Introduction: The purposes of this study were to explore the resemblance in the weight status within couples with different family contextual factors and analyze the influence of the level of overweight or obesity of a spouse on that of the other spouse. Methods: The data were from the sixth National Health Service Survey of Henan Province in 2018. After screening, 7432 eligible couples were finally included. Socioeconomic and demographic factors were compared by the χ² test or nonparametric test. The difference in the body mass index (BMI) of spouses was assessed by a t-test. The Pearson correlation coefficient and kappa value were used as indicators of consistency in weight status. A logistic regression analysis was used to further explore the effect of a spouse’s level of overweight/obesity on that of the other spouse. Results: The results show that the prevalence of overweight/obesity in couples aged 20 or older is 33.76%. The Pearson correlation coefficient of the BMI within couples was 0.102 (95% CI: 0.076–0.120). The kappa coefficients suggested a low resemblance in the weight status within couples (k = 0.049, 95% CI: 0.031–0.069). Besides, the influence of the overweight/obesity status of the wives on that of the husbands (odds ratio (OR) = 1.411, 95% CI: 1.309–1.521) was slightly higher than that of the husbands on that of the wives (OR = 1.404, 95% CI: 1.302–1.514). Conclusions: We found that there was a moderate but significant resemblance in the body weight status between spouses, especially elderly couples with a low education level in rural areas. Health education activities for couple interventions can have a good effect of intervention. Full article

The objective of this study was to investigate the immediate effects of electroacupuncture and manual acupuncture on hip flexion range of motion (ROM), knee joint (flexion replication at 15° and 45°) and quadriceps (strength and activation) function. Forty-five neurologically healthy adults participated in this randomized controlled laboratory study. Straight leg raise test, modified Thomas test, and hip abductors strength test were performed to determine acupoints. Afterwards, one of three 15-min treatments (control—no treatment, electroacupuncture, or manual acupuncture) was randomly applied using determined acupoints. Measurements (hip flexion ROM, and knee joint and quadriceps function) were recorded at baseline, and at 0, 20, and 40 min post treatment. Both electroacupuncture (4.0°, ES = 0.41) and manual acupuncture (5.4°, ES = 0.95) treatment immediately increased hip flexion ROM, and the increased values persisted for 40-min (p = 0.01). Knee flexion replication (at 15°: p = 0.17; 45°: p = 0.19) and quadriceps activation (p = 0.71) did not change at any of the time points. Post-treatment, both electroacupuncture and manual acupuncture decreased quadriceps strength at 0-min (electroacupuncture: 9.2%, p < 0.0001, ES = 0.60) and 40-min (electroacupuncture: 7.3%, p = 0.005, ES = 0.55; manual acupuncture: 8.7%, p = 0.01, ES = 0.54). A single session of either electroacupuncture or manual acupuncture treatment (selected acupoints based on physical examination) may immediately improve joint flexibility but reduce muscle strength. Full article

This article provides a narrative review on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) through a psychosocial lens and examines how this impairment affects its sufferers during adolescence and adulthood, as well as how it impacts family caregivers and healthcare professionals’ mental health. Since there has been a lack of investigation in the literature, the primary psychosocial stressor that this review focuses on is loneliness. As such, and in an attempt to help establish a theoretical framework regarding how loneliness may impact ME/CFS, loneliness is comprehensively reviewed, and its relation to chronic illness is described. We conclude by discussing a variety of coping strategies that may be employed by ME/CFS individuals to address their loneliness. Future directions and ways with which the literature may investigate loneliness and ME/CFS are discussed. Full article

(1) Background: There are various cognitive, perceptual, and social problems associated with acquired brain injury (ABI). The Allen cognitive impairment level indicates the degree of cognitive function required for everyday activities. Until recently, there have been no studies on the relationship between basic neurological cognition and social cognitive function according to the Allen cognitive level (ACL). The aim of this study is to identify the relationship between basic neurological and social cognition among Allen cognitive disability levels of ABI. (2) Methods: Thirty-four patients with ABI were identified. Cartoon Intention Inference Task (CIIT), Social Behavior Sequence Task (SBST), Korean version Mimi-Mental Status Examination (K-MMSE), and Lowenstein Occupational Therapy Cognitive Assessment (LOTCA)-tests were administered to examine the differences in neurological and social cognitive functions according to each participant’s Allen Cognitive Level Screening (ACLS). (3) Results: There were significant differences between K-MMSE, LOTCA, CIIT and SBST results among Allen cognitive levels (p < 0.05). There was a linear correlation between K-MMSE (r = 0.778, p < 0.01), LOTCA-total score (r = 0.627, p < 0.01), LOTCA-orientation (r = 0.470, p = 0.01), LOTCA-thinking operation (r = 0.341, p < 0.05), CIIT (r = 0.817, p < 0.05), and SBST (r = 0.376, p < 0.05) and ACL. Stepwise multivariate regression showed that the subscales affecting the ACLS score were SBST (β = 0.239, p = 0.000) and K-MMSE (β = 0.068, p = 0.001). The explanatory power of this regression equation, R², was 0.767. (4) Conclusions: A significant difference was found in neurological and social cognitive function according to the ACL level of the ABI patient. In addition, there was a linear correlation between the ACLS scores of the ABI patients and the underlying neurological cognitive function and social cognition. The higher the overall functional cognitive level (i.e., the group with higher ACLS scores), and the lower the degree of help required in daily life, the higher both the neurological cognition level and social cognitive level were determined to be. Full article

Background: It has recently been shown that suprahyoid muscle exercise using kinesiology taping (KT) increases the activation of the suprahyoid muscle in healthy adults, suggesting a potential therapeutic clinical exercise for dysphagia rehabilitation. This study investigated the effect of dysphagia rehabilitation using KT in stroke patients with dysphagia. Methods: Thirty subjects in South Korea were enrolled in this prospective placebo-controlled double-blind study. Participants were randomly assigned to the experimental and sham groups. In the experimental group, the tape was attached to the hyolaryngeal complex, pulled downward with approximately 70% tension, and then attached to the sternum and the clavicle bilaterally. In the sham group, the tape was applied similarly but without the tension. Both groups performed voluntary swallowing 50 times (10 times swallowing per set, times 5 sets) a day for 4 weeks with KT applied. Outcome measures were assessed using portable ultrasound equipment. The parameter measured was the change in thickness of the tongue muscle, mylohyoid muscle, and the anterior belly of the digastric muscle. Results: The experimental group showed statistically significant changes in the thickness of the tongue muscle, mylohyoid muscle, and anterior belly of the digastric muscle than the sham group (p = 0.007, 0.002, and 0.001). Conclusion: Dysphagia rehabilitation using KT is a technique that may promote oropharyngeal muscle thickness in patients with dysphagia after stroke. Full article

Patient safety means a condition in which a patient does not suffer any unnecessary actual harm, nor is exposed to any potential harm related to healthcare. The World Health Organization’s recognition of patient safety, as one of the most important factors in determining high quality healthcare, initiated the systematic introduction of changes in the approach to this issue, both globally and on the level of individual healthcare service providers. In order to enhance the quality and ensure the safety of healthcare services provided, national, European Union, and worldwide institutions focus on the introduction of a so-called patient safety culture. The creation of this safety culture would not be possible without the establishment of its legal framework. The purpose of this article is to shed light on the legislative achievements of the European Union within patient safety, taking into consideration acts that summarize the level of implementation of individual recommendations. This study can be useful both for those who focus their scientific interests on the subject of patient safety and those who need concise information on the legislative measures of the Community in this respect, as well as for medical personnel who want to become acquainted with this issue without reading comprehensive legal acts. Full article

We aimed to (a) evaluate the agreement between ultra-short-term and criterion resting heart rate variability (HRV) measures in military trainees, and (b) compare associations between HRV recording lengths and body composition. HRV recordings were performed for 10 min in 27 military male students. Mean RR interval, the root-mean square of successive differences (RMSSD), RMSSD:RR interval ratio, standard deviation of normal-to-normal RR intervals (SDNN), and SDNN:RR interval ratio were determined from the last 5 min of the 10-min recording and considered the criterion. Parameters were also recorded in successive 1-min epochs from the 5-min stabilization period. No differences were observed between criterion values and any of the 1-min epochs (p > 0.05). Effect sizes ranged from −0.36–0.35. Intra-class correlations ranged from 0.83–0.99. Limits of agreement ranged from 38.3–78.4 ms for RR interval, 18.8–30.0 ms for RMSSD, 1.9–3.1 for RMSSD:RR, 24.1–31.4 ms for SDNN, and 2.5–3.0 for SDNN:RR. Body fat% was associated (p < 0.05) with all HRV parameters at varying time segments. A 1-min HRV recording preceded by a 1-min stabilization period seems to be a suitable alternative to criterion measures. Ultra-short procedures may facilitate routine HRV tracking in tactical populations for status-monitoring purposes. Full article

This study examined the effects of healthcare inequality on personal health. It aimed to determine how health insurance type and income level influence catastrophic health expenditure and unmet healthcare needs among South Koreans. Unbalanced Korean Health Panel data from 2011 to 2015, including 33,374 adults, were used. A time-trend and panel regression analysis were performed. The first to identify changes in the main variables and, the second, mediating effects of unmet healthcare needs and catastrophic health expenditure on the relationship between health insurance type, income level, and health status. The independent variables were: high-, middle-, low-income employee insured, high-, middle-, low-income self-employed insured, and medical aid. The dependent variable was health status, and the mediators were unmet needs and catastrophic health expenditure. The medical aid beneficiaries and low-income self-employed insured groups demonstrated a higher probability of reporting poor health status than the high-income, insured group (15.6%, 2.2%, and 2.3%, respectively). Participants who experienced unmet healthcare needs or catastrophic health expenditure were 10.7% and 5.6% higher probability of reporting poor health, respectively (Sobel test: p < 0.001). National policy reforms could improve healthcare equality by integrating insurance premiums based on income among private-sector employees and self-employed individuals within the health insurance network. Full article

This cross-sectional study aimed to explore the relationships among sociodemographics, health literacy, self-efficacy, social support, health-promoting behavior, and health-related quality of life (HRQOL) in older adults. A total of 240 older adults aged >65 years were recruited from three community senior welfare centers in South Korea. Standardized self-administered questionnaires measuring sociodemographic characteristics, health literacy, social support, self-efficacy, health-promoting behavior, and health-related quality of life were distributed to older adults. Multiple regression analyses with stepwise selection was used to determine the factors affecting health-related quality of life. Factors affecting a higher physical component score of HRQOL were a higher comprehension level of and numeracy in health literacy, physical health-promoting behavior, perceived emotional-informational support, and a lesser number of comorbidities. Factors affecting a higher mental component score of HRQOL were a higher comprehension level of and numeracy in health literacy, self-efficacy, physical health-promoting behavior, perceived emotional-informational support, and a lesser number of comorbidities. To improve HRQOL among older adults, nursing interventions are required to measure health literacy, empower physical health-promoting behavior and self-efficacy, and enhance emotional-informational support from family or other resources. Full article

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition associated with several negative health outcomes. A hallmark of ME/CFS is decreased exercise capacity and often profound exercise intolerance. The causes of ME/CSF and its related symptoms are unknown, but there are indications of a dysregulated metabolism with impaired glycolytic vs oxidative energy balance. In line with this, we recently demonstrated abnormal lactate accumulation among ME/CFS patients compared with healthy controls after exercise testing. Here we examined if cardiac dimensions and function were altered in ME/CFS, as this could lead to increased lactate production. Methods: We studied 16 female ME/CFS patients and 10 healthy controls with supine transthoracic echocardiography, and we assessed cardiac dimensions and function by conventional echocardiographic and Doppler analysis as well as novel tissue Doppler and strain variables. Results: A detailed analyses of key variables of cardiac dimensions and cardiac function revealed no significant differences between the two study groups. Conclusion: In this cohort of well-described ME/CFS patients, we found no significant differences in echocardiographic variables characterizing cardiac dimensions and function compared with healthy controls. Full article

A retrospective observational study using an oral bacteria counter was conducted to evaluate the trends in the number of oral bacteria in the perioperative period of lung cancer patients and to verify the relationship between oral health status and postoperative fever. All patients received perioperative oral management (POM) by oral specialists between April 2012 and December 2018 at Kagawa Prefectural Central Hospital, Kagawa, Japan prior to lung cancer surgery. Bacteria counts from the dorsum of the tongue were measured on the day of pre-hospitalization, pre-operation, and post-operation, and background data were also collected retrospectively. In total, 441 consecutive patients were enrolled in the study. Bonferroni’s multiple comparison test showed significantly higher oral bacteria counts at pre-hospitalization compared to pre- and post-operation (p < 0.001). Logistic regression analysis showed that body mass index, performance status, number of housemates, number of teeth, and white blood cell count at pre-operation were significantly associated with postoperative fever. The study showed that POM can reduce the level of oral bacterial counts, that the risk of postoperative complications is lower with dentulous patients, and that appropriate POM is essential for prevent of complications. Therefore, POM may play an important role in perioperative management of lung cancer patients. Full article

(1) Aim: The aim of this study was to assess the preferences of oral anticoagulants (OA) in patients diagnosed with deep vein thrombosis (DVT) of lower limbs or non-valvular atrial fibrillation (AF) requiring anticoagulation for medium/long term. (2) Materials and methods: the study included consecutive patients admitted with a diagnosis of either acute DVT of lower limbs (without signs of pulmonary embolism) or non-valvular AF who required oral anticoagulation, in a time frame of 18 months from January 2017 until June 2018. The following data were recorded: demographic variables, comorbidities (ischemic heart disease, arterial hypertension, heart failure, stroke, peripheral artery disease, diabetes mellitus, obesity), type and dose of OA (acenocoumarol, dabigatran, apixaban, rivaroxaban), complications due to the use of OA. (3) Results: AF patients were older and had considerably more cardiovascular comorbidities than DVT patients. Vitamin K antagonists (VKA) were more likely to be administered in patients with AF, as they had indication for indefinite anticoagulation. VKA were more frequently prescribed in patients with ischemic heart disease, heart failure, and diabetes compared with DVT patients. Moreover, complications related to OA use were more frequent in the VKA group. Almost half of patients with acute DVT (48.5%) were treated with direct OA (DOAC) rather than VKA, and only a quarter of AF patients (24.8%) were treated with DOACs. Full article

This case study aimed to investigate the short-term effects of ankle eversion taping (AET) using kinesiology tape on bilateral acute ankle inversion sprains in an amateur college soccer goalkeeper. Ankle eversion taping was applied for two weeks (average 16 h/day) on a 24-year-old goalkeeper with bilateral grade 2 acute ankle inversion sprain with swelling (left ankle more severe) during a soccer match. The subject had a foot ankle outcome score (FAOS) of 41%; visual analog scale (VAS) scores of 5/10 and 7/10 for the right and left ankles, respectively; patient-specific functional and pain scale (PSFS) score of 12/50; and limited range of motion of the ankle. The swelling disappeared after AET in both ankles. In the weight-bearing lunge test, the right and left ankle distances increased from 2 cm to 12 cm, and from 0 cm to 12 cm, respectively. The FAOS improved from 20% to 97%, while the PSFS score improved from 12/50 to 50/50. The VAS scores decreased to 0/10 for both ankles. AET is a potential clinical treatment method for acute ankle inversion sprain with swelling. Full article

Balance disorders have a high prevalence among elderly people in developed countries, and falls resulting from balance disorders involve high healthcare costs. Therefore, tools and indicators are necessary to assess the response to treatments. Therefore, the aim of this study is to detect relevant changes through minimal detectable change (MDC) values in patients with balance disorders, specifically with vertigo. A test-retest of a static and dynamic balance test was conducted on 34 healthy young volunteer subjects using a portable stabilometric platform. Afterwards, in order to show the MDC applicability, eight patients diagnosed with balance disorders characterized by vertigo of vestibular origin performed the balance test before and after a treatment, contrasting the results with the assessment by a specialist physician. The balance test consisted of four tasks from the Romberg test for static balance control, assessing dynamic postural balance through the limits of stability (LOS). The results obtained in the test-retest show the reproducibility of the system as being similar to or better than those found in the literature. Regarding the static balance variables with the lowest MDC value, we highlight the average velocity of the center of pressure (COP) in all tasks and the root mean square (RMS), the area, and the mediolateral displacement in soft surface, with eyes closed. In LOS, all COP limits and the average speed of the COP and RMS were highlighted. Of the eight patients assessed, an agreement between the specialist physician and the balance test results exists in six of them, and for two of the patients, the specialist physician reported no progression, whereas the balance test showed worsening. Patients showed changes that exceeded the MDC values, and these changes were correlated with the results reported by the specialist physician. We conclude that (at least for these eight patients) certain variables were sufficiently sensitive to detect changes linked to balance progression. This is intended to improve decision making and individualized patient monitoring. Full article

Chemotherapy for acute lymphoblastic leukemia (ALL) patients is complex and intense, resulting in a high readmission rate. We aimed to identify the incidence, causes, and risk factors of readmission following inpatient chemotherapy among ALL patients, using 2016 National Readmission Database. We applied three different definitions of 30-day readmission: (1) nonelective readmission based on readmission type, (2) unplanned readmission defined by CMS, and (3) unintentional readmission, combining (1) and (2). We used unweighted multivariable Poisson regression with robust variance estimates for risk factors analysis, including patient-, hospital-, and admission-related characteristics. Percentage for nonelective, unplanned, and unintentional readmission were 33.3%, 22.4%, and 18.5%, respectively. The top three causes for unplanned readmissions were neutropenia/agranulocytosis (27.8%), septicemia (15.3%), and pancytopenia (11.5%). Risk ratios for unintentional readmission were 1.21 (1.08–1.36) for nonelective vs. elective admission, 1.19 (1.06–1.33) for public vs. private insurance enrollees, 0.96 (0.95–0.98) for each day of hospital stay, 0.77 (0.62–0.95) for large teaching and 0.87 (0.70–1.08) for small teaching vs. nonteaching hospitals. Possible strategies to reduce readmission among ALL patients could be shortening the gap in quality of care among teaching vs. non-teaching hospitals, understanding the difference between privately vs. publicly insured patients, and avoiding aggressive discharge after chemotherapy. Full article