Advancing elderly diabetes care: exploring the usability and acceptance of continuous glucose monitoring (CGM).

OBJECTIVES: This study aimed to evaluate the acceptability, usability, compliance, and satisfaction of Continuous Glucose Monitoring (CGM) among elderly diabetic patients. DESIGN: Utilizing a mixed-methods approach, the study involved 30 participants, averaging 74.79 years in age. Participants wore two CGM devices, and their experiences, along with survey data, were comprehensively analyzed to gauge the effectiveness of CGM in managing diabetes. RESULTS: The study demonstrated that -CGM- is highly usable and acceptable among elderly diabetic patients. Participants effectively utilized CGM to monitor and predict blood glucose trends, positively influencing their glucose control and lifestyle. The average adherence rate was found to be 81 %, indicating a substantial level of effective self-management and treatment decision-making. CONCLUSION: The study recommends developing CGM educational programs tailored for the elderly, educating healthcare professionals, expanding insurance coverage for CGM, and promoting real-time CGM technology to improve usability and acceptance among the elderly.

[Factors Influencing Sexual Experiences in Adolescents Using a Random Forest Model: Secondary Data Analysis of the 2019~2021 Korea Youth Risk Behavior Web-based Survey Data].

PURPOSE: The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the "variable importance." METHODS: The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ² tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix. RESULTS: The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. "Variable importance" for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol. CONCLUSION: Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.

Unveiling the Path: A Qualitative Study on the Initial Sexual Experiences of Cambodian Adolescents.

INTRODUCTION: There still remains a significant gap in understanding the sexual and reproductive health challenges faced by adolescents, particularly in the context of early sexual activity, teenage pregnancy, and sexually transmitted diseases. This study seeks to fill this gap by exploring the initial sexual experiences of Cambodian adolescents, highlighting the complex interplay of cultural, social, and personal influences that shape their sexual health decisions and outcomes. METHODOLOGY: A descriptive qualitative research design was used. Thirty Cambodian adolescents were interviewed from March to June 202 and data were analyzed using thematic analysis. RESULTS: Participants met their sexual partners in school and through friendships and social networking sites. Their motivations for sexual activities ranged from intrinsic desires to influences of inebriation, love, and trust. Consent was crucial but some were influenced by partners. Awareness of sexual protection varied, affecting condom use and information-seeking behaviors. After initial encounters, participants grappled with complex emotions and physical changes. DISCUSSION: The findings suggest the need for educational interventions that address substance use; promote safe behavior, consensual conduct, open communication, and mutual respect; and provide coping strategies.

Exploring Cambodian adolescents' perceptions on sex: a qualitative investigation.

Introduction: Involvement in sexual activities increases during adolescence in many countries, including Cambodia. The objective of this study is to explore the perspectives and interpretations of sex held by Cambodian adolescents within the context of their social norms and culture. Methods: A qualitative research design was used to conduct in-depth interviews with a purposive sample of 91 Cambodian adolescents aged between 15 and 19 years. Participants were recruited from rural areas, and data was collected through face-to-face interviews using semi-structured interview guides. Thematic analysis was used to analyze the data. Results: Four themes as perspectives of sex were identified: (1) Desire: Releasing sexual desire and stress; (2) relationship: an emotional connection and demonstration of love; (3) roles: responsibilities within a woman's marital duties; and (4) values: the value of virginity and future engagement. Cambodian adolescents' perspectives and interpretations of sex were deeply influenced by their social norms and cultural values. Men typically perceived sex through the lens of instinct and pleasure, while women often emphasized a deep sense of familial duty and held premarital sex to be morally unacceptable. Discussion: The findings suggest that interventions aimed at improving the sexual health of Cambodian adolescents should be designed with an understanding of the social norms and cultural values that shape their perspectives and interpretations of sex. Such interventions should focus on promoting safe sex practices and providing accurate and comprehensive sexual education.

Estimating the Prevalence and Identifying the Correlates of Sexting Behaviors Among Cambodian Male Adolescents.

Male youths are more likely to experience peer pressure that encourages them to engage in risky behaviors than female youths, and this pressure can lead to an increased risk of sexting among male youths. This study aimed to investigate the prevalence of and factors associated with sexting among Cambodian male youths. The correlational cross-sectional study design was utilized. This study surveyed 647 Cambodian male youths aged 15 to 24 years. The measurement included sending or receiving messages (sexts) that contain sexually explicit messages, images, or videos, and affecting factors to sexting. Around 32.5% of participants sent sexts, and 38.9% received them. Open relationships, pornographic website use, perception of friends' sexual activity, frequent thoughts about sex, higher sexual sensation-seeking tendencies, positive attitudes toward sex, and sexual experience were associated with increased likelihood of sending and receiving sexts. Based on the findings of this study, by offering suitable education, guidance, and intervention programs, we can effectively mitigate the adverse repercussions of sexting while fostering healthy sexual behaviors among youths.

Factors affecting unmet medical needs of patients with diabetes: A population-based study.

AIMS: The purpose of this study was to identify unmet medical needs and related factors in patients with diabetes. DESIGN: A cross-sectional study. METHODS: Participants included 2269 diabetes patients aged >19 years by using data from the National Health and Nutrition Examination Surveys. A complex sample design multiple logistic regression analysis was performed. RESULTS: The study found that 8.7% of diabetes patients experienced unmet medical needs, and it was found to be higher for those who thought their self-assessed health status was unhealthy and often felt stressed in their daily life. Gender and education level had a moderating effect on income level on unmet medical needs experience. CONCLUSION: These findings have important implications for nursing practice in the management of diabetes. Nurses can develop targeted interventions that address the specific needs of patients who are at risk for unmet medical needs, particularly those from low-income backgrounds. By considering the factors that contribute to unmet medical needs and the moderating effect of income level, nurses can improve patient outcomes and reduce the burden of diabetes.

A systematic review of social processes and mechanisms in the community that influence risky sexual behaviour among adolescents and young adults.

AIMS: To examine the associations between social processes and mechanisms within the community and risky sexual behaviour (RSB) among adolescents and young adults. DESIGN: Systematic review. METHODS: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and conducted a literature search in August 2020. From 11,216 identified articles, 605 were for full-text screen. We used 24 articles, 22 after applying inclusion criteria and 2 manually searched relevant articles. RESULTS: Social processes and mechanisms within the community included collective efficiency and social support, community safety and community norm. Collective efficacy and social support and community safety were examined using 10 and 16 studies, respectively. We found that collective efficiency and social support, and community norms partially supported the occurrences of RSB among adolescents and young adults. Community safety displayed inconclusive relationships with RSB. CONCLUSIONS: The findings highlight the importance of social processes and mechanisms within the community in preventing RSB among adolescents and young adults. Community-based programs to improve community efficacy and social support would be effective strategies to reduce such RSB and to promote better reproductive health among adolescents and young adults.

Relationship Between Alcohol Consumption and Risky Sexual Behaviors Among Adolescents and Young Adults: A Meta-Analysis.

Objectives: Adolescents exposed to alcohol have increased risky sexual behaviors (RSBs); however, the association between alcohol consumption and RSBs has to be systematically and quantitatively reviewed. We conducted a meta-analysis of the literature to systematically and quantitatively review the association between alcohol consumption and RSBs in adolescents and young adults. Methods: We searched for qualified articles published from 2000 to 2020 and calculated pooled odds ratios (ORs) using the random-effect model. We also conducted meta-regression and sensitivity analyses to identify potential heterogeneity moderators. Results: The meta-analysis of 50 studies involving 465,595 adolescents and young adults indicated that alcohol consumption was significantly associated with early sexual initiation (OR = 1.958, 95% confidence interval (CI) = 1.635-2.346), inconsistent condom use (OR = 1.228, 95% CI = 1.114-1.354), and having multiple sexual partners (OR = 1.722, 95% CI = 1.525-1.945). Conclusion: Alcohol consumption is strongly associated with RSBs, including early sexual initiation, inconsistent condom use, and multiple sexual partners among adolescents and young adults. To prevent the adverse consequences of alcohol consumption, drinking prevention programs should be initiated at an early age and supported by homes, schools, and communities.

Moderating the Effects of Health Behaviors on Sexual Intercourse among Adolescents: A Cross-Sectional Study Using the 2020 Adolescent Health Behavior Survey.

PURPOSE: This study investigated the association between adolescent health behaviors (drinking, smoking, and drug use) and sexual intercourse, as well as the moderating effects of economic status, cohabitation with parents, and school type, among adolescents in Korea. METHODS: Secondary data from the 16th Adolescent Health Behavior Survey (2020) were used. A total of 395 schools and 54,948 middle and high school students participated in the study. Complex sample frequency analysis, the Rao-Scott test, and complex sample logistic regression analyses were performed. RESULTS: Sexual intercourse rates for men and women were 5.8% and 3.3%, respectively. Approximately 7.3% of high school students and 1.8% of middle school students reported having had sexual relations. Drinking (odds ratio [OR] = 3.15, 95% confidence interval [CI] = 2.82~3.52), smoking (OR = 6.75, 95% CI = 5.90~7.71), and drug use (OR = 3.03, 95% CI = 2.23~4.11) significantly increased the risk of sexual intercourse. Economic status and school type had moderating effects on the association between drinking and sexual intercourse. CONCLUSION: Adolescent drinking, smoking, and drug use are associated with a higher risk of sexual experience. Thus, to reduce this risk, controlling alcohol consumption, smoking, and drug use is necessary. In addition, programs for healthy lifestyles and sexual intercourse should be differentiated according to the school type and the economic conditions of the adolescents' households.

Socially Disadvantaged Community Structures and Conditions Negatively Influence Risky Sexual Behavior in Adolescents and Young Adults: A Systematic Review.

Objectives: This review aims to examine the association between community-level factors, namely, community structure and condition, and risky sexual behavior (RSB) including early sexual debut, having multiple sex partners, and unprotected sex, in adolescents and young adults. Methods: In total, 17 observational studies were identified for review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Among the 11,216 identified articles, excluded articles comprised 8,361 duplicates, 2,855 articles by title screening, 893 by abstract screening, and 667 by full-text screening. Finally, eight additional articles were added by manual search. Results: The community structural factors included social disadvantage, economic, employment, education status, racial or ethnic composition, residential stability, and physical environment. The current review found that social disadvantage (six studies) and economic status (10 studies) were most frequently examined. Particularly, higher levels of social disadvantage were associated with higher rates of early sexual initiation, inconsistent condom use, and multiple sexual partners. Conclusion: This study highlights that community structure and conditions in terms of social disadvantages should be addressed to prevent RSB in the young population.

The best-worse scaling approach: prioritizing burdensome menopause symptoms among Cambodian women.

The objective of this study was to prioritize the most burdensome menopause symptoms among Cambodian women utilizing the best-worst scale (BWS). In total, 180 women aged 40-60 who lived in a community setting were recruited from four regions of Cambodia via convenience sampling. Using the BWS, 12 choice sets were prepared by combining 11 symptoms from the menopause rating scale (MRS), and the BWS choice sets were generated with the orthogonal main effects design (OMED). Counting approach determined the women's health priorities and calculated the best-minus-worst (BW) score. The modeling approach measured each respondent's basic utility function. Of the 180 participants, 41.1% were between the ages of 40 and 49, and 25.0% were over 50. The counting and modeling approaches revealed that heart discomfort was the most burdensome symptom (coefficient 0.739, p < .001) followed by joint and muscular discomfort (coefficient 0.606, p < .001) and sleep problems (coefficient 0.507, p < .001), whereas vaginal dryness was the least burdensome symptoms (coefficient -0.164, p = .018). This study revealed that the most burdensome menopause symptom among Cambodian women was heart discomfort while vaginal dryness was the least burdensome. The BWS enabled to prioritize the burdensome menopausal symptoms which warrants future studies using the BWS.

An observational study of hand-to-face contact via videotaping of Korean older people in daily life settings.

OBJECTIVES: This study aimed to quantify hand-to-face contact (HFC) and identify the related factors that influence HFC in the daily life of Korean older people. METHODS: From November 20-December 4, 2018, 30 older people were enrolled and were each videotaped for their daily activities for two hours in total. The videotaped HFC data were classified by frequency, duration, site of contact, and as self-contact with membranes (eye, nose and mouth) or non-membranes (head, forehead, chin, cheek and ear). RESULTS: Of the 4826 self-contacts, 1311 HFC (560 membrane contacts [42.7%], 751 non-membrane contacts [57.3%]) were observed in 60 person-hours. The mean contact frequency (mean/person) of membrane and non-membrane contact was 18.7 times (nose, 9.3; mouth, 5.7; and eye, 3.6) and 24.6 (highest with the chin, 8.5), respectively. The mean contact duration (seconds/contact) for membrane and non-membrane contacts was 3.4 s (nose, 3.1; mouth, 3.7; and eye, 3.0) and 6.3 s (highest with the chin, 8.2), respectively. Contact exposure (frequency-duration/second/person) of the membrane and non-membrane was 3510.7 (nose, 1002.3; mouth, 639.3; and eye, 92.3) and 11,727.1 (highest with the chin, 2,965.6), respectively. The frequency and duration of HFC differed by age, economic activity and household income. CONCLUSIONS: HFC was highest at the nose in Korean older people, followed by the mouth. Consequently, education about avoiding HFC of the nose and hygienic care of the nose should be a nursing priority. Awareness of the risks of HFC and the prophylactic effects of vigorous hand hygiene should be strengthened among the elderly to prevent the spread of infectious diseases via hand contact.

Attitudes toward Menopause in HIV-Infected Cambodian Women.

(1) Background: Attitudes toward menopause are believed to play a potential role in the experience of menopause, including its perceived severity. However, the studies available on the perspectives of women living with human immunodeficiency virus (HIV) on menopause in Cambodia are very limited. This study aimed to evaluate the attitudes toward menopause of Cambodian women living with HIV. (2) Methods: A cross-sectional study was conducted among 189 women using a questionnaire titled Attitude toward Menopause Scale and socio-demographics. (3) Results: The study analysis showed that the participants had slightly negative attitudes toward menopause with the mean attitude score of 86.81 ± 10.79 (Range 35-140). Postmenopausal women displayed more positive attitudes than premenopausal women. Older age, higher education, and a non-drinking habit were independently associated with a positive attitude toward menopause. (4) Conclusions: The results suggest the need for a multidisciplinary team of health care experts that would address the special needs of this population marked by the menopausal transition.

Behavioral problems in the children of women who are victims of intimate partner violence.

OBJECTIVE: The purpose of this study was to investigate the association between the maternal experience of intimate partner violence (IPV) and children's behavioral problems. SAMPLE: The secondary data of the National Survey on Women's Health and Life Experience, which included 980 Cambodian children aged 6-12 years whose mothers responded to questions, were analyzed. MEASUREMENTS: IPV was measured as any experience of physical or sexual violence against a woman by her husband. The children's behavioral problems were indicated by nightmares, bed-wetting, timidity, and aggressive behavior as reported by their mothers. RESULTS: The children of the women who had experienced sexual violence had a higher prevalence of nightmares (adjusted OR (aOR) = 2.22, 95% CI: 1.421-3.470), bed-wetting (aOR = 2.15, 95% CI: 1.398-3.308), and timidity (aOR = 1.80, 95% CI 1.075-3.019) than those without reported IPV. The children of mothers who had experienced physical violence had a higher rate of aggression (OR  =  2.19, 95% CI: 1.321-3.630). CONCLUSION: The Cambodian children exposed to IPV against their mothers experienced more behavioral problems. This study presents evidence to support changes in current policy to prevent violence and alleviate behavioral problems.

Characteristics of hand-to-environment contact during indoor activities in daily life among Korean adults using a video-based observation method.

OBJECTIVE: The aim of this study was to describe the characteristics of hand-to-environmental contact (HEC) and to identify the factors influencing HEC behavior in Korean adults' indoor daily life. METHODS: Thirty participants were enrolled from January 14 to February 12, 2018 after providing informed consent for being videotaped. Data were collected by recording their indoor daily lives for 2 hours, resulting in 4,732 HEC cases. To ensure the accuracy and reliability of the HEC readings, 3 training sessions were conducted for the videotape readers. Rereading and verifying randomly selected data ensured the validity of intra- and inter-reader readings. RESULTS: The most frequent contact items were phones, papers, computer accessories, and furniture surfaces. The contact density (frequency-duration/min) was highest for category II (items occasionally shared by others, 56.8), followed in descending order by category I (items for individual use, 35.9), and category III (public use items, 3.4). Significant differences in contact density were found according to participants' demographic characteristics. CONCLUSION: As mobile phones were the most frequent contact item, regular and strict mobile phone cleansing or disinfection strategies are needed, in addition to preventative measures taken for category II and III items. Avoiding sharing personal items with others, refraining from unnecessary HEC, and maintaining strict hand hygiene are recommended.

Factors Associated with Poor Glycemic Control Amongst Rural Residents with Diabetes in Korea.

(1) Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes. The purpose of this study was to identify the factors associated with poor glycemic control amongst rural residents with diabetes in Korea. (2) Methods: This cross-sectional analysis was conducted amongst a total of 522 participants who had completed baseline health examinations for the Korean Genome and Epidemiology Study (KoGES) Rural Cohort from 2005 to 2011. The subjects were divided into two groups: the good glycemic control group (GCG) (glycosylated hemoglobin (HbA1C) < 7%) and the poor GCG (HbA1C ≥ 7%). Logistic regression was used to examine the role of sociodemographics, health-related behavior, comorbidity and diabetes-related and clinical factors in poor glycemic control amongst rural residents with diabetes. (3) Results: In total, 48.1% of participants were in the poor GCG. Poor GCG was significantly associated with drinking (odds ratio (OR) = 0.42, 95% CI = 0.24-0.71), lack of regular physical activity (OR = 1.68, 95% CI = 1.03-2.76), fasting blood glucose (FBG) > 130 mg/dL (OR = 7.80, 95% CI = 4.35-13.98), diabetes for > 7 years (OR = 1.79, 95% CI = 1.08-2.98), cholesterol ≥ 200 mg/dL (OR = 1.73, 95% CI = 1.05-2.84) and positive urine glucose (OR = 6.24, 95% CI = 1.32-29.44). (4) Conclusion: Intensive glucose control interventions should target individuals amongst rural residents with diabetes who do not engage in regular physical activity, have been diagnosed with diabetes for more than seven years and who have high fasting-blood glucose, high cholesterol levels and glucose-positive urine.

Hand-to-face contact behaviors during indoor activities in daily life among Korean adults: an observational pilot study using videotaping.

OBJECTIVES: Hand-to-face contact (HFC) is the major route for the self-inoculation of pathogens. This study aimed to describe the characteristics of HFC behaviors among Korean adults during indoor activities. METHODS: Thirty participants were enrolled in the study, and 2 hours of videotaped data were collected from each participant. Contact data were recorded by examining the frequency and duration of HFC on the videos. Three training sessions were conducted for 2 readers to ensure the accuracy and reliability of videotape reading. Re-reading and verification of selected video data were performed to confirm intrapersonal and interpersonal validity. Contact exposure (CE) was determined by multiplying the contact frequency (CF) by the contact duration (CD) to quantify the intensity of contact during the observation time (2 hours). RESULTS: A total of 3,007 HFCs (1,305 mucous membrane contacts and 1,702 non-mucous membrane contacts) were observed for 60 person-hours. The median CF (person/2 hr) of the mucous membranes (eye; 4.0, nose; 15.5, mouth; 16.5) was 39.5/person and the median total CD was 177.0 sec/person. The median CE (frequency-duration/sec/person) was 5,795.0 (mouth: 1,356.0, nose: 600.0, eye: 57.5). CONCLUSIONS: This study showed that the mouth and nose were the most frequent exposure sites for HFC. Avoiding habitual HFC, awareness of self-inoculation by HFC, and vigorous hand hygiene should be strengthened to prevent the spread of infections.

A pilot study investigating the social contact patterns of Korean elderly.

OBJECTIVES: This pilot study describes the characteristics of social contact patterns of the elderly, a group at high-risk for contracting infections. DESIGN: A cross-sectional design was used. SAMPLE: Participants included 30 volunteers aged 65 years or older. MEASUREMENTS: Records of a contact diary were maintained for a period of 24-hr. RESULTS: Thirty participants recorded 340 contacts within the 24 hr period, with a mean of 11.3 people daily. Physical encounters accounted for 50.9% of contacts. Participants with an occupation had significantly higher contacts than those without (p=.013). Contact type differed by location and duration (p<.001). Contact locations included: home (11.5%), work (2.4%), elderly welfare facilities (32.9%), transport (1.2%), and other places (52.1%). Contact duration (p < .001) and frequency (p < .001) differed by location. Contact duration differed by frequency (p < .001). CONCLUSIONS: The elderly participate in frequent physical contact that increases their risk of infection, especially among those with an occupation in comparison to those without an occupation. Infection control nursing should focus on providing education to reduce the risk of infections during contact events. Social distancing should be applied to limited periods of infection transmission risk.

Hand-to-Environment Contact During Indoor Activities in Senior Welfare Centers Among Korean Older Adults: A Pilot Study.

(1) Background: This study aimed to describe the characteristics of hand-to-environment contact (HEC) and identify the influencing factors of HEC behavior during the indoor daily life of Korean older adults in senior welfare centers. (2) Methods: A cross-sectional observational study was used with 30 participants over 65 years of age attending programs in senior welfare centers. Video recordings of the 30 participants were collected for two hours a day for participants selected from 20 November to 4 December 2018. Contact frequency, density, and duration were measured. (3) Results: Video recordings of 3,930 HEC cases were analyzed. Furniture surface (25.0%), tableware and cooking utensils (5.4%), phones (5.3%), and door handles (0.1%) were found to be the items with the most frequent contact, in this order. The average contact frequency and contact density (frequency-duration/min/person) of HEC for two hours were highest for the Category I equipment (personally used, accounting for 70.4%), and the average contact duration of HEC was highest in the Category III equipment (commonly used, 47.7 s/contact/person). Contact density was as high as 266.5 (frequency-duration/min/person). Participants above 75 years of age and the unemployed showed high HEC with Category III. (4) Conclusions: Older adults need to be educated to avoid unnecessary hand contact with items in Category III. In particular, hand hygiene and sanitization through the regular and thorough disinfection of furniture surfaces and shared equipment are very important to prevent the spread of pathogens.