No abstract available.
Calcinosis ; Calcium ; Calcium Gluconate ; Gluconates ; Humans ; Infant, Newborn

Purpose: This study reviewed the pathophysiological mechanisms of cellular aging caused by psychological stress and aimed to establish a biobehavioral theoretical framework for nursing interventions to promote autonomic balance based on these mechanisms. Methods: A comprehensive literature review was conducted. Results: A review of the literature showed that the stress response increases the secretion of catecholamines and glucocorticoids, resulting in a greater allostatic load. This load induces inflammatory reactions and oxidative stress, shortening telomere length and damaging mitochondrial DNA, which can lead to cellular aging. Based on this mechanism, a biobehavioral theoretical framework for nursing interventions was established. This framework focuses on delaying or inhibiting the cellular aging process by acting on the stress response stage and improving autonomic balance. Conclusion According to the proposed biobehavioral theoretical framework, stress-relieving nursing interventions may act on the mechanism of cellular aging caused by stress responses. We believe that this framework could expand our understanding of the biobehavioral aspects of stress and would facilitate efforts to use biomarkers to evaluate the effectiveness of stress-related nursing interventions at the cellular level.

PURPOSE: This study was to identify factors influencing the quality of sleep in elderly women with urinary incontinence and examine the relationship among the factors. METHODS: The study investigated 113 elderly women with urinary incontinence who were subject to the visiting care program at health centers in D-gu, D-si, South Korea. The collected data were analyzed using IBM SPSS version 19.0 along with χ²-test, t-test, ANOVA, Pearson's correlation, and multiple regression. RESULTS: The total Pittsburgh Sleep Quality Index (PSQI) of the participants was found to be 11.41±4.34. As a result of the correlation analysis, PSQI was found to have significant correlations with Female Lower Urinary Tract Symptoms (BFLUTS) (r=.32, p<.001). The Korean version of Physical Activity Scale for Elderly (K-PASE) was (r=−.34, p<.001) and the Geriatric Depression Scale Short Form (GDS-SF) was (r=.23, p=.012). Multiple regression analysis found sleeping pill use (β=−.35, p<.001) had the strongest influence on PSQI, followed by physical activity (β=−.20, p<.001), depression (β=.20, p<.001), and lower urinary tract symptoms (β=.19, p<.001). The total model explanatory power was 28.3% (F=12.07, p<.001). CONCLUSION: The study findings are expected to be useful for enhanced understanding of the quality of sleep in elderly women with urinary incontinence.
Aged* ; Depression* ; Female ; Humans ; Korea ; Lower Urinary Tract Symptoms* ; Motor Activity* ; Urinary Incontinence*

Purpose: The purpose of the study was to re-evaluate Florence Nightingale’s achievements celebrating the 200 th anniversary of Nightingale’s birth and to reflect on her legacy. Methods: We conducted an extensive literature review with key words in Korean and English using 9 electronic databases, related data, books, articles, websites, and secondary literature. Results: As a result of this study, the five legacy of Nightingale as a social reformer were examined. First, founding nursing in response to social needs. Second, reform of the health care system. Third, a practical social activist who promoted social change for the public good. Fourth, first adoption of health statistics. Fifth, emancipation of women. Nightingale’s legacy as a social reformer has had an considerable influence on our society so far. Conclusion Nightingale was a pioneer in nursing, but she was a social reform activist who successfully transformed the medical systems and even the whole social system based on her keen insight, religious vocation, profession vision, and personal competency. In the middle of World’s chaos and uncertainty due to the COVID-19 pandemic, it seems more necessary than ever to embody the legacy of Nightingale as a social reformer, and put it into practice.

BACKGROUNDS/AIMS: While clinical practice guidelines are effective tools for improving the quality of patient care and provide specific recommendations for daily practice, the usage of them have been often suboptimal. Therefore, evaluation of physician attitude to guidelines is an important initial step in improving guideline adherence levels. The aim of this study was to survey the attitude on general guidelines and adherence with the Korea Practical Guidelines for gallbladder (GB) polyp two year after their publication and distribution among Korean private clinicians. METHODS: To evaluate the survey, questionnaires were sent with a stamp on an addressed envelope to 3,256 private clinicians who were registered at the Seoul Medical Association in April, 2010. From the 3,256 questionnaires, 376 clinicians (11.5%) responded to the survey. RESULTS: A total of 91.0% responders agreed to the statement that general guidelines were useful tools for improving patient care and quality of care. One hundred one responders (26.9%) stated that they were aware of the Korea GB polyp guidelines while 73 physicians (72.3%) founded the guideline had changed their practice and user-friendly. Most of physicians (73.4%) agreed to practical procedures recommended by guidelines. CONCLUSIONS: Korean primary physicians were generally positive to the practical guidelines, as propagation of the guideline among primary physicians may improve adherence to guideline and patients care for GB polyps.
Gallbladder* ; Guideline Adherence ; Humans ; Korea ; Patient Care ; Polyps* ; Publications ; Seoul ; Surveys and Questionnaires

BACKGROUND: High-intensity focused ultrasound (HIFU) treatment has recently emerged in response to the increasing demand for noninvasive procedures for skin lifting and tightening. OBJECTIVE: This study was aimed at evaluating the clinical efficacy of and patient satisfaction with HIFU treatment for wrinkles and laxity in seven different areas of the face in Asian skin. METHODS: Twenty Korean patients with facial wrinkle and laxity were analyzed after a single session of HIFU treatment. Two independent, blinded clinicians evaluated the clinical improvement in seven areas of the face by comparison of standardized photographs obtained before, and at 3 and 6 months after treatment. Assessment of subjective satisfaction and adverse effects of treatment were done by using questionnaires. RESULTS: The physicians' evaluation and patients' satisfaction with the clinical effects of HIFU in each area were similar regardless of the number of treatment shots. The jawline, cheek, and perioral areas were the sites where HIFU was most effective, in decreasing order. The adverse effects included erythema and swelling in six cases, and purpura and bruising in two cases. However, the adverse effects were mild and transient. CONCLUSION: HIFU could be a safe, effective, and noninvasive procedure that can be used to improve facial wrinkles and skin laxity in Asian skin. It is particularly effective for clinical improvement in the jawline, cheek, and perioral areas.
Asian Continental Ancestry Group ; Cheek ; Erythema ; Humans ; Lifting ; Patient Satisfaction ; Purpura ; Skin* ; Ultrasonography*

Objectives: Statins are essential in the prevention of cardiovascular disease; however, their association with type 2 diabetes mellitus (T2DM) risk is concerning. We examined whether genetic susceptibility to T2DM modifies the association between regular statin use and T2DM risk. Methods: This study included 447 176 individuals from the UK Biobank without baseline diabetes or major cardiovascular disease. Statin use was recorded at baseline, and T2DM incidence was determined using clinical records. Polygenic risk scores (PRS) for T2DM risk were provided by the UK Biobank. Using propensity scores adjusted for age, sex, body mass index, and comorbidities, 14 831 statin users were matched with 37 060 non-users. Cox proportional hazards models were used to estimate the interaction effect of statin use and PRS on T2DM incidence, adjusting for key confounders. Results: In the propensity-matched cohort, 3675 of 51 891 participants developed T2DM over a mean follow-up period of 13.7 years. Within the top 5% of the PRS distribution, per 1000 person-years, the incidence of T2DM was 15.42 for statin users versus 12.18 for non-users. Among the lowest 5%, the incidence was 1.90 for statin users and 1.65 for non-users. Based on the Cox proportional hazards model, regular statin use was associated with a 1.24-fold increased T2DM risk (95% confidence interval [CI], 1.15 to 1.33). Furthermore, PRS exhibited a significant multiplicative interaction with regular statin use (odds ratio, 1.10; 95% CI, 1.02 to 1.19). Conclusions PRS may help identify individuals particularly susceptible to the diabetogenic effects of statins, providing a potential path for personalized cardiovascular disease management.

Objectives: Statins are essential in the prevention of cardiovascular disease; however, their association with type 2 diabetes mellitus (T2DM) risk is concerning. We examined whether genetic susceptibility to T2DM modifies the association between regular statin use and T2DM risk. Methods: This study included 447 176 individuals from the UK Biobank without baseline diabetes or major cardiovascular disease. Statin use was recorded at baseline, and T2DM incidence was determined using clinical records. Polygenic risk scores (PRS) for T2DM risk were provided by the UK Biobank. Using propensity scores adjusted for age, sex, body mass index, and comorbidities, 14 831 statin users were matched with 37 060 non-users. Cox proportional hazards models were used to estimate the interaction effect of statin use and PRS on T2DM incidence, adjusting for key confounders. Results: In the propensity-matched cohort, 3675 of 51 891 participants developed T2DM over a mean follow-up period of 13.7 years. Within the top 5% of the PRS distribution, per 1000 person-years, the incidence of T2DM was 15.42 for statin users versus 12.18 for non-users. Among the lowest 5%, the incidence was 1.90 for statin users and 1.65 for non-users. Based on the Cox proportional hazards model, regular statin use was associated with a 1.24-fold increased T2DM risk (95% confidence interval [CI], 1.15 to 1.33). Furthermore, PRS exhibited a significant multiplicative interaction with regular statin use (odds ratio, 1.10; 95% CI, 1.02 to 1.19). Conclusions PRS may help identify individuals particularly susceptible to the diabetogenic effects of statins, providing a potential path for personalized cardiovascular disease management.

Objectives: Statins are essential in the prevention of cardiovascular disease; however, their association with type 2 diabetes mellitus (T2DM) risk is concerning. We examined whether genetic susceptibility to T2DM modifies the association between regular statin use and T2DM risk. Methods: This study included 447 176 individuals from the UK Biobank without baseline diabetes or major cardiovascular disease. Statin use was recorded at baseline, and T2DM incidence was determined using clinical records. Polygenic risk scores (PRS) for T2DM risk were provided by the UK Biobank. Using propensity scores adjusted for age, sex, body mass index, and comorbidities, 14 831 statin users were matched with 37 060 non-users. Cox proportional hazards models were used to estimate the interaction effect of statin use and PRS on T2DM incidence, adjusting for key confounders. Results: In the propensity-matched cohort, 3675 of 51 891 participants developed T2DM over a mean follow-up period of 13.7 years. Within the top 5% of the PRS distribution, per 1000 person-years, the incidence of T2DM was 15.42 for statin users versus 12.18 for non-users. Among the lowest 5%, the incidence was 1.90 for statin users and 1.65 for non-users. Based on the Cox proportional hazards model, regular statin use was associated with a 1.24-fold increased T2DM risk (95% confidence interval [CI], 1.15 to 1.33). Furthermore, PRS exhibited a significant multiplicative interaction with regular statin use (odds ratio, 1.10; 95% CI, 1.02 to 1.19). Conclusions PRS may help identify individuals particularly susceptible to the diabetogenic effects of statins, providing a potential path for personalized cardiovascular disease management.

BACKGROUND/AIMS: Gastrointestinal (GI) diseases impose a heavy economic burden. We aimed to provide the first report on the health care utilization and costs of GI diseases in Korea. METHODS: We collected the data from all insurance claims database of National Health Insurance Corporation in Korea and the cause of death database in 2007 of Korea National Statistical Office. We compiled information about all digestive disease as a primary diagnosis on clinic visits, hospitalization, and cause of death from these databases. RESULTS: Seventeen million people (35.6%) had a diagnosis of GI diseases during the year 2007. Among them, the proportion of patients with upper GI diseases was prevalent in 54.9% (9.5 million patients/year). The 1/4 patients in out-patients clinic had any one of gastroesophageal reflux disease, irritable bowel syndrome and constipation. Thirteen percent of the total direct cost in 2007 was attributed to all GI diseases, which was 3,649 billion won (0.4% of GDP). The patients with hospitalization occupied by 5% of all patients with GI diseases, however, attributed to 58.9% of GI-related direct costs. GI malignancy was the major cause of medical expenses in hospitalization. Stomach cancer continues to be the leading cause of GI-related death in Korea. CONCLUSIONS: GI diseases causes a heavy socioeconomic burden with high morbidity of functional GI disorders in outpatients care and high mortality of GI malignancy in inpatient care. This report highlights the healthcare utilization burden of GI diseases for researchers and public health policy maker to create new directions of integrated researches and health care plan.
Databases, Factual ; Gastrointestinal Diseases/*economics ; Gastrointestinal Neoplasms/economics/mortality ; *Health Care Costs ; Hospitalization/economics ; Humans ; National Health Programs/economics ; Republic of Korea ; Survival Analysis