• 비만대사연구학술지
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• 제1권2호
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• pp.74-77
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• 2022

Treatment of obesity includes diet therapy, exercise therapy, cognitive behavioral therapy, drug therapy, and bariatric surgery. Most obese patients lose weight by combining diet, exercise, cognitive behavioral therapy or medication. But, in some cases, only one of these treatments is preferred. A 56-year-old male patient had a body mass index (BMI) of 33.1 kg/m² and a waist circumference of 108 cm. He had been treated for hypertension; diabetes and dyslipidemia were diagnosed but not treated. However, at the initial visit to treat obesity, he was diagnosed with type 2 diabetes mellitus and dyslipidemia again. So he decided to treat these two diseases with drugs first and modify his lifestyle. He started walking more than 20,000 steps every day and then he really walked about 15,000 steps every day during 5 months, although diet calorie or alcohol drinking amount was not significantly decreased. After about 6 months, the patient's weight decreased by 10.1 kg, the BMI decreased by 4.1 kg/m², the waist circumference decreased by 10 cm, the glycated hemoglobin (HbA1c) decreased by 4.59%, the visceral fat area decreased by 115 cm², and the subcutaneous fat decreased by 38 cm². As a result of body composition analysis, muscle mass increased by 1.2 kg, and the percentage of body fat decreased by 10.4%. The walking exercise does not have any space restrictions and has high accessibility by using a mobile phone app. Therefore, considering the patient's situation, it would be better to treat obese patients by first recommending walking exercises and increasing the number of steps to lose weight and improve the comorbidities.

• 영어영문학
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• 제55권2호
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• pp.293-314
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• 2009

Leslie Marmon Silko's Storyteller does not belong to a typical category of books, for it looks more like a family album with photographs, poems and Pueblo narratives as well as short stories authored by her. This 'book' without any chapters defies a traditional concept of books we are familiar with. In addition to refusing to be labelled as a conventional book, I argue, Storyteller defies the tradition of Western personal writing in that it shows the collective power of stories. That is, stories have the collective power which is impersonal beyond personal, internalized identity. It does not mean, however, the collective power comes from groups rather than individuals. It is not the conventional opposition of group and individual but that of group and collectiveness that matters here. I draw a distinction between group and collectiveness on the ground that the former actually groups individuals into categories with which individuals identify themselves. It is not group but collectiveness where stories find their power. "Storyteller," the first of eight short stories in the book, tells the story of an unnamed protagonist, a Yupik Eskimo girl, who takes revenge of her parents who died after drinking poisoned alcohol sold by a white storeman. There are four layers of stories in this short story. The first one is the old man's story of a blue glacier bear; the second one is a revenge story of the Yupik girl; the third one is a story told by the girl to the attorney after being arrested for the death of a storeman. And the final one is the story told to us by Silko, entitled "Storyteller." Although the structure of story within story resembles a technique of metafiction at a glance, it surely is a characteristic of Pueblo narratives in general, according to Silko. This kind of stories within stories refers to the collective power of story which, like a spider's web with many little threads radiating from the center and crisscrossing one another, is also a characteristic of stories on the Web today.

• Journal of Korean Biological Nursing Science
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• 제23권1호
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• pp.31-42
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• 2021

Purpose: This study was performed to assess the level of blood glucose and to identify poor glycemic control groups among patients with type 2 diabetes mellitus (DM). Methods: Data of 1,022 Korean type 2 DM patients aged 30-64 years were extracted from the Korea National Health and Nutrition Examination Survey VII. Complex samples analysis and a decision-tree analysis were performed using the SPSS WIN 26.0 program. Results: The mean level of hemoglobin A1c (HbA1c) was 7.22±0.25%, and 69.0% of the participants showed abnormal glycemic control (HbA1c≥6.5%). The characteristics of participants associated with poor glycemic control groups were presented with six different pathways by the decision-tree analysis. Poor glycemic control groups were classified according to the patients' characteristics such as period after DM diagnosis, awareness of DM, sleep duration, gender, alcohol drinking, occupation, income status, low density lipoprotein-cholesterol, abdominal obesity, and number of walking days per week. Period of DM diagnosis with a cut-off point of 6 years was the most significant predictor of the poor glycemic control group. Conclusion: The findings showed the predictable characteristics of the poor glycemic control groups, and they can be used to screen the poor glycemic control groups among adults with type 2 DM.

• 한국환경보건학회지
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• 제48권2호
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• pp.96-105
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• 2022

Background: Pyrethroid insecticides account for more than 30% of the global insecticide market and are frequently used in agricultural settings and residential and public pest control among the general population. While several animal studies have suggested that exposure to pyrethroids can alter glucose homeostasis, there is only limited evidence of the association between environmental pyrethroid exposure and diabetes in humans. Objectives: This study aimed to report environmental 3-phenoxybenzoic acid (3-PBA) concentrations in urine and evaluate its association with the risk of diabetes in Korean adults. Methods: We analyzed data from the Korean National Environmental Health Survey (KoNEHS) Cycle 2 (2012~2014) and Cycle 3 (2015~2017). A total of 10,123 participants aged ≥19 years were included. Multiple logistic regressions were used to calculate the odds ratios (ORs) for diabetes according to log-transformed urinary 3-PBA levels. We also evaluated age, sex, education, monthly income, marital status, alcohol drinking, physical activity, urinary cotinine, body mass index, and sampling season as potential effect modifiers of these associations. Results: After adjusting for all the covariates, we found significant dose-response relationships between urinary 3-PBA as quartile and the prevalence of diabetes in pooled data of KoNEHS Cycles 2 and 3. In subgroup analyses, the adverse effects of pyrethroid exposure on diabetes were significantly stronger among those aged 19~39 years (p-interaction<0.001) and those who consumed high levels of cotinine (p-interaction=0.020). Conclusions: Our findings highlight the potential diabetes risk of environmental exposure to pyrethroids and should be confirmed in large prospective studies in different populations in the future.

• 의학교육논단
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• 제24권3호
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• pp.231-239
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• 2022

This study aimed to examine the influence of the coronavirus disease 2019 (COVID-19) pandemic on areas of Korean medical students' lives, assess concerns, and investigate the strategies they used to cope with stress due to the pandemic. An online survey with a total of 53 items on the impact of COVID-19, concerns, and coping strategies was sent to medical students, and responses were collected from April 27, 2021 to May 30, 2021. In total, 1,329 students were included in the study. Analysis was performed using the chi-square test, independent-sample t-test, and one-way analysis of variance, and the post-hoc Scheffé test or Games-Howell test was performed for multiple comparisons. The main negative impacts of the pandemic were on hobbies/leisure activities and mental health, and medical students expressed the highest levels of concern regarding restriction of movement, returning to everyday life, and risk of infection for family and friends. Female students more strongly agreed that COVID-19 had increased their depressed mood and anxiety (p<0.001 and p=0.003, respectively). Furthermore, the negative impacts of the pandemic on different areas of life significantly affected current levels of depressed mood and anxiety. To cope with pandemic-related stress, students used several strategies such as talking with family or friends (91.5%), sleeping (83.1%), exercising (72.8%), using social networking services (60.8%), drinking alcohol (37.8%), and practicing meditation/mindfulness (24.4%); the effectiveness of these strategies ranged from 3.45 to 4.19 on a 5-point Likert-type scale (1-5). The study findings suggest that COVID-19 has influenced the mental health of medical students and raised concerns in many areas of their lives. Students used various strategies to cope with the pandemic-related stress; since the effectiveness of frequently used approaches varied, it is essential to guide medical students to develop effective coping strategies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.277-283
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• 2022

Objectives: The main purpose of the present study was to investigate the associations between the risk of obstructive sleep apnea (OSA) and chronic orofacial pain in a nationally representative sample of the Korean population. Materials and Methods: Data from the 8th wave Korean national health and nutrition examination survey, which was conducted from 2019 to 2020 were analyzed. This study included 5,780 Koreans (2,503 males, 3,277 females) over 40 years of age. The presence of subjective chronic facial pain lasting more than 3 months was evaluated based on a self-reported questionnaire. The risk of OSA was determined using the STOP-BANG questionnaire. Data related to anthropometric and sociodemographic factors; diagnostic history of hypertension, depression, and OSA; level of health-related quality of life and stress awareness; health-related behaviors, including smoking and alcohol drinking; and sleep duration were collected. The participants were classified into two groups according to the presence of chronic facial pain. Results: The level of health-related quality of life and stress awareness showed significant differences between the two groups. The sleep duration on weekends also presented significant differences. No significant differences were observed in the presence of snoring and observed apnea, while participants with chronic facial pain showed significantly higher levels of tiredness between the groups. The risk of OSA evaluated by STOP-BANG questionnaire showed significant differences between groups; however, the risk of OSA seemed to be higher in participants without chronic facial pain. Conclusion: The participants with chronic facial pain demonstrated decreased sleep duration, lower health-related quality of life, and increased stress and tiredness. Even though, the role of OSA in the development of chronic facial pain was inconclusive from the study, it is possible that ethnicity play a role in relationship between OSA and chronic facial pain.

• Nutrition Research and Practice
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• 제16권5호
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• pp.673-684
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• 2022

BACKGROUND/OBJECTIVES: Although adherence to a higher diet quality may help prevent cognitive decline in older adults, literature for this in a Korean population is limited. Thus, the aim of this study was to examine the association between diet quality indices and the risk of mild cognitive impairment (MCI) in Korean older adults. SUBJECTS/METHODS: This cross-sectional study included 806 community-dwelling people aged 60 yrs and over in Korea. Diet quality was assessed via the revised Recommended Food Score (RFS) and alternate Mediterranean Diet Score (aMDS). Cognitive function was measured using a Korean version of the Mini-Mental State Examination (MMSE-KC). Associations between diet quality indices and MMSE-KC score were assessed with a general linear model after adjusting for covariates. Logistic regression was used to determine the association between diet quality indices and the risk of MCI. RESULTS: The prevalence of MCI was 35.3%. There were no significant trends between MMSE-KC scores and RFS and aMDS after adjusting for age, gender, education, exercise, living status, social activity, and alcohol drinking. Among total subjects, RFS was inversely associated with the risk of MCI after adjusting for covariates (Q5 vs. Q1; odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.83). Among total subjects and men, aMDS was inversely related to the risk of MCI after adjusting for covariates (Q5 vs. Q1; OR, 0.51; 95% CI, 0.29-0.89 for total subjects; Q5 vs. Q1; OR, 0.36; 95% CI, 0.15-0.83 for men). CONCLUSIONS: Our results demonstrate that high diet quality evaluated by RFS and aMDS is inversely associated with the risk of MCI. Thus, high quality diet may reduce or retard cognitive decline in the old population. Longitudinal studies are needed to determine the causal relationship between diet quality and the risk of MCI in the elderly.

• 산업융합연구
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• 제20권11호
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• pp.141-148
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• 2022

본 연구는 청장년층과 노년층의 고혈압 환자의 건강행위 수행정도를 파악하고, 이에 따른 복합만성질환으로의 이행과 합병증 발생을 예방하는데 유용한 기초자료를 얻기 위해 시도 되었다. 연구자료는 2018년 한국의료패널자료를 이용하여 분석하였다. 연구대상은 고혈압을 진단받은 자 중에서 장애 및 활동장애가 없는 3,117명이고 청장년층과 노년층으로 구분하여 분석하였다. 연구결과 첫째, 의료이용율과 약물복용 순응도는 전체적으로 높은 것으로 나타났으며, 노년층에서 더 높게 나타났다. 둘째, 체질량지수(BMI)평균 및 25kg/㎡ 이상 비만인 경우도 청장년층에서 더 높게 나타났다. 셋째, 흡연경험과 음주경험, 흡연량과 음주량은 모두 청장년층이 노년층에 비해 높은 것으로 나타났다. 넷째, 중등도 신체활동 및 걷기는 전체적으로 청장년층이 많이 실행하고, 중등도 신체활동량과 걷기 지속시간에는 차이가 없었다. 다섯째, 주관적 건강상태는 청장년층이 더 긍정적으로 인식하는 것으로 나타났다. 본 연구결과를 토대로 젊을때부터 맞춤형 건강관리의 필요성 인식제고와 지속가능한 실효성 있는 프로그램 개발이 이루어지도록 할 필요가 있다.

• 한국심리학회지:법
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• 제11권3호
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• pp.309-327
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• 2020

본 연구는 판단자의 강간통념이 피해자와 가해자에 대한 판단에 어떠한 영향을 주는지 살펴보고 이러한 영향이 피해자의 강간 사건 전 일탈 행위 여부에 따라 어떻게 달라지는지 살펴보고자 하였다. 이를 위해 세 연구에서 일탈 조건과 비일탈 조건으로 시나리오를 구성하여 참가자들에게 피해자 책임과 가해자 책임, 피해자 고통 수준, 가해자 처벌정도를 평정하도록 하였다. 그 결과, 세 실험에서 모두 강간 사건 전 피해자가 일탈 행동을 보이지 않은 경우(비일탈행동 시나리오 조건)에는 강간통념 수준에 따른 강간 피해자와 가해자에 대한 평가에 차이가 나타나지 않았다. 하지만 강간 사건 전 피해자가 일탈 행동을 보인 경우(일탈행동 시나리오 조건)에는 강간통념 수준이 높을수록 강간 사건의 책임을 가해자가 아닌 피해자에게서 찾으려는 태도를 보였다. 이는 강간통념 수준이 강간 사건 평가에 미치는 효과가 해당사건의 원인을 피해자에게 귀인하기 용이한 정도에 따라 달라질 수 있음을 보여주는 증거라할 수 있다. 마지막으로 본 연구의 의의와 제한점이 논의되었다.

• Korean Circulation Journal
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• 제52권2호
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• pp.93-109
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• 2022

With the recent rapid increase in obesity worldwide, metabolic syndrome (MetS) has gained significant importance. MetS is a cluster of obesity-related cardiovascular risk factors including abdominal obesity, atherogenic dyslipidemia, high blood pressure and impaired glucose tolerance. MetS is highly prevalent and strongly associated with an increased risk of developing diabetes and cardiovascular disease, putting a great burden on human society. Therefore, it is very important to reduce MetS risk, which can improve patients' cardiovascular prognosis. The primary and most effective strategy to control each component of MetS is lifestyle change such as losing body weight, keeping regular exercise, adopting a healthy diet, quitting smoking and alcohol drinking in moderation. Many studies have shown that lifestyle modification has improved all components of MetS, and reduces the incidence of diabetes and cardiovascular disease. Here, the Korean Society of CardioMetabolic Syndrome has summarized specific and practical methods of lifestyle modification in the management of MetS in the healthcare field.