Psychosocial support interventions for women with gestational diabetes mellitus: a systematic review

Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion: Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.ope

Effectiveness of behavioral sleep interventions on children's and mothers' sleep quality and maternal depression: a systematic review and meta-analysis

This systematic review and meta-analysis was conducted to investigate the effectiveness of behavioral sleep interventions (BSIs) on the number of child night awakenings, and maternal sleep quality and depression. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) using PubMed, CINAHL, Cochrane, and EMBASE databases and retrieved studies published until April 2021. We calculated the odds ratios (ORs) and 95% confidence intervals (CIs) for child sleep problems, and the mean differences (MD) and 95% CI for the number of child night awakenings, and maternal sleep quality and depression. Ten studies of 1628 initial searched were included in the final analysis. Two of the 10 studies were divided into two subgroups by participants and intervention type; thus, 12 subgroups were included in the meta-analysis. BSIs significantly reduced child sleep problems (OR 0.51; 95% CI 0.37-0.69) and improved maternal sleep quality (MD - 1.30; 95% CI - 1.82 to - 0.77) in the intervention group. There were no significant differences in the number of child night awakenings and maternal depression between the two groups. More RCTs to examine the effect of BSIs considering children's age, duration of intervention, and outcome measuring time points are needed.ope

Patterns of instrumental activities of daily living and association with predictors among community-dwelling older women: A latent class analysis

BACKGROUND: The purpose of this study was to classify patterns of instrumental activities of daily living (IADL) among community-dwelling older women, to examine difference in characteristics among the classes, and to explore predictors of class membership. METHODS: This study was a secondary analysis of nationwide data from the 2014 Actual Living Condition of the Elderly and Welfare Need Survey. A total of 10,451 individuals aged 65 years or older were interviewed for the 2014 dataset, but we only selected the female participants (n = 6095) for this study. For statistical analyses, latent class analysis was applied to identify different latent classes of IADL and then the effects of predictors on IADL patterns were analyzed by using multinomial logistic regression. RESULTS: The 5-class model was the best fit for the data. The size of class 1was the biggest (n = 5093, 83.6%), followed by class 5 (n = 401, 6.6%), class 3 (n = 308, 5.1%), class 2 (n = 181, 3.0%), and class 4 (n = 113, 1.8%). The largest class had total independency on all items of IADL. In the multinomial regression, members in the classes 2, 3, 4 and 5 were significantly more likely to have older age and decreased cognitive status compared with the class of total independency on all items of IADL (class1). CONCLUSIONS: The predictors of the classes identified in this study can be used for tailored and targeted interventions to increased old adults' independency on IADL.ope

Association of Functional Ability and Benign Prostatic Hyperplasia With Urinary Incontinence in Older Korean Men.

PURPOSE: The purpose of this study was to determine the prevalence of urinary incontinence (UI) and analyze its association with instrumental activities of daily living (IADL) and benign prostatic hyperplasia (BPH) in community-dwelling older men in Korea. METHODS: This study was a secondary analysis of data from the Actual Living Condition of the Elderly and Welfare Need Survey conducted in the year 2008. Data was subjected to hierarchical logistic regression analysis to examine the association of IADL and BPH with UI in older men, entering IADL and BPH in model 1, and age, body mass index (BMI) and education in model 2, and then comorbidities and walking speed in model 3. RESULTS: Of 6,185 men, 243 (3.9%) had self-reported UI. The prevalence of UI was 1.8% in men aged 60-64 years and 11.7% in those aged 85 years and above, indicating an increase in the prevalence of UI with their age. IADL and BPH remained the only significant factors associated with UI in model 1 (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.44-1.64 and OR, 2.73; 95% CI, 1.47-5.10, respectively), model 2 (OR, 1.50; 95% CI, 1.40-1.61 and OR, 2.68; 95% CI, 1.42-5.07), and model 3 (OR, 1.43; 95% CI, 1.32-1.54 and OR, 2.58; 95% CI, 1.36-4.90). CONCLUSIONS: IADL limitations and presence of BPH were associated with UI in older men after controlling for BMI, education, comorbidities, and walking speed. Thus, UI should be assessed in older Korean men with IADL decline and BPH. Gender-sensitive interventions to attenuate IADL limitations and manage BPH should be developed and applied to improve UI in older men.ope

A new perspective on arctic soil metazoan diversity: metagenetics reveals local and geographical patterns of variation in community structure and habitat specialization in high arctic tundra of Svalbard

학위논문 (석사)-- 서울대학교 대학원 : 생명과학부, 2015. 2. Jonathan Adams.Little is known of the diversity, community structuring, niche differentiation and habitat specialization of small soil Metazoa in polar environments. Here, I studied three contrasting high arctic tundra types at Kongsford, NW Svalbard (78° 55 N), comparing the small soil Metazoa community in each along with the comparison to a mid-latitude temperate forest site in Korea (37 deg.N), using an identical interrupted grid sampling scheme. In addition, communities of nematode present in local microsites (rhizosphere, cyanobacterial mat, etc.) in the arctic tundra were also compared. Soil Metazoa, mostly nematodes were extracted using combined Baermann funnel and sugar flotation, and the DNA extracted, PCR amplified for the NF1-18Sr2b region of the 18s rRNA gene, and 454 pyrosequenced. Our samples revealed diverse communities of soil Metazoa in all three tundra types, with species proxy (operational taxonomic unit, [OTU]) diversity far exceeding the species diversity based on morphological surveys in previous studies of Svalbard. There was no difference in OTU α-diversity between the three tundra types. I found no correlation between nematode and soil properties but across individual samples there was a positive correlation between Shannon α-diversity with TOC, C/N ratio and P2O5. β-diversity was significantly higher in IV and LV tundra, suggesting that their mosaic of bare and vegetated patches supports a greater range of local metazoan communities than the more uniformly vegetated HV tundra. HV tundra had a distinct community from the LV tundra type, with the community of IV tundra falling between these in terms of OTU composition, indicating an important element of niche and habitat differentiation amongst small soil Metazoa between the three different tundra types. Different microsite types were differentiated at some degree based on NMDS resulted from Bray Curtis similarity matrix. The strongest differences were between rhizophere and cyanobacterial mat areas, and this pattern was consistent for Nematoda and for all Metazoa combined. However, no distinct community composition of the Metazoa was found within the microsites (e.g. between the rhizosphere of two different cushion plant species) suggesting the limits of microhabitat specialization in this environment. Overall, total nitrogen, total organic carbon and available phosphorus in the soil in each microsite were the best predictor of variation in both total metazoan and nematode communities. Despite the evidence of niche specialization in the communities, there was only about 5.56% of overlap in OTUs shared among different microsites suggesting that many species are actually quite generalized in their distribution and most likely in their ecology. However, I concluded that despite this being an extreme environment amongst land ecosystems, normally thought to require generalized niches amongst animals, the Metazoa in the high arctic tundra are still to some extent habitat-specialized. When the Svalbard tundra was compared with temperate forest, arctic tundra had markedly lower alpha-diversity for soil Metazoa than the temperate forest, reinforcing the view that there may be a classic latitudinal diversity difference in this group. However, two of the three sites in the Svalbard tundra had higher beta diversity than the Korean temperate forest, while a third tundra site has equally high beta diversity. This may reflect the greater influence of small scale environmental heterogeneity within the tundra compared to temperate forest. Also of interest is the fact that while most Metazoa OTUs in the temperate forest did not occur in the tundra, and vice versa, reflecting the degree of geographical endemism or environmental specialization that differentiates these regions. However, a small proportion (around 10%) of species do apparently occur in both environments despite their very distinct environments.CONTENTS ABSTRACT Ⅰ CONTENTS Ⅳ LIST OF FIGURES Ⅷ LIST OF TABLES Ⅸ CHAPTER1. GENERAL INTRODUCTION 1 1.1 General knowledge of arctic soil Metazoa 1 1.2 Objectives of this study 10 CHAPTER2. DISTINCT SOIL METAZOAN COMMUNITIES ACROSS DIFFERENT TUNDRA TYPES WITHIN THE SVALBARD HIGH ARCTIC TUNDRA. 14 2.1 Introduction 14 2.2 Methodology 19 2.2.1 Site description 19 2.2.2 Sampling method 23 2.2.3 Soil metazoan DNA extraction 24 2.2.4 DNA extraction, PCR and pyrosequencing of 18SrRNA gene 24 2.2.5 Sequencing processing 25 2.2.6 Statistical analysis 26 2.2.7 Soil analysis 29 2.3 Results 30 2.3.1 General findings 30 2.3.2 α- and β-diversity in the main tundra types of Svalbard 33 2.3.3 Difference in Metazoa community composition among tundra types 36 2.3.4 Soil parameters predicting Metazoa diversity and relative abundance within the Svalbard tundra 40 2.4 Discussion 42 2.4.1Nematode species diversity detected by this metagenetic study is much higher than is detected by classical morphological studies 42 2.4.2 Differences in Nematoda α- and β-diversity between the different main tundra types of Svalbard 43 2.4.3 Difference in nematode and total soil metazoan community composition between the different main tundra types of Svalbard 47 CHAPTER3. MICROSITE DIFFERENTIATION IN SOIL METAZOAN COMMUNITIES WITHIN THE SVALBARD HIGH ARCTIC TUNDRA. 52 3.1 Introduction 52 3.2 Methodology 55 3.2.1 Site description 55 3.2.2 Sampling method 57 3.2.3 Soil metazoan DNA extraction 61 3.2.4 DNA extraction, PCR and pyrosequencing of 18SrRNA gene 63 3.2.5 Sequencing processing 64 3.2.6 Statistical analysis 65 3.2.7 Soil analysis 67 3.3 Results 68 3.3.1 General findings 68 3.3.2 Community composition of each microsite type 69 3.3.3 Rhizosphere metazoan community of two different plant species 74 3.4 Discussion 78 3.4.1 There is a distinct community composition of Metazoa between different microsite 78 3.4.2 Metazoan community of the rhizosphere is not affected by the species identity of the host plant 79 CHAPTER4. How do polar soil Metazoa communities differ from temperate ones? High polar tundra and temperate forest compared using a common methodology. 82 4.1 Introduction 82 4.2 Methodology 90 4.2.1 Sampling times and sites 90 4.2.2 Sampling method 92 4.2.3 Soil Metazoa DNA extraction 94 4.2.4 DNA extraction, PCR and pyrosequencing of 18SrRNA gene 95 4.2.5 Sequence processing 96 4.2.6 Statistical analysis 97 4.2.7 Soil analysis 99 4.3 Results 100 4.3.1 General findings 100 4.3.2 α-,β-diversity and community composition in the arctic and temperate biome 101 4.3.3 Community composition 104 4.3.4 Shared OTUs and Indicator OTUs 107 4.3.5 Soil properties structuring community composition 111 4.4 Discussion 113 4.4.1 Metazoa α-diversity of Svalbard tundra is less than that of Korean temperate forest, but the tundra has higher β-diversity 113 4.4.2 There is little OTU overlap between Korean temperate forest and Svalbard tundra 115 4.4.3 Nematode guild structure is different between the Korean and Svalbard sites 116 CONCLUSIONS 118 REFERENCES 121 SUPPLEMENTARY 140 국문초록 144Maste

Experience of Nurses with Intravenous Fluid Monitoring for Patient Safety: A Qualitative Descriptive Study

Purpose: Medication administration is a complex process and constitutes a substantial component of nursing practice that is closely linked to patient safety. Although intravenous fluid administration is one of the most frequently performed nursing tasks, nurses' experiences with intravenous rate control have not been adequately studied. This study aimed to explore nurses' experiences with infusion nursing practice to identify insights that could be used in interventions to promote safe medication administration. Patients and methods: This qualitative descriptive study used focus group interviews of 20 registered nurses who frequently administered medications in tertiary hospitals in South Korea. Data were collected through five semi-structured focus group interviews, with four nurses participating in each interview. We conducted inductive and deductive content analysis based on the 11 key topics of patient safety identified by the World Health Organization. Reporting followed the consolidated criteria for reporting qualitative research (COREQ) checklist. Results: Participants administered infusions in emergency rooms, general wards, and intensive care units, including patients ranging from children to older adults. Two central themes were revealed: human factors and systems. Human factors consisted of two sub-themes including individuals and team players, while systems encompassed three sub-themes including institutional policy, culture, and equipment. Conclusion: This study found that nurses experienced high levels of stress when administering infusions in the correct dose and rate for patient safety. Administering and monitoring infusions were complicated because nursing processes interplay with human and system factors. Future research is needed to develop nursing interventions that include human and system factors to promote patient safety by reducing infusion-related errors.ope

Determinants of Protective Behaviors Against Endocrine Disruptors in Young Korean Women

Purpose: A convenience-oriented lifestyle in young people is accompanied by greater consumption of and exposure to endocrine disruptors, which can affect reproductive health, especially in women. We aimed to identify factors that influence protective behaviors against endocrine disruptors among female college students in South Korea. Methods: Using a cross-sectional survey design, we recruited 199 female college students. A self-administered questionnaire was used, and data were collected at the site. Results: A healthy lifestyle, information utilization, receiving peer advice on avoiding exposure to endocrine disruptors, and a history of environmental illnesses were found to be significant factors, explaining 42.0% of the variance in protective behaviors against endocrine disruptors. Conclusion: Health consequences of environmental hazards and importance of maintaining a healthy lifestyle need to be emphasized in young women's healthcare. Health professionals should advocate for and empower women to protect themselves against endocrine disruptors.ope

Effectiveness of Fluid and Caffeine Modifications on Symptoms in Adults With Overactive Bladder: A Systematic Review

Overactive bladder (OAB) is prevalent in men and women and negatively impacts physical and psychological health. Fluid and caffeine intake modifications, which are lifestyle modification interventions, are simple methods to manage OAB. Howev er, studies that synthesized both interventions and found scientific evidence are scarce. This review aimed to synthesize scien tific evidence on whether fluid and caffeine intake modifications are effective for OAB symptoms. PubMed, CINAHL (Cumu lative Index for Nursing and Allied Health Literature), Embase, Scopus, the Cochrane Library, KoreaMed, and RISS (Research Information Sharing Service) were used to search for studies and 8 studies were included. The Cochrane risk of bias tool (RoB 2.0) and ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) were used to assess the quality of selected studies. Due to the heterogeneous outcome variables, a meta-analysis was not conducted. Among the 8 included, 7 studies were randomized controlled trials and one was a quasi-experimental study. Four studies assessed urgency. Caffeine reduction was statistically effective for urgency symptoms, but increasing fluid intake was not. Frequency was assessed in 5 studies, which showed decreasing caffeine and fluid intake was effective in treating the symptoms. Urinary incontinence episodes were assessed in 6 studies, and nocturia in 2. Restricting caffeine intake was effective in treating these 2 symptoms, but restricting both caffeine and fluid intake was not. Quality of life (QoL) was examined in 5 studies, and modifying fluid and caffeine in take significantly improved QoL in 2. Although there were limited studies, our review provides scientific evidence that fluid and caffeine intake modification effectively manages OAB symptoms. Further research should examine acceptability and sus tainability of interventions in the long-term and enable meta-analysis.ope

Factors Associated With Self-reported and Medically Diagnosed Urinary Incontinence Among Community-Dwelling Older Women In Korea

PURPOSE: The purpose of this study was to examine the prevalence of urinary incontinence (UI) in community-dwelling Korean women 60 years or older, and to identify factors associated with self-reported and medically diagnosed UI. METHODS: This study was a secondary analysis of data from the 2008 Actual Living Condition of the Elderly and Welfare Need Survey, which used a stratified two-stage cluster sampling method to select a representative sample of 8,961 elderly Korean women. RESULTS: Of the 8,961 women in this study, 579 (6.5%) had self-reported UI, and 209 (2.3%) were medically diagnosed with UI. As patient age and exercise ability of the upper extremities increased, risk for self-reported UI decreased (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.96-0.99; OR, 0.99; 95% CI, 0.98-0.99, respectively). In contrast, as the number of limited instrumental activities of daily living (IADL) increased, the risk for self-reported UI increased (OR, 1.30; 95% CI, 1.24-1.35). Overweight women were 1.94 times more likely to have self-reported UI compared to underweight women. Women with a history of stroke or asthma were more likely to have self-reported UI compared to women with no history. Also, women who reported being in good health were less likely to have UI, compared to women who reported being in poor health (OR, 0.47; 95% CI, 0.31-0.70). Medically diagnosed UI was negatively associated with the number of limited IADL and exercise ability scores for the lower extremities (OR, 0.86; 95% CI, 0.80-0.92; OR, 0.98; 95% CI, 0.97-0.99, respectively). In contrast, as the exercise ability score for the upper extremities increased, so did the risk for medically diagnosed UI (OR, 1.02; 95% CI, 1.01-1.03). CONCLUSIONS: An interventional program for home visit health services is needed for incontinent women who are highly dependent on others for IADL.ope

Endocrine Disrupting Chemicals and Premenstrual Syndrome in Female College Students in East Asia: A Multi-Country Study

Purpose: This study aimed to explore the severity of premenstrual syndrome (PMS) and to examine associated factors with PMS among East Asian female college students with regard to endocrine-disrupting chemical (EDC). Patients and methods: This study was a cross-sectional design. An online survey was completed by 520 female college students in Hong Kong and Korea. The structured questionnaire included items measuring knowledge of EDCs, actions taken and willingness to minimize exposure to EDCs, interest in EDCs, prior education on EDCs, life stress, severity of PMS, and general and health-related characteristics. Multiple logistic regressions were performed. Results: The prevalence of severe PMS among the participants was 54.6%. Factors associated with severe PMS included a self-reported heavy menstrual flow, underweight, obesity, interpersonal relationship stress, actions taken to minimize exposure to EDCs, and interest in EDCs. Conclusion: This study provided the evidence of a negative association between severe PMS and the actions taken to minimize exposure to EDCs. To alleviate symptoms of PMS among young female adults, practical interventions, such as education to overcome barriers to preventing exposure to EDCs, are suggested.ope