Background: With increasing life expectancy, the number of older adults with multiple chronic conditions requiring complex medication regimens is growing, raising concerns about polypharmacy and potentially inappropriate medication (PIM) use. This study investigated trends in polypharmacy and PIM use among 66-year-olds in South Korea from 2012 to 2021, considering participant characteristics, to inform interventions and policies. Methods: A repeated cross-sectional study was conducted using the National Health Insurance Services database covering approximately 97% of Koreans. We included 3,397,044 individuals aged 66 who underwent the National Screening Program for Transitional Ages between 2012 and 2021. Polypharmacy was defined as the use of ≥5 medications for ≥90 days annually, hyper-polypharmacy as ≥10 medications, and PIM use as ≥1 PIM for ≥28 days. Trends were analyzed by sex, frailty, comorbidity, income, insurance type, and residence. Results: Polypharmacy prevalence increased from 32.0% in 2012 to 35.4% in 2021, and hyper-polypharmacy also rose. PIM use slightly decreased from 55.7% to 53.7%. Higher rates of polypharmacy and PIM use were observed among rural residents, medical aid beneficiaries, and those with lower income. Despite improvements in comorbidity and frailty, socioeconomic disparities widened, particularly among medical aid beneficiaries. Frequently prescribed PIMs included NSAIDs, PPIs, muscle relaxants, and anxiolytics/hypnotics. Conclusion While PIM use slightly decreased over the study period, it remained above 50%, and polypharmacy prevalence increased among older adults in Korea. Socioeconomic disparities in medication use persist, highlighting the need for targeted interventions and policies to promote safe medication use among vulnerable groups.

Purpose: This study aimed to evaluate the effect of information regarding health and safety risks on the subjective health status of workers using data from the Fifth Korean Working Conditions Survey. Methods: Among the survey respondents, 30,094 people classified as salaried workers, of which 8,513 (28.3%) used protective equipment. Results: Although the majority of workers using protective equipment reported being well-informed about safety and health risks, 15% of them were still insufficiently informed. Multivariate analyses have shown that the subjective health status of workers using protective equipment was significantly better if they received sufficient information.When the workers using protective equipment were classified by the kinds of hazards they were exposed to, the satisfaction of information was also significantly beneficial for the subjective health status of all groups. However, in workers who did not use protective equipment, information satisfaction did not appear to be a significant factor. Conclusion These results suggest that when providing information on safety and health risks, it is necessary to focus on workers using protective equipment, for whom the effects of the policy are clearly expected.

Clonorchis sinensis is a food-borne trematode that infects more than 15 million people. The liver fluke causes clonorchiasis and chronical cholangitis, and promotes cholangiocarcinoma. The underlying molecular pathogenesis occurring in the bile duct by the infection is little known. In this study, transcriptome profile in the bile ducts infected with C. sinensis were analyzed using microarray methods. Differentially expressed genes (DEGs) were 1,563 and 1,457 at 2 and 4 weeks after infection. Majority of the DEGs were temporally dysregulated at 2 weeks, but 519 DEGs showed monotonically changing expression patterns that formed seven distinct expression profiles. Protein-protein interaction (PPI) analysis of the DEG products revealed 5 sub-networks and 10 key hub proteins while weighted co-expression network analysis (WGCNA)-derived gene-gene interaction exhibited 16 co-expression modules and 13 key hub genes. The DEGs were significantly enriched in 16 Kyoto Encyclopedia of Genes and Genomes pathways, which were related to original systems, cellular process, environmental information processing, and human diseases. This study uncovered a global picture of gene expression profiles in the bile ducts infected with C. sinensis, and provided a set of potent predictive biomarkers for early diagnosis of clonorchiasis.

Clonorchis sinensis is a carcinogenic human liver fluke that promotes hepatic inflammatory environments via direct contact or through their excretory-secretory products (ESPs), subsequently leading to cholangitis, periductal fibrosis, liver cirrhosis, and even cholangiocarcinoma (CCA). This study was conducted to examine the host inflammatory responses to C. sinensis ESPs and their putative protein components selected from C. sinensis expressed sequenced tag (EST) pool databases, including TGF-β receptor interacting protein 1(CsTRIP1), legumain (CsLeg), and growth factor binding protein 2 (CsGrb2). Treatment of CCA cells (HuCCT1) with the ESPs or bacterial recombinant C. sinensis proteins differentially promoted the secretion of proinflammatory cytokines (IL-1β, IL-6, and TNF-α) as well as anti-inflammatory cytokines (IL-10, TGF-β1, and TGF-β2) in a time-dependent manner. In particular, recombinant C. sinensis protein treatment resulted in increase (at maximum) of ~7-fold in TGF-β1, ~30-fold in TGF-β2, and ~3-fold in TNF-α compared with the increase produced by ESPs, indicating that CsTrip1, CsLeg, and CsGrb2 function as strong inducers for secretion of these cytokines in host cells. These results suggest that C. sinensis ESPs contribute to the immunopathological response in host cells, leading to clonorchiasis-associated hepatobiliary abnormalities of greater severity.
Carrier Proteins ; Cholangiocarcinoma ; Cholangitis ; Clonorchis sinensis ; Cytokines ; Fasciola hepatica ; Fibrosis ; Humans ; Interleukin-6 ; Liver Cirrhosis

INTRODUCTIONThis study was conducted to provide an overview of the community-based hypertension and diabetes control programme of 19 cities in Korea and to evaluate its effectiveness in controlling hypertension at the community level.

MATERIALS AND METHODSIn this longitudinal observational study, we analysed the data of 117,264 hypertensive patients aged ≥65 years old from the time of their first enrolment in July 2012 to October 2013 (up to their 2-year follow-up).

RESULTSThe hypertension control rate of 72.5% at the time of enrolment increased to 81.3% and 82.4% at 1 and 2 years after enrolment. Treatment continuity, completion of hypertension self-management education, and longer enrolment duration in the programme contributed to improvements in hypertension control rate.

CONCLUSIONThis programme was characterised by a public health-clinical partnership at the community level. Despite its simplicity, the programme was evaluated as a successful attempt to control hypertension among patients aged >65 years at the community level.

Aged ; Community Networks ; Humans ; Hypertension ; drug therapy ; Longitudinal Studies ; Patient Education as Topic ; Program Evaluation ; Republic of Korea ; Self Care

There was an error in the article, “The structure and orientation of governance for Healthy Cities programs.” The footnote at the bottom of page 8 should be corrected.

The Healthy Cities program is being actively pursued worldwide under the leadership of the World Health Organization as an effort to improve urban health through changes in the physical and social environment. As the core of the Healthy Cities program, governance establishes and implements diverse health plans and healthy public policies through political support, intersectoral cooperation, community participation, and multilevel networks. With the development of Healthy Cities programs, governance has evolved in the direction of autonomy, equity, and integration. These governance orientations should be continuously reflected in Healthy Cities strategies in order to successfully improve citizens' health.
Consumer Participation ; Leadership ; Public Policy ; Social Environment ; Urban Health ; World Health Organization

'Health in All Policies' is a new strategy for governance for health in 21st century. The evolution of health promotion has affected the creation of the strategy through the efforts to tackle health inequalities by addressing social determinants of health. More concern about health inequalities, involving wider policy areas, and higher level of institutionalization distinguish the strategy from the old intersectoral collaboration such as intersectoral action for health and healthy public policy. Making intersectoral collaboration the mainstream of policy making is important to address integrated policy agendas such as 'Health in All Policies' and 'Sustainable Development Goals.' Political leadership and interpersonal skills are also required to strengthen the capacity of public health sector for implementing 'Health in All Policies' in local, national, and international circumstances.
Cooperative Behavior ; Health Promotion* ; Institutionalization ; Leadership ; Policy Making ; Public Health ; Public Policy ; Social Determinants of Health ; Socioeconomic Factors

No abstract available.
Cardiopulmonary Resuscitation*

No abstract available.
Cardiopulmonary Resuscitation*