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Achieving Health Equity Through Health Promotion (건강증진사업의 효율성과 형평성: 건강증진을 통한 건강 형평성 제고)

  • Moskowitz, Joel M.
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2005.09a
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    • pp.91-119
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    • 2005
  • 오타와 헌장에 따르면 건강증진은 건강형평성을 성취하는 것이다. 건강격차를 감소시키고, 모든 사람들이 건강잠재력을 달성할 수 있도록 동등한 기회와 자원이 제공되어야 한다. 또한 각 개인들은 자신의 건강에 대한 결정요인들에 대한 통제능력을 가져야 한다. 미국의 조기사망은 40%가 행동양식에 의하여, 30%가 유전적인 문제로, 15%가 사회적 환경에 의하여, 10%는 의료적 치료의 부족으로, 그리고 5%는 환경위해 물질에 대한 노출로 발생한다. 건강불평등을 발설시키는 사회적 요인으로는 경제적 요인을 들 수 있다. 이러한 요인으로 야기되는 건강불평등의 문제를 해결하여 건강형평성을 달성하기 위해서는 절대적 목표들과 평등관련 목표들이 모두 필요하다. 건강형평성은 인구집단의 건강과 함께 향상되는 것으로 나은 건강상태에 있는 사람들의 건강을 악화시키면서 건강형평성을 달성하는 것은 아니다. 각자의 관심이 형평성을 어떻게 규정하는가에 영향을 미친다. 혜택을 받은 사람들은 성과/투입의 정의를 선호하며, 소외계층은 똑같은 성과 또는 요구에 기반한 정의를 선호한다. Healthy People 2010은 미국의 국가적 예방체계를 의미하며, 가장 중요하며 예방 가능한 건강위협들을 파악하고 이러한 위협들을 감소하기 위한 목적들이 설정되어 있다. 궁극적인 목적은 건강한 삶의 질적인 면과 양적인 측면을 향상시키는 것이며, 건강불평등을 제거하는 것이다. 그러나 미국이 유럽의 국가들에 비해서 사회 프로그램에 대한 투자가 적은 이유는 재분배는 소수인종만을 위한 것이라는 믿음과, 우리는 개방되고 공정한 사회에 살고 있기 때문에 가난하다는 것은 가난한 사람들 자신들의 잘못으로 인한 것이라는 믿음 그리고 재분배를 방지하는 정치체계 때문이다. 국가기관인 CDC의 예방연구센터(Prevention Research Centers)는 지역사회 파트너들과 함께 건강증진, 질병예방, 그리고 질병과 상해로 인한 합병증을 관리하게 위한 효과적인 예방 전략을 개발하고 있다. 예방연구센터의 프로그램들은 지역사회 기반 참여연구와 소외된 계층에 중점을 두며, 다학제 간 접근방법을 활용하고, 교육기관, 공공보건기관 그리고 지역사회의 파트너들 간의 네트웍을 형성을 통한 협력관계를 강조하고 있다. 지역사회 위원회가 구성되어 있으며, 또한 근거중심 프로그램을 개발하고 있다. 이들은 건강 결정요인에 관한 연구, 형성적 연구, 개입 프로그램 및 프로그램의 확산에 관한 연구를 진행한다. UC Berkeley의 가족/지역사회 보건센터(Center for Family & Community Health)는 1993년에 설립되었다. 사업의 대상이 되는 주요 지역사회는 한국교민사회이며, 한국교민사회 자문위원회(Korean Community Advisory Board, KCAB)가 구성되어 있다. 1993년부터 2003년까지는 'Health is Strength' 사업이 시범연구사업으로 진행되었는데, 그 내용은 유방암과 자궁경부암 검진 프로그램이었다. 2003년부터 2009년까지 진행될 'Quitting is Winning'이라는 두 번째 시범연구사업은 남성들의 금연에 중점을 둔 사업이다. 'Health is Strength'는 아시아 보건서비스 및 한국교민사회 자문위원회가 함께 협력하여 진행된 사업으로, 주요 목표는 18세 이상 여성의 자궁암 조기 검진(Pap test)과 자가 유방검진 실천을 증가시키는 것이며, 50세 이상여성의 유방 임상검사와 유방 X선촬영 비율을 증가시키는 것이었다. 한 지역의 카운티에 거주하는 한국 여성들은 4년간의 개입프로그램의 대상이 되었으며, 이들을 대상으로 횡단적인 전화조사를 3번(사전, 중간, 사후)실시하였다. 개입 프로그램은 교회에서 워크샵 개최, Tell-A-Friend Form 작성하기, 포스터 및 책자 발행, 신문광고 등과 함께 자궁암 조기 검진(Pap test)과 유방 X선 촬영권을 무료로 제공하는 것으로 구성되었다. 'Quitting is Winning'은 지역사회 기반 참여 연구모형으로 한국교민사회 자문위원회는 흡연을 1순위의 사업으로 선정하였고, 근거에 기반한 금연 프로그램에 대한 연구들을 검토하여, 기존의 보편적 방법이 아닌 인터넷을 활용하는 프로그램을 진행하는 것으로 결정되었다. 이는 무작위 임상실험으로 연구대상으로 미국에 거주하는 한국인 남성흡연자 2300명을 모집하였다. 이들의 1/2은 실험군인 인터넷 프로그램 집단에, 또 다른 1/2은 대조군인 인쇄책자 집단에 무작위 할당되었다. 12개월 동안 11번의 진단이 인터넷을 통하여 진행되었으며, 참여와 참여유지에 대한 금전적인 보상이 제공되었다.

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Molecular Cytogenetic Characterization of Supernumerary Marker Chromosomes by Chromosomal Microarray (염색체 마이크로어레이를 이용한 표지염색체의 분자세포유전학적 특성)

  • Bae, Mi-Hyun;Yoo, Han-Wook;Lee, Jin-Ok;Hong, Maria;Seo, Eul-Ju
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.119-124
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    • 2011
  • Purpose: Supernumerary marker chromosome (SMC) could be associated with various phenotypic abnormalities based on the chromosomal origin of SMCs. The present study aimed to determine the genomic contents of SMCs using chromosomal microarray and to analyze molecular cytogenetic characterizations and clinical phenotypes in patients with SMCs. Materials and Methods: Among patients with SMCs detected in routine chromosomal analysis, SMCs originating from chromosome 15 were excluded from the present study. CGH-based oligonucleotide chromosomal microarray was performed in 4 patients. Results: The chromosomal origins of SMCs were identified in 3 patients. Case 1 had a SMC of 16.1 Mb in 1q21.1-q23.3. Case 2 showed 21 Mb gain in 19p13.11-q13.12. Case 3 had a 4.5 Mb-sized SMC rearranged from 2 regions of 2.5 Mb in 22q11.1-q11.21 and 2.0 Mb in 22q11.22-q11.23. Conclusion: Case 1 presented a wide range of phenotypic abnormalities including the phenotype of 1q21.1 duplication syndrome. In case 2, Asperger-like symptoms are apparently related to 19p12-q13.11, hearing problems and strabismus to 19p13.11 and other features to 19q13.12. Compared with cat-eye syndrome type I and 22q11.2 microduplication syndrome, anal atresia in case 3 is likely related to 22q11.1-q11.21 while other features are related to 22q11.22-q11.23. Analyzing SMCs using high-resolution chromosomal microarray can help identify specific gene contents and to offer proper genetic counseling by determining genotype-phenotype correlations.

Comparison between Propofol/Remifentanil and Ketamine/Remifentanil for TIVA in Beagle Dogs (비글견에서 Propofol/Remifentanil과 Ketamine/Remifentanil을 사용한 완전 정맥 내 마취법의 비교)

  • Choi, Woo-Shik;Jang, Hwan-Soo;Park, Jai-Soon;Yun, Sung-Ho;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.479-485
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    • 2011
  • The cardiopulmonary responses during total intravenous anesthesia (TIVA) between remifentanil/propofol infusion and remifentanil/ketamine infusion in dogs were compared. Fourteen healthy adult beagle dogs were premedicated with acepromazine (0.1 mg/kg, SC) and medetomidine (20 ${\mu}g$/kg, IV), and anesthetized for 3 hr with remifentanil (0.5 ${\mu}g$/kg/min)/propofol (loading dose: 1 mg/kg, CRI: 0.3 mg/kg/min) CRI (group 'P') or remifentanil/ ketamine (loading dose : 5 mg/kg, CRI: 0.1 mg/kg/min) CRI (group 'K'), respectively. Hemodynamics, blood gas analysis and behavioral changes during recovery were measured. The level of anesthesia was determined by toe-web clamping test. The level of surgical anesthesia was maintained throughout the experiment in both groups. Systolic arterial pressure, mean arterial pressure, $PaO_2$ and $SpO_2$ in group 'K' were significantly higher than in group 'P', and were maintained near the normal ranges. In addition, $PaO_2$ in group 'K' was significantly lower than in group 'P'. However, diastolic arterial pressure, heart rate and respiratory rate were not significantly differed. Mean extubation time from the end of infusion was significantly reduced in group 'K', but mean sitting time was significantly reduced in group 'P'. Mean head-up time and mean walking time were not significantly differed. In group 'K', brief muscle rigidity, head waving and licking during recovery were observed. In conclusion, infusion rate of ketamine (0.1 mg/ kg/min) with remifentanil (0.5 ${\mu}g$/kg/min) is an appropriate for obtaining the surgical plane of anesthesia. These results showed that group 'K' had better cardiopulmonary function than group 'P'. That is, remifentanil/ketamine CRI is better TIVA protocol than remifentanil/propofol CRI for 3 hr surgery.

Horticultural Activities Using Colorful Food for the Improvement of Emotional Intelligence and the Reduction of Unbalanced Vegetable Diet of Young Children (유아의 채소편식 감소와 정서지능 향상을 위한 컬러푸드 원예활동)

  • Son, Hyo-Jung;Song, Jong-Eun;Son, Ki-Cheol
    • Horticultural Science & Technology
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    • v.33 no.5
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    • pp.772-783
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    • 2015
  • This study focuses on horticultural activities using colorful food to reduce diets unbalanced in vegetables and to increase emotional intelligence. Horticultural activities using colorful food vegetables were based on 'Health in Daily Life' in the '7th Kindergarten Curriculum'; to improve the dietary habits of the young children, the program was also linked with a parents' education program. The research was conducted with a total of 70 children from classes for four-year-olds in three child-care centers located in Seoul. The horticultural activities based upon nutrition education included activities using colorful food vegetables and nutrition education. For the nutrition education group, only nutrition education was provided, while neither horticultural activities nor nutrition education were provided to the control group. The study was conducted from September to December 2011. A total of twelve sessions were conducted once a week for 60 minutes each. According to the result, after the horticultural activities with colorful food vegetable were conducted, both the nutrition education group and horticultural activity & nutrition education group showed improvements in 'Nutrition Knowledge' compared to the control group. Regarding 'Unbalanced Diet Behaviors', the horticultural activities & nutrition education group showed meaningful decreases compared to the control group. Moreover for preference of fruits and vegetables, the horticultural activities & nutrition education group revealed meaningful improvements. In conclusion, colorful food vegetable horticultural activity could be an effective approach to resolve the imbalance of health caused by unbalanced diets as children who participated in the colorful food vegetable horticultural activities continued to respond spontaneously to the colors of vegetables and fruits and showed joy and kept voluntarily eating them.

Development of Neuropsychological Model for Spatial Ability and Application to Light & Shadow Problem Solving Process (공간능력에 대한 신경과학적 모델 개발 및 빛과 그림자 문제 해결 과정에의 적용)

  • Shin, Jung-Yun;Yang, Il-Ho;Park, Sang-woo
    • Journal of The Korean Association For Science Education
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    • v.41 no.5
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    • pp.371-390
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    • 2021
  • The purpose of this study is to develop a neuropsychological model for the spatial ability factor and to divide the brain active area involved in the light & shadow problem solving process into the domain-general ability and the domain-specific ability based on the neuropsychological model. Twenty-four male college students participated in the study to measure the synchronized eye movement and electroencephalograms (EEG) while they performed the spatial ability test and the light & shadow tasks. Neuropsychological model for the spatial ability factor and light & shadow problem solving process was developed by integrating the measurements of the participants' eye movements, brain activity areas, and the interview findings regarding their thoughts and strategies. The results of this study are as follows; first, the spatial visualization and mental rotation factors mainly required activation of the parietal lobe, and the spatial orientation factor required activation of the frontal lobe. Second, in the light & shadow problem solving process, participants use both their spatial ability as a domain-general thought, and the application of scientific principles as a domain-specific thought. The brain activity patterns resulting from a participants' inferring the shadow by parallel light source and inferring the shadow when the direction of the light changed were similar to the neuropsychological model for the spatial visualization factor. The brain activity pattern from inferring an object from its shadow by light from multiple directions was similar to the neuropsychological model for the spatial orientation factor. The brain activity pattern from inferring a shadow with a point source of light was similar to the neuropsychological model for the spatial visualization factor. In addition, when solving the light & shadow tasks, the brain's middle temporal gyrus, precentral gyrus, inferior frontal gyrus, middle frontal gyrus were additionally activated, which are responsible for deductive reasoning, working memory, and planning for action.

Discourse Analysis of Business Chinese and the Comparison of Negotiation Culture between Korea and China - Focused on Business Emails Related to 'Napkin Holder' Imports - (무역 중국어 담화 고찰과 한중 협상문화 비교 - '냅킨꽂이' 수입 관련 비즈니스 이메일을 중심으로 -)

  • Choi, Tae-Hoon
    • Cross-Cultural Studies
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    • v.50
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    • pp.103-130
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    • 2018
  • This research aims to explore the associated linguistic features and functions of Chinese as used for business trading purposes, and which is based on a discourse analysis through a case in which a Korean buyer and a Chinese supplier have exchanged Internet based e-mails. The research questions include first, the linguistic functions and characteristics of Chinese shown as identified in this trade case through e-mails, second, the use of Chinese trade specific terms, and third, the apparent and dynamic negotiation strategies that are identified as followed by the cultural value systems which are used for resolving interest conflicts and issues between the buyer and supplier in the course of negotiating business contracts between two parties. The participants of this research pertain to a Korean buyer, James and a Chinese supplier, Sonya. The associated data consists of 74 e-mails exchanged between the two parties, initiated in an effort to begin and complete a trade item, in this case namely the product of napkin holders. The research for the study is based on the discourse analysis and empirically analyses models of Chinese linguistic functions and features. The findings are the following. First, as identified, the specific Chinese functions used and sequenced in this trade case are of a procedure, request, informing, negotiation and persuasion. Second, the essential trade terms used in this business interaction involve the relevant issues of 1) ordering and price negotiating, 2) marking the origin of the products, 3) the arrangement of the product examination and customs declaration for the anticipated import items, 4) preparation of the necessary legal documents, and 5) the package and transport of the product in the final instance. Third, the impact of the similarities and differences in the cultural value systems between Korea and China on the negotiations and conflict resolution during a negotiated contract between two parties are speculated in terms of the use of culturally based techniques such as face-saving and the utilization of uncertainty-avoiding strategies as meant to prevent misunderstandings from developing between the parties. The concluding part of the study discusses the implications for a practical Chinese language education utilizing the linguistic functions and features of the Chinese culture and language strategies as useful in business associations for trading purposes, and the importance of intercultural communication styles based on similar of different identified cultural values as noted between two parties.

A Study on a Korean-Translated Version of the Pediatric Volitional Questionnaire (PVQ) (Pediatric Volitional Questionnaire의 국내적용을 위한 번역연구)

  • Ra, Dae-Yeop;Chang, Ki-Yeon;Kong, Myung-Ja;Lee, Sun-Wook
    • The Journal of Korean Academy of Sensory Integration
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    • v.16 no.3
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    • pp.34-49
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    • 2018
  • Objective : This study aimed to examine the psychometric properties of Korean version of Pediatric Volitional Questionnaire (PVQ-K) using classical test theory. Methods : For the translation of Pediatric Volitional Questionnaire (PVQ), as recommended in the literature, four-stage translation method was used. For the psychometric properties of Korean version of the Pediatric Volitional Questionnaire (PVQ-K), internal consistency reliability, content validity, and construct validity of the test using the known groups method and convergent and divergent methods were examined. For the recruitment of participants, a convenience sampling method is used. Participants of this study were 10 children with neuro-developmental disabilities hospitalized two different rehabilitations center and 10 children with typical development living in Daejeon, South Korea. All 20 participants were in aged from two to five years. Results : In terms of the content validity index, it was over 0.78, confirmed by nine experts of children development. PVQ-K successfully discriminated the scores of children with typical development from those with neurodevelopmental disabilities (p < .05). It is found that there is significant correlations between achievement stage of PVQ-K and the Korean Developmental Screening Test for Infants & Children (K-DTS)(.652 ~ .799 for subcategory, .706 for total scale). The internal consistency was .944 (Cronbach's ${\alpha}$). In qualitative content analysis, it was examined that how Korean children behave and respond in the environment, and how children's volition was strengthened or weakened by the environment. Conclusion : The results propose that PVQ-K can be a useful occupation-focused measure. This study recommend further study on PVQ-K with larger samples combined with the item-response theory approach.

Clinical Utility of the MMPI-A-RF's Internalization and Externalization Higher-Order Scales: Comparison With the K-CBCL's Internalization and Externalization Scales (MMPI-A-RF의 내재화 및 외현화 상위 척도의 임상적 유용성: K-CBCL의 내재화 및 외현화 척도와의 비교)

  • Eun-Bin, Shin;Eun-Hee, Park;Hyun-Joo, Hong
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.119-126
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    • 2022
  • Objectives : The purpose of this study was to examine the clinical utility of the internalization and externalization higher-order scales of the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form (MMPI-A-RF), compared with those scales of the Korean Child Behavior Checklist (K-CBCL). Methods : 43 adolescents with internalizing disorders and 44 adolescents with externalizing disorders and their parents were administered the MMPI-A-RF and K-CBCL each. To verify the difference between the internalization and externalization scales of the MMPI-A-RF and K-CBCL for each group, independent-sample t test was performed. To compare the agreement between the MMPI-A-RF and K-CBCL, correlation analysis was also conducted. Lastly, to identify which scales significantly best predict each of the internalizing and externalizing disorder, logistic regression analysis was conducted. Results : Internalization scales of the MMPI-A-RF and K-CBCL were significantly higher in the internalizing disorder group, and the externalization scales were significantly higher in the externalizing disorder group. The positive correlation was significant only for internalization problems between the two evaluation measures in both groups (each r=0.360, p<0.05, r=0.572, p<0.05). In addition, the scales significantly predicted internalizing and externalizing disorders were the internalization and externalization scales of the MMPI-A-RF, followed by the externalization scale of the K-CBCL (R2=0.407, p<0.05). Conclusions : The internalization and externalization higher-order scales of the MMPI-A-RF were found to reliably reflect the characteristics of each disorder in adolescents and be useful evaluative scales to differentiate disorders. Moreover, if adolescents show externalization problems, additional information from the K-CBCL can be more useful to differentiate disorders.

Development and Validation of the Korean Wellness Scale (한국형 웰니스 척도(KWS) 개발 및 타당화)

  • Choi, Kyunghwa;Tak, Jinkook
    • The Korean Journal of Coaching Psychology
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    • v.5 no.2
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    • pp.127-170
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    • 2021
  • This study developed a measure to measure wellness-seeking behavior in important areas of life for general adults in Korea and verified its validity. For the development of the wellness scale, 31 factors derived through literature review, expert interviews, in-depth interviews, open questionnaires 1 and 2, and 182 questions were selected as the final 10 factors and 99 questions. Through exploratory factor analysis of the results of the preliminary survey of 351 adults in Korea, 58 questions of 10 factors were derived, and some of the questions reflecting important concepts in each factor were revised, and this survey was conducted with 63 questions of 10 factors. In this survey conducted on 667 people, to verify the validity of the composition concept of this test, the entire sampling was divided into two groups, one group was subjected to exploratory factor analysis, and the other group was subjected to confirmatory factor analysis. As a result of exploratory factor analysis, 63 questions of 10 factors (work, community, family, others, economic power, self-esteem, leisure, physical health, spirituality, and self-growth) were finally derived, and confirmatory factor analysis using the structural equation model verified that the model fit criteria were met. Convergence validity was verified using the K-MHC-SF and Wellness Index for Workers to verify whether the derived wellness scale and its sub-factors actually measure wellness. As a result of analyzing the relationship between the variables and factors of the Subjective Happiness Scale and Life Scale to verify the validity related to the criteria, it was found to be a significant correlation. As a result of confirming the significance of each path through multiple regression analysis, the 'self-esteem' on the wellness scale was identified as the most important factor influencing subjective happiness and life satisfaction. Finally, discussions on this research process and results, academic significance and practical significance, limitations, and future research directions were presented.

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An event-related potential study of global-local visual perception in female college students with binge drinking (폭음 여자대학생의 전체-세부 시지각 처리에 관한 사건관련전위 연구)

  • So-yeon Lim;Myung-Sun Kim
    • Korean Journal of Cognitive Science
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    • v.34 no.2
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    • pp.111-151
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    • 2023
  • It is reported that binge drinkers show cognitive impairment similar to alcohol use disorder patients. A previous studies using neuropsychological tests and brain imaging techniques to investigate the visual perception of alcohol use disorder patients reported that they had global-local visual perception defects. Although the neurological basis for the global-local visual perception deficit in the heavy drinking group has been presented, there are no studies to date that have investigated the global-local visual perception in the heavy drinking group. This study investigated local-biased visual perception in female college students with binge drinking (BD) using event-related potentials (ERPs). Based on the scores of the Korean version of Alcohol Use Disorder Identification Test and the Alcohol Use Questionnaire, participants were assigned into BD (n=25) and non-BD (n=25) groups. Local-global visual processing was assessed using a local-global paradigm, in which large stimuli (global level) composed of small stimuli (local level) were presented. The stimuli presented at global and local levels were either congruent or incongruent. The behavioral results exhibited that the BD and non-BD groups did not differ in terms of accuracy and response time. In terms of ERPs, the BD and non-BD groups did not show difference in N100, P150 and N200 amplitude. However, the BD group showed significantly smaller P300 amplitude than non-BD group especially in the local condition. In addition, a negative correlation between P300 amplitude and binge drinking score was observed, i.e., severer binge drinking smaller P300 amplitude. The P300 is known to reflect cognitive inhibition and attentional allocation. In the global-local paradigm, the local condition required to attend to local target while ignoring global non-target. Therefore, the present results indicate that female college students with BD do not have local-biased visual processing, instead they seem to have difficulties in inhibition of irrelevant stimuli.