Objectives: This study examined differences in health care spending and characteristics among older adults in Korea by high-cost status (persistently, transiently, and never high-cost). Methods: We identified 1 364 119 older adults using data from the Korean National Insurance Claims Database for 2017-2019. Outcomes included average annual total health care spending and high-cost status for 2017-2019. Linear regression was used to estimate differences in the outcomes while adjusting for individual-level characteristics. Results: Persistently and transiently high-cost older adults had higher health care spending than never high-cost older adults, but the difference in health care spending was greater among persistently high-cost older adults than among transiently high-cost older adults (US$20 437 vs. 5486). Despite demographic and socioeconomic differences between transiently high-cost and never high-cost older adults, the presence of comorbid conditions remained the most significant factor. However, there were no or small differences in the prevalence of comorbid conditions between persistently high-cost and transiently high-cost older adults. Rather, notable differences were observed in socioeconomic status, including disability and receipt of Medical Aid. Conclusions: Medical risk factors contribute to high health care spending to some extent, but social risk factors may be a source of persistent high-cost status among older adults in Korea.
Background: While the perinatal outcomes of active maternal smoking are well documented, results of the effects of environmental tobacco smoke (ETS) exposure during pregnancy are inconsistent. We aimed to examine the effect of ETS exposure, assessed by maternal hair nicotine levels at $35^{th}$ week of gestation, on birth weight and the risk of small for gestational age (SGA) and low birth weight (LBW). Materials and Methods: A total of 871 non-smoking healthy pregnant women were recruited by one Korean hospital between 1 October 2006 and 31 July 2007. Hair samples were collected and anthropometric questionnaires administered at $35^{th}$ week of gestation. The primary outcome was birth weight and secondary outcomes were the risk of babies being SGA and LBW. Results: Log-transformed hair nicotine concentrations were inversely related with birth weight after adjusting for confounding variables (${\beta}=-0.077$, p=0.037). After stratifying hair nicotine levels by tertiles (T1, low [0.0-0.28 ng/mg]; T2, medium [0.29-0.62 ng/mg]; and T3, high [0.63-5.99 ng/mg]), the mean birth weight in each groups were 3,342g (T1) 3,296g (T2) and 3,290 g (T3), respectively. However the difference between groups was not statistically significant by analysis of co-variance (ANCOVA) adjusting for covariates (p=0.062). In logistic regression analysis, the risk of SGA was higher in the T3 (OR=1.59, 95%CI 1.05-2.42) than in the reference group (T1), after controlling for confounding variables. The risk of low birth weight (<2,500g, LBW) was not significantly higher (OR=1.44, 95%CI 0.95-2.19), but the risk of babies being below 3,000g birth weight was increased in the T3 group (OR=1.53, 95%CI 1.00-2.36) compared with that in the T1 group. Conclusions: Maternal ETS exposure during pregnancy was inversely related with birth weight. The risk of SGA increased in the highest ETS exposure group compared with in the low exposure group. To prevent ETS exposure during pregnancy, more comprehensive tobacco control policies are needed.
Although dietary intake of pregnant is supposed to have beneficial effects on development of infants, it may be harmful for fetal growth and development since specific food is a common source of toxicants including heavy metal. The purpose of this study was to investigate the association of maternal food intake and mid-pregnancy and their newborns blood lead levels. Pregnant women of 18-20 weeks of gestation were recruited from prenatal clinic in Seoul, Cheonan and Ulsan. In 422 pregnant women, dietary intake during pregnancy was assessed by a 24-hour recall method. Blood sample from pregnant (18-20 wks) and their cord blood at delivery were collected. Blood leas levels were analyzed by atomic-absorption spectrometry methods. Pregnant blood lead levels whose meat and meat products intake were in the highest quartile was significantly higher compared to the lowest quartile. Maternal meat and meat products intake was positively correlated maternal blood lead level (r=0.120, P=0.014). After adjusting for age, maternal blood lead level was positively correlated with their newborn blood lead level (r=0.303, P=0.030). As maternal food intake effects on blood lead levels of pregnant, careful regulation of food intake during pregnancy is perceives to be important in order to bring about desirable pregnancy outcomes.
Background: Cancer is a major life event that imposes huge economic and mental burdens on patients and families. In addition, the diagnosis of cancer also causes significant family discordance that can lead to marital problems such as divorce or separation. The aim of this study was to investigate the association and any related gender differences between cancer diagnosis and marital disruption among cancer survivors. Materials and Methods: We used the recent cross-sectional Korea National Health and Nutrition Examination Survey ($4^{th}$ and $5^{th}$; Years 2008-2012). The study participants were 623 married cancer survivors over the age of 19. A multivariate logistic regression analysis was conducted to estimate odds ratios. Results: After adjusting for socioeconomic status and health-related behaviors, the odds ratio of marital disruption among female cancer survivors compared with male cancer survivors was 3.94 (95%CI 1.30-11.94; p=0.02). The odds ratio of marital disruption for the below-average economic level compared with the above-average economic level was 5.64 (95%CI: 1.03-31.02; p=0.05). When compared with the non-smoking cancer survivors, the smoking cancer survivors had an OR of marital disruption equal to 2.94 (95%CI: 1.08-8.00; p=0.03). Conclusions: The findings of this study suggest that the odds of marital disruption among female cancer survivors are higher than those among their male couterparts. Medical practitioners should be sensitive to early signs of marital discord in couples affected by a cancer diagnosis. Early identification and psychosocial intervention might reduce the frequency of divorce and separation and thus improve quality of life and quality of care for cancer survivors.
The purposes of this study were to examine effects of job-seeking stress, adult attachment, self-assertiveness on depression among Korean college students. Data were collected through self reported structured questionnaire form 239 Korean college students by convenient sampling methods from April 20 to May 30, 2013. The mean score of depression 14.38(SD=9.81) and 27.6% of the subjects were depression risk groups. A hierarchical multiple regression showed that job-seeking stress (${\beta}$=0.31, p<.001) and adult attachment (${\beta}$=0.32, p<.001) were identified as significant predictors of depression of college students after adjusting for gender, grade, living arrangement, satisfaction for major. And these variables accounted for 34% of depression (F=12.20, p<.001). Therefore, therapeutic nursing intervention should be developed to reduce job-seeking stress and to control attachment-related anxiety, avoidance as a way to regulate depression for Korean college students.
Park, Gwanyong;Kwon, Kyeong-Seok;Lee, In-bok;Ha, Taehwan;Kim, Rack-Woo;Lee, Minhyung
Journal of The Korean Society of Agricultural Engineers
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제59권3호
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pp.71-81
/
2017
Organic dust generated inside livestock facilities includes toxic organic matters such as bacteria and endotoxin. Dust can cause respiratory disease for worker and livestock, and consequently, degradation of welfare and productivity. Influence of dust on livestock workers has been studied since the 1970s. However, exposure limit for cattle farmer has not been established, unlike exposure limit for pig and poultry farmer. Furthermore, study on air quality inside livestock facility, especially inside dairy farm has been rarely conducted in Korea. In this study, dust concentration of TSP, PM10, inhalable and respirable dust has been monitored in the commercial dairy house according to location and working activities. Bedding material inside the stall was one of the major sources of dust. The amount of dust was related to water content level of the bedding material. Dust concentration was relatively high in leeward location, and the highest concentration was measured during TMR mixing process. The maximum value of inhalable dust concentration was 29.1 times higher than the reference value as fine particles drop to the TMR mixer. Dust generated by TMR mixing was presumed to decrease by adjusting moisture and drop height of feed.
Efficient defluorination of perfluorooctanoic acid (PFOA) was achieved by integrating UV irradiation and $Fe^{2+}$ activation of persulfate ($S_2O{_8}^{2-}$). It was found that the UV-$Fe^{2+}$, $Fe^{2+}-S_2O{_8}^{2-}$, and UV-$S_2O{_8}^{2-}$ processes caused defluorination efficiency of 6.4%, 1.6% and 23.2% for PFOA at pH 5.0 within 5 h, respectively, but a combined system of UV-$Fe^{2+}-S_2O{_8}^{2-}$ dramatically promoted the defluorination efficiency up to 63.3%. The beneficial synergistic behavior between $Fe^{2+}-S_2O{_8}^{2-}$ and UV-$S_2O{_8}^{2-}$ was demonstrated to be dependent on $Fe^{2+}$ dosage, initial $S_2O{_8}^{2-}$ concentration, and solution pH. The decomposition of PFOA resulted in generation of shorter-chain perfluorinated carboxylic acids (PFCAs), formic acid and fluoride ions. The generated PFCAs intermediates could be further defluorinated by adding supplementary $Fe^{2+}$ and, $S_2O{_8}^{2-}$ and re-adjusting solution pH in later reaction stage. The much enhanced PFOA defluorination in the UV-$Fe^{2+}-S_2O{_8}^{2-}$ system was attributed to the fact that the simultaneous employment of UV light and $Fe^{2+}$ not only greatly enhanced the activation of $S_2O{_8}^{2-}$ to form strong oxidizing sulfate radicals ($SO{_4}^{\cdot-}$), but also provided an additional decarboxylation pathway caused by electron transfer from PFOA to in situ generated $Fe^{3+}$.
Objective: This study investigated the relationship between orthodontic treatment and temporomandibular disorders (TMD) in South Korean population. Methods: This study obtained data from the 2012 Korean National Health and Nutrition Examination Survey. The final sample size was 5,567 participants who were ${\geq}19$ years of age. Logistic regression analysis was performed to evaluate the relationship between orthodontic treatment and TMD. Results: Participants who underwent orthodontic treatment showed higher educational level, lower body mass index, reduced chewing difficulty, and reduced speaking difficulty. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for orthodontic treatment and TMD were 1.614 (1.189-2.190), 1.573 (1.162-2.129) and 1.612 (1.182-2.196) after adjusting for age, sex and psychosocial factors. Adjusted ORs and their 95% CIs for orthodontic treatment and clicking were 1.778 (1.289-2.454), 1.742 (1.265-2.400) and 1.770 (1.280-2.449) after adjusting for confounding factors. However, temporomandibular joint pain and functional impairment was not associated with orthodontic treatment. Conclusions: Temporomandibular joint pain and dysfunction was not associated with orthodontic treatment.
Objectives The aim of this study is to investigate the association between secondhand smoke (SHS) exposure and depressive symptoms among Korean adults. This study also explored the mediating role of self-rated health (SRH) and perceived usual stress (PUS) in the association between depressive symptoms, suicidal ideation and SHS exposure. Methods Data from the Korea National Health and Nutrition Examination Surveys (KNHANES) in 2014 and 2016 was analyzed for 10539 participants aged 19 years or older. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated in the logistic regression analysis with adjustment for the potential confounding factors. We also adopted the mediation analysis method by Hayes and Preacher. Results After adjusting for the potential confounding factors, SHS at home and at public places were associated with depressive symptoms and suicidal ideation among non-smokers. After adjusting for the potential confounding factors, SHS at home and at public places was associated with depressive symptoms and suicidal ideation among non-smokers. Meanwhile SHS at workplaces was associated with depressive symptoms among former smokers and with suicidal ideation among current smokers. There was an additive effect of SHS on depressive symptoms only among non-smokers. SRH mediated the association between SHS and depressive symptoms and suicidal ideation among non-smokers. We did not observe any significant mediating effect of SRH nor PUS on the association between SHS and depressive symptoms among former and current smokers. Conclusions SHS may be associated with depressive symptoms and suicidal ideation in Korean adults. Our study elucidated how SHS interacted with depressive symptoms among non-smokers through the mediation by SRH.
Sohn, Jungwoo;Cho, Jaelim;Moon, Ki Tae;Suh, Mina;Ha, Kyoung Hwa;Kim, Changsoo;Shin, Dong Chun;Jung, Sang Hyuk
Journal of Preventive Medicine and Public Health
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제47권6호
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pp.327-335
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2014
Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.
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