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BACKGROUND: Global population aging, and the accelerated increase in the number of oldest-old adults, over 80 years, has implied a heightened need for long-term care (LTC). We aimed to provide a theoretical care cascade of LTC services to assess publicly funded LTC (Analysis 1) and to investigate the association between the use of LTC insurance (LTCI) and unmet care needs among older people (Analysis 2) in South Korea. METHODS: Analysis 1 used data from the eighth wave (2020) of the Korean Longitudinal Study of Aging (KLoSA), the 2020 National Health Insurance Service LTCI Statistical YearBook and the 2020 National Awareness Survey of LTCI. The care cascade consisted of the target population, service contacts, coverage and outcomes. Analysis 2 used the fifth to eighth waves of KLoSA, and LTCI analysis was based on three groups: not aware, aware but do not use and aware and use. Unmet care needs were defined as the absence of help among older people with care needs. RESULTS: Among 8,489,208 people aged 65 or older in 2020, 1,368,148 (16.1%) were estimated to want care. Of these, 62.7% (N = 857,984) had LTCI service contact and 807,067 (94.1%) of those had used LTCI services in the past year (Analysis 1). Older people who were aware and used LTCI were less likely to report unmet activities of daily living (ADL) (prevalence ratio (PR): 0.34, 95% confidence interval (CI): 0.18-0.66) or unmet instrumental ADL (IADL) needs (PR: 0.27, 95% CI: 0.17-0.43) than those who were not aware (Analysis 2). CONCLUSIONS: This article provides a theoretical cascade to assess LTC provision in South Korea and a preliminary model for other countries. Korea's LTCI is associated with reduced unmet ADL and IADL needs.
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Atividades Cotidianas , Assistência de Longa Duração , Humanos , Idoso , Idoso de 80 Anos ou mais , Estudos Longitudinais , Seguro de Assistência de Longo Prazo , República da Coreia/epidemiologiaRESUMO
Chemosensory-related gene (CRG) families have been studied extensively in insects, but their evolutionary history across the Arthropoda had remained relatively unexplored. Here, we address current hypotheses and prior conclusions on CRG family evolution using a more comprehensive data set. In particular, odorant receptors were hypothesized to have proliferated during terrestrial colonization by insects (hexapods), but their association with other pancrustacean clades and with independent terrestrial colonizations in other arthropod subphyla have been unclear. We also examine hypotheses on which arthropod CRG family is most ancient. Thus, we reconstructed phylogenies of CRGs, including those from new arthropod genomes and transcriptomes, and mapped CRG gains and losses across arthropod lineages. Our analysis was strengthened by including crustaceans, especially copepods, which reside outside the hexapod/branchiopod clade within the subphylum Pancrustacea. We generated the first high-resolution genome sequence of the copepod Eurytemora affinis and annotated its CRGs. We found odorant receptors and odorant binding proteins present only in hexapods (insects) and absent from all other arthropod lineages, indicating that they are not universal adaptations to land. Gustatory receptors likely represent the oldest chemosensory receptors among CRGs, dating back to the Placozoa. We also clarified and confirmed the evolutionary history of antennal ionotropic receptors across the Arthropoda. All antennal ionotropic receptors in E. affinis were expressed more highly in males than in females, suggestive of an association with male mate-recognition behavior. This study is the most comprehensive comparative analysis to date of CRG family evolution across the largest and most speciose metazoan phylum Arthropoda.
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Artrópodes/genética , Receptores Odorantes/genética , Animais , Células Quimiorreceptoras/fisiologia , Copépodes/genética , Crustáceos/genética , Bases de Dados de Ácidos Nucleicos , Evolução Molecular , Genoma/genética , Insetos/genética , Família Multigênica/genética , FilogeniaRESUMO
AIMS: To determine the association between sleep quality and nurse productivity. BACKGROUND: Although poor sleep quality may decrease nurses' productivity, the association between the two has not yet been evaluated in the literature. METHODS: A cross-sectional survey was completed in May 2014 by 188 nurses working in acute hospitals in South Korea using the Pittsburgh Sleep Quality Index. Descriptive statistics, t tests, ANOVA, Pearson's correlation, and stepwise multiple regression were conducted for data analysis. RESULTS: The prevalence of poor sleep quality was high (79.8%). Among the components of sleep quality, sleep disturbances (ß = -0.19) and subjective sleep quality (ß = -0.16) were determined to be statistically significant predictive factors of nurse productivity, in addition to shift work (ß = -0.20) and age (ß = 0.32). CONCLUSION: Poor sleep quality may lead to lower nurse productivity. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders and executives should consider measures to improve nurses' sleep quality and enhance nurse productivity. Steps that need to be considered include longer intervals between shift-work cycles, clockwise scheduling order, a longer break time after night shift work, allowing nurses to nap before / during a night shift, and providing a worksite healthy sleep programme.
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Eficiência , Enfermeiras e Enfermeiros/normas , Transtornos do Sono do Ritmo Circadiano/complicações , Adulto , Análise de Variância , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Prevalência , República da Coreia , Transtornos do Sono do Ritmo Circadiano/psicologia , Inquéritos e Questionários , Tolerância ao Trabalho Programado/psicologiaRESUMO
This study aimed to develop and psychometrically test an instrument for measuring patient-perceived satisfaction with community-based case management services in Korea. The study was conducted in 4 phases: Phase I, development of the instrument; Phase II, pilot testing of the instrument; Phase III, a large-scale study to test reliability and validity; and Phase IV, conversion of the new instrument from Korean to English. The new instrument was determined to have six factors-advocacy of case manager, outcome of care, communication skills, practice of a healthy lifestyle, referral, and recognition of risk factors-and also shown to be reliable.
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Administração de Caso/normas , Enfermagem em Saúde Comunitária/normas , Satisfação do Paciente , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Encaminhamento e Consulta , Reprodutibilidade dos Testes , República da Coreia , Inquéritos e Questionários , Resultado do TratamentoRESUMO
OBJECTIVES: To examine the impact of a nurse-led home visitation program for hypertension self-management among older community-dwelling Koreans. DESIGN AND SAMPLE: As part of a larger community-based home visitation project aimed at behavioral change in this vulnerable population, a single group pre- and posttest design was used. MEASURES: Visiting nurses affiliated to public health center assisted vulnerable elders with hypertension self-management tailored according to their health problems through home visits for a period of 2-4 months. RESULTS: A total of 13,452 hypertensive persons over the age of 65 completed the intervention. All outcomes were significantly improved and included hypertension knowledge, blood pressure monitoring, dietary management, medication adherence, and self-confidence in hypertension self-management (p < .001). Changes in hypertension knowledge, medication adherence, and self-confidence varied by gender with women showing greater knowledge improvement than men but less improvement in medication adherence and confidence in hypertension self-management. There was a marginal interaction effect for gender and age on dietary management (F = 3.55, p = .063), with men (≥75 years) showing greater improvement than their female counterparts after the intervention. CONCLUSIONS: This nurse-led home visitation intervention can be helpful in self-management skill building among hypertensive Korean elders. The program may improve medication adherence and health-promoting behavioral changes.
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Serviços de Assistência Domiciliar/organização & administração , Visita Domiciliar , Hipertensão/terapia , Padrões de Prática em Enfermagem , Autocuidado/psicologia , Idoso , Feminino , Seguimentos , Humanos , Vida Independente , Coreia (Geográfico) , Masculino , Pesquisa em Avaliação de Enfermagem , Autocuidado/estatística & dados numéricosRESUMO
BACKGROUND: Despite the growing prevalence of metabolic syndrome (MetS) in Korea, information is lacking on gender- and age-specific patterns in prevalence of MetS among Korean adults. AIMS: The aims of this study were to examine (1) gender-specific prevalence of MetS by its component abnormalities, (2) the prevalence of MetS and its component abnormalities by gender and 10-year age groups, and (3) gender-specific lifestyle risk factors for MetS presentation among Korean adults. METHODS: A secondary data analysis was performed using the most recent national survey. A sample group of 5760 adults (mean age, 44.6 ± 0.46 years; 43.5% men) completed household interviews to provide blood (for high-density lipoprotein cholesterol, triglyceride, and glucose) and anthropometric measurements (ie, waist circumference, weight, and height) to define MetS, as well as data on lifestyle risk factors. RESULTS: Approximately 1 in 4 Korean adults met the MetS diagnostic criteria. Given each component abnormality, MetS was the most prevalent in men with low high-density lipoprotein cholesterol (63.4%), followed by abdominal obesity (62.3%). In women, it was most prevalent in those with hypertriglyceridemia (73.2%), followed by hyperglycemia (69.7%). Metabolic syndrome showed an association with advanced age for both men and women (P < .001 for both), with greater prevalence of MetS in young and middle-aged men than in women (6.7%-39.9% vs 3.3%-36.4%); these patterns were reversed in people 60 years or older (34.0%-40.5% vs 55.2%-64.1%). Gender-specific lifestyle risk factors for MetS presentation showed a significant association with heavy alcohol drinking and obesity for both men (odds ratio, 1.65 and 5.26, respectively; P < .001 for both) and women (odds ratio, 1.96 and 5.94; P < .042 and < .001, respectively). CONCLUSIONS: Metabolic syndrome is prevalent in a representative sample of Korean adults, with gender- and age-specific patterns. These results are helpful in identification of vulnerable subgroups at high risk for MetS, providing a basis for promotion of cardiovascular health and risk management of MetS.
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Síndrome Metabólica/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Povo Asiático , HDL-Colesterol/sangue , Feminino , Inquéritos Epidemiológicos , Humanos , Hiperglicemia/epidemiologia , Hipertrigliceridemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , Distribuição por Sexo , Adulto JovemRESUMO
Suicidal ideation increases the risk of suicide. This study investigated the age-specific contributions of sociodemographic factors, health status, and health behaviors to suicidal ideation using nationally representative data. The factors associated with suicidal ideation differ by age. Perceived bad health, stress, and depression had a significant influence on suicidal ideation in all age groups, but their specific effects differed in different age groups. The influence of perceived bad health increased with age, and the effect of stress was strongest among those aged 45-64 years. Moreover, the effect of being depressed decreased by age and was strongest among those 20-44 years of age. Disease and marital status did not have a significant effect on suicidal ideation among those 45-64 years old, and education had no effect among those 65 years or older.
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Ideação Suicida , Adulto , Fatores Etários , Idoso , Feminino , Nível de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , República da Coreia/epidemiologia , Fatores de Risco , Adulto JovemRESUMO
Objectives: This study investigated the residential, area-specific prevalence and associated factors of suicidal ideation among adolescents in South Korea, based on nationally representative data. Methods: A secondary analysis was performed using the database of the 17th Korean Youth Health Behavior Survey, which contained data from 54,848 adolescents. Results: Female adolescents (more influential in counties), low economic status (more influential in metropolitan cities), perceived stress (more influential in metropolitan cities), depression (more influential in counties), loneliness (more influential in counties), and anxiety (more influential in counties) were influencing factors in all areas, and the factors associated with suicidal ideation differed by residential area. The factors related to suicidal ideation were similar by residential area, but the degree of relevance differed from area to area; in particular, the prevalence of variables related to mental health (depression, loneliness, and anxiety) was high in counties. Alcohol drinking was significant only in small- and medium-sized cities in terms of suicidal ideation. Conclusion: Suicide prevention programs for adolescents should be implemented given the higher incidence of suicidal ideation among female adolescents, the greater influence of mental health-related variables in counties, and the influence of smoking in cities. There were differences in the prevalence and risk factors of suicidal ideation by residential areas.
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BACKGROUND: This study investigated the association between living arrangements and healthrelated quality of life (HRQoL) in older people. METHODS: A secondary analysis was conducted of 6,153 participants (aged ≥60 years) from the seventh Korean National Health and Nutrition Examination Survey (2016 to 2018). HRQoL was measured using the 3-level version of the EuroQol 5-dimensional questionnaire. The chi-square test, t-test, and multiple regression were used, applying sampling weights for the analysis. RESULTS: The proportion of respondents living alone was 18.0%, with a higher prevalence among women and older age groups (p<0.001). The overall HRQoL was lower in groups living alone than in groups living with others (p<0.001). Older people living alone showed higher impairments in all dimensions of the 3-level version of the European Quality of Life 5-Dimensional Questionnaire (EQ-5D-3L) than those living with others, including mobility (p<0.001), self-care (p<0.001), usual activities (p<0.001), pain/discomfort (p<0.001), and depression/anxiety (p<0.001). Problems with mobility were most prevalent (42.8%), followed by pain/ discomfort (41.9%) in respondents living alone. Living alone was significantly associated with a lower HRQoL index score (b=-0.048, p<0.001) after adjusting for age, gender, education, exercise, perceived stress, and perceived health status. CONCLUSION: Living alone was negatively associated with HRQoL. Based on this study, future care planning for older people should consider their living arrangements. The need to strengthen and expand care programs targeting those living alone should also be addressed.
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BACKGROUND: Standardized Korean red ginseng extract has become the best-selling influenza-like illness (ILI) remedy in Korea, yet much controversy regarding the efficacy of the Korean red ginseng (KRG) in reducing ILI incidence remains. The aim of the study is to assess the efficacy of the KRG extract on the ILI incidence in healthy adults. METHODS/DESIGN: We will conduct a randomized, double-blind, placebo-controlled study at the onset of the influenza seasons. A total of 100 subjects 30-70 years of age will be recruited from the general populations. The subjects will be instructed to take 9 capsules per day of either the KRG extract or a placebo for a period of 3 months. The primary outcome measure is to assess the frequency of ILI onset in participated subjects. Secondary variable measures will be included severity and duration of ILI symptoms. The ILI symptoms will be scored by subjects using a 4-point scale. DISCUSSION: This study is a randomized placebo controlled trial to evaluate the efficacy of the KRG extract compared to placebo and will be provided valuable new information about the clinical and physiological effects of the KRG extract on reduction of ILI incidence including flu and upper respiratory tract infections. The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if KRG extract can be shown to be an effective reduction strategy in ILI incidence. TRIAL REGISTRATION: NCT01478009.
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Influenza Humana/prevenção & controle , Panax , Fitoterapia , Extratos Vegetais/uso terapêutico , Adulto , Idoso , Cápsulas , Método Duplo-Cego , Humanos , Pessoa de Meia-Idade , Extratos Vegetais/normas , República da Coreia , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
This study was conducted to identify the trends in obesity prevalence among adolescents and changes in the risk factors related to obesity. The study analyzed secondary data obtained from Korean Youth Risk Behavior Web-based Surveys conducted from 2009 to 2019. The Korean Youth Risk Behavior Web-based Survey is an annual survey of a nationwide representative sample of enrolled students aged 13-18 years in middle and high schools in Korea. Linear and trend analyses showed that the prevalence of obesity increased by 0.47% on average annually; this increase was statistically significant. Healthy food intake decreased significantly, but the prevalence of unhealthy food intake and the prevalence of skipping breakfast increased significantly. Vigorous-intensity physical activity, physical activity for over 60 min a day, and muscle-strengthening exercise for more than 3 days a week increased significantly, but so did the adolescents' sedentary time. Therefore, health care providers and public policymakers need to actively manage adolescent obesity, which has been continuously increasing since 2009. In addition, long-term trends in obesity-related risk factors such as physical activity and dietary behaviors need to be considered in the development of obesity management strategies.
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Comportamento do Adolescente , Obesidade Infantil , Adolescente , Dieta , Exercício Físico , Humanos , Obesidade Infantil/epidemiologia , República da Coreia/epidemiologia , Fatores de Risco , Comportamento SedentárioRESUMO
BACKGROUND: The long-term care workforce is an essential factor in the provision of qualified long-term care services. Identifying workforce issues can help developing countries in East Asia and the Pacific prepare for the increase in the older population. Their experiences can be used as lessons for other countries. This study aimed to identify the workforce issues that should be addressed in order to provide high-quality long-term care services for older adults. METHODS: In-depth interviews and content analysis were conducted with a purposive sample of long-term care experts. There were eight participants from Australia and 14 from South Korea. The participants were questioned on important workforce issues to improve the quality of long-term care services. These were open-ended questions that comprised ideas derived from the literature. Major themes were systematically and comprehensively classified and coded to examine recurring comments and themes. RESULTS: The issues in the two countries were very similar: labor shortages, inadequate working conditions, insufficient career and staff training, and the need of counselors or consultants for finding proper services. There were also differences in terms of competency of the service operators and their corresponding multicultural competency. CONCLUSIONS: Providing high-quality long-term care service requires multipronged approaches to workforce capacity and work environment. An adequate and competent workforce should be established to match the service needs of the older population. To improve quality, better working conditions and improved motivation to work in care for older people should be considered. Concurrently, each country would need a workforce strategy tailored to different conditions and environments. This should include policies to induce an influx into the workforce.
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OBJECTIVE: The global population is rapidly ageing. To tackle the increasing prevalence of older adults' chronic conditions, loss of intrinsic capacity and functional ability, long-term care interventions are required. The study aim was to identify long-term care interventions reported in scientific literature from 2010 to 2020 and categorise them in relation to WHO's public health framework of healthy ageing. DESIGN: Scoping review conducted on PubMed, CINHAL, Cochrane and Google Advanced targeting studies reporting on long-term care interventions for older and frail adults. An internal validated Excel matrix was used for charting.Setting nursing homes, assisted care homes, long-term care facilities, home, residential houses for the elderly and at the community. INCLUSION CRITERIA: Studies published in peer-reviewed journals between 1 January 2010 to 1 February 2020 on implemented interventions with outcome measures provided in the settings mentioned above for subjects older than 60 years old in English, Spanish, German, Portuguese or French. RESULTS: 305 studies were included. Fifty clustered interventions were identified and organised into four WHO Healthy Ageing domains and 20 subdomains. All interventions delved from high-income settings; no interventions from low-resource settings were identified. The most frequently reported interventions were multimodal exercise (n=68 reports, person-centred assessment and care plan development (n=22), case management for continuum care (n=16), multicomponent interventions (n=15), psychoeducational interventions for caregivers (n=13) and interventions mitigating cognitive decline (n=13). CONCLUSION: The identified interventions are diverse overarching multiple settings and areas seeking to prevent, treat and improve loss of functional ability and intrinsic capacity. Interventions from low-resource settings were not identified.
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Assistência de Longa Duração , Casas de Saúde , Atividades Cotidianas , Idoso , Cuidadores , Humanos , Pessoa de Meia-Idade , Organização Mundial da SaúdeRESUMO
BACKGROUND: Allergic disease is a consequence of exposure to normally innocuous substances that elicit the activation of mast cells. Mast-cell-mediated allergic response is involved in many diseases such as anaphylaxis, urticaria, allergic rhinitis, asthma and allergic dermatitis. The development of food products for the prevention of allergic disease is an important subject in human health. The chungkookjang (CKJ) has been reported to exhibit antiallergic inflammatory activity. Therefore, the aim of the study is to examine the effects of the CKJ to reduce histamine-induced wheal and flare skin responses. METHODS/DESIGN: A randomized, double-blind, placebo-controlled study in 60 healthy subjects will be carried out. Sixty volunteers (aged 20-80) who gave a written consent before entering the study will be randomized in two groups of thirty subjects each. The skin prick test with histamine solution of 10 mg/ml will be performed on the ventral forearm, 10 cm from the elbow. The subjects will be instructed to take 35 g per day of either the CKJ pills or a placebo pills for a period of 3 months. Diameters of wheal and flare will be assessing 15 minutes after performing the above-mentioned skin prick test. The primary outcome is change in wheal and flare responses. Secondary outcomes will be include change in serum histamine, immunoglobulin E, cytokines (interferon-gamma, interleukin-4, -10, and tumor necrosis factor-alpha), and eosinophil cationic protein. DISCUSSION: This study will show the potential anti-inflammatory properties of the CKJ in their skin activity when histamine is the challenging agent as occurs in the clinical situation. And the present protocol will confirm the efficacy and safety of the CKJ for allergy symptoms, suggesting more basic knowledge to conduct further randomized controlled trials (RCT). If this study will be successfully performed, the CKJ will be an alternative dietary supplemental remedy for allergy patients. TRIAL REGISTRATION: NCT01402141.
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Antialérgicos/uso terapêutico , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Histamina/imunologia , Hipersensibilidade/tratamento farmacológico , Isoflavonas/uso terapêutico , Pele/imunologia , Proteínas de Soja/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos Clínicos , Método Duplo-Cego , Feminino , Humanos , Hipersensibilidade/imunologia , Masculino , Pessoa de Meia-Idade , Pele/efeitos dos fármacos , Testes Cutâneos , Adulto JovemRESUMO
Examining the socioeconomic vulnerability-obesity relationship is a different approach than comparing obesity rates according to the socioeconomic level. This study explored the socioeconomic vulnerability-obesity relationship among Korean adults. This secondary analysis used data from the Korea National Health and Nutrition Examination Survey, which were collected nationwide from participants aged 30-64 years. Seven socioeconomic indicators (education level, residential area, personal income level, household income level, food insecurity, house ownership, and national basic livelihood security beneficiary status) were used to create the socioeconomic vulnerability index. The prevalence of obesity was higher in the lowest socioeconomic vulnerability index quartile than in the highest socioeconomic vulnerability index quartile (odds ratio = 1.31; 95% confidence interval = 1.13-1.52) after adjusting for gender. When developing future interventions for the prevention and management of obesity, health care providers and researchers need to consider the differences in socioeconomic vulnerability index in adults.
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Obesidade , Adulto , Escolaridade , Humanos , Inquéritos Nutricionais , Obesidade/epidemiologia , Prevalência , República da Coreia/epidemiologia , Fatores SocioeconômicosRESUMO
PURPOSE: This study aimed to explore the environmental factors affecting childhood obesity using photovoice from the perspectives of students, parents, and teachers in the community. METHODS: Six school students, seven parents, and seven school teachers completed an assignment requiring them to take 24 pictures and participate in group discussions. After training session, the participants were asked to take pictures associated with food and physical activity environments related to childhood obesity at home, school, and within their communities for two weeks and to submit the pictures with records. Each group had four sessions for discussion. RESULTS: School cafeteria, convenience stores near schools, instant food and fast food joints, food delivery, and high-calorie snacks comprised the food environmental factors. Lack of physical activity classes at school, commuting by car, barriers to physical activity, and use of smart-phone were environmental factors that inhibited physical activity. CONCLUSION: To reduce childhood obesity, the creation of a supportive environment for encouraging the consumption of healthy foods and enhancing physical activity should be considered. Modifications of and improvement to the obesogenic environment might be a good strategy to prevent and reduce childhood obesity.
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Pais/psicologia , Obesidade Infantil/prevenção & controle , Professores Escolares/psicologia , Estudantes/psicologia , Adolescente , Adulto , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Infantil/patologia , Fotografação , Mídias Sociais , Fatores SocioeconômicosRESUMO
OBJECTIVES: Harmful alcohol consumption is associated with considerable social and economic damage to individuals and society. Because gender and ethnic background influence alcohol intake differently, examining gender specific factors influencing harmful drinking is necessary. This study investigated gender differences in alcohol consumption, harmful drinking, and the associated factors among Korean adults. METHODS: We analyzed the data from the 2012-2015 Korean National Health and Nutrition Examination Survey. Data from survey participants aged 20-64 years (N = 18,581) were included. The Alcohol Use Disorders Identification Test was used for alcohol dependence, and pooled weights were used. Chi-squared tests and multiple logistic regression analyses were conducted. RESULTS: The prevalence of harmful alcohol use (Alcohol Use Disorders Identification Test score ≥ 16) was 10.7% in the total sample; 18.4% in men and 3.4% in women, which constituted a significant difference. Education, marital status, smoking, perceived stress, and depressive feeling were associated with harmful drinking in both genders. However, household income, occupation, and perceived health status were associated with harmful drinking only in men. CONCLUSION: Since there are gender differences in harmful drinking and alcohol dependence, gender tailored prevention and intervention strategies for alcohol dependence are necessary including consideration of smoking, stress, and depressive feeling.
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BACKGROUND: People with chronic diseases may experience poor cognitive functioning associated with advanced age, progression of disease, or other comorbid chronic conditions. Empirical evidence of this phenomenon is limited despite the clinical relevance of cognitive decline and associated adverse outcomes such as poor physical functioning. PURPOSE: The purpose of this study was to examine cognitive functioning in the domains of memory, attention, and executive function and its association with functional capacity in a sample of community-dwelling adults with a spectrum of chronic diseases. METHODS: An exploratory cross-sectional study was conducted in a sample of community-dwelling adults with chronic diseases, including hypertension (58.9%), diabetes mellitus (DM; 20.0%), and dyslipidemia (14.4%). Participants' mean age was 64.1 ± 11.2 years, and 48.9% were male. Ninety persons completed the face-to-face interviews, which evaluated cognitive functioning in the domains of memory, attention, and executive function using neuropsychological tests and the physical well-being test, which measured functional capacity using the Duke Activity Status Index. RESULTS: Compared with those with other chronic diseases, our sample with hypertension and DM had significantly more memory loss and poorer executive function. These significant differences were nullified when adjusting for age, gender, and education. Approximately one third had functional limitations (n = 29, 32.2%), using a cutoff point of 35 or less (Duke Activity Status Index). Memory loss (delayed recall, b = 1.5, p = .016) and poor executive function (Trail Making Test Part A, b = -0.2, p < .001) were predicting factors of functional decline, independent of age, gender, education, and comorbidity. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Cognitive function, particularly memory and executive function, was poorer among chronically ill Korean adults in the community with hypertension or DM than their counterparts. Functional decline was worse in the presence of memory loss and poor executive function. Studies examining the mechanism by which overall functioning is impacted by cognitive decline and its relevance to functional declines in a larger representative sample are warranted.
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Transtornos Cognitivos/complicações , Cognição , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/psicologia , Transtornos Cognitivos/psicologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Vida Independente/psicologia , Vida Independente/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , República da Coreia , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Social participation contributes to better health and has been regarded as an important component of quality of life. Despite its importance, social participation significantly decreases as age advances. Social participation may vary by sex and age and, consequently, may have different influences on health by age and sex. Few studies have examined how sex and age affect individual health status in this regard. OBJECTIVES: This paper focuses on whether the association between self-rated health and social participation differs between men and women, and among age groups. DESIGN: The study was based on cross-sectional analysis of data from the 2003 Social Statistics Survey. SETTINGS: This survey was conducted in South Korea. PARTICIPANTS: The survey respondents were 59,202 Koreans aged 25 and over. The sample population comprised each household member of 33,000 sample households who were selected by multistage probability sampling of household registries based on geographic area, sex and age group. METHODS: Face-to-face interviews were nationally conducted. Multiple logistic regression analysis was performed to examine factors that associated social participation with self-rated health, and the adjusted odds ratios (ORs) were presented, together with their 95% confidence intervals (CIs). The model included various individual socioeconomic characteristics, health behaviors, and morbidity variables, such as marital status, education level, housing tenure, employment status, smoking status, alcohol intake, number of restricted activity days, and bed days. RESULTS: For both sexes, self-rated good health was strongly associated with social participation levels in all age groups. The influence of social participation increased as age advanced. Particularly among elderly women, those who had participated in more than two activities had more than twice the odds of self-rated good health of those who did not participate in any activities. CONCLUSIONS: Social participation significantly decreases as people age, however, the influence of social participation on health status increases with age. This study has shown that social participation, which is an individual psychological resource, is important for health in all age groups, notwithstanding that the effect of social participation differs by age and sex. Social participation should be a basic consideration in the field of community nursing intervention, especially for the elderly and women's health promotion. Promoting social participation by individuals may lead to better health, and may therefore be an effective strategy for enhancing health.