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Hypertension Care Quality and Incidence of Complications Among Hypertensive Patients With Disabilities in Korea: An Analysis of a Cohort Study Using National Health Insurance Data

Fri, 01 May 2026 00:00:00 GMT

Title: Hypertension Care Quality and Incidence of Complications Among Hypertensive Patients With Disabilities in Korea: An Analysis of a Cohort Study Using National Health Insurance Data Authors: Lee, Hwa-Young; Kim, Kyusung; Shin, Dong Wook; Han, Kyungdo; Jung, Jin Hyung; Park, Jae-hyun Abstract: Background: Hypertension is more prevalent among individuals with disabilities than in the general population. This study analyzed long-term trends in disparities in hypertension care quality and the incidence of hypertensive complications among individuals with and without disabilities. Methods: This retrospective cohort study followed 52,743 hypertensive patients aged 20 or older with disabilities newly diagnosed in 2010, along with 47,564 age-and sex-matched patients without disabilities, from 2011 to 2019. Hypertension care quality was assessed using indicators of medication adherence and the completion of three complication-monitoring tests at recommended frequency: blood test, urine test, and electrocardiogram (ECG). Hypertensive complications included major cardiovascular and cerebrovascular events, kidney diseases, and all-cause mortality. Logistic regression was repeated annually to assess hypertension care quality, and Cox-proportional model was used to estimate the risk of hypertension-related complications. Results: Hypertensive patients with disabilities consistently demonstrated lower medication adherence throughout the study period (adjusted odds ratio [aOR], 0.90-0.96, depending on the year), but a higher likelihood of undergoing screenings at recommended frequency (e.g., aOR for blood test, 1.31-1.39, for urine test, 1.24-1.33, and for ECG, 1.30-1.37). The risk of complications remained significantly higher among hypertensive patients with disabilities, even after adjusting for care quality indicators (e.g., adjusted hazard ratio for cardiovascular events: 1.36, 95% confidence interval: 1.31-1.41). Subgroup analyses revealed that the excess risks for complications varied across different sociodemographic groups. Conclusion: These findings underscore the need for comprehensive strategies to enhance medication adherence among hypertensive patients with disabilities. Additionally, other factors beyond medication adherence and monitoring test completion that contribute to the increased risk of complications require further exploration.

Ethics and Regulation of Human Brain Organoid Research: Recommendations from the Asia Pacific Neuroethics Working Group

Wed, 01 Apr 2026 00:00:00 GMT

Title: Ethics and Regulation of Human Brain Organoid Research: Recommendations from the Asia Pacific Neuroethics Working Group Authors: Ishida, Shu; Kagan, Brett J.; Kataoka, Masanori; Koplin, Julian; Porsdam Mann, Sebastian; Lewis, Jonathan; Browning, Heather; Erler, Alexandre; Feroz, Faisal; Fukushi, Tamami; Holm, Soren; Kokubo, Masatoshi; Latham, Stephen; Lavazza, Andrea; Lee, Ilhak; Lee, Tsung-Ling; Lyreskog, David; Menikoff, Jerry; Niikawa, Takuya; Nagaishi, Naoya; Nakazawa, Eisuke; Ong, Serene; Ota, Koji; Register, Christopher; Veit, Walter; Yang, Ji Hyun; Yeo, Shang Long; Sawai, Tsutomu; Savulescu, Julian; Earp, Brian D. Abstract: Human brain organoids (HBOs) are three-dimensional structures derived from human stem cells that model aspects of brain development and function, offering potentially unprecedented opportunities for studying neurological disorders and for developing treatments. This consensus paper presents recommendations from the Asia Pacific Neuroethics Working Group, developed through interdisciplinary collaboration among scientists, bioethicists, philosophers, and legal scholars who convened in Singapore in November 2024. We provide a comprehensive analysis of the ethical, legal, and sociocultural dimensions of HBO research, addressing both current realities and future possibilities. The paper examines key ethical considerations, including the potential moral status of HBOs, particularly regarding sentience and consciousness, while identifying and dispelling common misconceptions and "ethical red herrings" arising from sensationalized portrayals. We analyze consent frameworks for cell donation, privacy concerns, dual-use risks, and questions of distributive justice. Legal challenges are explored, including the categorical ambiguity of HBOs within existing regulatory frameworks, intellectual property issues, and cross-border inconsistencies in standards. Sociocultural perspectives emphasize the importance of public understanding, cross-cultural engagement, and empirical research on diverse community attitudes toward HBO research. In our recommendations, we advocate for evidence-based ethical discussions, anticipatory frameworks addressing potential future developments, contextualized analysis comparing HBOs to related experimental models, robust informed consent processes, proportionate responses to consciousness concerns, development of adaptive regulatory frameworks, responsible science communication to manage public expectations, and sustained interdisciplinary collaboration. We emphasize a balanced approach that promotes scientific innovation while maintaining rigorous ethical oversight, recognizing HBOs' significant potential for advancing neuroscience and medicine. This represents the first comprehensive ethical framework for HBO research from the Asia Pacific region, helping to establish foundational principles for responsible development of this rapidly advancing field.

Life-Sustaining Treatment Decision-Making for Unrepresented Adults from Korean Hospital Staff's Perspectives: A Qualitative Descriptive Study

Wed, 01 Apr 2026 00:00:00 GMT

Title: Life-Sustaining Treatment Decision-Making for Unrepresented Adults from Korean Hospital Staff's Perspectives: A Qualitative Descriptive Study Authors: Kim, Hyejin; Choi, Jiyeon; Lee, Won; Lee, Ilhak; Song, Mi-Kyung Abstract: ObjectivesUnrepresented adults - incapacitated individuals lacking surrogates and documented treatment preferences - pose profound clinical and ethical care challenging. This qualitative descriptive study explored hospital staff's encounters with unrepresented adults, their characteristics, and life-sustaining treatment decision-making for this population in South Korea.MethodsWe conducted semi-structured interviews with 48 hospital staff including physicians, nurses, and social workers across South Korea who provided care for unrepresented adults. Data were analyzed using directed content analysis.ResultsParticipants frequently encountered these adults, typically socioeconomically vulnerable middle-aged or older men exhibiting complex care needs, requiring prolonged hospitalization. The life-sustaining treatment decision-making involved physician-led decision-making, consultation with other professionals, alternative consent strategies, and constrained withdrawal and selective withholding of such treatment. Staff navigated these ethically complex decisions by weighing patients' recoverability, presumed life values, and the ethical principle of justice in resource allocation. Crucially, participants experienced significant clinical distress constrained by the lack of legal frameworks and standardized clinical guidelines.ConclusionsAd-hoc life-sustaining treatment decision-making for unrepresented adults places an immense ethical burden on healthcare providers.Clinical implicationsSafeguarding this vulnerable population and alleviating provider distress urgently requires robust legal frameworks, standardized clinical guidelines, and institutional multidisciplinary ethics support.

Exploring the factors associated with early sexual debut among young women in Kinshasa: evidence from two cross-sectional studies

Sun, 01 Feb 2026 00:00:00 GMT

Title: Exploring the factors associated with early sexual debut among young women in Kinshasa: evidence from two cross-sectional studies Authors: Ingoma, Reagan M.; Kim, So Yoon; Kamangu, Erick N.; Choi, Youngsoon; Kim, David Hyung Ho; 최영순; 김형호 Abstract: Background Early sexual debut among young women in Kinshasa, Democratic Republic of Congo (DRC), represents a complex and multifaceted issue that carries significant implications for a range of factors including individual health and social dynamics. Aim This research seeks to illuminate the factors influencing early sexual debut among young women in Kinshasa. Method The analysis involved 1,352 young women using a chi-square test at p < 0.05 and 95% CI for categorical variables. A mixed-effects multilevel binary logistic regression identified determinants of early sexual debut, showing adjusted odds ratios (AOR) and related factors, with 95% CI. Result The prevalence of early sexual debut among respondents aged 15-24 years was 16.3% with an average current age of 16.6 years. Being aged 20-24 years [AOR = 1.40, CI;1-1.97], cohabiting with a partner [AOR = 0.46, CI;0.31-0.69] or being married [AOR = 0.43, CI; 0.25-0.76], tertiary education [AOR = 7.91, CI; 3.11-20.08], high wealth index [AOR = 1.78, CI; 1.18-2.2], were significantly associated with early sexual debut. The analysis showed minimal differences across clusters, suggesting that individual factors predominantly shape attitudes towards sexual debut, while community-level attributes play a lesser role in predicting these attitudes. Conclusion The analysis showed minimal differences across clusters, suggesting that individual factors predominantly shape attitudes towards sexual debut, while community-level attributes play a lesser role in predicting these attitudes. Furthermore, reinforcing the legal marriage and providing resources to support single and cohabiting women in delaying sexual commitments can significantly mitigate early initiation.