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Objectives: To investigate differences in the incidence of enteropathy or intestinal malabsorption in patients taking angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme inhibitor (ACEI), calcium channel blocker (CCB), and beta blockers (BBs) at a single center in Korea. Methods: In this retrospective study, we utilized data from the Yangsan electronic medical records to identify 129,169 patients. These individuals were prescribed olmesartan, other ARBs, ACEI, CCB, and BBs between November 2008 and February 2021. Results: Of the 44,775 patients, 51 (0.11%) were observed to have enteropathy or intestinal malabsorption. Compared with the ACEI group, the adjusted odds ratios (ORs) for enteropathy and intestinal malabsorption were OR=1.313 (95% confidence interval [CI]: [0.188-6.798], p=0.893) for olmesartan, OR=0.915 (95% CI: [0.525-1.595], p=0.754) for the other ARBs, OR=0.928 (95% CI: [0.200-4.307]; p=0.924) for the CCB, and OR=0.663 (95% CI: [0.151-2.906]; p=0.586) for the BBs group. These findings were adjusted for factors such as age, gender, duration of antihypertensive medication, and comorbidities. Conclusion: In a retrospective cohort study of patients on antihypertensive medications, no significant difference was found in the incidence of enteropathy or intestinal malabsorption when ACEI was compared to olmesartan, other ARBs, CCB, and BBs. [ABSTRACT FROM AUTHOR]

Background Considering the prolongation of the COVID-19 pandemic, the lack of studies on burnout, particularly in healthcare workers, needs to be addressed. This report aimed to identify the risk factors of burnout by comparing the level of burnout between nurses in general wards and those in COVID-19-dedicated wards in a national university hospital. Methods A survey based on the Korean version of Burnout Assessment Tool (BAT-K) was conducted on nurses between 10 January and 31 January 2022. The BAT-K consists of exhaustion, mental distance, cognitive impairment, emotional impairment and secondary symptoms. Results A total of 165 nurses, including 81 nurses from the COVID-19-dedicated ward, completed the questionnaire. The percentage of general-ward nurses with an emotional impairment score above the clinical cutoff was higher than that of COVID-19 ward nurses. General ward compared to the COVID-19 ward increased the risk of presenting with total-core symptoms. Two factors increased the risk regarding mental distance: short career length and underlying disease. Conclusions In contrast to previous studies, the risk of burnout in the COVID-19-ward nurses was lower than that of the general ward nurses. The risk regarding mental distance was correlated with short career length and presence of an underlying disease. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to evaluate irritable bowel syndrome (IBS) as a risk factor for osteoporosis and osteoporotic fracture in Korean women after controlling for basic confounding factors and considering detailed demographic and clinical information.Subjects and Methods: We performed a nationwide population-based retrospective cohort analysis and matched every IBS case with a non-IBS case at a 1:4 frequency ratio based on age. The population consisted of female patients with data in the Health Insurance Review and Assessment (HIRA) database from 2002 to 2010. To determine the risk of osteoporosis and osteoporotic fracture in IBS and non-IBS patients, hazard ratios (HRs) with 95% confidence intervals (CI) were estimated using Cox proportional hazards regression models, adjusting for confounding variables, such as the area of residence, health insurance type, and economic status.Results: We identified 1,017,468 patients in the HIRA database with data from 2002 to 2010 who could potentially be included in the cohort. Among these, we identified 1,545 (11.4%) women (age >19 years) with newly diagnosed IBS (IBS group). Additionally, 6,180 patients without IBS and age-matched to the IBS group were selected. Cox modeling revealed that the crude HRs for osteoporosis and osteoporotic fractures in patients with IBS were 1.476 (95% CI, 1.241-1.754) and 1.427 (95% CI, 1.086-1.876), respectively.Conclusion: Our data showed an increased incidence of osteoporosis and osteoporotic fractures in women with IBS compared with age-matched controls. [ABSTRACT FROM AUTHOR]

Background: Many older adults prefer to live alone in their own homes, with age-related issues in physical movement, regardless of their cultural background. Importantly, however, to identify the features of successfully ageing in place (AIP), and foster independent living among these individuals, this study explored their level of self-confidence to live alone and its related factors.Methods: We conducted a cross-sectional study using secondary data from an earlier study with older adults living alone in South Korea recruited by convenience sampling methods (N = 936, mean age = 77.1 years, 76.1% female). Data regarding the general, health-related, and social characteristics as well as self-confidence to live alone were collected via face-to-face interviews in 2019. Self-confidence to live alone was measured with a numeric rating scale of 0 to 10.Results: The average self-confidence score to live alone was 6.59. A regression analysis showed that mould exposure at home, depression, emergency department visits, and loneliness hinder self-confidence to live alone. Meanwhile, such self-confidence was facilitated by independency in instrumental activities of daily living (IADL), interactions with family members, social service utilisation, and social support.Conclusions: This study suggests that healthcare providers need to consider the importance of self-confidence to live alone and influencing functional, mental, social, and environmental factors to promote quality of life as well as successful AIP for older adults living alone. Further, self-confidence to live alone could be a new practical index in the field of health and ageing to screen the successful AIP of older adults living alone. [ABSTRACT FROM AUTHOR]

Background: Obesity is an important risk factor of cardiovascular disease (CVD). Atherosclerosis can be considered an important signal of CVD. Primary physicians can reduce the risk of CVD by preventing and treating obesity. Therefore, finding a tool to diagnose the association of obesity with arteriosclerosis is important. The association between obesity parameters and arterial stiffness remains controversial. To our knowledge, no previous studies reported the relationships between multiple new anthropometric parameters (a body shape index [ABSI], body round index [BRI], and visceral adiposity index [VAI]) and brachial-ankle wave velocity (ba-PWV) as an indicator of CVD risk, especially in the Korean population. Objective: To investigate the relationships between arterial stiffness (assessed using ba-PWV) and anthropometric parameters estimated on the basis of body mass index (BMI), waist circumference (WC), ABSI, BRI, and VAI, and to identify the indicators of obesity that best represents CVD risk. Methods: A total of 2,647 adults (1,474 men and 1,173 women) were recruited for this cross-sectional study. The correlations between the anthropometric indexes (BMI, WC, ABSI, BRI, and VAI) and mean ba-PWV were analyzed. A multivariate linear regression analysis was performed to evaluate the association between each anthropometric and the presence of arterial stiffness. Results: We investigated the relationships between the obesity parameters and ba-PWV by adjusting the covariates (age, diabetes mellitus [DM], hypertension [HTN], and smoking status) related to the mean ba-PWV. In the multivariate regression analysis, ABSI (men: β =0.066, p<0.01; women: β =0.087, p<0.001) and VAI (men: β =0.067, p<0.01; women: β =0.136, p<0.001) were found to be significantly correlated with the mean ba-PWV in both men and women in Korea. Conclusion: Among the new obesity indices, ABSI and VAI were found to be significantly associated with arterial stiffness, represented by the mean ba-PWV, in both men and women in Korea. These results suggest that ABSI and VAI may be convenient, highly cost-effective, and simple assessment tools for obesity and CVD risk in clinical practice. [ABSTRACT FROM AUTHOR]

BACKGROUND Although previous studies have explored the effect of smoking on blood pressure, little is still known about the role of time to first cigarette (TTFC)—an indicator of nicotine dependence—in hypertension. Therefore, we evaluated this association using representative nationwide data. METHODS Current daily smokers (N = 941; aged 19–79 years) who participated in the 7th version of the Korea National Health and Nutrition Examination Survey I (2016) were included. We categorized participants into 4 groups according to their TTFC. Furthermore, we categorized participants into hypertensive and nonhypertensive groups based on whether they were taking antihypertensive medications or had high blood pressure (≥140/90 mm Hg). The association of daily TTFC and hypertension was examined without adjusting for any covariates; after adjusting for smoking behaviors; and after adjusting for demographic characteristics, socioeconomic status, health-related behaviors, and comorbidities. RESULTS In the fully adjusted weighted regression analysis, participants reporting TTFC ≤ 5 minutes (vs. >60 minutes) had roughly twice the odds of having hypertension (95% confidence interval [CI] = 1.07–4.16) and the adjusted odds ratios compared with TTFC of >60 minutes were 1.53 (95% CI = 0.81–2.86) for 6–30 minutes and 1.31 (95% CI = 0.68–2.50) for 31–60 minutes (P trend = 0.03). CONCLUSIONS Hypertension risk increases with shorter TTFC. Especially, TTFC of ≤5 minutes may prove valuable in assessing the risk of hypertension. Screening smokers based on their TTFC might be useful in assessing their risk of hypertension and smoking cessation programs. [ABSTRACT FROM AUTHOR]

Objective: Breast arterial calcifications (BACs) are common but underreported findings on mammography. The purpose of this study was to examine the relationship between BACs, metabolic syndrome (MS), and coronary heart disease (CHD) risk. Research Design and Methods: This was a case-control study. A total of 101 women with BACs and 101 age-matched controls without BACs were included in the analysis. BACs were calculated using the mammography of both breasts, and then the total BACs were summed. MS was defined by using criteria from the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). The 10-year estimated CHD relative risk (10-year CHD risk) was calculated based on the Framingham Scores. Metabolic characteristics were compared between the BAC positive group and the BAC negative group. Results: Diabetes ( P=0.039) and MS ( P=0.043) were more frequently observed in the BAC positive group than in the BAC negative group. The only independent factor was MS ( P=0.04). The 10-year CHD risk was higher in the BAC positive group than in the negative group ( P=0.007). Furthermore, the more extensive the BACs, the greater increase in the 10-year CHD risk (r=0.167, P=0.018). Conclusions: Findings of BACs on mammogramy are associated with an increased risk of MS and the calculated risk of CHD in women older than 40 years of age. [ABSTRACT FROM AUTHOR]

Korea initiated a new experiment, called a dynamic response system for open democratic societies as a principle to respond to the novel coronavirus (COVID-19). The global pandemic of COVID-19 led to a surge in demand for healthcare medical masks and respirators, and strained the global supply chain of mask production and distribution systems. This study provides a systemic view of critical personal protective equipment for both healthcare staff and the public to stop the spread of COVID-19. This study investigates the dynamic response system of healthcare mask production to the coronavirus and discusses lessons learned in view of systems thinking. The study shows that it is critical to developing a quick and dynamic response system to the evolving market conditions with flexible and agile operations. Visibility with transparency with information sharing with the public is also critical under global pandemic. Due to the shortage of mask supply, smart consumption is required along with collaboration with public and private sectors, as well as global organizations. Democratic leadership and a well-prepared strategic plan for long-term period are essential to the open society to prepare the global pandemic in the future. This study serves as a benchmark for dynamic and timely responses to the global pandemic. [ABSTRACT FROM AUTHOR]

Background: This study investigates the effects of a new medical insurance payment system for hospice patients in palliative care programs and analyzes length of survival (LoS) determinants. Method: At the Pusan National University Hospital hospice center, between January 2015 and April 2016, 276 patients were hospitalized with several diagnosed types of terminal stage cancer. This study separated patients into two groups, “old” and “new,” by admission date, considering the new system has been applied from July 15, 2015. The study subsequently compared LoS, total cost, and out-of-pocket expenses for the two groups. Results: Overall, 142 patients applied to the new medical insurance payment system group, while the old medical insurance payment system included 134 patients. The results do not show a significantly negative difference in LoS for the new system group (p = 0.054). Total cost is higher within the new group (p < 0.001); however, the new system registers lower patient out-of-pocket expenses (p < 0.001). Conclusion: The novelty of this study is proving that the new medical insurance payment system is not inferior to the classic one in terms of LoS. The total cost of the new system increased due to a multidisciplinary approach toward palliative care. However, out-of-pocket expenses for patients overall decreased, easing their financial burden. [ABSTRACT FROM AUTHOR]

• Men were more likely to report suicidal thoughts and feeling lonely and depressed. • Women reported less cognitive function, social support, and lower QoL scores. • Men reported needing more help in preparing food and connecting to older adult education programs. • Women needed more help with home repairs and health and movement support. • Mental and physical health were associated with QoL for older adults living alone. The aim of this study was to identify gender differences in the health status, community service needs, and quality of life of older adults living alone in an urban city in South Korea. A cross-sectional descriptive correlational design was used. The study sampled 1023 older adults (≥65 years) living alone in S* City, during the period from August to October in 2018. Trained interviewers conducted face-to-face interviews with the participants, using the UCLA Loneliness Scale, Short Form Geriatric Depression Scale – Korean version, ENRICHD Social Support Instrument (ESSI), the Mini-Mental State Examination Standard Version (MMSE-2SV), and Health-Related Quality of Life (EQ-5D). 77.8% were women and the mean age was 77.38 years (men = 74.65, women = 78.16). Women had lower socioeconomic and health status than men. Men felt more lonely, depressed, and had suicidal thoughts more frequently than women. Women had more needs regarding care, residential environment, movement, connection, and emergency services than men. In men, depressive symptoms, suicidal thoughts, loneliness, and right-hand grip strength were identified using the EQ-5D. The EQ-5D was also used to explain depressive symptoms, suicidal thoughts, cognitive function, and physical activity in women. Health status and community service needs were dependent on gender; therefore interventions should be tailored according to gender. Our research found that to decrease depression and suicidal thoughts, improve physical health, and enhance quality of life for older adults living alone, interventions need to be designed to decrease male loneliness and to enhance female cognitive function. [ABSTRACT FROM AUTHOR]

• Data-driven techniques are a fruitful way of studying the psychosocial patterning. • Our study identified three distinct profiles of psychosocial risk among older adults. • Various factors associated with profile membership may inform tailored interventions. Objectives. This study explored the psychosocial risk profiles and various characteristics associated with profile membership among Korean older adults living alone. Methods. Our analyses were based on a cross-sectional cohort of 1030 community-dwelling older adults (≥ 65 years) living alone in one Korean city. Latent profile analysis was used to identify psychosocial risk profiles across a wide range of psychosocial dimensions (depressive symptoms, suicidal ideation, cognitive dysfunction, loneliness, and perceived social support). We then explored the characteristics associated with distinct profiles by conducting bivariate and regression analyses. Results. The three-profile was selected as the best solution: a group with high cognitive dysfunction, high loneliness, and low social support (profile 1), a group with low psychological risks and high social support (profile 2), and a group with high depression and high suicidal ideation (profile 3). Regression analyses showed that a lower frequency of interaction with neighbors or families, a greater frailty score, and lower quality of life were significantly associated with profile 1 or profile 3 than with profile 2 (p <.05). Further, being male and having a poorer nutritional status was more significantly related to profile 3 than profile 2 (p <.05). Conclusions. Findings provide evidence for healthcare professionals when developing interventions to prevent and reduce these psychosocial risks for older individuals living alone. In particular, factors associated with profile membership identified in the study may facilitate more tailored interventions. [ABSTRACT FROM AUTHOR]