김경애, et al. J Korean Acad Nurs. 2019 Apr;49(2):113-125. https://doi.org/10.4040/jkan.2019.49.2.113

The purpose of this study was to investigate the monthly contamination rate of pathogenic Escherichia coli, a major cause of food poisoning, in vegetables sold in agricultural wholesale markets, which distribute vegetables from all over the country, in the Incheon Metropolitan City area, South Korea, and to identify a source of the pathogen. In total, 1739 vegetables of 80 types, along with 109 soil, 67 manure, and 33 livestock feces samples, were tested for pathogenic E. coli using polymerase chain reaction, from September 2016 through August 2017. The average annual prevalence rate of vegetables was 5.8%, and the prevalence rate was above 5% from June through October. The highest prevalence rate (15.7%) was recorded in July. Water dropwort showed the highest prevalence rate (28.6%) among the vegetables examined. Pathogenic E. coli was detected in >20 types of the vegetables that were to be consumed without cooking. Among these, the prevalence rates of ponytail radish (n = 21), crown daisy (n = 86), young radish (n = 68), romaine lettuce (n = 133), perilla leaf (n = 103), Korean leek (n = 43), young Chinese cabbage (n = 68), and Chinese cabbage (n = 30) were 9.5%, 8.1%, 7.4%, 6.8%, 4.9%, 4.7%, 4.4%, and 3.3%, respectively. Among the vegetables cooked before consumption, prevalence rates were 28.6%, 27.3%, and 25.0% in wormwood, sweet potato stalk, and edible mountain vegetables (Saussurea sp., etc.), respectively. In soil, manure, and livestock feces, 36.7%, 26.9%, and 90.6% prevalence rates were confirmed, respectively. This study confirmed the pathogenic E. coli contamination of vegetables to be consumed without cooking. Therefore, to produce agricultural products that do not induce food poisoning and are safe for consumption, it is important to develop a process for killing the pathogenic microorganisms and set up a sanitary environment for effectively managing compost. In addition, it is necessary to establish surveillance systems to monitor the production chain.

It is important to prevent the increase in the prevalence of diabetes mellitus (DM) worldwide by efficiently managing its controllable risk factors. This study aimed to identify factors associated with the 4-year estimated incidence of type 2 DM (T2DM) by sex and provide basic data for a sex-specific strategic approach to lifestyle modification. We performed a secondary data analysis using raw data from the seventh Korea National Health and Nutrition Examination Survey (KNHANES, 2016–2018). The KNHANES is a descriptive correlational survey designed to examine sex differences in the factors associated with the 4-year estimated incidence of T2DM. This study included 9,614 Korean adults (4,134 men and 5,480 women) aged 40–69 years without a diagnosis of T2DM. For the statistical analysis, a complex sample analysis was performed for sex comparison using the χ²-test or one-way analysis of variance; a multiple regression analysis was performed to analyze the sex-specific influencing variables of 4-year estimated T2DM incidence. The waist-to-height ratio, an indicator of central obesity in adults, showed the strongest association with the 4-year estimated incidence of T2DM in both groups (male: β = 0.33, ; female: β = 0.38, ). The influencing variables were the monthly drinking rate (β = 0.07, ) and sleep time (β = −0.03, ) in men and the sedentary time in women (β = 0.03, ). The overall explanatory power of these variables was 11.3% for men and 14.3% for women. Thus, significant sex differences were found in the 4-year estimated incidence of T2DM. Therefore, intervention programs need to be sex-specific to enhance the efficacy of the interventions in reducing the incidence of T2DM, and such intervention programs should be administered with a strategic approach differentiated by sex.

Early risk stratification and preventative strategies are required in patients with ischemic heart disease (IHD) to prevent heart failure (HF). We aimed to investigate the rate of progression to HF and to investigate the factors predicting the development of HF in a population with IHD for 10 years. A descriptive study was conducted using Korea National Health Insurance Service-National Sample Cohort (NHI-NSC) data (2005–2015). Among the patients diagnosed with IHD for the first time in 2005–2006, 2271 men and 2037 women who responded to the health check-up survey were finally selected. Cox Proportional Hazard regression analyses and the Kaplan–Meier survival analysis were used. HF incidence rates were 5.1% in men and 8.0% in women. The mean duration of transition to HF was 4.85 ± 2.73 years in men and 4.73 ± 2.73 years in women. The non-incidence rate of HF was higher in men than in women (Log-rank test, p = 0.0003). Bivariate analyses showed that older age, prevalence of hypertension and diabetes, less alcohol, and lower physical exercise were associated with the incidence of HF in both men and women. Multivariate analyses found that HF incidence in aged subjects ≥70 years was 1.46 times higher in men and 1.44 times higher in women compared to those in their 30 s (p < 0.001). Prevalence of hypertension reduced the incidence of HF by 0.78 and 0.87 for men and women, respectively. The prevalence of diabetes increased 1.23 times only in men. These findings suggest that special attention such as periodic counseling and education is needed to prevent progression to HF in elderly and diabetic patients during follow-up after IHD.

Background: This descriptive study investigated the effects of sleep quality and depression on somatization symptoms in middle-aged women with cardiovascular risk factors. Methods: Data were collected from outpatients who visited three general hospitals and one private hospital in Korea between May 2017 and December 2018. Questionnaires and anthropometric data were used to analyze 144 middle-aged women (45–65 years) with at least one cardiovascular risk factor. SPSS and WIN 21.0 software were used for statistical analysis. To test the mediating effects, the relationships between independent variables and somatic symptoms were compared using the t-test, analysis of variance, and χ²-test, and correlations were analyzed using Pearson’s correlation coefficient. Finally, multiple linear regression and the Sobel test were used to identify predictors. Results: Somatic symptoms showed a positive correlation with depression (r=46, P<0.001) and a strong negative correlation with sleep quality (r=-52, P<0.001). Depression and sleep quality explained 37% of somatic symptom variance in a multiple linear regression analysis after correcting for age (R²=0.37, F=41.53, P<0.001). The Sobel test showed a sleep quality Z-value of 3.78, demonstrating that it was a mediating variable. By adding sleep quality to depressive symptoms, the absolute value of β, which shows the effect’s strength, decreased from .49 to .32, confirming a partial mediating effect. Conclusion: Depression and sleep quality were predictive of somatic symptoms in middle-aged women with cardiovascular risk factors, and sleep quality had a partial mediating effect on somatic symptoms. To reduce somatic symptoms, strategies that alleviate depression by improving sleep quality are required.

Cardiovascular disease (CVD) is the second leading cause of death among Korean women, and its incidence is dramatically elevated in middle-aged women. This study aimed to identify the predictors of sleep quality, a CVD risk factor, in middle-aged women with CVD risk factors to provide foundational data for developing intervention strategies for the prevention of CVD. The subjects, 203 middle-aged women (40–65 years old) with one or more CVD risk factors were selected through convenience sampling and included in this descriptive correlational study. The effects of somatic symptoms, depression symptoms, and sedentary time on sleep quality were examined. CVD-related characteristics were analyzed using descriptive statistics, whereas the mean values of the independent variables were analyzed using t-tests and analysis of variance. Predictors of sleep quality were analyzed using multiple regression analysis. The results showed that sleep quality increased with decreasing somatic symptoms (β = −0.36, p < 0.001), depression symptom score (β = −0.17, p = 0.023), and daily sedentary time (β = −0.13, p = 0.041), and the regression model was significant (F = 19.80, p < 0.001). Somatic symptoms are the most potent predictors of sleep quality in middle-aged women. Thus, intervention strategies that improve somatic symptoms are crucial for the enhancement of sleep quality, which deteriorates with advancing age.