Factors affecting unmet healthcare needs of low-income overweight and obese women in Korea: analysis of the Korean National Health and Nutrition Examination Survey 2017

Purpose The purpose of this study was to explore unmet healthcare needs among low-income overweight and obese women and to identify the factors affecting unmet healthcare needs. Methods The study was a secondary analysis of data from the 2017 Korea National Health and Nutrition Examination Survey. A final sample of 388 out of 8,127 participants was analyzed using complex descriptive statistics, the chi-square test, the independent t-test, and logistic regression. Results The mean age of the participants was 66.51±1.05 years. Unmet healthcare needs were experienced by 19.4% of low-income overweight and obese women. Women with depression, stress, and poor self-reported health status were significantly more likely than their counterparts to experience unmet healthcare needs. Poor self-reported health status was confirmed to be related to unmet health needs in low-income overweight and obese women (odds ratio, 2.65; p=.011). Conclusion The study provides the novel insight that the unmet healthcare needs of low-income overweight and obese women were influenced by self-reported health status. Healthcare providers should make efforts to develop strategies to reduce unmet healthcare needs among low-income overweight and obese women, who constitute a vulnerable population

Periodontitis-induced systemic inflammation exacerbates atherosclerosis partly via endothelial-mesenchymal transition in mice.

Growing evidence suggests close associations between periodontitis and atherosclerosis. To further understand the pathological relationships of these associations, we developed periodontitis with ligature placement around maxillary molars or ligature placement in conjunction with Porphyromonas gingivalis lipopolysaccharide injection at the ligature sites (ligature/P.g. LPS) in Apolipoprotein E knock out mice and studied the atherogenesis process in these animals. The mice were fed with high fat diet for 11 weeks and sacrificed for analyzing periodontitis, systemic inflammation, and atherosclerosis. Controls did not develop periodontitis or systemic inflammation and had minimal lipid deposition in the aortas, but mice receiving ligature or ligature/P.g. LPS showed severe periodontitis, systemic inflammation, and aortic plaque formation. The aortic plaque contained abundant macrophages and cells expressing both endothelial and mesenchymal cell markers. The severity of periodontitis was slightly higher in mice receiving ligature/P.g. LPS than ligature alone, and the magnitude of systemic inflammation and aortic plaque formation were also notably greater in the mice with ligature/P.g. LPS. These observations indicate that the development of atherosclerosis is due to systemic inflammation caused by severe periodontitis. In vitro, P.g. LPS enhanced the secretion of pro-inflammatory cytokines from macrophages and increased the adhesion of monocytes to endothelial cells by upregulating the expression of adhesion molecules from endothelial cells. Moreover, secretory proteins, such as TNF-α, from macrophages induced endothelial-mesenchymal transitions of the endothelial cells. Taken together, systemic inflammation induced by severe periodontitis might exacerbate atherosclerosis via, in part, causing aberrant functions of vascular endothelial cells and the activation of macrophages in mice

Preventive effect of Ligularia fischeri on inhibition of nitric oxide in lipopolysaccharide-stimulated RAW 264.7 macrophages depending on cooking method

BACKGROUND: Ligularia fischeri (common name Gomchwi) is known for its pharmaceutical properties and used in the treatment of jaundice, scarlet-fever, rheumatoidal arthritis, and hepatic diseases; however, little is known about its anti-inflammatory effect. In this study the influence of blanching and pan-frying on the anti-inflammatory activity of Ligularia fischeri (LF) was evaluated. RESULTS: Fresh LF and cooked LF showed no significant effect on the viability of macrophages after 24 h incubation. Fresh LF was found to be the most potent inhibitor of nitric oxide (NO) production at 100 μg/ml, while pan-fried LF showed little inhibitory effect on lipoloysaccharide (LPS) stimulated murine machrophage RAW264.7 cells. In contrast with its effect on NO production, pan-fried LF showed significant attenuation of the expression of inducible nitiric oxide synthase (iNOS) compared with fresh LF. In the cooking method of LF, PGE2 production was not affected in the LPS-induced RAW 264.7 cells. In LPS-induced RAW 264.7 cells, pretreatment by fresh and cooked LF increased COX2 mRNA expression. The 3-O-caffeoylquinic acid content of blanching and pan-frying LF increased by 4.92 and 9.7 fold with blanching and pan-frying respectively in comparison with uncooked LF. CONCLUSIONS: Regardless of the cooking method, Ligularia fischeri exhibited potent inhibition of NO production through expression of iNOS in LPS-induced RAW264.7 cells

Fatty Acid-Induced Lipotoxicity in Pancreatic Beta-Cells During Development of Type 2 Diabetes

Type 2 diabetes is caused by chronic insulin resistance and progressive decline in beta-cell function. Optimal beta-cell function and mass is essential for glucose homeostasis and beta-cell impairment leads to the development of diabetes. Elevated levels of circulating fatty acids (FAs) and disturbances in lipid metabolism regulation are associated with obesity, and they are major factors influencing the increase in the incidence of type 2 diabetes. Chronic free FA (FFA) treatment induces insulin resistance and beta-cell dysfunction; therefore, reduction of elevated plasma FFA levels might be an important therapeutic target in obesity and type 2 diabetes. Lipid signals via receptors, and intracellular mechanisms are involved in FFA-induced apoptosis. In this paper, we discuss lipid actions in beta cells, including effects on metabolic pathways and stress responses, to help further understand the molecular mechanisms of lipotoxicity-induced type 2 diabetes

Sorafenib Modulates the LPS- and A beta-Induced Neuroinflammatory Response in Cells, Wild-Type Mice, and 5xFAD Mice

Sorafenib is FDA-approved for the treatment of primary kidney or liver cancer, but its ability to inhibit many types of kinases suggests it may have potential for treating other diseases. Here, the effects of sorafenib on neuroinflammatory responses in vitro and in vivo and the underlying mechanisms were assessed. Sorafenib reduced the induction of mRNA levels of the proinflammatory cytokines COX-2 and IL-1 beta by LPS in BV2 microglial cells, but in primary astrocytes, only COX-2 mRNA levels were altered by sorafenib. Interestingly, sorafenib altered the LPS-mediated neuroinflammatory response in BV2 microglial cells by modulating AKT/P38-linked STAT3/NF-kB signaling pathways. In LPS-stimulated wild-type mice, sorafenib administration suppressed microglial/astroglial kinetics and morphological changes and COX-2 mRNA levels by decreasing AKT phosphorylation in the brain. In 5xFAD mice (an Alzheimer's disease model), sorafenib treatment daily for 3 days significantly reduced astrogliosis but not microgliosis. Thus, sorafenib may have therapeutic potential for suppressing neuroinflammatory responses in the brain. © 2021 Kim, Park, Park and Hoe.1

Associated factors of depression in pregnant women in Korea based on the 2019 Korean Community Health Survey: a cross-sectional study

Purpose Various individual and social factors influence depression in pregnant women. The purpose of this study was to identify the influence of socioeconomic status, health behaviors, and health status on depression of pregnant women in Korea. Methods This study analyzed data from the 2019 Korean Community Health Survey conducted from August to October 2019. A structural questionnaire with Patient Health Quetsionnaire-9 (PHQ-9), health behavior, health status, and psychological characteristics was used. The data of 1,096 pregnant women between the ages of 19 and 55 years were analyzed using descriptive statistics, independent-test and chi-square tests, and multiple regression. Results The mean score of prenatal depression as measured by the PHQ-9 during pregnancy was 2.35 points out of 0 to 27 points. Low income (B=0.69, p<.001), low-education level (B=0.70, p<.001), skipping breakfast (B=0.34, p=.001), less than 8 hours of sleeping (B=0.26, p=.009), binge drinking during pregnancy (B=0.46, p=.001), and stress (B=1.89, p<.001) were significantly associated with increased depression scores. In contrast, depression scores significantly decreased as subjective health status (B=–0.59, p<.001) and subjective oral health status (B=–.17, p=.003) increased. Conclusion Findings support the need for healthcare policies and clinical screening to alleviate prenatal depression, especially for pregnant women with low socioeconomic status, poor health behavior, poor health status, and high stress

Comparison of Prenatal Health Management State and Educational Needs for Pregnant Women with Advanced Maternal Age and Under the Age of 35

PURPOSE: This study was done to confirm prenatal health management and educational needs for pregnant women with advanced maternal age (AMA) and pregnant women under 35 years of age. METHODS: This study was a descriptive research in which self-report questionnaires were used. Participants were 279 pregnant women (83 AMA and 196 less than 35). RESULTS: Only 32.5% of AMA women had received prenatal education and 51.8% reported wanting internet education. AMA women, compared to the under 35 women, had higher levels of self-awareness of health problems and possibility of health problems but lower levels of alcohol experience before pregnancy. For prenatal health management, scores were low for prenatal exercise, prenatal education and nutrition. For prenatal health management education, AMA women reported high levels of need for education on health problems. CONCLUSION: The results indicate that prenatal health management education must be given considering differences in age-related requirements by emphasizing health care and obstetric complications during pregnancy for AMA womenand anemia and information on substance use during pregnancy for women under 35. Reliable internet-based education programs need to be developed using available information and communication technology for the increasing number of employed pregnant women

Impact of the COVID-19 pandemic on women’s health nursing clinical practicums in the spring 2020 semester in Korea: a nationwide survey study

Purpose This study investigated the impact of coronavirus disease 2019 (COVID-19) on women’s health nursing clinical practicums in undergraduate nursing schools in Korea during the spring 2020 semester. Methods A cross-sectional online survey on clinical practicum teaching experiences in the spring 2020 semester was distributed to members of the Korean Society of Women Health Nursing (KSWHN) who taught undergraduate nursing. One faculty member from each of 203 institutions was requested to respond and there were no duplicate participants. Seventy-nine participants (38.9%) responded and 74 responses were analyzed. Descriptive statistics were presented for all survey items. Results Fifty-two faculty members (70.3%) belonged to universities and 22 (29.7%) taught at colleges. Thirty-eight (51.4%) answered that their institutions had affiliated teaching hospitals. More than half (52.7%) conducted hospital-based clinical practicums either entirely (n=20) or partially (n=19), whereas the rest of them (47.3%) conducted clinical practicums at school or home via online teaching. The typical teaching methods for offline or online education were case conferences, tests or quizzes, scenario studies, nursing skill practicums, (virtual) nursing simulations, and simulated patient education. Most of faculties (93.2%) supported the development of an educational platform to share educational materials and resources, such as case scenarios. Conclusion Nursing faculty members utilized various teaching methods to enhance clinical skills and mitigate limited clinical exposure during the early stage of the COVID-19 pandemic. The KSWHN should move forward to develop an education platform and modalities for members who face many challenges related to the accessibility and quality of nursing education contents