• Research in Community and Public Health Nursing
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• v.32 no.3
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• pp.404-414
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• 2021

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.

• Journal of Preventive Medicine and Public Health
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• v.54 no.4
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• pp.238-244
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• 2021

Objectives: Previous pandemics have demonstrated that several demographic, geographic, and socioeconomic factors may play a role in increased infection risk. During this current coronavirus disease 2019 (COVID-19) pandemic, our aim was to examine the association of timing of lockdown at the county level and aforementioned risk factors with daily case rate (DCR) in the United States. Methods: A cross-sectional study using publicly available data was performed including Americans with COVID-19 infection as of May 24, 2020. The United States counties with >100 000 population and >50 cases per 100 000 people were included. The independent variable was the days required from the declaration of lockdown to reach the target case rate (50/100 000 cases) while the dependent (outcome) variable was the DCR per 100 000 on the day of statistical calculation (May 24, 2020) after adjusting for multiple confounding socio-demographic, geographic, and health-related factors. Each independent factor was correlated with outcome variables and assessed for collinearity with each other. Subsequently, all factors with significant association to the outcome variable were included in multiple linear regression models using stepwise method. Models with best R² value from the multiple regression were chosen. Results: The timing of mandated lockdown order had the most significant association on the DCR per 100 000 after adjusting for multiple socio-demographic, geographic and health-related factors. Additional factors with significant association with increased DCR include rate of uninsured and unemployment. Conclusions: The timing of lockdown order was significantly associated with the spread of COVID-19 at the county level in the United States.

• Neurospine
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• v.15 no.4
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• pp.348-352
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• 2018

Objective: Postoperative dynamic cryo-compression (DC) therapy has been proposed as a method of reducing pain and the inflammatory response in the early postoperative period after orthopedic joint reconstruction surgery. Our aim was to analyze the analgesic efficacy of DC therapy after adult lumbar spinal surgery. Methods: DC was applied for 30 minutes every 6 hours after surgery. Pain was measured by a visual analogue scale (VAS) in the preoperative period, immediately after surgery, and every 6 hours postoperatively for the first 72 hours of the hospital stay. Patients' pain medication requirements were monitored using the patient-controlled analgesia system and patient charts. Twenty patients who received DC therapy were compared to 20 historical controls who were matched for demographic and surgical variables. Results: In the postanesthesia care unit, the mean VAS back pain score was $5.87{\pm}0.9$ in the DC group and $6.95{\pm}1.0$ (p=0.001) in the control group. The corresponding mean VAS scores for the DC vs. control groups were $3.8{\pm}1.1$ vs. $5.4{\pm}0.7$ (p < 0.001) at 6 hours postoperatively, and $2.7{\pm}0.7$ vs. $6.25{\pm}0.9$ (p<0.001) at discharge, respectively. The cumulative mean analgesic consumption of paracetamol, tenoxicam, and tramadol in the DC group vs. control group was $3,733.3{\pm}562.7mg$ vs. $4,633.3{\pm}693.5mg$ (p<0.005), $53.3{\pm}19.5mg$ vs. $85.3{\pm}33.4mg$ (p<0.005), and $63.3{\pm}83.4mg$ vs. $393.3{\pm}79.9mg$ (p<0.0001), respectively. Conclusion: The results of this study demonstrated a positive association between the use of DC therapy and accelerated improvement in patients during early rehabilitation after adult spine surgery compared to patients who were treated with painkillers only.

• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.364-369
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• 2018

Background: Compared with other chronic diseases, hearing loss is generally overlooked from the perspective of disease burden. However, hearing loss is emerging as an important issue in the current society. The objective of this study was to investigate disease burdens and marginal utilities associated with hearing loss and other chronic diseases. Methods: This study analyzed the cross-sectional data of 32,986 participants aged 19 years and older who completed the Korea National Health and Nutrition Examination Surveys between 2009 and 2013. Additionally, this study used the pure tone audiometric test, European Quality of Life-Five Dimensions Questionnaire, and chronic disease status. The data were analyzed using a multiple linear regression method. Results: The data of 23,297 people who underwent a pure tone audiogram and completed the European Quality of Life-Five Dimensions Questionnaire were used in this analysis. The marginal utility of hearing loss ranked fifth among nine chronic diseases. The estimated loss of quality-adjusted life years associated with hearing loss was -93.69 years per 100,000 people, which is similar to other chronic diseases. Conclusion: This study assessed the marginal utilities and public burdens of hearing loss and eight chronic diseases in a South Korean population. Although the values may vary depending on country and race, this study may provide an indispensable foundation for more detailed studies on hearing loss.

• Korean Journal of Family Medicine
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• v.39 no.6
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• pp.355-359
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• 2018

Background: Body image is associated with the perception of people on themselves. Influencing factors are generated internally and/or externally. The most common issue pertaining to body image is body weight and weight loss. This study aimed to determine the association between body weight perception and weight loss practices among college students. Methods: A cross-sectional study was conducted involving 297 college students from private nursing colleges in the state of Kelantan, Malaysia. A self-administered questionnaire was used to assess sociodemographic characteristics, body weight perception, and weight loss methods. Weight and height were measured, and body mass index (BMI) was calculated based on weight and height measurement. The World Health Organization BMI cutoffs were applied in the study. Results: More than half (54.2%) of college students perceived their weight correctly as per actual measured BMI. A total of 51.5% of participants had tried various methods to reduce their weight. Body weight perception is associated with weight loss practices (odds ratio, 0.31; 95% confidence interval, 0.19-0.50; P<0.001) adjusted for sex, marital status, and status of having obese family members. Those who had correct body weight perception were less likely to engage in weight loss practice. Food intake restriction (42.4%) is the most popular weight reduction method among students in nursing colleges. Over a quarter of the participants chose physical exercise (25.3%) to reduce their weight, and a small number engaged in unhealthy weight loss practices. Conclusion: Body weight perception is an important factor that influences the practice to reduce weight especially among young adult group and college students.

• Journal of the Korean Dietetic Association
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• v.25 no.2
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• pp.142-155
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• 2019

The aim of this study was to construct and test a structural equation model for the risk factors of metabolic syndrome in Korean adults. The structural equation model hypothesizes that eating alone and feeling depressed is a risk factor for metabolic syndrome. The data of this study were obtained from the Sixth Korea National Health and Nutrition Examination Survey which was cross-sectional data from the representative national survey. A total of 4,013 subjects replied to the survey item of lifestyle and completed the physical examinations among adults aged 19 years or older in South Korea was in 2015. The structural model in this study was composed of four latent variables: eating alone, depression, negative health behavior, and metabolic syndrome. Two variables, the rate of eating alone and depression, were exogenous variables. Negative health behavior was both a mediating variable and endogenous variable, and metabolic syndrome was the final endogenous variable. The data were analyzed using the Maximum Likelihood method and bootstrapping. The structural model was appropriate for the data based on the model fit indices. The results of this study can be summarized as follows: Eating alone is a direct risk factor of metabolic syndrome in Korean women. Depression can mediate metabolic syndrome through negative health behaviors. Negative health behavior had a direct impact on metabolic syndrome in both men and women. This study may be a guideline for interventions and strategies to reduce the incidence of metabolic syndrome in Korean adults.

• Journal of the Korean Society of School Health
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• v.32 no.2
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• pp.67-76
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• 2019

Purpose: The purpose of this study was to explore self-directed learning ability and its affecting factors among undergraduate students. Methods: A descriptive cross-sectional study design was used. Using a convenience sampling method, data were collected from 196 undergraduate students enrolled in one national university. Negative psychological tendency (i.e. Type D personality), academic engagement, and self-directed learning ability were assessed using a structured questionnaire. Data were analyzed by descriptive statistics, t-test, and analysis of covariance, Pearson's correlation coefficients, and stepwise multiple linear regression, using SPSS/WIN 23.0 program. Results: The mean age of the students was $21.61{\pm}2.40years$ and 56.6% were male students. Approximately, one third (n=67, 34.2%) of the students had Type D personality. The average scores of academic engagement and self-directed learning ability were $3.01{\pm}1.14$ and $3.46{\pm}0.50$, respectively. After controlling for sociodemographic variables, the Type D personality and academic engagement were significant predictors of self-directed learning ability (${\beta}=.64$, p<.001; ${\beta}=-.13$, p=.021, respectively). This model explained 53.6% of the variance in self-directed learning ability. Conclusion: The study identified that Type D personality and academic engagement affect self-directed learning ability of undergraduate students, one in a negative way, the other in a positive way. Educators and educational policy makers need to make efforts to include interventions and strategies that increase academic engagement and change negative psychological dispositions such as D-type personality in the undergraduate education curriculum.

• Physical Therapy Rehabilitation Science
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• v.8 no.2
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• pp.61-66
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• 2019

Objective: The purpose of this study was to investigate the effects of resistance applied in various directions on lower extremity muscle activity and balance during squat exercise performance. Design: Cross-sectional study. Methods: Forty-one adults (19 males and 22 females) agreed to the study purpose and procedures. All subjects randomly performed squat exercises with an intensity of overcoming 10% of body weight resistance pulled forward, backward and general squats with $60^{\circ}$ of knee joint flexion. Electromyography was used to measure muscle activity of the vastus medialis oblique (VMO), rectus femoris (RF), vastus lateralis oblique (VLO), biceps femoris (BF), and semitendinosus (ST) muscles. The Wii Balance Board was used to assess balance during the three-method squat operation. Each operation was measured three times for 10 seconds. Results: There were significant differences in muscle activities of the VMO, RF, VLO, ST and balance ability with the application of three directions of resistance (p<0.05). Post hoc comparisons revealed that squats performed with resistance pulled in the backward direction resulted in higher VMO, RF and VLO activity than with the resistance placed in a pulled forward direction (p<0.05). In the ST, resistance applied in the pulled forward direction showed greater muscle activity compared to the pulled backward direction (p<0.05). With balance, squats performed with resistance pulled in the forward direction showed greater muscle activity than with resistance applied in the pulled backward direction and during general squat performance (p<0.05). Conclusions: In this study, squat exercises performed with resistance applied in the direction of pulling backwards was found to be the most effective in improving quadriceps muscle strength and balance. It is effective to provide resistance that is placed in the forward when it is difficult to perform a general squat due to weakness of the quadriceps.

• Journal of Pharmacopuncture
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• v.22 no.3
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• pp.131-139
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• 2019

Introduction: Mastalgia is the most common benign breast disorder during the fertility period of women. So far a wide range of natural or complementary medicines is used to cure mastalgia. Sanitary organizations need complete and suitable details to help women, for making the proper decision for alternative treatment based on the evidence. The aim of the present study is to introduce medicinal plant-based treatments about mastalgia and summarizes clinical trials about this disorder. Method: The articles were provided using mixture of keywords including cyclic pain, breast, treatment, therapeutics, therapy, clinical trial, herbal, drug, mastalgia and all the probable terms, in national and international databases SID, Iran Medex, Magiran, PubMed, Scopus, Medline, Science direct and Cochrane library, in both Persian and English languages. All cross-sectional and review articles about herbal treatment of mastalgia until 2018 November were studied. Results: Nineteen articles from all of the available articles (45 cases) and a sample size about of (1987 cases) were included in our study. The articles were clinical trials. The results revealed that mastalgia could be healed by Nigella sativa, Vitex agnus-castus, curcumin, Hypericum perforatum, Citrus sinensis, wheat germ, and Ginkgo biloba. Conclusion: Most of the evaluated medicinal plants possessing antioxidant compounds with anti-inflammatory and analgesic properties, exhibited healing effects in the treatment of mastalgia. Thus, medicinal plants can be considered in the treatment of mastalgia; however, further investigations are needed to obtain more details about their probable side effects.

• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.51-59
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• 2019

Objectives: The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated. Methods: Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables. Results: The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model. Conclusions: The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.