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Background: Parental history of dementia appears to increase the risk of dementia, but there have been inconsistent results. We aimed to investigate whether the association between parental history of dementia and the risk of dementia are different by dementia subtypes and sex of parent and offspring. Methods: For this cross‐sectional study, we harmonized and pooled data for 17,194 older adults from nine population‐based cohorts of eight countries. These studies conducted face‐to‐face diagnostic interviews, physical and neurological examinations, and neuropsychological assessments to diagnose dementia. We investigated the associations of maternal and paternal history of dementia with the risk of dementia and its subtypes in offspring. Results: The mean age of the participants was 72.8 ± 7.9 years and 59.2% were female. Parental history of dementia was associated with higher risk of dementia (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.15–1.86) and Alzheimer's disease (AD) (OR = 1.72, 95% CI = 1.31–2.26), but not with the risk of non‐AD. This was largely driven by maternal history of dementia, which was associated with the risk of dementia (OR = 1.51, 95% CI = 1.15–1.97) and AD (OR = 1.80, 95% CI = 1.33–2.43) whereas paternal history of dementia was not. These results remained significant when males and females were analyzed separately (OR = 2.14, 95% CI = 1.28–3.55 in males; OR = 1.68, 95% CI = 1.16–2.44 for females). Conclusions: Maternal history of dementia was associated with the risk of dementia and AD in both males and females. Maternal history of dementia may be a useful marker for identifying individuals at higher risk of AD and stratifying the risk for AD in clinical trials. [ABSTRACT FROM AUTHOR]

Background: Time elapsed since pain onset might affect the likelihood of neuropathic component in low back pain. The aim of this study was to investigate the relationship between neuropathic pain component and pain duration in patients with low back pain and to identify factors associated with neuropathic pain component. Methods: Patients with low back pain who received treatment at our clinic were enrolled. Neuropathic component was assessed using the painDETECT questionnaire at the initial visit. PainDETECT scores and the results for each item were compared according to pain duration category (< 3 months, 3 months to 1 year, 1 year to 3 years, 3 years to 10 years, and ≥ 10 years). A multivariate analysis was used to identify factors associated with neuropathic pain component (painDETECT score ≥ 13) in low back pain. Results: A total of 1957 patients, including 255 patients who reported neuropathic‐like pain symptoms (13.0%), fully satisfied the study criteria for analysis. No significant correlation between painDETECT score and pain duration was observed (ρ = −0.025, p = 0.272), and there were no significant differences between median painDETECT score or trend of change in the proportion of patients with neuropathic component and the pain duration category (p = 0.307, p = 0.427, respectively). The electric shock‐like pain symptom was frequently reported in patients with acute low back pain, and the persistent pain pattern with slight fluctuations was predominant in chronic low back pain. The pattern of attacks with pain between them was much less common in patients with pain for 10 years or longer. Multivariate analysis revealed that a history of lumbar surgery, severe maximum pain, opioid use, lumbosacral radiculopathy, and sleep disturbance were significantly associated with a neuropathic component in low back pain. Conclusion: Time elapsed since current pain onset did not correlate with neuropathic pain component in patients with low back pain. Therefore, diagnostic and therapeutic approaches for this condition should be based on a multidimensional evaluation at assessment and not on pain duration alone. [ABSTRACT FROM AUTHOR]

Background: An assessment of paraspinal muscle degeneration based on magnetic resonance imaging has been used to investigate both sarcopenia and myosteatosis. The morphologic changes in cross‐sectional area and fat infiltration of the paraspinal muscles can affect pain outcomes after epidural steroid injection. Methods: Patients ≥65 years of age who underwent fluoroscopy‐guided lumbar epidural steroid injections were enrolled. Good analgesia was defined as ≥50% reduction in pain score at 4 weeks after injection. Cross‐sectional area and grade of fat infiltration of the paraspinal muscles on magnetic resonance images at the level of L3–L4 disc were measured. Patient demographics, pain‐related factors, clinical factors, and paraspinal muscle measurements were compared between good and poor analgesia groups. The factors associated with pain outcomes after injection were identified using multivariate analysis. Results: A total of 245 patients consisting of 149 and 96 patients in the good and poor analgesia groups, respectively, fully satisfied the study criteria for analysis. Patients of older age, opioid use, and high‐grade foraminal stenosis were frequently observed in the poor analgesia group. The grade of fat infiltration of the paraspinal muscles was significantly higher in the poor analgesia group (Grade 2, 20.8% vs. 42.7%, p < 0.001), and this result was predominantly observed in female patients. However, there was no difference in the muscle cross‐sectional area between the two groups (18.29 ± 3.16 vs. 18.59 ± 3.03 cm2/m2, p = 0.460). The percentage of patients with good analgesia decreased as the grade of fat infiltration increased (Grade 0 = 75.0%, Grade 1 = 65.8%, Grade 2 = 43.0%, p < 0.001). Multivariate logistic regression analysis revealed that preinjection opioid use [adjusted odds ratio (aOR) = 1.926, 95% confidence interval (CI) = 1.084–3.422, p = 0.025], moderate to severe foraminal stenosis (aOR = 2.859, 95% CI = 1.371–5.965, p = 0.005), and high‐grade fat infiltration of the paraspinal muscles (aOR = 4.258, 95% CI = 1.805–10.043, p = 0.001) were significantly associated with poor analgesia after injection. Conclusion: High fat infiltration of the paraspinal muscles at the mid‐lumbar region appeared to be an independent factor associated with poor analgesia after epidural steroid injection in elderly patients with symptomatic degenerative lumbar spinal disease receiving conservative care. However, the cross‐sectional area of the paraspinal muscles was not associated with pain relief after injection. [ABSTRACT FROM AUTHOR]

Background: The present study examined whether mitochondrial DNA copy number (mtDNAcn) and telomere length — key markers of cellular aging — were altered in male and female participants with obsessive–compulsive disorder (OCD) compared to healthy controls. We also tested for associations between these alterations and OCD-related clinical features and inflammatory index. Methods: A total of 235 patients with OCD (38.7% female) and 234 healthy controls (41.5% female) were included. We quantified whole-blood mtDNAcn and leukocyte telomere length using quantitative polymerase chain reaction. We also calculated the neutrophil-to-lymphocyte ratio from complete blood cell counts. Results: Multivariate analysis of covariance showed that OCD status had a significant overall effect on cellular aging markers in men (Wilks λ = 0.889, F 2,275 = 17.13, p < 0.001) and women (Wilks λ = 0.742, F 2,182 = 31.61, p < 0.001) after controlling for age, body mass index and childhood trauma. In post-hoc comparisons, men with OCD had lower mtDNAcn than controls (p < 0.001), but we found no between-group difference for telomere length (p = 0.55). Women with OCD had a significantly lower mtDNAcn (p < 0.001) and shortened telomere length (p = 0.023) compared to controls. Moreover, the lower mtDNAcn shown in the OCD group was significantly correlated with an increase in systemic inflammation for both sexes, as measured by neutrophil-to-lymphocyte ratio. Limitations: The present cross-sectional design did not allow us to infer a causal relationship between OCD disease status and cellular aging markers. Conclusion: The present study is, to our knowledge, the first to demonstrate alterations in mtDNAcn and telomere shortening in OCD. These results suggest that aging-associated molecular mechanisms may be important in the pathophysiology of OCD. [ABSTRACT FROM AUTHOR]

Objective: To date, there have been few studies on dietary supplement (DS) use in Korean children and adolescents, using nationally representative data. This study aimed to investigate the current status of DS use and its related factors, among Korean children and adolescents from the Korean National Health and Nutrition Examination Survey (KNHANES) data.Design: A cross-sectional study.Setting: Data from the KNHANES 2015-2017. Participants completed 24-h dietary recall interviews, including DS products that the subjects consumed.Participants: The study population was 4380 children and adolescents aged 1-18 years.Results: Approximately 20.3 % of children and adolescents were using DS; the highest use was among children aged 1–3 years old, and the lowest use was among adolescents aged 16–18 years. The most frequently used DS was prebiotics/probiotics, followed by multivitamin/mineral supplements. Factors that were associated with DS use were lower birth weight in children aged <4 years; younger age, higher household income, regular breakfast intake and lower BMI in children aged 4-9 years; and regular breakfast intake and use of nutrition facts label in adolescents aged 10-18 years. Feeding patterns in infancy and having chronic diseases were not associated with DS use.Conclusions: We report that over 20 % of children and adolescents use DS. Nutritional education for parents and children about proper DS consumption is needed. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the relationship between physical function and quality of life in multiple myeloma patients.Methods: In this retrospective cross-sectional study, data from patients with multiple myeloma (N = 63), who were referred to the department of Rehabilitation Medicine from October 2017 to May 2018, were reviewed. Patients were excluded based on the following criteria: acute illness, unstable medical conditions, impaired cognition or communication, refusal, or inability to perform the assessment. Physical function was evaluated with the Mini-Balance Evaluation Systems Test (Mini-BESTest), and the European Organization for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-MY20 were used for the evaluation of quality of life. To evaluate fatigue and psychotic status, the Fatigue Severity Scale and Beck Depression Inventory were used. Patients were divided into two groups ("good-function group" and "poor-function group"), based on previously studied normative values of the Mini-BESTest. Clinical data was reviewed to interrogate the contributing factors of physical function.Results: Positive correlations were observed between Mini-BESTest scores and all domains of the QLQ-C30. The Mini-BESTest score was lower in patients with lower serum hemoglobin (r = 0.396, p = 0.001) and albumin levels (r = 0.440, p < 0.001), severe disease-related symptoms (r = - 0.39, p = 0.02), and depression (r = - 0.538, p < 0.001). Further, the poor-function group showed lower hemoglobin (p = 0.024) and albumin levels (p = 0.004).Conclusion: In patients with multiple myeloma, physical function had a significant relationship with quality of life. Low hemoglobin and albumin levels, severe disease- or treatment-related symptoms, and depression were related to decreased physical function, and thus consequentially exert an effect on quality of life in multiple myeloma patients. [ABSTRACT FROM AUTHOR]

Reducing functional decline is an essential treatment goal in older adults after hip fracture surgery. The current study examined different effects of functional decline–related factors according to activities of daily living (ADL) and instrumental ADL (IADL) in older adults after hip fracture surgery. A total of 120 participants were included. In quantile regression, preoperative walking and fear of falling were significantly associated with ADLs in the 25th percentile ADL group. Fear of falling was the only significant factor in the poorest IADL group (25th percentile). Efforts should be made to reduce fear of falling after hip fracture surgery. Preoperative walking status was significant in patients with poor ADL after hip fracture surgery; therefore, walking status should be taken into consideration when planning rehabilitation care in this group, so that the best possible ADL outcomes can be attained. (6),312–320.][Research in Gerontological Nursing, 12(6),312–320.] [ABSTRACT FROM AUTHOR]

Background: The minimal literature on the relation between chronic pain and both eudaimonic (EWB) and hedonic well-being (HWB) examines the relation cross-sectionally, and most studies have examined chronic pain's effect only on psychopathology. Methods: Using a sample of 473 midlife and older adults with chronic pain, this study examined both the cross-sectional and longitudinal relations between chronic pain and EWB and HWB in addition to psychological distress. Results: Multiple-group longitudinal structural equation modeling revealed that chronic pain was related significantly and negatively to EWB and HWB, and significantly and positively to distress among both men and women. When examined longitudinally, chronic pain at time 1 was associated significantly only with decreased EWB at time 2, suggesting chronic pain's risk to psychological functioning, especially because of its long-term effects on future EWB. Conclusions: Our study provides a comprehensive picture of the way chronic pain is associated both with EWB and HWB, in addition to psychological distress. Further, chronic pain may have a lasting influence on EWB, while it may have little predictive value for future HWB and psychological distress. Our study supports well-being's relevance to chronic pain research and has the potential to guide prevention strategies and treatment for chronic pain using a positive psychological framework. [ABSTRACT FROM AUTHOR]

Background: The Institute of Medicine (IOM) revised gestational weight gain recommendations in 2009. We examined associations between healthcare provider advice about gestational weight gain and inadequate or excessive weight gain, stratified by prepregnancy body mass index category. Materials and Methods: We analyzed cross-sectional data from women delivering full-term (37–42 weeks of gestation), singleton infants from four states that participated in the 2010–2011 Pregnancy Risk Assessment Monitoring System (unweighted n = 7125). Women reported the weight gain range (start and end values) advised by their healthcare provider; advice was categorized as follows: starting below recommendations, starting and ending within recommendations (IOM consistent), ending above recommendations, not remembered, or not received. We examined associations between healthcare provider advice and inadequate or excessive, compared with appropriate, gestational weight gain using adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs). Results: Overall, 26.3% of women reported receiving IOM-consistent healthcare provider advice; 26.0% received no advice. Compared with IOM-consistent advice, advice below recommendations was associated with higher likelihood of inadequate weight gain among underweight (aPR 2.22, CI 1.29–3.82) and normal weight women (aPR 1.57, CI 1.23–2.02); advice above recommendations was associated with higher likelihood of excessive weight gain among all but underweight women (aPR range 1.36, CI 1.08–1.72 to aPR 1.42, CI 1.19–1.71). Not remembering or not receiving advice was associated with both inadequate and excessive weight gain. Conclusions: Few women reported receiving IOM-consistent advice; not receiving IOM-consistent advice put women at-risk for weight gain outside recommendations. Strategies that raise awareness of IOM recommendations and address barriers to providing advice are needed. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to identify factors influencing beliefs about intimate partner violence among Korean adults. Design and Sample This is a cross-sectional descriptive study that analyzed data from 466 adults. Measures Beliefs about intimate partner violence were measured using a self-report questionnaire with a total of 28 items consisting of four subscales: perpetrator's justification for beating women, blaming women for violence against them, perpetrator's responsibility for violence, and giving help to victims. Results Men and women had significantly different beliefs about intimate partner violence ( t = −7.19, p < .001). Some characteristics were identified that led to unhealthy beliefs about intimate partner violence. Four variables-gender, age, educational level, and witnessing parental violence-had an explanatory power of 20% with regard to beliefs about IPV ( F = 10.50, p = .000). Conclusions In South Korea, men, older individuals, and those with less formal education or who have witnessed parental violence need education to foster healthier beliefs about intimate partner violence. Nurses can play a vital role in efforts to decrease intimate partner violence. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the differences in suicide risk, meaning in life, and need for life respect among three age groups (young adults, the middle aged, and the elderly) of 540 public hospital outpatients in South Korea. This was a cross-sectional study. Among these 3 age groups, we observed significant differences in suicide risk, meaning in life, and need for life respect according to education level, marital status, living arrangements, type of disease, gender, and monthly income. These findings might contribute to the prevention of suicide in the future and the implementation of better community-based nursing care. [ABSTRACT FROM PUBLISHER]

Purpose The aim of this study was to identify the physiological, psychological, and situational factors affecting fatigue among mothers of hospitalized children. Design and Methods This study used a cross-sectional descriptive design with a self-report questionnaire. Participants were 211 mothers with children younger than 6 years old who were admitted to general hospitals. Based on the theory of unpleasant symptoms, the physiological, psychological, and situational factors were tested using structural equation modeling. Results Mothers' fatigue was influenced by physiological ( β = .24), situational, and psychological factors ( β = .17), and situational ( β = .37) factors such as the mother's sleeping hours, the child's adaptation to hospitalization, anxiety and having support with their housework. These three factors explained 31.34% of the variance in fatigue. In particular, it was found that the psychological factors exacerbate the negative influence of the situational factors on fatigue. Moreover, the situational factors were most strongly related to mothers' fatigue, and they had an indirect effect via the psychological factors as a mediator. Practice Implications It is necessary to implement a nursing intervention that targets the controllable factors such as anxiety and children's adaptation to hospitalization that were identified in this study. Pediatric nursing care should not be limited to treating children's illnesses, but should be extended to providing family-centered care. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the association of a urinary tubular marker, liver-type fatty acid binding protein (L-FABP) and an inflammatory marker, serum/urinary YKL-40, with albuminuria in patients with childhood-onset type 1 diabetes (T1D). Methods: Twenty-nine patients with childhood-onset T1D and 32 controls were enrolled. Serum and urinary concentrations of YKL-40 and urinary concentrations of L-FABP were measured. Results: The serum levels of YKL-40 were not significantly different between the control group and the patient groups. However, the levels of urinary YKL-40/creatinine (Cr) were higher in the patients, even those with normoalbuminuria than in the controls ( p < 0.001). The levels of urinary L-FABP/Cr were not different between the control group and the patient groups. However, the level of urinary L-FABP/Cr in the microalbuminuria group was higher than that in the normoalbuminuria group ( p = 0.03). There were no associations between the levels of urinary albumin-to-creatinine ratio and urinary L-FABP/Cr or YKL-40/Cr. However, the urinary L-FABP/Cr level was significantly correlated with the hemoglobin A1C level ( p = 0.005) and the urinary YKL-40/Cr level ( p = 0.043). Conclusions: Urinary L-FABP/Cr and YKL-40/Cr may reflect renal injury in early stages of nephropathy in patients with childhood-onset T1D, even in the normoalbuminuric state. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the relationship between different types of living arrangements and depressive symptoms among older Korean women and men. Methods: Data were obtained from a nationally representative cross-sectional health survey conducted in 2009 in South Korea. A total of 60,305 participants (34,172 women and 26,133 men) aged 60 years and older were included in the analysis. The living arrangements were categorised into six types as follows: (1) living with a spouse only; (2) living with a spouse in an extended family; (3) living with a spouse in a nuclear family; (4) living alone; (5) living without a spouse in an extended family; and (6) living without a spouse in a nuclear family. The Korean version of the Center for Epidemiologic Studies Depression Scale was used as the measurement tool for depressive symptoms. We used multiple regression analysis to estimate the effects of living arrangement on depressive symptoms. Results: A total of 16.8 % of the total study population showed depressive symptoms. Living with a spouse only was the most common type of living arrangement (46.3 %). Women and men living with a spouse only were the least likely to have depressive symptoms. However, living without a spouse in a nuclear family and living alone were most strongly associated with depressive symptoms in women (OR 1.81; 95 % CI 1.64-2.00) and men (OR 2.71; 95 % CI 2.43-3.03), respectively. Conclusions: The prevalence of depressive symptoms are associated with the living arrangements of elderly Koreans. There are gender differences in these associations, that may stem from the different demands of social roles and relationships in the family. [ABSTRACT FROM AUTHOR]

ObjectiveWe aimed to assess the prevalence and associated factors of vitamin D deficiency in healthy adolescents and to determine parent–adolescent association in vitamin D status.DesignA cross-sectional study.SettingData from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2009. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using 125I-labelled RIA kits. Vitamin D deficiency in adolescents was defined as 25(OH)D level <27·5 nmol/l, and 25(OH)D levels between 27·5 and <50 nmol/l were considered insufficient. For the parents, vitamin D deficiency was defined as 25(OH)D level <50 nmol/l.SubjectsThe study population consisted of 2062 adolescents (1095 boys, 967 girls; aged 10–18 years) and their parents (1005 fathers, 1341 mothers).ResultsOverall, 13·4 % of adolescents (boys 11·7 %, girls 15·4 %) were 25(OH)D deficient, 54·7 % were 25(OH)D insufficient. Prevalence of vitamin D deficiency increased with age (P < 0·0001). Parental vitamin D deficiency was more prevalent in vitamin D-deficient adolescents than in non-deficient adolescents (all P < 0·0001). In multivariate logistic regression analyses, predictors for vitamin D deficiency were senior high school students (OR = 3·45–4·33), winter/spring season (OR = 3·18–5·11/5·35–7·36) and parental vitamin D deficiency (OR = 1·78–4·88; all P < 0·05).ConclusionsVitamin D insufficiency is prevalent among healthy Korean adolescents and the parent–offspring association warrants vitamin D screening for family members of deficient individuals. [ABSTRACT FROM AUTHOR]

In this study, we identified the factors influencing behavioral intention to undergo Papanicolaou testing among Japanese and Korean women in early adulthood. Their behavioral intentions were compared in this cross-sectional descriptive study. In total, 887 women (Japanese = 498, Korean = 389) aged 20-39 years participated in this study. Using a self-report questionnaire, knowledge, attitudes, subjective norm, perceived behavioral control, and behavioral intention were surveyed. There were significant differences between Japanese and Korean women's scores on all main variables. For Japanese women, all the variables moderately correlated with behavioral intention. In comparison, for Korean women, all independent variables, except for knowledge, moderately correlated with behavioral intention. Through a multiple regression analysis, age, undergoing Papanicolaou testing, attitudes, subjective norm, and perceived behavioral control were identified as significant predictors of behavioral intention among Japanese women. Among Korean women, job status, undergoing a Papanicolaou test, attitudes, subjective norm, and perceived behavioral control were demonstrated as significant predictors of behavioral intention. Health professionals should consider these factors to encourage Papanicolaou testing in women in early adulthood. [ABSTRACT FROM AUTHOR]