The relationship between catastrophic health expenditure and health-related quality of life.

OBJECTIVES: The objective of our study was to investigate the relationship between catastrophic health expenditure (CHE) and health-related quality of life (HRQoL) in general population. METHODS: We used Korean Health Panel Survey data from 2011 to 2013, which included data from 8850 baseline participants of 19 years of age or older. We defined CHE as total annual out-of-pocket health payment that was 40% greater than the household's capacity to pay. HRQoL was measured using the EuroQol-visual analogue scale (EQ-VAS). We used generalized estimating equations to perform a longitudinal regression analysis. RESULTS: A total of 4.5% of the participants (n = 398) experienced CHE. Those with CHE tended to have a lower EQ-VAS index score compared with those without CHE (ß: - 1.34, p = 0.013). A subgroup analysis revealed that individuals experiencing CHE had significant decreases as the number of chronic diseases increased (three or more, ß: - 1.85, p = 0.014). CONCLUSIONS: Catastrophic health expenditure influences HRQoL, which was more pronounced in patient with chronic disease. The efforts should focus on people who suffer from excessive health expenditures and chronic diseases.

The association between loss of work ability and depression: a focus on employment status.

PURPOSE: Work-related factors are one of the known risk factors for depression. Given that the ability to work is considered an important aspect of well-being and health status, we investigated the association between the loss of work ability and depression. We further examined the association stratified by employment status. METHODS: We used data from the Korea Welfare Panel Study. The dependent variable of the present study was depression, which is measured by the Center for Epidemiologic Studies Depression Scale. Work ability transition from the previous year was divided into three categories: maintained, loss, and complete loss. A linear mixed-effects model was performed for the analysis. RESULTS: The work ability loss group (ß = 2.071, p < 0.0002) and the work ability completely loss group (ß = 2.651, p = 0.015) had higher depression scores compared to those who maintained their work ability from the previous year. Specifically, those who lost their work ability and their job (ß = 3.685, p = 0.0068) had the highest depression scores compared to those who maintained their work ability and job. CONCLUSIONS: We found that those who lost their ability to work may be at risk of depression, and this finding was particularly prominent among those who also became unemployed. Therefore, psychological support is needed for these individuals to overcome the negative influence of the loss of work ability.

Hovenia dulcis Extract Attenuates High-Fat Diet-Induced Hepatic Lipid Accumulation and Hypertriglyceridemia in C57BL/6 Mice.

The effects of dietary supplementation with aqueous Hovenia dulcis Thunb. extract (HDE) (20 weeks) on high-fat diet (HFD)-induced nonalcoholic fatty liver disease and dyslipidemia were evaluated in mice. Supplementation with 200 and 800 mg/kg feed HDE (HDE200 and HDE800, respectively) resulted in no significant difference in growth in the HFD-fed groups. The triglyceride (TG) levels and free fatty acids were significantly decreased, whereas high-density lipoprotein cholesterol was increased in the HDE800 group (P < .05). The hepatic intracellular TGs were significantly decreased in the HDE-fed groups and lipogenic enzymes (acetyl CoA carboxylase, fatty acid synthase, stearoyl CoA desaturase, and diacylglycerol transferase) in the liver were significantly downregulated by HDE supplementation (P < .05). The diminished serum antioxidant enzyme activities in the HFD group were effectively restored by HDE supplementation, which also contributed to the attenuation of hyperlipidemia.

The association between satisfaction with husband's participation in housework and suicidal ideation among married working women in Korea.

Although married women are increasingly participating in paid labor, housework remains their primary responsibility. This uneven distribution of housework could have a negative impact on their mental health. In this study, we examined the association between satisfaction with husbands' participation in housework and suicidal ideation in married working women. Data were obtained from 3544 participants of the fourth and fifth waves of the Korean Longitudinal Survey of Women and Families. Satisfaction with husbands' participation in housework was classified as satisfactory, less satisfactory, and dissatisfactory. A generalized estimating equations model was used to examine the association. Those who were dissatisfied with their husbands' participation in housework were 2.65 times more likely to think about suicide than those who were satisfied. Subgroup analysis showed that women with an egalitarian gender ideology or low job dissatisfaction were more likely to think about suicide when they were dissatisfied with their husbands' participation in housework. In conclusion, married working women who were dissatisfied with their husbands' participation in housework are more likely to think about suicide than those who are satisfied. Therefore, fostering an environment of fair distribution of housework is necessary for alleviating their stress from the dual burden of work and family.

The Relationship Between Physical Activity Level of Parents and That of Their Adolescent Children.

BACKGROUND: Intergenerational transmission, which refers to the similarity between parent and their children, is a possible explanation of adolescent physical activity (PA). However, only a few existing studies explore the relationship of parent-adolescent PA in East Asian countries. Therefore, this study aimed to investigate the association of parent-adolescent PA using a nationally representative data in Korea with a large sample size. METHODS: Data were collected from the Korean National Health and Nutrition Examination Survey conducted from 2010 to 2014. The authors performed a linear mixed effects regression analysis with 1342 cases after using log conversion of parent and adolescent moderate- to vigorous-intensity physical activity (MVPA) levels. RESULTS: In the study, the median MVPA of adolescents was 150 (interquartile range: 360) minutes per week. Adolescent MVPA levels were significantly correlated with their mother's MVPA (ß = 0.055, P = .02). Similar findings of greater association in girls and younger adolescents (age: 13-15 y) were found in subgroup analysis (girls: ß = 0.073, P = .05; younger adolescents: ß = 0.103, P = .001). CONCLUSION: Increasing maternal PA levels could stimulate their adolescent's PA levels. Therefore, intervention at the family level may lead to an increase in adolescent PA levels.

The effect of job loss on depressive symptoms: The results from the Korean Welfare Panel Study (2007-2013).

BACKGROUND: Unemployment is closely associated with depressive symptoms. We conducted analysis to find whether the job loss increased the risk of depressive symptoms according to job status, occupation and tenure. METHODS: Data were collected from Korean Welfare Panel Study (KOWEPS) from 2007 to 2013. To measure the increase in depressive score, we selected respondents who answered for at least 2 years of continuous waves. We performed a longitudinal analysis by generalized estimating equation (GEE) method with a total of 19,399 cases. Among them, 608 cases (3.1%) experienced job loss. RESULTS: There was a significant rise in depressive score after job loss (ß = 1.34, p = .000). In subgroup analysis, precarious and low-tenure workers are considerably more depressed after job loss (precarious: ß = 1.98, p < .0001, low-tenure workers: ß = 1.31, p = .001). Both white and blue collar workers showed a rise in depressive score significantly (white collar: ß = 1.16, p = .031; blue: ß = 2.03, p = .001). CONCLUSION: The results showed that precarious and low-tenure workers were relatively vulnerable in mental health after experiencing job loss with low and negative expectation for re-employment. It implies that supports for encouraging work skill and financial supports during the unemployment period should be needed.

Differential gene profiles in developing embryo and fetus after in utero exposure to ethanol.

Alcohol consumption during pregnancy results in morphological abnormalities in the fetuses of humans and experimental animals, and is referred to as fetal alcohol syndrome (FAS). However, the molecular mechanism underlying FAS has not been completely elucidated. The aim of the present study was to investigate the potential molecular mechanisms of ethanol-induced FAS in the developing embryo and fetus. cDNA microarray analysis was used to screen for altered gene profiles. Ethanol at a teratogenic dosage (3.8 g/kg, twice a day) was administered intraperitoneally to pregnant C57Bl/6J mice from gestation day (GD) 6 to 8. Morphologic observations showed excessive malformations of the craniofacial regions (reduction of the face, the absence of eyes, nose, jaw, and mandible, underdevelopment of vibrissae areas, cleft lip, and palate) in ethanol-exposed embryos (GD 10) and fetusus (GD 15). cDNA microarray analysis showed alterations in several gene profiles, including the "palate, lung, and nasal epithelium clone (plunc), "neurofilament, " and "pale ear. " Of these genes, the expressions of plunc were confirmed by reverse-transcription polymerase chain reaction (RT-PCR) and whole-mount in situ hybridization. The plunc was highly expressed in the craniofacial region, specifically in upper airways and nasopharyngeal epithelium. RT-PCR analysis revealed that normal plunc mRNA expression levels were present in GD 15 fetuses, but not in GD 10 embryos. Interestingly, ethanol significantly downregulated the plunc expression in GD 15 fetuses. Our results suggest that ethanol-induced FAS is due in part to the downregulation of plunc expression in the fetus, and this gene may be a candidate biological marker for FAS.

Divergent mechanisms in generating molecular variations of alphaRYR and betaRYR in turkey skeletal muscle.

(1) Molecular variations in two turkey skeletal muscle ryanodine receptor gene isoforms, alphaRYR and betaRYR, were analyzed by cloning and sequencing the entire cDNAs of the two isoforms. (2) Ten alternative splicing transcript variants (ASTVs) in the alphaRYR isoform were identified. These variants were clustered in three alternative splicing regions (ASRs). Two ASRs overlap with the divergent regions (DRs) of the two isoforms. Only four ASTVs did not contain a frame shift and potentially can be translated into alphaRYR channel proteins. The expression of these three ASTVs was developmentally or environmentally regulated. (3) Ten SNPs and eight haplotypes, divergent in the ten SNP positions, were identified in betaRYR. Although the ten SNPs were synonymous, different mRNA secondary structures of betaRYR and different stability of the structures were predicted for several SNPs. (4) The intriguing finding of this study is that alphaRYR and betaRYR use completely divergent mechanisms to generate molecular variations. Alternative splicing generates ASTVs of alphaRYR, whereas the presence of SNPs may change the secondary mRNA structure of betaRYR. These divergent mechanisms could affect calcium channel activity of either or both RYR isoforms.