Pharmacist interventions in Asian healthcare environments for older people: a systematic review and meta-analysis on hospitalization, mortality, and quality of life.

BACKGROUND: Pharmaceutical interventions play a key role in the care of older people experiencing polypharmacy. Despite the rapid increase in the aging population in Asia, there is a lack of evidence regarding the effectiveness of pharmacist interventions on older adult's healthcare. This systematic review and meta-analysis assessed the effects of pharmacist interventions in Asian health care environments on hospitalization, mortality, and quality of life (QoL) among older people in Asia. METHODS: A comprehensive search was conducted across 5 databases, encompassing studies published from inception through June 2023. Only studies involving pharmacist interventions for people aged 65 years or older, residing in Asian countries, were considered. Studies without evidence of pharmacist involvement or conducted outside of Asia were excluded. Data extraction was performed by two reviewers, one reviewer (I.K.) performed the initial extraction, and another reviewer (G.R.) verified the extracted data. Forest plots were generated using a random effects model to obtain risk ratios or pooled standardized mean differences (SMDs). RESULTS: A total of 170 articles underwent thorough review, and ultimately, ten studies meeting the inclusion criteria were included in the meta-analyses. These studies encompassed diverse healthcare settings such as outpatient, inpatient, and nursing homes, with sample sizes ranging from 32 to 306 older people. Pharmacist interventions were found to significantly reduce hospitalization rates (n = 5, risk ratio = 0.57, 95% CI = 0.41-0.81) and mortality rates (n = 4, risk ratio = 0.57, 95% CI = 0.37-0.88) among older people. The analysis revealed less significant improvement in QoL in these patients than in those receiving usual care (n = 6, SMD = 0.36, P = 0.057). CONCLUSIONS: These findings highlight the crucial role of pharmacists within healthcare teams in Asian countries. Pharmacist interventions have an impact on reducing hospitalization and mortality rates among the elderly people, underscoring the importance of optimizing patient outcomes in Asia.

Regeneration of a full-thickness defect in rotator cuff tendon with umbilical cord-derived mesenchymal stem cells in a rat model.

Although rotator cuff disease is a common cause of shoulder pain, there is still no treatment method that could halt or reveres its development and progression. The purpose of this study was to investigate the efficacy of umbilical cord-derived mesenchymal stem cells (UC MSCs) on the regeneration of a full-thickness rotator cuff defect (FTD) in a rat model. We injected either UC MSCs or saline to the FTD and investigated macroscopic, histological and biomechanical results and cell trafficking. Treatment with UC MSCs improved macroscopic appearance in terms of tendon thickness at two weeks, and inflammation, defect size, swelling/redness and connection surrounding tissue and slidability at four weeks compared to the saline group. Histologically, UC MSCs induced the tendon matrix formation recovering collagen organization, nuclear aspect ratio and orientation angle of fibroblast as well as suppressing cartilage-related glycosaminoglycan compared to saline group at four weeks. The UC MSCs group also improved ultimate failure load by 25.0% and 19.0% and ultimate stress by 27.3% and 26.8% at two and four weeks compared to saline group. UC MSCs labeled with PKH26 exhibited 5.3% survival at four weeks compared to three hours after injection. This study demonstrated that UC MSCs regenerated the FTD with tendon tissue similar properties to the normal tendon in terms of macroscopic, histological and biomechanical characteristics in a rat model.

A cross-sectional study on the association between vitamin D levels and caries in the permanent dentition of Korean children.

BACKGROUND: A recent study in Canada reported that vitamin D deficiency is associated with dental caries. Because Koreans have been reported to be deficient in vitamin D, we investigated the relationship between dental caries and reduced serum vitamin D levels in Korean children. The purpose of this study was to analyze the relationships between blood vitamin D [25(OH)D] concentrations and dental caries in the permanent dentition of Korean children. METHODS: Data were collected from the Korea National Health and Nutrition Examination Survey performed in 2008-2013. A total of 1688 children (10-12 years of age) were enrolled. Vitamin D intake was measured through analysis of 25-hydroxy vitamin D [25(OH)D] levels. Caries experience in permanent dentition was assessed using the decay-missing-filled teeth (DMFT) index and decayed-missing-filled (DMF) rate. Statistical analyses included complex samples Chi-square tests, complex samples logistic regression analyses, and Pearson's correlations. RESULTS: The group with 25(OH) D levels lower than 50 nmol/L had a higher proportion of children with caries in the permanent dentition and permanent first molar than the group with 25(OH)D levels of 50 nmol/L or more. When external factors, such as sex, were controlled, 25(OH)D levels were not significantly correlated with caries, but were significantly correlated with first molar caries. Children with 25(OH)D levels lower than 50 nmol/L were 1.295 times more likely to have first molar caries than those with 25(OH)D levels of 50 nmol/L or more. Additionally, 25(OH)D levels and DMFT were negatively correlated; however, the degree of correlation was not strong. CONCLUSIONS: The association between 25(OH)D and dental caries is still not clear. However, our findings suggested that vitamin D insufficiency may be a risk factor for dental caries.

[Psychometric Properties and Item Evaluation of Korean Version of Night Eating Questionnaire (KNEQ)].

PURPOSE: The aim of this study was to develop a Korean version of Night Eating Questionnaire (KNEQ) and test its psychometric properties and evaluate items according to item response theory. METHODS: The 14-item NEQ as a measure of severity of the night eating syndrome was translated into Korean, and then this KNEQ was evaluated. A total of 1171 participants aged 20 to 50 completed the KNEQ on the Internet. To test reliability and validity, Cronbach's alpha, correlation, simple regression, and factor analysis were used. Each item was analyzed according to Rasch-Andrich rating scale model and item difficulty, discrimination, infit/outfit, and point measure correlation were evaluated. RESULTS: Construct validity was evident. Cronbach's alpha was .78. The items of evening hyperphagia and nocturnal ingestion showed high ability in discriminating people with night eating syndrome, while items of morning anorexia and mood/sleep provided relatively little information. The results of item analysis showed that item2 and item7 needed to be revised to improve the reliability of KNEQ. CONCLUSION: KNEQ is an appropriate instrument to measure severity of night eating syndrome with good validity and reliability. However, further studies are needed to find cut-off scores to screen persons with night eating syndrome.

Assessment of the Impact of Male Urinary Incontinence on Health-Related Quality of Life: A Population Based Study.

OBJECTIVE: To assess the impact of male urinary incontinence on health-related quality of life by population based study. METHODS: A two-stage systematic sampling method was adopted. A total of 5830 men participated in this survey. Face -to-face interviews were used to collect data. Urinary incontinence and symptom bother were measured with the Urogenital Distress Inventory-6 (UDI-6). General health-related quality of life (QoL) was measured using EQ-VAS, which evaluates the respondent's self-rated health on a vertical visual analogue scale. RESULTS: The age-adjusted prevalence of Korean male UI was 5.5%. Incontinent men reported higher score of UDI-6 and lower score of EQ-VAS than continent men. Men with mixed urinary incontinence reported significantly lower QoL than men with pure stress or urge incontinence. CONCLUSIONS: Urinary incontinence affects men's QoL negatively. In particular, mixed urinary incontinence has the greatest impact on QoL.

Psychometric Properties of the Korean Versions of Three Sleep Evaluation Questionnaires.

Psychometric properties of the Korean versions of three sleep evaluation questionnaires were described to provide tools for practitioners and researchers interested in transcultural studies in Korea. The Pittsburgh Sleep Quality Index (PSQI), the General Sleep Disturbance Scale (GSDS), and the Leeds Sleep Evaluation Questionnaire (LSEQ) were analyzed using data from 959 community-dwelling adults in Korea. Furthermore, cut-off points and prevalence of sleep disturbance were identified. Reliability and concurrent validity for all measures were acceptable. Optimal cut-off points of PSQI, GSDS, and LSEQ with highest Youden's index were 5, 33, and 66, and prevalence of sleep disturbance was 22.1%, 26.3%, and 25.8%, respectively. The Korean PSQI, GSDS, and LSEQ are all valid and reliable tools for detecting sleep disturbance. We provide suggestions for selecting the right tools according to the purpose, setting, and participants of transcultural studies.

Effects of an enjoyable nurse-led intervention to promote movement in poststroke inpatients.

It is important to have the stroke survivors move as soon as possible to improve disability as well as related problems such as fatigue, sleep, and depression. However, there were few reports on a movement intervention for the inpatients who were in the rehabilitation unit just after taking acute care. An enjoyable intervention was developed that promoted movement focusing on plegic limbs and looked more like a game or a play; the game was designed to be a group activity that could be led by nurses. Twenty participants participated in 30- to 40-min sessions, 3 times a week for 2 weeks. Functional status (cognitive, motor, and total), fatigue, sleep, and depression were measured. Except for the cognitive function, all outcomes were significantly improved in the experimental group as compared to those in the control group. Safe and enjoyable nursing interventions should be developed and implemented to improve disability and related problems for the poststroke inpatients.

[Psychometric properties of Korean Minimal Insomnia Screening Scale].

PURPOSE: The purposes of this study were to develop a Minimal Insomnia Screening Scale for Korean adults (KMISS) and to evaluate psychometric properties and discriminant ability of the developed scale. METHODS: Data from a cross-sectional survey of 959 Korean adults were analyzed to develop the summated insomnia scale, which was evaluated in terms of reliability, validity, and discriminant ability by receiver operating characteristics (ROC) curve analysis. RESULTS: Item-total correlations ranged between .71-.79 and Cronbach's α was .87. Adequate validity was also evident. ROC-curve analysis showed area under ROC was .87 (95% CI: .84-.90) and identified the optimal cut-off score as ≤ 20 (sensitivity, .83; specificity, .75; positive/negative predictive values, .40/.95). Using this cut-off score, the prevalence of insomnia in the study sample was 26.3% and most frequent among women and the oldest group. CONCLUSION: Data supports the psychometric properties of KMISS as a possible insomnia screening instrument. KMISS also shows promise as a convenient ultra-short screening measure of insomnia for adults and epidemiological studies in community health care settings.

A study on Korean nursing students' educational outcomes.

The purpose of this study was to describe outcome indicators of nursing education including critical thinking, professionalism, leadership, and communication and to evaluate differences among nursing programs and academic years. A descriptive research design was employed. A total of 454 students from four year baccalaureate (BS) nursing programs and two three-year associate degree (AD) programs consented to complete self-administered questionnaires. The variables were critical thinking, professionalism, leadership and communication. Descriptive statistics, χ(2)-test, t-tests, ANOVA, and the Tukey test were utilized for the data analysis. All the mean scores of the variables were above average for the test instruments utilized. Among the BS students, those in the upper classes tended to attain higher scores, but this tendency was not identified in AD students. There were significant differences between BS students and AD students for the mean scores of leadership and communication. These findings suggested the need for further research to define properties of nursing educational outcomes, and to develop standardized instruments for research replication and verification.

Health-related quality of life by the type of physical activity in Korea.

This study examined if health-related quality of life is different based upon the type of physical activity performed by 1,266 community-dwelling adults in urban area of Korea. Physical activity was categorized into (a) work, (b) leisure (non-sport), and (c) sports activity. The results indicated that only leisure and sports activity were positively correlated with health-related quality of life. Therefore, it is recommended that leisure and sports activity must be encouraged, especially to people who do not think that they need any leisure or sports activity because they are very active physically at work.

Risk factors for female urinary incontinence among middle-aged Korean women.

OBJECTIVE: The aim of this study was to investigate risk factors for urinary incontinence (UI) in middle-aged (35-64 years) Korean women. METHODS: This was a cross-sectional, case-control study using a structured self-administered questionnaire. To identify the unadjusted associations of each potential risk factor with prevalence of UI, univariate logistic regression analyses were used. A multiple logistic regression model was then constructed with only those variables that were significantly associated with the UI (p < 0.05) in the univariate analyses. Multivariate logistic regression analysis was used to determine adjusted odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Of 608 community-dwelling women included in the analyses, 259 (42.6%) met the definition of UI (at least once a month or the amount of more than a few drops lost during the past 12 months). A multivariate regression model was constructed that included the eight variables of age, body mass index (BMI), number of vaginal deliveries, menstrual status, hysterectomy, present hormone use, hypertension, and diabetes mellitus (DM). Obesity (BMI > 25 kg/m(2)), being postmenopausal, having two or more vaginal deliveries, having a history of hysterectomy, and being a current user of hormones increased the odds of having UI. CONCLUSIONS: Obesity as defined using Asian-Pacific criteria was a strong risk factor for middle-aged Korean women's UI. More than one vaginal birth caused increased odds of having stress or mixed UI. Hysterectomy, menopause, and hormone replacement were also significant risk factors.

Effects of regular exercise on pain, fatigue, and disability in patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) is a major health problem in Korea. To explore the effects of regular exercise on pain, fatigue, and disability, a descriptive study was conducted in 435 Korean patients with RA. Exercisers were defined as those who are currently exercising more than 3 times a week, for at least 20 minutes, and for more than 6-consecutive months after being diagnosed with RA. The primary finding was that exercisers had significantly less fatigue and disability compared with nonexercisers. Results suggest that regular exercise has advantages for patients with RA to decrease fatigue and disability.