Background Smoking is a global health risk known to elevate hemoglobin (HB) levels through its effects on hematopoiesis. Urine cotinine, a metabolite strongly correlated with serum cotinine, serves as an effective biomarker for assessing smoking status. This study aimed to explore the relationship between urinary cotinine levels and both HB and hematocrit (HCT) levels in a Korean population.
Methods The study analyzed 4,454 healthy participants, categorized into three groups based on urine cotinine tertiles. Steiger’s Z tests were used to assess correlations between HB, HCT levels, and urine cotinine. After adjusting for clinical variables, multiple linear regression was employed to evaluate the relationship between urine cotinine levels and HB/HCT. Receiver operating characteristic curves helped determine the cut-off values for urine cotinine in relation to HB and HCT levels.
Results After adjusting for covariates, a positive correlation was found between urine cotinine and both HB and HCT levels. HB levels were 18% higher in the second tertile and 23% higher in the highest tertile than the lowest. Similarly, HCT levels increased by 44% in the second tertile and 50% in the highest tertile. The highest tertiles of HB and HCT had values of 504.650 and 202.950, respectively, with area under the curve values of 0.634 for HB and 0.616 for HCT.
Conclusion This study demonstrates a significant correlation between urine cotinine levels and elevated HB and HCT levels in a representative Korean population. Clinicians should consider urine cotinine levels when assessing anemia in smokers or individuals exposed to secondhand smoke. Further research is needed to validate these findings.
Background Early screening and management of metabolic dysfunction-associated steatotic liver disease (MASLD) are essential to prevent progression to fibrosis, cirrhosis, and related chronic diseases. The neck circumference to height ratio (NHtR) is a reliable measure of upper body fat. This study explored the relationship between the NHtR and MASLD in the Korean population, with the aim of validating it as a reliable screening tool.
Methods We analyzed data from the 2019 to 2021 Korea National Health and Nutrition Examination Survey, including 11,414 participants aged 40 years or older. The association between the NHtR and MASLD was evaluated using logistic regression analysis, while predictive accuracy was evaluated using receiver operating characteristic curve analysis.
Results A total of 11,414 participants aged 40 years or older were included in the study. Participants in the highest NHtR quartile had higher levels of metabolic risk markers, including body mass index, waist circumference, glucose, hemoglobin A1c, and homeostatic model assessment of insulin resistance (P<0.001). In logistic regression analysis, the odds ratio for MASLD in quartile 4 compared to quartile 1 was 1.77 (95% confidence interval [CI], 1.31–2.40; P<0.001) in the fully adjusted model. The area under the curve and 95% CI of NHtR for MASLD were 0.749 (95% CI, 0.740–0.758), demonstrating superior accuracy compared with other indicators. The optimal NHtR cut-off for MASLD was 21.564, with a sensitivity and specificity of 0.726 and 0.644, respectively.
Conclusion NHtR is a more effective predictor of MASLD than other measures, highlighting its potential as a valuable screening tool in clinical and self-care settings.
Background Indonesia faces significant maternal and child health challenges, including a high maternal mortality ratio. The country’s vast geography results in disparities in healthcare facility availability. This study aimed to identify factors influencing maternal delivery choices in health facilities across Indonesia’s rural and urban areas.
Methods This cross-sectional study analyzed data from the 2017 Indonesia Demographic Health Survey. The study population included women aged 15–49 who had given birth within 5 years preceding the survey. A total of 14,162 women were included, with 6,339 from urban and 5,009 from rural areas. Logistic regression was performed to identify factors associated with maternal delivery locations.
Results The findings showed that 91.37% of urban and 69.33% of rural mothers delivered in healthcare facilities. All analyzed variables were significantly correlated with maternal delivery in health facilities across both areas. In rural areas, the sex of the household head (adjusted odds ratio [AOR], 1.32; 95% confidence interval [CI], 1.02–1.71; P=0.031) and the absence of barriers to healthcare access (AOR, 1.31; 95% CI, 1.07–1.60; P=0.008) were significant factors. Conversely, in urban areas, only maternal age was significantly associated with delivering in health facilities.
Conclusion Determinants of maternal delivery choices vary between rural and urban settings. In rural areas, healthcare access and household head sex are key factors, while maternal age is significant in urban areas. The government should prioritize equitable healthcare facility distribution, particularly in rural areas, and promote family involvement, especially among husbands, during antenatal care to encourage facility-based deliveries.
Background The coronavirus disease 2019 (COVID-19) pandemic in Indonesia has led to an increase in mental health problems, especially among those with comorbid hypertension. Uncontrolled hypertension is the primary comorbidity of COVID-19. Thus, this study aimed to determine the pattern of uncontrolled hypertension at two time points during the pandemic and to confirm its relationship with common mental disorders (CMDs).
Methods This longitudinal study was conducted at two time points (2019 and 2021), and the data of individuals with hypertension was sourced from the Bogor of Noncommunicable Diseases Risk Factors Cohort Study. Data of 1,231 respondents who met the inclusion and exclusion criteria were included in the analyses. The Self-Reported Questionnaire-20 was used to measure CMDs (score of >6). This study used a generalized estimating equation to analyze the data.
Results The percentage of those with uncontrolled hypertension increased from 57.6% to 66.4%, whereas those with CMDs increased from 6.1% to 11.5%, from 2019 to 2021. The risk of uncontrolled hypertension was higher in patients with CMDs than in those without CMDs. The risk of uncontrolled hypertension increased from twice (adjusted odds ratio [aOR], 1.57; 95% confidence interval [CI], 1.071–2.069) in 2019 to 3 times (aOR, 2.765; 95% CI, 2.243–3.287) in 2021.
Conclusion Since stress increases the risk of developing uncontrolled hypertension, individuals with hypertension must be able to manage their stress. Apropos this, the governments should provide mental health consultation services in treating patients with hypertension, especially during adverse events such as pandemics.
Background Hormonal and physical changes during pregnancy affect mothers’ mental health. Because depression during pregnancy is closely associated with poor pregnancy outcomes, treatment is important for pregnant women with depression. This study aimed to identify barriers to treatment-seeking behaviors among pregnant women with depression in Indonesia.
Methods Data from the 2018 Indonesian Basic Health Research were used, which focused on pregnant women aged 15–54 years who exhibited depressive symptoms. The Mini-International Neuropsychiatric Interview was used to assess depression. Logistic regression analysis was conducted to explore the factors affecting treatment-seeking behaviors.
Results Among the pregnant women in Indonesia, 7.9% experienced depression; however, only 11.4% sought treatment. Higher transportation costs to the clinic were associated with 41% lower odds of seeking treatment (adjusted odds ratio [AOR], 0.59; 95% confidence interval [CI], 0.37–0.95; P=0.029). Women in their second and third trimesters had 48% (AOR, 0.52; 95% CI, 0.28–0.98; P=0.042) and 54% (AOR, 0.46; 95% CI, 0.24–0.89; P=0.022) lower odds of seeking treatment, respectively, than those in their first trimester.
Conclusion Financial barriers and the challenges of late pregnancy hinder treatment-seeking behaviors for depression in pregnant women. Therefore, there is an urgent need for affordable and accessible mental health care for vulnerable populations.
Background This study examined disparities in 1-year mortality rates between infants born to married and unmarried single-parent families, emphasizing the need for targeted health policies.
Methods Data from 3,298,263 cases, obtained from the South Korea National Statistical Office (2010–2017), were analyzed. T-tests and chi-square tests were used to assess the demographic characteristics of the study group. The number of deaths per 1,000 live births was calculated, and logistic and multivariable logistic regressions were employed to compare infant mortality rates between family types. Additional stratified analyses, based on gestational age and birth weight, further elucidated the relationship between parental marital status and infant mortality.
Results Infants from unmarried families exhibited a 3.34-fold higher crude odds ratio (OR) for 1-year mortality (95% confidence interval [CI], 2.56–4.36; P<0.001) than that from married families. After adjusting for confounders, the adjusted OR was 1.40 (95% CI, 1.03–1.92). Stratification by gestational age and birth weight revealed crude ORs of 4.62 (95% CI, 3.34– 6.39) in non-preterm infants (≥37 weeks) and 4.76 (95% CI, 3.46–6.56) in non-low-birth-weight infants (≥2.5 kg), highlighting a more pronounced disparity in infants born at or above normal weight and full term. No significant difference (P>0.05) was found in the crude OR for 1-year mortality rates among low-birth-weight (<2.5 kg) or preterm (<37 weeks) infants between the two-family types.
Conclusion This study highlights the significant disparity in infant mortality rates based on parental marital status, underscoring the need for enhanced social support and tailored policies for unmarried single-parent families.
Semaglutide, a medication used for type 2 diabetes and weight loss, may have unexpected side effects such as sarcopenia and age-related loss of muscle mass and strength. A 74-year-old male patient with type 2 diabetes and dyslipidemia presented with progressive fatigue over 2 years. He experienced a significant decline in walking endurance and speed despite the absence of joint pain or other obvious causes. He had a history of ocular myasthenia gravis and localized prostate cancer, both of which were well-managed. Further investigation revealed a weight loss of 8 kg after starting semaglutide treatment for diabetes. Physical examinations revealed reduced muscle bulk and strength. Extensive investigations, including blood tests, imaging, and cardiopulmonary exercise testing, have ruled out other potential causes of fatigue. The patient’s fatigue improved after reducing the semaglutide dose and implementing a tailored exercise program that focused on muscle strengthening. This case highlights the potential contribution of semaglutide to muscle mass loss and subsequent fatigue, particularly among older adults.
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Chiari malformation type I (CMI) is a structural abnormality characterized by cerebellar tonsil herniation through the foramen magnum, often leading to disrupted cerebrospinal fluid dynamics and syringomyelia. While CMI commonly presents with occipital headaches and neck pain, atypical manifestations, such as bilateral foot drops, are exceedingly rare. We describe a 37-year-old female patient presenting with bilateral foot drop, which was later established to be caused by syringomyelia secondary to CMI. Magnetic resonance imaging revealed an 8 mm tonsillar descent and a syrinx extending to the conus medullaris. The patient refused surgical intervention and opted for conservative management; partial functional recovery was subsequently observed. This report emphasizes the importance of recognizing rare neurological presentations of CMI. To our knowledge, this is the first documented case of CMI with syringomyelia presenting as a bilateral foot drop.
Background The association between sleep duration and obesity risk among risky drinkers remains controversial. This study aims to investigate the relationship between adequate sleep duration and both central and overall obesity among risky drinkers in Korea, with a focus on identifying potential interventions to reduce obesity rates.
Methods We analyzed data from 978 individuals, selected from 1,356 risky drinkers—as defined by the World Health Organization criteria—who participated in the 2019–2020 Korea National Health and Nutrition Examination Survey. Participants had no missing values and were engaged in economic activities. Demographic characteristics and key variables by obesity status were examined using frequency analysis and chi-square tests. Multivariable logistic regression analysis was performed to explore the association between sleep duration and obesity. To account for the stratified sampling design, we utilized complex sample analysis with weighted values.
Results Risky drinkers with adequate sleep duration (7–9 hours) were less likely to be obese based on waist circumference (≥90 cm in males; ≥85 cm in females) (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.48–0.86) and body mass index (≥25 kg/m2) (OR, 0.56; 95% CI, 0.41–0.76). Trend analysis revealed a significant inverse relationship between sleep duration and obesity likelihood (P for trend <0.05). Gender-stratified analysis demonstrated that the association was significant among males and more pronounced in risky drinkers compared to the general population.
Conclusion This study suggests that adequate sleep duration may play a key role in reducing obesity rates among Korean male risky drinkers. Further longitudinal studies are recommended to strengthen this finding.
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Cumulative circadian disruption factors and metabolic syndrome Jungun Lee Korean Journal of Family Medicine.2025; 46(3): 125. CrossRef
Background Although breakfast provides essential nutrients and energy, skipping this meal has become increasingly common among young adults in Korea. In this study, we examine the relationship between breakfast consumption and body composition.
Methods We analyzed data from 17,763 students aged 18–39 at Seoul National University (2018–2022). Participants were categorized based on their breakfast frequency: non-skippers, 1 to 3-day skippers, and 4 to 7-day skippers. Measurements included body mass index, waist circumference, body fat percentage, fat mass index (FMI), fat-free mass index (FFMI), and skeletal muscle mass index (SMI). Multivariable logistic and linear regression models adjusted for age, sex, alcohol use, smoking, physical activity, sleep, and food consumption frequencies were used.
Results Obesity (17.4% vs. 14.8%) and abdominal obesity (10.0% vs. 7.8%) were higher in those skipping breakfast 4 to 7 d/wk compared with non-skippers. Skipping breakfast was not significantly associated with abdominal obesity in either sex. In women, the odds of obesity were higher (odds ratio, 1.57; 95% confidence interval, 1.14–2.15; P=0.006), whereas no significant difference was observed in men. Men who skipped breakfast had increased body fat percentage (coefficient, 0.87; P<0.001) and FMI (coefficient, 0.18; P=0.009) and decreased FFMI and SMI. Women showed increased body fat percentage (coefficient, 0.92; P<0.001) and FMI but no significant differences in FFMI or SMI.
Conclusion Skipping breakfast adversely affects body composition by increasing body fat percentage and FMI. Further research is needed to confirm these findings and explore the underlying mechanisms.
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Cumulative circadian disruption factors and metabolic syndrome Jungun Lee Korean Journal of Family Medicine.2025; 46(3): 125. CrossRef
Background Insulin resistance (IR) influences lipid metabolism, particularly small dense low-density lipoprotein cholesterol (sdLDL-C), a key feature of diabetic dyslipidemia and a predictor of cardiovascular disease. The single-point insulin sensitivity estimator (SPISE) index is an effective tool for assessing IR. This study explored the relationship between the SPISE index and average low-density lipoprotein cholesterol (LDL-C) particle size in obese Korean adults.
Methods Cardiovascular risk was assessed in 161 obese individuals. The participants were divided into three groups based on SPISE index tertiles. Steiger’s Z test was used to assess the differences in correlation coefficients among various IR indices and average LDL-C particle size. Multivariate linear regression models were used to determine the independent association between the SPISE index and average LDL-C particle size. Receiver operating characteristic (ROC) curves established the SPISE index cut-off for sdLDL-C particle dominance.
Results The SPISE index was positively correlated with mean LDL-C particle size after adjusting for confounders. It demonstrated a stronger independent association with average LDL-C particle size (r=0.679, P<0.001) than with fasting insulin, the homeostatic model assessment for IR, and the quantitative insulin sensitivity check index (P<0.001 for all). ROC analysis identified an optimal SPISE index cutoff for sdLDL-C predominance of 4.955, with an area under the curve of 0.745.
Conclusion Our findings indicate a direct correlation between the SPISE index and average LDL-C particle size, suggesting that the SPISE index may complement labor-intensive IR indices and sdLDL-C measurement techniques for estimating IR-induced sdLDL-C predominance.
Background Depression is a prevalent mental health disorder that presents substantial public health challenges. Emerging evidence underscores the role of dietary patterns in mitigating depressive symptoms. This study investigated the association between diet quality, assessed using the Recommended Food Score (RFS), and depressive symptoms, evaluated with the Patient Health Questionnaire-9 (PHQ-9), in a sample of Korean adults.
Methods This cross-sectional study analyzed data from 19,786 participants recruited from a general hospital in Korea, all of whom completed the RFS and PHQ-9 assessments. General characteristics and anthropometric indices were recorded. Statistical analyses included chi-square tests and binary logistic regression to calculate odds ratios (ORs) and 95% confidence intervals for depressive symptoms according to RFS scores, adjusting for potential confounders.
Results Higher RFS scores were associated with reduced odds of depression in univariate (OR, 0.59; P<0.001) and multivariate (OR, 0.72; P<0.001) analyses. Sociodemographic factors, including older age, higher education, marital status, higher income, professional occupation, and regular exercise, were linked to decreased odds of depression. Conversely, female sex, current smoking, and alcohol consumption were associated with increased odds.
Conclusion The findings reveal an inverse relationship between diet quality and depressive symptoms among Korean adults, emphasizing the potential of dietary improvements in mental health promotion. Sociodemographic factors significantly influence depression risk. Future studies should adopt longitudinal designs incorporating a wider range of variables to elucidate these complex interactions.
Background Menstrual hygiene is crucial to a woman’s physical, social, and mental well-being. The menstrual cup offers a safe and effective solution but still requires wider adoption. This study aims to assess awareness, practices, and barriers regarding the use of menstrual cups among women of reproductive age.
Methods A cross-sectional study was conducted among 246 participants, randomly selected from outpatient settings of a tertiary care hospital in 2022. Non-pregnant menstruating women were included, while those with pelvic infections or cognitive impairments were excluded. After explaining the study’s purpose and ensuring anonymity, data were collected using a structured questionnaire adapted from previous studies conducted in India and abroad. Knowledge and practices were depicted using descriptive statistics, while factors affecting awareness were analyzed using a multivariable binary logistic regression analysis approach.
Results Approximately 64.2% of participants were aware of menstrual cups, but only three were users. Participants living in urban areas, practicing Hinduism, and marrying after the age of 20 years showed higher awareness. Users rated the cup as comfortable, with no skin irritation, foul odor, or dryness. The primary barrier to use was insufficient knowledge.
Conclusion There is a gap in awareness and usage of menstrual cups, especially in low- and middle-income countries like India. Preliminary feedback from users is encouraging, suggesting that menstrual cups could offer a cost-effective, eco-friendly, and sustainable way to improve menstrual hygiene.
Background The use of heated tobacco products (HTPs) among Korean adults has been steadily increasing since they were first introduced in 2017. It is known that smoking combustible cigarettes (CCs) adversely affects the serum lipid profile and increases the risk of cardiovascular disease. However, the health impacts of HTPs remain under- researched. This study, therefore, aims to explore the effects of HTP use on serum lipid levels.
Methods This study involved 10,309 participants, selected from the Korea National Health and Nutrition Examination Survey VII-1 and VIII conducted between 2018 and 2021. Participants were categorized based on their smoking status: “HTPs ever user” included dual, triple, and past HTP users; “current HTPs only user” for those exclusively using HTPs; “current CCs only user” for those exclusively smoking CCs; and “never smoker.” Logistic regression analysis was used to assess the impact of smoking type on serum lipid concentrations.
Results The analysis revealed that the “HTPs ever user” group had a higher odds ratio (OR) for elevated total cholesterol compared to the “never smoker” group (OR, 1.40; 95% confidence interval [CI], 1.03–1.92). The likelihood of having high low-density lipoprotein (LDL)-cholesterol was greatest in the “current HTPs only user” group when compared to “never smokers” (OR, 1.71; 95% CI, 1.01–2.89).
Conclusion The findings indicate that exclusive use of HTPs is linked to an increased level of serum LDL-cholesterol. Further longitudinal studies are necessary to fully determine the health risks associated with HTPs.
Background Updated reports on the population-based analysis of atopic dermatitis (AD) in Korea are rare. This study aimed to investigate the nationwide prevalence and systemic medication prescription trends of AD in Korea.
Methods Based on the Korean National Health Insurance database, the prevalence of AD and systemic medication prescription trends in patients with AD were analyzed according to age groups and regional districts from 2010 to 2015.
Results The prevalence of AD was the highest among patients aged 0–1 year (18.6%–24.5%), decreasing rapidly with increasing age (<2% in patients aged ≥20 years). From 2010 to 2015, the prevalence of AD decreased in children but increased slightly in adolescents and adults. In 2015, the proportion of systemic steroid prescriptions increased from 11.2% in the 0–9 years age group to 41.1% in the 50–59 years age group, while that of systemic antibiotic prescriptions gradually decreased from 6.2% in the 0–9 years age group to 1.8% in the 80–89 years age group. The proportion of systemic steroid prescriptions by region remained consistently high in Gyeongbuk (34.2%– 34.9%) and low in Daejeon (20.2%–22.5%). The annual proportion of systemic cyclosporine prescriptions increased significantly from 0.6% in 2010 to 1.2% in 2015, with the highest rates observed in patients in their 30s (1.5%–2.4%), followed by those in their 20s (1.3%–2.3%) and 40s (1.1%–2.0%).
Conclusion From 2010 to 2015, the prevalence of AD decreased in children but increased slightly in adolescents and adults. Approximately one-fourth of the patients with AD were prescribed systemic steroids, and the percentage of cyclosporine prescriptions doubled during the study period.
Background Osteoporosis and hearing impairment are known to be associated, but specific data regarding gender, bone mineral density (BMD) measurement sites, and hearing frequency ranges remain unclear. This study aimed to clarify the relationship between hearing loss and BMD in adults over the age of 50. Additionally, the study sought to determine the frequency ranges of pure tone audiometry (PTA) related to osteoporosis, identify BMD measurement sites, and investigate gender differences.
Methods A total of 1,523 adults (651 men and 872 women) over the age of 50, who participated in a medical health check-up at a university hospital, were included. PTA was conducted to assess hearing, and BMD was measured using dual-energy X-ray absorptiometry at the lumbar vertebrae (LV) and femur.
Results In women over the age of 50, a significant association was observed between hearing impairment and osteoporosis (P<0.01), but no such association was found in men. Lumbar BMD (L1–4) in women was significantly associated with hearing loss at 4,000 and 8,000 Hz (both P<0.05), whereas femoral neck and total femur BMD showed no significant relationship. In multiple logistic regression analysis, the odds ratio (OR) between osteoporosis and hearing threshold at 4,000 Hz (OR, 2.078; 95% confidence interval [CI], 1.092–3.954) and 8,000 Hz (OR, 2.648; 95% CI, 1.543–4.544) remained statistically significant in women after adjusting for age and other risk factors.
Conclusion In women over the age of 50, low BMD at the LV is significantly associated with hearing impairment, particularly at the high frequencies of 4,000 and 8,000 Hz.
Background The use of e-cigarettes is increasing globally, particularly among young adults. Although several use them to quit smoking, their effects are controversial. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess nicotine dependence in the smoking cessation process. This study examined changes in FTND scores among young adults using different types of cigarettes over a 1-year period.
Methods Prospective cohort data were collected from cigarette users at higher education institutions in the lower northern region of Thailand to analyze changes in FTND scores over a 1-year period. E-cigarette users and combined users were compared with conventional cigarette users. A marginal structural model (MSM) with an inverse probability of weighting (IPW) was used to adjust for time-dependent and time-independent confounders.
Results Of the 133 participants, 58 were e-cigarette users (43.6%), 33 were combined cigarette users (24.8%), and 42 were conventional cigarette users (31.6%). The results revealed that when both time-dependent and time-independent confounders were adjusted using MSM with IPW, e-cigarette users had a 0.20 decrease in the mean FTND score, and combined users had a 0.47 decrease in the mean FTND score compared to conventional cigarette users. However, the difference was not statistically significant.
Conclusion The use of e-cigarettes or combined cigarettes did not significantly affect nicotine dependence levels in young adults over a 1-year period. Consequently, e-cigarettes should not be recommended to reduce nicotine dependence among young adult cigarette users. Further studies are required to determine whether e-cigarettes affect smoking cessation rates.
Background Gestational diabetes can lead to complications in pregnant women and neonates. Maternal glycated albumin levels during late pregnancy may help predict complications in both mothers and neonates.
Methods This study was conducted in 120 singleton pregnant women diagnosed with gestational diabetes who visited Trinium Woman’s Hostipal between July 1, 2020, and June 30, 2022. In this study, the patients’ medical records were retrospectively analyzed. Gestational diabetes was diagnosed using a two-step testing method, and glycated albumin tests were performed during the third trimester of pregnancy. The optimal cutoff value of glycated albumin for predicting maternal complications during pregnancy and neonatal complications was determined using the receiver operating characteristic curve.
Results A total of 45 patients developed maternal complications, with cesarean section (39 patients) due to fetal cephalopelvic disproportion being the most common. As for the neonatal complications, eight neonates were macrosomic or overweight, while 15 neonates required neonatal intensive care unit admission. Additionally, 13 patients had concurrent complications affecting both the mother and neonate. The glycated albumin level in patients with complications was 12.87%, which was significantly higher than that in patients without complications (glycated albumin, 11.67%) (P<0.001). The optimal cutoff value of glycated albumin for predicting maternal and neonatal complications was 12.45%. The sensitivity, specificity, and Youden index were 66.7 %, 86.7%, and 0.534, respectively.
Conclusion The third trimester glycated albumin test in mothers with gestational diabetes provides limited predictive value for maternal and neonatal complications.
Background Family caregivers should focus on maintaining independence when assisting older adults with mobility. This may, however, bring about a counterproductive effect, namely Informal Caregiver-induced Forced Immobility (ICFI). This study explored the perceptions and experiences of older adults and their informal caregivers regarding ICFI.
Methods This qualitative study used a conventional content analysis approach and was conducted from January to September 2023 in Tabriz, Iran. Twenty older adults (aged 60 years and above) who had used a mobility aid, such as a cane or walker, and 14 informal caregivers were purposefully (purposive sampling) selected to participate in the study. Individual semi-structured interviews were conducted until data saturation was achieved. MAXQDA ver. 20.0 software (VERBI Software, Germany) was used to manage and analyze the data.
Results Based on the participants’ perceptions, ICFI means that for an older adult, “social interaction/social participation is limited,” “performing activities of daily living is disallowed,” and “engaging in physical activities and exercising is prohibited.”
Conclusion Our findings revealed the concept of ICFI from various perspectives in Iranian families with older adults, leading to a clearer understanding of this phenomenon. This aspect should be considered when developing intervention strategies for the care of older adults in home and residential care settings by, health practitioners, gerontologists, and policymakers. This research can serve as a foundation for future studies to develop pertinent indicators and tools for measuring ICFI in the hope of providing sufficient evidence to support interventions that aim to prevent or stop ICFI.
Background The influx of immigrants into Korea has increased in recent years, affecting Korean society and the healthcare system. This study analyzed the frequency of anxiety and depression in immigrants, which negatively affects their quality of life.
Methods We analyzed data from a 2020 survey on the Health Rights of Migrants and the Improvement of the Medical Security System. Bivariate analyses and a multiple logistic regression model were used to identify the risk factors associated with the presence of anxiety or depression among immigrants.
Results We included 746 immigrants, 55.9% of whom were female. The overall rate of anxiety or depression was 31.77%, with 38.3% in females, which was significantly higher than the 26.62% in males. The frequency of anxiety and depression was also strongly associated with certain immigrant groups, including immigrants of African or Western Asian origin (over 64%); those with student visas (60.53%); those who self-reported poor health (52%), physical or mental disabilities (69.23%), or chronic diseases (58.43%); and those facing difficulties accessing medical services (59.47%).
Conclusion This study showed the frequency of feelings of anxiety or depression and associated risk factors among immigrants. These findings may have implications for policymakers in reducing the likelihood of developing anxiety or depression in the future and improving the quality of life of immigrants in Korea.
Background Although the association between smoking and health-related quality of life (HRQoL) has been established, the effects of tobacco products, including combustible cigarettes (CCs) and non-combustible nicotine or tobacco products (NNTPs), on HRQoL remain unclear. This study examined the association between tobacco use and HRQoL in Korean men.
Methods Data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020 were analyzed. A total of 16,429 male participants aged ≥19 years completed the European Quality of Life-5 Dimensions (EQ-5D). Impaired HRQoL was defined as scoring in the lowest 20% of the EQ-5D index and having some or extreme problems in the following five domains of the EQ-5D: mobility, self-care, usual activities, pain/ discomfort, and anxiety/depression. Multiple logistic regression was conducted to evaluate the risk of impaired HRQoL in current tobacco users.
Results Current tobacco users exhibited a significantly higher risk of impaired HRQoL compared with never users (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.05–1.92). Compared to never users, current tobacco users reported more problems with mobility and pain/discomfort (all P<0.05). Moreover, compared with former tobacco users, current tobacco users had a higher risk of impaired HRQoL (OR, 1.60; 95% CI, 1.18–2.17). Compared to former tobacco users, current tobacco users reported more problems with mobility and pain/discomfort (all P<0.05).
Conclusion Use of CCs and NNTPs is associated with impaired HRQoL in Korean men. Therefore, further interventions for lifestyle modification and smoking cessation treatments are required to reduce the risk of impaired HRQoL among current tobacco users.
Background Whether land- or aquatic-based rehabilitation is more effective in improving knee osteoarthritis (OA) is still unclear. This study assessed the effectiveness of aquatic-based treatments in patients with knee OA.
Methods The participants were divided into a land-based exercise group (G1, n=30) and a water-based exercise group (G2, n=30). The exercises were performed for 8 weeks. The primary endpoint was a response to physical therapy, defined as a 20% decrease in the summed score for the Western Ontario and McMaster Universities-Osteoarthritis Index (WOMAC) pain subscale from T1 (before the start of the rehabilitation program) to T2 (8 weeks later). The secondary endpoints included the Visual Analog Scale (VAS) for pain, WOMAC functional and stiffness subscales, Lequesne Index, and Medical Outcome Study Short Form (SF-12) for physical and mental health.
Results A 20% decrease in the summed WOMAC pain subscale score was noted in 33% of patients in G1 (n=10) and 93% in G2 (n=28) (P<0.001). VAS scores at walking decreased by 14% in G1 vs. 37% in G2 (P<0.001), WOMAC stiffness subscale decreased by 18% in G1 vs. 53% in G2 (P<0.001), and the Lequesne index decreased by 10% in G1 vs. 33% in G2 (P<0.001). Quality of life improvement was greater in G2 than in G1; SF-12 (physical) increased by 2.3 in G1 vs. 5.4 in G2 (P=0.023), and SF-12 (mental) increased by 6.3 in G1 vs. 10.9 in G2 (P=0.022).
Conclusion Both aquatic and land-based exercises improved pain intensity, functional impairment, degree of handicap, and quality of life impairment caused by OA. However, the improvement was more significant in the aquatic-based exercises group.
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Background The liver plays an important role in gonadal steroid hormone metabolism, which can affect reproductive health, including the menstrual cycle. However, evidence from large population-based studies is limited. Therefore, this study aimed to investigate the association between liver function markers and menstrual cycle irregularities in premenopausal Korean women using nationwide data.
Methods This study analyzed Data from the Korea National Health and Nutrition Examination Survey 2010–2011. We investigated 3,045 premenopausal women aged 19–59 years. Liver function markers including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase, and fatty liver index were analyzed. Multivariable logistic regression analysis was performed to investigate the association between liver function markers and menstrual cycle irregularity while adjusting for confounding factors. Values were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analysis was also performed.
Results Baseline characteristic analysis showed that approximately 14.4% of the study population experienced menstrual cycle irregularity. The mean age was 34.5±0.7 years. The highest quartile of serum ALT and AST levels showed significantly higher ORs for menstrual cycle irregularity (adjusted OR, 1.83; 95% CI, 1.26–2.64 and adjusted OR, 1.67; 95% CI, 1.17–2.39, respectively). A similar result was observed in the subgroup analysis.
Conclusion Liver function markers were positively associated with menstrual cycle irregularities. In clinical settings, women of reproductive age with relatively decreased liver function should be considered for regular followup of their reproductive health status.
Dahae Lim, Jung In Choi, Ryuk Jun Kwon, Sang Yeoup Lee, Young Hye Cho, Eun Ju Park, Youngin Lee, Sae Rom Lee, Soo Min Son, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Gyu Lee Kim, Young Jin Ra
Received August 21, 2023 Accepted April 22, 2024 Published online August 20, 2024
Background Insulin resistance contributes to the development of cardiovascular disease and type 2 diabetes mellitus. Smoking leads to an increase in triglyceride levels, which, in turn, increases insulin resistance. Although the number of e-cigarette users has increased in recent years, few studies have investigated the association between ecigarette use and insulin resistance. Therefore, this study aimed to determine the association between e-cigarette use and insulin resistance using the triglyceride-glucose (TyG) index in Korean adults.
Methods This study included 4,404 healthy adults aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2020. Participants were categorized as never-smokers or ecigarette users, and the TyG index was categorized into low- and high-TyG index groups according to the median value (9.22). A logistic regression analysis was performed to determine the association between e-cigarette smoking and insulin resistance.
Results E-cigarette users had a higher TyG index than never smokers (e-cigarette: mean=3.95; never: mean=9.18; P<0.001). The e-cigarette users had a higher risk of being in the high TyG index group than never-smokers (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.03–1.84). In the subgroup analysis stratified by sex, age, and body mass index, a higher OR for a high TyG index was observed in men (OR, 1.46; 95% CI, 1.03–2.08) and individuals aged 60 years or older (OR, 3.74; 95% CI, 1.14–12.30).
Conclusion Our findings suggest that e-cigarette use is significantly associated with insulin resistance.
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Association Between Electronic Cigarette Use and Risk of Obstructive Sleep Apnea Among Korean Adults: A Cross-Sectional Nationwide Population-Based Study Wonseok Jeong, Min Ji Song, Ji Hye Shin, Ji Hyun Kim Journal of Clinical Medicine.2025; 14(11): 3616. CrossRef
Background The Korean Journal of Family Medicine (KJFM), which is an official journal of the Korean Academy of Family Medicine, is an English-text medical journal published since 2009. Although nearly 15 years have passed since the journal was launched, to the best of our knowledge, no study has reviewed articles published in the KJFM. Accordingly, we analyzed articles published in the KJFM for the first time.
Methods Articles published in the KJFM between January 2018 and November 2023 were categorized according to article type. Information about author affiliations, study subjects, research methods, and modes of data collection was then scrutinized. Moreover, we compared the frequencies of subjects, research methods and modes of data collection before, during, and after the coronavirus disease 2019 pandemic.
Results Original article was the most common article type. Approximately 52% of the articles were published by authors affiliated with departments other than family medicine, and 40% were published by family medicine. Approximately 60% and 38% of the articles were published by Korean authors and authors of international affiliations, respectively. Throughout the pandemic periods, research subjects focusing on “diseases & symptoms” have diminished, while “principles of family medicine” have progressively increased. Additionally, the use of cross-sectional study methods has declined. In terms of data collection, the use of “big data,” “medical records,” and “questionnaires” has decreased, whereas the use of “study results” has increased.
Conclusion KJFM is journal with wide and international participation covering various research subjects and study methods. We believe that our study provides valuable data for the future direction and development of the KJFM.
Background No disease-specific, reliable, and valid self-assessment tools exist for athletes with mild coronavirus disease (COVID-19) to self-return to sports. This study aimed to develop a self-assessment screening method for athletes with mild COVID-19.
Methods Item generation, item reduction, and pretesting were used to develop a questionnaire that served as a screening tool to detect severe post-COVID-19 complications. The questionnaire was validated by both internal and external reviewers, and the final version consisted of 11 items. Face validity was assessed through direct interviews with 11 athletes. Severe COVID-19 complications were identified for criterion validity and correlation analysis. A total score of 11 indicates that there is no risk of severe COVID-19 complications and gradual return to play is recommended; results <11 indicate a need for further evaluation by trained medical personnel. For reliability test, 50 respondents were chosen and asked to answer the questionnaires 7 days after their first responses.
Results Physical Activity Readiness Questionnaires for post-COVID-19 athletes (PAR-COVID-Q) demonstrated excellent internal consistency (r=1, P<0.05) and test-retest reliability (r=1, P<0.05). A total of 118 athletes scored 11, had normal health screening, normal electrocardiogram and chest X-ray, and successfully returned to sports without any reported complications (r=1, P<0.05). Two athletes scored <11 and underwent further medical evaluation.
Conclusion The PAR-COVID-Q is a valid and reliable self-assessment tool with a low burden for athletes to return to sports following mild COVID-19.
Background Female workers in Indonesia are vulnerable, because they must work to earn a living while still being responsible for domestic problems. This study analyzes the barriers to the use of modern contraceptives by female workers in Indonesia’s urban areas.
Methods This cross-sectional survey looked at 21,696 female workers. We used modern contraceptive use as a dependent variable, and age, education, wealth, known modern contraceptives, number of live births, ideal number of children, and insurance ownership as independent variables. In the final test, we employed binary logistic regression.
Results The results showed that women at all age categories were more likely than those aged 15–19 years not to use modern contraceptives, except those aged 35–39 years, who showed no difference. All other marital types were more likely to use modern contraceptives than married individuals. Rich female workers were 1.139 times more likely than poor workers not to use modern contraceptives (adjusted odds ratio [AOR], 1.139; 95% confidence interval [CI], 1.026–1.264). Female workers who did not know about modern contraceptives were 4.549 times more likely than those who did not to use modern contraceptives (AOR, 4.549; 95% CI, 1.037–19.953). Female workers with more than two children were 9.996 times more likely than those with two or fewer children not to use modern contraceptives (AOR, 9.996; 95% CI, 9.1890–10.875).
Conclusion This study identified five factors associated with the non-use of modern contraceptives by female workers in Indonesia’s urban areas: young, unmarried, rich, did not know about modern contraceptives, and had more than two children.
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