Background Diet and physical activity are key factors related to depressive mood. Previous studies have demonstrated the effects of diet and physical activity on depression. However, the effect of energy intake-expenditure balance (EIEB) on mental health has not been fully evaluated. This study aimed to analyze the association between EIEB and depression.
Methods A total of 13,460 participants (5,660 men and 7,800 women) aged ≥19 years were obtained from the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey (KNHANES). EIEB was defined as the difference between the daily energy intake and energy expenditure. Energy intake was calculated and provided by the KNHANES using a 24-hour recall survey. Energy expenditure was estimated as the sum of basal metabolic rate and physical activity. Logistic regression analyses were used to investigate the association between sex-specific quartile groups (Q1–Q4) of EIEB and depression after adjusting for socioeconomic status, body mass index, lifestyle factors, and underlying diseases.
Results Women in Q3 of EIEB (211–669 kcal) had a significantly lower risk of depression (odd ratio [OR], 0.78; 95% confidence interval [CI], 0.67–0.92) than those in Q1 of EIEB (<-167 kcal). The adjusted ORs of depression were 0.87 (95% CI, 0.75–1.02) in Q2 and 0.86 (95% CI, 0.74–1.01) in Q4, with P for trend=0.030. There were no significant associations between the EIEB quartile groups and depression in men after adjusting for potential confounders (P for trend=0.564).
Conclusion Our results suggested that the EIEB is negatively associated with depression in Korean women.
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Background Continuity of care in primary care settings is crucial for managing diabetes. We aimed to statistically define and analyze continuity factors associated with demographics, clinical workforce, and geographical relationships.
Methods We used 2014–2015 National Health Insurance Service claims data from the Korean registry, with 39,096 eligible outpatient attendance. We applied multivariable logistic regression to analyze factors that may affect the continuity of care indices for each patient: the most frequent provider continuity index (MFPCI), modified-modified continuity index (MMCI), and continuity of care index (COCI).
Results The mean continuity of care indices were 0.90, 0.96, and 0.85 for MFPCI, MMCI and COCI, respectively. Among patient factors, old age >80 years (MFPCI: odds ratio [OR], 0.81; 95% confidence interval [CI], 0.74–0.89; MMCI: OR, 0.84; 95% CI, 0.76–0.92; and COCI: OR, 0.81; 95% CI, 0.74–0.89) and mild disability were strongly associated with lower continuity of care. Another significant factor was the residential area: the farther the patients lived from their primary care clinic, the lower the continuity of diabetes care (MFPCI: OR, 0.74; 95% CI, 0.70–0.78; MMCI: OR, 0.70; 95% CI, 0.66–0.73; and COCI: OR, 0.74; 95% CI, 0.70–0.78).
Conclusion The geographical proximity of patients’ residential areas and clinic locations showed the strongest correlation as a continuity factor. Further efforts are needed to improve continuity of care to address the geographical imbalance in diabetic care.
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Background In the Republic of Korea, which medical specialties should take the responsibility for primary care and what the role of primary care should be are still unclear. In this study, we focused on the comprehensiveness of primary care to identify related factors.
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Results The clinics included in the study had provided treatment for an average of 14 SMDGs during a 2-year period. Compared to general practitioners, internal medicine physicians presented higher comprehensiveness with an odds ratio (OR) of 2.29 (95% confidence interval [CI], 2.03–2.59), and family medicine physicians illustrated higher comprehensiveness (OR, 4.96; 95% CI, 3.59–6.83). Other specialties showed lower comprehensiveness than general practitioners. Clinics located in the capital city and metropolitan area tended to have lower comprehensiveness. Clinics hiring more doctors and having hospitalization facility showed higher comprehensiveness.
Conclusion General physician, internal medicine, and family medicine are the fields providing comprehensive medical care in Korea. Clinics located in metropolitan area and capital city show lower comprehensiveness. The number of physicians is related to higher comprehensiveness of clinics.
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Background : Hypertension is a main cause of heart blood vessel disease. To diagnose and treat hypertension, it is necessary to measure blood pressure accurately. There are various factors that influence blood pressure. According to real clinical demonstrators and some recent studies, blood pressure differences between right and left arms are often observed. This study was intended to know whether the differences are really found and wheather the correlation exists between mid-arm circumferences and the blood pressure differences according to right-handed or left-handed which were considered as an important factor in affecting blood pressures.
Methods : One hundred sixty nine college freshmen of year 2001 were chosen. Among them, 103 were right- handed and 66 left-handed. Which arms to be checked first were determined randomly. This sequence was repeated two times on each person. Their mid-arm circumferences were measured, also.
Results : For right-handed persons, systolic blood pressure in right arm (119.2±12.3 mmHg) was significantly higher than in left arm (118.0±12.0 mmHg) (P＜0.005). But diastolic blood pressure differences between right arm (75.3±10.0 mmHg) and left arm (75.0±9.5 mmHg) was not significant statistically. For left-handed persons, systolic blood pressure was 120.3±9.9 mmHg in right arm and 120.0±10.3 mmHg in left arm. However, diastolic blood pressure in right arm (76.7±9.4 mmHg) was significantly higher than in left arm (75.0±8.6 mmHg) (P＜0.005). For right handed persons, their arm circumferences (26.2±2.8 cm) were significantly thicker than left ones (25.9±2.9 cm). For left-handed, left arm circumference (25.9±2.7 cm) was significantly thicker than right one (25.5±2.6 cm). As for the blood pressure difference in arm tested order, the first measured systolic blood pressure (right arm; 120.9±11.7 mmHg, left arm; 120.0±11.9 mmHg) was significantly higher than the second measured one (right arm; 118.3±11.8 mmHg, left arm; 117.8±11.6 mmHg) (P＜0.005). However, the first measured diastolic blood pressure (right arm; 76.3±10.5 mmHg, left arm; 75.5±9.4 mmHg) did not have more significance than the second measured one (right arm; 75.4±9.9 mmHg, left arm; 74.6±10.8 mmHg).
Conclusion : The right-handed person's blood pressure was higher in the right arm, but for the left-handed persons it was not significantly different in both arms. The second measurement of blood pressure was lower than the first measurement in both arms. The arm circumference depending on the right/left-handedness influenced the blood pressure, but clear correlation between them was not observed. Therefore, if possible, when the blood pressure is measured, it is advised to check blood pressure in both arms before diagnosing hypertension.
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