the odds ratios of the habit in day laborers were 3.1 times higher than in the commercial workers. All variables were statistically significant. @*Conclusions@#Poor working conditions contribute to reduced practice of brushing teeth after lunch. Therefore, a modified working environment for workers, such as day laborers and simple laborers, is required to improve their oral health behavior. In addition, it is necessary to prepare oral health promotion programs that take into account the occupational characteristics of workers.

Using a Mobile-based Nutritional Intervention Application Improves Glycemic Control but Reduces the Intake of Some Nutrients in Patients with Gestational Diabetes Mellitus: A Case Series Study

Nutrition Care in Gestational Diabetes Mellitus / 임상당뇨병

Maintaining blood glucose levels within recommended targets during pregnancy is associated with improved maternal and fetal outcomes. Optimal gestational nutrition care is required for maintenance of normoglycemia, appropriate gestational weight gain and prevention of ketosis. Energy intake is not different from pregnant women without diabetes and an optimal eating plan for gestational diabetes has not been not developed. Because carbohydrates affect blood glucose levels, especially postprandial levels, it is important to monitor the quantity and quality of carbohydrate intake in women with gestational diabetes. Macronutrient and micronutrient planning must be considered. After childbirth, postpartum care is important to women with gestational diabetes mellitus. To decrease the risk of type 2 diabetes, metabolic syndrome and hypertension, weight control and breastfeeding is recommended to women with gestational diabetes mellitus.

A Study on the Number of Brushing Strokes in Toothbrushing Education / 치위생과학회지

The purpose of this study was to focus on the number of brushing strokes among the performance factors and identify if the 10 times stroke of the rolling method is rational. Moreover, we evaluated the changes in oral health knowledge, perception, and behavior after our rolling method instruction. The 10-stroke method of toothbrushing has been regarded as an effective method of removal of dental plaque, although there is little evidence to support this claim. We allocated 40 healthy subjects to two intervention groups. During five visits, we measured a score for dental plaque removal and instructed the subjects on a toothbrushing technique with 5 or 10 strokes per section. At the initial and final visits, subjects completed a questionnaire on one designed specifically for this study about oral health knowledge, perceptions, and behaviors. Repeated measures analysis of variance was used to compare the dental plaque removal score between the groups, and the changes in scores within each group over time. We also compared changes in mean scores in oral health knowledge, perceptions and behaviors before and after toothbrushing instruction. We found that the score for dental plaque removal increased with each additional toothbrushing instruction in both groups (p < 0.001). However, we found no differences in the dental plaque removal scores between the 5-stroke and 10-stroke groups (p=0.399). The levels of oral health knowledge, perceptions and behaviors increased after the toothbrushing instructions in both groups. Our findings suggest that there is no advantage in emphasizing the 10-stroke method of toothbrushing in an oral health education program.

Qualitative Research on Communication Education of Dental Hygienist by Focus Group Interview / 치위생과학회지

The purpose of this study to review clinicians and educators on required communication education factors of dental hygienists using qualitative research by focus group interview. The participants were dentists, dental hygienists and professors. A questionnaire was developed on communication education to collect data. The collated data derived concepts related to communication education. After transferring the data, were analyzed by open coding and axial coding using computer-aided qualitative data analysis software. Focus group emphasized that higher education on communication should be preceded before they are put into the clinical field. However, the dental hygienist emphasized experiential education in the clinical field, the professor emphasized additional education for continuity of communication education even after graduation. Besides, focus group emphasized role play, and the professor required that the standardization of the dental communication training courses objectives and role play modules and the education environment infrastructure should be established to implement communication education efficiently. The categories of communication education stated in the focus group were time and method for the dental communication training courses, dental communication training courses standardization and educational environment, of evaluation of communication competency, of perception of the dental communication training courses. This study identified the communication education development to conform with the needs of the clinical field strengthen and cultivate communication competency dental hygienists based on factors of communication education emphasized in focus groups.

Chromosomal Microarray With Clinical Diagnostic Utility in Children With Developmental Delay or Intellectual Disability

BACKGROUND: Chromosomal microarray (CMA) testing is a first-tier test for patients with developmental delay, autism, or congenital anomalies. It increases diagnostic yield for patients with developmental delay or intellectual disability. In some countries, including Korea, CMA testing is not yet implemented in clinical practice. We assessed the diagnostic utility of CMA testing in a large cohort of patients with developmental delay or intellectual disability in Korea. METHODS: We conducted a genome-wide microarray analysis of 649 consecutive patients with developmental delay or intellectual disability at the Seoul National University Children's Hospital. Medical records were reviewed retrospectively. Pathogenicity of detected copy number variations (CNVs) was evaluated by referencing previous reports or parental testing using FISH or quantitative PCR. RESULTS: We found 110 patients to have pathogenic CNVs, which included 100 deletions and 31 duplications of 270 kb to 30 Mb. The diagnostic yield was 16.9%, demonstrating the diagnostic utility of CMA testing in clinic. Parental testing was performed in 66 patients, 86.4% of which carried de novo CNVs. In eight patients, pathogenic CNVs were inherited from healthy parents with a balanced translocation, and genetic counseling was provided to these families. We verified five rarely reported deletions on 2p21p16.3, 3p21.31, 10p11.22, 14q24.2, and 21q22.13. CONCLUSIONS: This study demonstrated the clinical utility of CMA testing in the genetic diagnosis of patients with developmental delay or intellectual disability. CMA testing should be included as a clinical diagnostic test for all children with developmental delay or intellectual disability.

The relationship between pit and fissure sealant (PFS) experience and the socio-economic factors of adolescents before and after coverage by National Health Insurance (NHI) / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to review the relationship between pit and fissure sealant (PFS) experience and the socio-economic factors of adolescents before and after coverage by National Health Insurance (NHI). METHODS: Our sources were the Korea Youth Risk Behavior Web-based Surveys from 2008 and 2014. The variables used were PFS experience, demographic factors, socio-economic factors, and oral health-related behaviors. RESULTS: PFS experience was higher in 2014 than in 2008. The relationship between PFS experience and socio-economic factors was significant in both 2008 and 2014. Although the inequity of PFS experience among adolescents was reduced as PFS was included in NHI coverage, a disparity still exists. CONCLUSIONS: Even after NHI coverage included PFS, the policies to reduce the inequity of PFS experiences among adolescents should be further devised. In addition, a longitudinal study is recommended to determine the relationship between PFS experience and various socio-economic or behavioral factors.

Development of Hospital Nurses' Job Description based on DACUM Method: Focusing on General Ward and Intensive Care Unit / 간호행정학회지

PURPOSE: This study was done to clarify nurses' duties, tasks and task elements and to develop a job description for clinical nurses on general and intensive care units in tertiary-level hospitals, and dramatically reflect changing medical trends in Korea. METHODS: The job description was developed based on the Developing a Curriculum Method (DACUM). The questionnaire included frequency, importance, and difficulty of duties, tasks and task elements, measured on a 4-point scale. Results were analyzed using SPSS version 21.0. Data were collected from September 4 to 7, 2017, and analyzed using descriptive statistics and a scattered graph. RESULTS: The job description consisted of 10 duties, 38 tasks, and 51 elements. Of the 10 duties, the highest duty in order of importance was ‘Direct nursing care’ followed by ‘Infection control’. The highest duties according to frequency and difficulty were ‘Document and notify’ and ‘Research and quality improvement’. ‘Safety management’ and ‘Infection control’ were considered as relatively simple duties, however, these two duties were still included as important jobs for clinical nurses. CONCLUSION: The job descriptions for clinical nurses developed from this study contain nursing ethics and safety as well as infection control, to faithfully reflect clinical nurses' jobs.

A Case Study on the Validity of Dental Communication Curriculum of a Dental Hygiene Department / 치위생과학회지

The purpose of this study was to examine the validity of the content of an educational curriculum by understanding the opinions of experts in the development of weekly educational content for dental communication or communication-related subjects. It was composed of educational content on how to communicate with patients by cultivating a professional attitude through basic contents and a self-understanding of communication. Three experts were asked to evaluate the feasibility of educational contents and their appropriateness in order to evaluate the criteria for certification as a dental hygienist. The validity of the weekly educational contents and the period of education were awarded 4 points out of a maximum of 5 points; overall, the curriculum was evaluated to be valid and to be acceptable for use as criteria for certification evaluation. On the other hand, it was confirmed that not only should the contents be made appropriate for the grade level, but it should be complemented so that theoretical and practical learning can be achieved in a gradual and interrelated manner rather than as a one-time curriculum. Therefore, the result of this study can be considered for use as background data for curriculum development, and for standardization of the communication course in the dental hygiene department.

Comparison of supplied amount of pit and fissure sealing on the first permanent molars by age and disparity of dental accessibility using National Health Insurance data / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to review the supplied amount of pit and fissure sealing (PFS) by age and dental accessibility of children after PFS was included in the list of treatments covered by National Health Insurance (NHI). METHODS: The comparison period was selected by considering the availability of data and the initiated time of PFS inclusion into NHI. The selected data period after inclusion was 2010-2012. Data were collected from the NHI database. To categorize the areas by high and low dental accessibility, the number of dental institutions was standardized by population per width of area. RESULTS: Supplied amount of PFS to the first permanent molars in children aged 6 to 8 years constituted to about 70% of the total supplied amount during 2010-2012. However, this supplied amount was less than 8% of the total number of the first permanent molars in that age group. Number of supplied PFS for ages 6 to 8 years was 8.4% and 6.3% of the total number of first permanent molars for high and low dental accessibility areas, respectively. CONCLUSIONS: Although PFS supply was increased after inclusion in NHI coverage, it is still insufficient to reduce the decayed-missing-filled teeth (DMFT) index effectively. To increase the supplied amount of PFS and to reduce inequality of supply between areas of high and low dental accessibility, strengthening of and focus on education related to PFS, reduced out-of-pocket expenditure, and advocacy are needed for appropriate target age groups and areas.

Core nursing practice and educational requirements according to nursing unit and clinical career in tertiary hospital / 기본간호학회지

PURPOSE: The purpose of this study was to provide fundamental data to develop an educational program for the development of nurses' core competences, and to improve the curriculum in nursing education institutions. METHODS: This study, based on a descriptive survey, was conducted with 1,019 nurses working in a tertiary hospital in Seoul. Among 47 core nursing practice items, core nursing practices as perceived by the participants and relevant educational requirements were measured on a four-point scale. The collected data were analyzed using descriptive statistics for the mean and standard deviation, one way ANOVA, and Duncan test as post-hoc test. RESULTS: Regarding the core nursing practice perceived as by the nurses, there were statistically significant differences in 43 out of 47 items according to nursing unit, and in 15 items according to clinical career. Regarding the educational requirements for core nursing practice, there were also statistically significant difference for the same items as perception differences according to nursing unit and clinical career. CONCLUSION: The results of this study suggest further study on the development of educational programs to advance the clinical expertise of nurses and for the development of curriculum reflecting the actual conditions and requirements in clinical nursing practice fields.

Changes in the amount of pit and fissure sealants supplied in Korea after inclusion in the National Health Insurance coverage / 대한구강보건학회지

OBJECTIVES: The purposes of this study were to review changes in the amount of pit and fissure sealant (PFS) provided after the inclusion of PFS in treatments covered by the National Health Insurance (NHI) and to assess differences in the supplied amount between geographical areas where accessibility to dental care differs. METHODS: The years for comparison were selected based on data availability and the time of inclusion of PFS into NHI coverage. The selected pre-inclusion year was 2008, and the post-inclusion year was 2012. Data regarding the amount of PFS supplied were collected from the oral health program, NHI, and Medical care. To dichotomize areas by high and low dental care accessibility, we standardized the population size, number of dental institutions, and number of dentists in each group. RESULTS: We considered metropolitan areas and Gyeonggi Province as high dental care accessibility areas, while other provinces were considered as low dental care accessibility areas. Regardless of the transforming constant, the amount of PFS supplied increased in high dental care accessibility areas and decreased in low dental care accessibility areas after inclusion of PFS in NHI. CONCLUSIONS: To increase the amount of PFS provided in low dental care accessibility areas, promotion of PFS should be strengthened and support from oral health programs should be increased. Additionally, waiving out-of-pocket money for PFS in NHI should be considered to remove barriers of supply.

A case of isodicentric chromosome 15 presented with epilepsy and developmental delay / 소아과

We report a case of isodicentric chromosome 15 (idic(15) chromosome), the presence of which resulted in uncontrolled seizures, including epileptic spasms, tonic seizures, and global developmental delay. A 10-month-old female infant was referred to our pediatric neurology clinic because of uncontrolled seizures and global developmental delay. She had generalized tonic-clonic seizures since 7 months of age. At referral, she could not control her head and presented with generalized hypotonia. Her brain magnetic resonance imaging scans and metabolic evaluation results were normal. Routine karyotyping indicated the presence of a supernumerary marker chromosome of unknown origin (47, XX +mar). An array-comparative genomic hybridization (CGH) analysis revealed amplification from 15q11.1 to 15q13.1. Subsequent fluorescence in situ hybridization analysis confirmed a idic(15) chromosome. Array-CGH analysis has the advantage in determining the unknown origin of a supernumerary marker chromosome, and could be a useful method for the genetic diagnosis of epilepsy syndromes associated with various chromosomal aberrations.

Food Nutrition Information, Where Can We Get Sources of Nutrition Information in Food? / 임상당뇨병

The prevalences of many chronic diseases (obesity, diabetes mellitus, hypertension, stroke, etc.) are increasing in worldwide, and the association between chronic diseases and dietary habit has been established. Many people are thus concerned with dietary habits and nutrition information. In order to prevent and treat chronic disease, it is necessary to provide proper nutrition information for foods, including data on balanced diets, adequate intake amounts and food choice. I will review the available materials (books, web-sites, smart phone applications, nutrition information labeling) containing nutrition information for foods.

Effect on Glycemic, Blood Pressure, and Lipid Control according to Education Types

BACKGROUND: Diabetes self-management education and reinforcement are important for effective management of the disease. We investigated the effectiveness of interactive small-group education on glycemic, blood pressure, and lipid levels. METHODS: For this study, 207 type 2 diabetes patients with suboptimal glycemic control (HbA1c levels >6.5%) were enrolled. The conventional education group received an existing education program from April to November in 2006, and the interactive education group received a new small-group education program from December 2006 to July 2007. The two groups were comparatively analyzed for changes in blood sugar, glycated hemoglobin, lipid, and blood pressure at baseline, 3, 6, and 12 months and the proportion of patients achieving target goals at 12 months. RESULTS: After 12 months of follow-up, HbA1c levels in the interactive education group were significantly lower than in the conventional education group (6.7% vs. 6.4%, P<0.001). Fasting and 2 hour postprandial glucose concentrations, total cholesterol, and low density lipoprotein cholesterol were significantly lower in the interactive education group than in the conventional education group. The proportion of patients that achieved target goals was significantly higher in the interactive education group. CONCLUSION: The small-group educational method improved and re-established the existing group educational method. This finding suggests that the importance of education appears to be related to the method by which it is received rather than the education itself. Thus, the use of small-group educational methods to supplement existing educational methods established for diverse age levels should be considered in the future.

The Study on the Serum Levels of Resistin, Adiponectin, and Leptin in Obese Children

Resistin, adiponectin, and leptin are hormones secreted by adipose tissue and are known to play an important role in adipose tissue metabolism. The purpose of this study was to evaluate the levels of adipocyte-derived hormones (resistin, adiponectin, leptin) in obese children aged 10-12 years. The subjects were 102 obese children with obesity index (OI) over 120% and 51 control children with obesity index less than 120% were included for comparison. Anthropometric variables and serological parameters were assessed. Height, weight, OI, body mass index (BMI) were significantly higher in obese group than in control. Obese children showed significantly higher serum concentrations of triglyceride (TG), total cholesterol (TC), and LDL-cholesterol and significantly lower HDL-cholesterol compared with control children, even though the values were within normal ranges for both groups. Concentrations of resistin and leptin were significantly higher in obese group than in control. Adiponectin and insulin levels were tended to lower in obese group even though the differences were not statistically significant. Resistin had significant positive correlation with OI and TG, and leptin with weight, OI, BMI, TG and TC. On the other hand, adiponectin showed significant negative correlations with height, OI and BMI. These finding showed that obese children had higher serum levels of resistin and leptin and lower adiponectin, and also these hormones had correlations with related factors of obesity, suggesting adipocyte-derived hormones has a role in child obesity.

A Case of Paratesticular Liposarcoma / 대한비뇨기과학회지

We report a rare case of well differentiated paratesticular liposarcoma in a 72-year -old male. His chief complaint was left painless scrotal mass for about three years. The mass was composed of hard, soft, and rubbery components and its size was 20x5x5 cm in dimension. Scrotal ultrasonography showed huge highly echogenic multilobulated mass with some calcification and CT scan excluded the presence of nodal involvement. Left radical orchiectomy was performed as treatment and the patient has survived 24 months without evidence of recurrence. Paratesticular liposarcoma is very rare and most of them are low-grade malignancies and treatment is radical orchiectomy with wide local excision.

Prospective Clinical Study for Asymptomatic Urinary Retention in Post-partum Period / 대한비뇨기과학회지

PURPOSE: Asymptomatic urinary retention in the post-partum period is a relatively common problem. We investigated prospectively the incidence and the various risk factors associated with asymptomatic urinary retention in post-partum. MATERIALS AND METHODS: From Feb. 1999 to Apr. 1999, all pregnant women who visited our hospital for delivery were evaluated. Among them 103 women who had undergone vaginal delivery were evaluated, Exclusion criteria were cesarean section, incidental catheter indwelling during delivery, and symptomatic urinary retention. Residual urine volume was measured using BladderScanTM BVI 2500(Diagnostic Ultrasound co.) within 10 minutes after first voiding in immediate post-partum period. Asymptomatic urinary retention was defined as residual urine volume over 150ml. Pre-partal urinary symptoms and various obstetric parameters were evaluated in asymptomatic urinary retention group and normal group as control. Asymptomatic urinary retention group were followed up daily to monitor their post-void residual urine volume. RESULTS: The incidence of asymptomatic urinary retention after vaginal delivery was 13.6%. Factors associated with asymptomatic urinary retention included second stage of labor, episiotomy, and instrumental delivery. There was no relationship between pre-partal lower urinary tract symptoms and post-partal asymptomatic urinary retention. In patients with asymptomatic urinary retention, catheterization was done for removing residual urine and thus preventing progression of further distension. Post-void residual volume was normalized within 3 days in all patients. CONCLUSIONS: Asymptomatic post-partum urinary retention is a self-limiting phenomenon associated with various traumatic events during hard labor such as prolonged labor, episiotomy, instrumental delivery. Close observation of voiding patterns in patients with risk factors is needed to prevent myogenic failure associated with unrecognized asymptomatic post-partum urinary retention.