Exploring the Health and Social Needs of Community Residents Using an Online Community Care Platform: Linkage to the International Classification of Functioning, Disability, and Health / 대한의료정보학회지

Objectives@#This study aimed to analyze the outcomes of the Comprehensive Health and Social Need Assessment (CHSNA) system, which identifies community residents’ health and social needs, and to link these needs with the International Classification of Functioning, Disability, and Health (ICF). @*Methods@#Adult community residents in a metropolitan city in Korea were recruited. They were asked to assess their health and social needs via the CHSNA system, which was integrated into an online community-care platform. Three assessment steps (basic health assessment, needs for activities of daily living, and in-depth health assessment) associated with five ICF components were used to evaluate physical health impairment, difficulties in activities and participation, and environmental problems. The final list of health and social needs was systematically linked to the domains and categories of the ICF. Only data from participants who completed all three assessment steps were included. @*Results@#Wide ranges of impairments and difficulties regarding the daily living activities, physical health, and environmental status of the community were recorded from 190 people who completed assessments of their health and social needs by the CHSNA system. These participants reported various health and social needs for their community life; common needs corresponded to the ICF components of body functions and activities/participation. @*Conclusions@#The ICF may be suitable for determining the health-related problems and needs of the general population. Possible improvements to the present system include providing support for completing all assessment steps and developing an ICF core set for an enhanced understanding of health and social needs.

Mediating Effect of Meaning in Life on the Relationship between Social Connectedness and Depression among Middle-aged Women / 정신간호학회지

PURPOSE: This study was conducted to examine the mediating effect of meaning in life on the relationship between social connectedness and depression among middle-aged women.METHODS: A descriptive correlational design was employed. One hundred and forty-two middle-aged women who visited welfare centers or churches in Seoul and Gyeonggi Province participated in the study. The data were collected from May to June, 2019 and analyzed using descriptive statistics, Pearson's correlation coefficients, and multiple linear regression analyses based on Baron and Kenny criteria.RESULTS: Social connectedness was significantly positively correlated with meaning in life (r=.52, p < .001) and negatively with depression (r=−.53, p < .001). Meaning in life was also significantly negatively correlated with depression (r=−.50, p < .001). Furthermore, meaning in life had a significant mediating effect on the relationship between social connectedness and depression (β=−.31, p < .001).CONCLUSION: Our study findings suggest that meaning in life plays an important role in maintaining mental health and well-being for middle-aged women. Therefore, it is necessary to develop a nursing intervention program that can enhance the meaning in life to promote mental health and well-being.

A 12-Week Multi-Domain Lifestyle Modification to Reduce Depressive Symptoms in Older Adults: A Preliminary Report

OBJECTIVE: The objective of this study was to compare the effectiveness of usual care management (UCM) and a newly-developed lifestyle modification with contingency management (LMCM) for geriatric depressive symptoms in the community. METHODS: A randomized controlled trial was conducted in 93 older adults with major depressive disorder at community mental health centers. A 12 week multi-domain LMCM was developed by providing positive reinforcement using ‘gold medal stickers’ as a symbolic incentive to motivate their participation and adherence. Participants were allocated to LMCM (n=47) and UCM (n=46) groups. They were then subjected to the 12 week treatment. Effects of the two intervention methods on Geriatric Depression Scale were determined using mixed model analysis. RESULTS: Participants in the LMCM group had greater decline in GDS score per month than participants in the UCM group after adjusting for age, sex, years of education, living alone, and MMSE scores at baseline examination [coefficient for GDS score (95% CI): -1.08 (-1.51, -0.65), p < 0.001, reference: UCM group]. CONCLUSION: LMCM is safe and easy to use with a low cost. LMCM is suitable as psychosocial intervention for older adults with depressive symptoms in the community.

Anti-Inflammatory Properties of Flavone di-C-Glycosides as Active Principles of Camellia Mistletoe, Korthalsella japonica

The chemical components and biological activity of Camellia mistletoe, Korthalsella japonica (Loranthaceae) are relatively unknown compared to other mistletoe species. Therefore, we investigated the phytochemical properties and biological activity of this parasitic plant to provide essential preliminary scientific evidence to support and encourage its further pharmaceutical research and development. The major plant components were chromatographically isolated using high-performance liquid chromatography and their structures were elucidated using tandem mass spectrometry and nuclear magnetic resonance anlysis. Furthermore, the anti-inflammatory activity of the 70% ethanol extract of K. japonica (KJ) and its isolated components was evaluated using a nitric oxide (NO) assay and western blot analysis for inducible NO synthase (iNOS) and cyclooxygenase (COX)-2. Three flavone di-C-glycosides, lucenin-2, vicenin-2, and stellarin-2 were identified as major components of KJ, for the first time. KJ significantly inhibited NO production and reduced iNOS and COX-2 expression in lipopolysaccharide-stimulated RAW 264.7 cells at 100 μg/mL while similar activity were observed with isolated flavone C-glycosides. In conclusion, KJ has a simple secondary metabolite profiles including flavone di-C-glycosides as major components and has a strong potential for further research and development as a source of therapeutic anti-inflammatory agents.

The Effects of Stressors on Subjective Well-Being in the Elderly

OBJECTIVE: This study aims to identify self-reported stressors in the Korean community-dwelling elderly and examine their effects on subjective well-being. METHODS: The subjects of this research were 1,010 elderly people who lived in Suwon, Korea. Each subject was administered the questionnaires regarding the socio-demographic characteristics, self-reported stressors, Concise Measure of Subjective Well-Being (COMOSWB) consisting of life satisfaction, positive emotion and negative emotion, Mini-Mental State Examination for dementia screening and Short Form Geriatric Depression Scale-Korean version. Statistical analyses including the Pearson's correlation test and multiple linear regressions were performed in this study. RESULTS: In our adjusted model for confounding variables, stress from physical problems (S-PP) (ss=-0.133, p<0.001), stress from loneliness or solitude (S-LS) (ss=-0.077, p=0.007), stress from family members (S-FM) (ss=-0.083, p=0.001) were negatively associated with the total score of COMOSWB. In subscale analyses of COMOSWB, we also found that S-PP (ss=-0.184, p<0.001), S-LS (ss=-0.077, p=0.014), stress from economic problems (ss=-0.072, p=0.021) were negatively associated with life satisfaction score. While S-PP (ss=-0.140, p<0.001) and S-FM (ss=-0.079, p=0.003) were negatively associated with positive emotion score, S-FM (ss=0.105, p=0.001) and stress from friends and neighbors (ss=0.072, p=0.016) were positively associated with negative emotion score. CONCLUSION: Stresses from physical problems, loneliness, and family members might be associated with subjective well-being in the elderly. While life satisfaction appears to be affected by one's perceived physical health status, loneliness, and economic conditions, positive and negative emotions appear to be affected by relationships with family members, friends, or neighbors.

Present Situation of Helicopter Emergency Medical Services (HEMS) in South Korea during the First Year

PURPOSE: HEMS is expected to shorten transportation time to an advanced facility and to enable administration of advanced treatment at the scene. In Korea, HEMS was launched in September 2011. The aim of this study is to provide an overview of HEMS in South Korea during the first year and to provide information for use in improvement. METHODS: Data were collected from September 23. 2011 to September 22. 2012; emergency patients on islands and in vulnerable areas were transported by helicopter. During the one-year study period, a prospective cohort study was conducted. Target diseases were acute coronary syndrome, stroke, and severe trauma. We classified patients according to two groups (severe group vs. mild group), whether they had been admitted to the intensive care unit (included death in the emergency room) or not. RESULTS: During this period, the total request mission number was 555 and the number of patients transported to base hospitals was 322. Differences between severe group and minor group were as follows: (1) final diagnosis; severe trauma (27.7% vs. 3.5%), cerebrovascular accident (CVA) (24.3% vs. 4.2%), and acute coronary syndrome (7.3% vs. 2.1%), p<0.001. (2) classification of transport area; islands (45.8% vs. 77.2%), bridge islands (26.0% vs. 15.9%), and inland area (28.3% vs. 6.9%), p<0.001. (3) the median time of call to hospital time was 52 vs. 55 minutes (p=0.289). and the median time of on scene time was 9 vs. 8 minutes (p=0.046). CONCLUSION: During the 12-month period, air ambulance played an important role in medically vulnerable areas (inclusion islands). However, the number of transport missions was still relatively low, and has shown a gradual increase.

Present Situation of Helicopter Emergency Medical Services (HEMS) in South Korea during the First Year

PURPOSE: HEMS is expected to shorten transportation time to an advanced facility and to enable administration of advanced treatment at the scene. In Korea, HEMS was launched in September 2011. The aim of this study is to provide an overview of HEMS in South Korea during the first year and to provide information for use in improvement. METHODS: Data were collected from September 23. 2011 to September 22. 2012; emergency patients on islands and in vulnerable areas were transported by helicopter. During the one-year study period, a prospective cohort study was conducted. Target diseases were acute coronary syndrome, stroke, and severe trauma. We classified patients according to two groups (severe group vs. mild group), whether they had been admitted to the intensive care unit (included death in the emergency room) or not. RESULTS: During this period, the total request mission number was 555 and the number of patients transported to base hospitals was 322. Differences between severe group and minor group were as follows: (1) final diagnosis; severe trauma (27.7% vs. 3.5%), cerebrovascular accident (CVA) (24.3% vs. 4.2%), and acute coronary syndrome (7.3% vs. 2.1%), p<0.001. (2) classification of transport area; islands (45.8% vs. 77.2%), bridge islands (26.0% vs. 15.9%), and inland area (28.3% vs. 6.9%), p<0.001. (3) the median time of call to hospital time was 52 vs. 55 minutes (p=0.289). and the median time of on scene time was 9 vs. 8 minutes (p=0.046). CONCLUSION: During the 12-month period, air ambulance played an important role in medically vulnerable areas (inclusion islands). However, the number of transport missions was still relatively low, and has shown a gradual increase.

The Effect of Subjective Physical and Mental Health on Cognitive Decline in the Elderly

OBJECTIVES: The aim of this study was to describe subjective physical and mental health assessed by the single item self-rated physical health (SRPH), and self-rated mental health (SRMH) had influence on the cognitive decline in community-dwelling elderly. METHODS: This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. 1,356 individuals were assessed at 2 time points 2 years apart for questionnaire which included demographic characteristics, medical history, Korean Mini-Mental State Examination (K-MMSE), Korean version of Geriatric Depression Scale (SGDS-K), SRPH, and SRMH. Multiple logistic regression was used to assess K-MMSE score change from the SRPH, and SRMH. RESULTS: At baseline, both SRPH (beta=0.18, p<0.01) and SRMH (beta=0.19, p<0.01) score positively associated with the K-MMSE score. At follow-up, subjects with baseline lower SRMH score had significantly greater decline in K-MMSE score (beta=0.09, p=0.007). However, baseline SRPH score showed no effect to follow up K-MMSE score before and after adjusting age, sex, education, number of chronic disease, SGDS-K, and baseline K-MMSE score (p=0.89). CONCLUSION: Brief and easily collected subjective mental health may predict the risk of cognitive decline, but subjective physical health may not.

Association of Toll-Like Receptor 2 Polymorphisms with Papillary Thyroid Cancer and Clinicopathologic Features in a Korean Population

Toll-like receptors (TLRs) single nucleotide polymorphisms (SNPs) were analyzed in patients with papillary thyroid cancer (PTC; n = 133) and their clinicopathologic features and age-matched controls (n = 321) using direct sequencing. PTC patients were divided into subgroups according to size, number, location, extrathyroidal invasion and lymph node metastasis. The two SNPs of TLR2 gene were not associated with the development of PTC. In clinical analysis, two SNPs were associated with location of cancer (rs3804099, P = 0.032, OR, 0.52; 95% CI, 0.28-0.96 in log-additive model; rs3804100, P = 0.039, OR, 0.46, 95% CI, 0.22-0.96 in codominant1 model; P = 0.018, OR, 0.42, 95% CI, 0.21-0.87 in dominant model; P = 0.011, OR, 0.46, 95% CI, 0.25-0.85 in log-additive model). The allele frequencies of two SNPs also showed significant associations with location of cancer (rs3804099, P = 0.046, OR, 0.57, 95% CI, 0.33-0.99 and rs3804100, P = 0.019, OR = 0.52, 95% CI = 0.30-0.90). However, two SNPs were not associated with the clinicopathologic features of PTC. It is suggested that TLR2 polymorphisms may contribute to the clinicopathologic features of PTC, especially the PTC in both lobes.

Association of Toll-Like Receptor 2 Polymorphisms with Papillary Thyroid Cancer and Clinicopathologic Features in a Korean Population

Toll-like receptors (TLRs) single nucleotide polymorphisms (SNPs) were analyzed in patients with papillary thyroid cancer (PTC; n = 133) and their clinicopathologic features and age-matched controls (n = 321) using direct sequencing. PTC patients were divided into subgroups according to size, number, location, extrathyroidal invasion and lymph node metastasis. The two SNPs of TLR2 gene were not associated with the development of PTC. In clinical analysis, two SNPs were associated with location of cancer (rs3804099, P = 0.032, OR, 0.52; 95% CI, 0.28-0.96 in log-additive model; rs3804100, P = 0.039, OR, 0.46, 95% CI, 0.22-0.96 in codominant1 model; P = 0.018, OR, 0.42, 95% CI, 0.21-0.87 in dominant model; P = 0.011, OR, 0.46, 95% CI, 0.25-0.85 in log-additive model). The allele frequencies of two SNPs also showed significant associations with location of cancer (rs3804099, P = 0.046, OR, 0.57, 95% CI, 0.33-0.99 and rs3804100, P = 0.019, OR = 0.52, 95% CI = 0.30-0.90). However, two SNPs were not associated with the clinicopathologic features of PTC. It is suggested that TLR2 polymorphisms may contribute to the clinicopathologic features of PTC, especially the PTC in both lobes.

Relationship between Social Activity and Cognitive Function in Korean Elderly

OBJECTIVES: Among non-pharmaceutical measures for preventing cognitive impairment, involving in social activities is known to be very effective. We tried to examine the correlation between social activity and cognitive function. METHODS: This study was based on the Suwon Project, a cohort comprising of non-random convenience samples of ethnic Koreans aged 60 years and above. All the subjects completed the study questionnaire which included demographic characteristics, current and past history of illnesses, drug history, Korean version of Mini Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale, and Beck Anxiety Inventory. We checked the time consumed in each 9 social activities through the checklist. RESULTS: On multiple logistic regression analysis, the total time spent in social activities wasinversely associated with the K-MMSE score after adjusting confounding variables like age, sex, education level, depression, anxiety and vascular risk factor (beta=-0.041, p=0.024). On the other hand, correlation was found between K-MMSE score and time spent in participating in religious party (beta=0.053, p=0.003) as well as time spent in elder's university (beta=0.040, p=0.025) after adjustingage, sex, education, depression, anxiety and vascular risk factor. CONCLUSION: Our results suggest that involving in quality social activities might be more effective in improving cognitive function than spending longer total time in any social activity.