• Title/Summary/Keyword: Determinant of health

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Severity of Comorbidities among Suicidal Attempters Classified by the Forms of Psychiatric Follow-up (자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이)

  • Lee, Hyeok;Oh, Seung-Taek;Kim, Min-Kyeong;Lee, Seon-Koo;Seok, Jeong-Ho;Choi, Won-Jung;Lee, Byung Ook
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.74-82
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    • 2016
  • Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

Review of Family Planning / Health Integration Efforts and Evaluation Results in Korea (가족계획과 보건사업의 통합시도 및 평가결과)

  • Bang, Sook
    • Korea journal of population studies
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    • v.10 no.2
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    • pp.58-81
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    • 1987
  • The purpose of this study is to examine major factors that affect patterns of living arrangements of older Korean noncitizens in the United States using the 1990 8% Public Use Microdata Sample(PUMS). In order to do so, I analyzed the effects of four factors including acculturation(English proficiency and Age at migration), economic circumstances(Personal Income and Supplemental Security Income: SSI receipt), health status(Mobility and Personal care limitation), and the ethnic community. The results show that acculturation and economic circumstances play an important role in determining the patterns of living arrangements among older Korean aliens, whereas the health status and the ethnic community do not show consistent effects. Regardless of marital status, the impact of age at migration is positively associated with solitary living of older Korean noncitizens, though, the effect of English proficiency show the opposite direction in accordance with marital status. That is, among nonmarried elders, those who cannot speak English are more likely to live alone. The case is reverse for married elders. The impact of economic feasibility is also positively associated with independent living arrangements. Those who receive SSI are much more likely to live apart from family, and elders whose annual personal income between $5,001 and $10,000 have the greatest propensity of solitary living-a large proportion of their income source is SSI. Individuals who receive SSI are also qualified to collect Medicaid, food stamps, rent subsidies, and other welfare benefits. In a sense, the economic feasibility provided by welfare benefits is the key determinant of independent living of older Korean noncitizens. Therefore, the recent welfare reform which denies legal aliens welfare benefits such as SSI and food stamps will severly affect the present living arrangements of older Korean aliens, and give economic burden to their family member The findings also show that there are significant differences within the elderly Korean Americans in terms of demographics, income, fertility, health status, and patterns of living arrangements by U.S. citizenship status. In particular, after controlling for age at migration as a proxy for acculturation, there is a statistically significant variation in living arrangements between elderly Korean noncitizens and naturalized citizens. For both theoretical and methodological reasons, future research on minority aging needs to investigate the concept of U.S. citizenship status for its impact on patterns of living arrangements among the minority elderly.

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Alternative Immunossays

  • Barnard, G.J.R.;Kim, J.B.;Collins, W.P.
    • Korean Journal of Animal Reproduction
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    • v.9 no.2
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    • pp.133-139
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    • 1985
  • An immunoassay may be defined as an analytical procedure involving the competitive reaction between a limiting concentration of specific antibody and two populations of antigen, one of which is labelled or immobillized. The advent of immunoassay has revolutionised our knowledge of reproductive physiology and the practice of veterinary and clinical medicine. Radioimmunoassay (RIA) was the first of these methods to be developed, which meausred the analyte with good sensitivity, accuracy and precision (1,2). The essential components of RIA are:-(i) a limited concentration of antibodies, (ii) a reference preparation, and (iii) an antigen labelled with a radioisotope (usually tritium or iodine-125). Most procedures invelove isolating the antibody-bound fraction and measuring the amount of labelled antigen. Good facilities are available for scintilltion counting, data reduction nd statistical analysis. RIA is undergoing refinement through:-(i) the introduction of new techniques to separate the antibody-bound and free fractions which minimize the misclassification of labelled antigen into these compartments, and the amount of non-specfic binding. (3), (ii) the development of non-extration for the measurement of haptens (4), (iii) the determination of a, pp.rent free (i.e. non-protein bound) analytes (5), and (iv) the use of monoclonal antibodies(6). In 1968, Miles and Hales introduced in important new type of immunoassay which they termed immunora-diometric assay (IRMA) based on t도 use of isotopically labelled specific antibodies(7) in a move from limited to excess reagent systems. The concept of two-site IRMAs (with a capture antibody on a solid-phase, and a second labelled antibody to a different antigenic determinant of the analyte) has enabled the development of more sensitive and less-time consuming methods for the measurement of protein hormones ovar wide concentration of analyte (8). The increasing use of isotopic methos for diverse a, pp.ications has exposed several problems. For example, the radioactive half-life and radiolysis of the labelled reagent limits assay sensitivity and imposes a time limit on the usefulness of a kit. In addition, the potential health hazards associated with the use and disposal of radioactive cmpounds and the solvents and photofluors necessary for liquid scientillation counting are incompatable with the development of extra-laboratory tests. To date, the most practical alternative labels to radioisotopes, for the measurement of analytes in a concentration > 1 ng/ml, are erythrocytes, polystyrene particiles, gold sols, dyes and enzymes or cofactors with a visual or colorimetric end-point(9). Increased sensitivity to<1 pg/ml may be obtained with fluorescent and chemiluminescent labels, or enzymes with a fluorometric, chemiluminometric or bioluminometric end-point. The sensitivity of any immunoassay or immunometric assay depends on the affinity of the antibody-antigen reaction, the specific activity of the label, the precision with which the reagents are manipulated and the nonspecific background signal (10). The sensitivity of a limited reagent system for the measurement of haptens or proteins is mainly dependent upon the affinity of the antibodies and the smalleest amount of reagent that may be manipulated. Consequently, it is difficult in practice to improve on the sensitivity obtained with iodine-125 as the label. Conversely, with excess reagent systems for the measurement of proteins it is theoretically possible to increase assay sensitivity at least 1000 fold with alternative luminescent labels. To date, a 10-fold improvement has been achieved, and attempts are being made to reduce the influence of other variables on the specific signal from the immunoreaction.

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Clinical Implications of Device-Detected Atrial Fibrillation in Cardiac Resynchronization Therapy

  • Minjae Yoon;Jaewon Oh;Kyeong-Hyeon Chun;Hee Tae Yu;Chan Joo Lee;Tae-Hoon Kim;Hui-Nam Pak;Moon-Hyoung Lee;Boyoung Joung;Seok-Min Kang
    • Korean Circulation Journal
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    • v.53 no.7
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    • pp.483-496
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    • 2023
  • Background and Objectives: Atrial fibrillation (AF) is associated with decreased cardiac resynchronization therapy (CRT) benefits compared to sinus rhythm (SR). Effective biventricular (BiV) pacing is a determinant of CRT success, but AF can interfere with adequate BiV pacing and affect clinical outcomes. We investigated the effect of device-detected AF on clinical outcomes and optimal BiV pacing in patients with heart failure (HF) treated with CRT. Methods: We retrospectively analyzed 174 patients who underwent CRT implantation between 2012 and 2019 at a tertiary center. The optimal BiV pacing percentage was defined as ≥98%. Device-detected AF was defined as an atrial high-rate episode ≥180 beats per minute lasting more than 6 minutes during the follow-up period. We stratified the patients without preexisting AF at pre-implantation into device-detected AF and no-AF groups. Results: A total of 120 patients did not show preexisting AF at pre-implantation, and 54 had AF. Among these 120 patients, 19 (15.8%) showed device-detected AF during a median follow-up of 25.1 months. The proportion of optimal BiV pacing was significantly lower in the device-detected AF group than in the no-AF group (42.1% vs. 75.2%, p=0.009). The devicedetected AF group had a higher incidence of HF hospitalization, cardiovascular death, and all-cause death than the no-AF group. The device-detected AF and previous AF groups showed no significant differences regarding the percentage of BiV pacing and clinical outcomes. Conclusions: For HF patients implanted with CRT, device-detected AF was associated with lower optimal BiV pacing and worse clinical outcomes than no-AF.

A Survey on Perception and Attitude of Patients and their Families to the Korean Shamanism (환자와 보호자의 샤머니즘적 사고와 태도에 대한 조사연구)

  • Shim Hyung-Wha;Park Jum-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.2
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    • pp.288-309
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    • 1999
  • This survey was done to construct a nursing theory according to Korean culture and to identify the Korean traditional view. From ancient time until now, shamanism has played an important role as determinant of Korean culture and of the personality formation of Korean people. The subjects are 321 patients and member of their families who were over 18 years old, and who are living in five large cities and two rural communities in Korea. Data collection was done from March, 8th to April, 29th in 1999. SPSS The tool developed by the investigator through literature review was used to measure the perception and the attitude of patients and their families to Korean shamanism. Collected data were analyzed by frequency, percent and $x^2$ test with SPSS program. The results are summarized as follows ; 1) While 35% of respondents answed that the destiny or fate(八字) was only relied on the abilities and endeavor of individual, 65% of respondents were fatalists(運命論者) or eclectic(折衷主義者) are compromised between the fate and endeavor. 2) While half of the respondents belief in divination(占) to some degree, the rest of them reported hardly any belief in divination. 3) There were almost twice as many respondents who directly consulted fortune-tellers were as respondents who did not consult fortunetellers. 4) The reasons for consulting fortunetellers were job problems, home problems, health problems by in that order. 5) The respondents almost always interpreted the cause of physical disease and mental disease as being psycho-sociological, but 1% of them explained mental disease as a shamanistic manitestation. 6) In case of disease, the reasons for consulting a fortuneteller was a) no hope of recovery from the sickness in any other way, b) the chronic disease in that order. 7) Of the respondents, 65% answered that diseases could not be cured by a 'Gut' (the performance done by the shaman), but 27% of respondents thought that disease could be cured by a 'Gut' in the case of mental disease. 8) Sixty six percent of the respondents answered that they have experienced praying for their wishes with clean water(井華水). 9) While 54% of the respondents answered that they have seen or heard the 'Beung Gut'(the performance to pray for recovery of sickness done by the shaman), 46% responded that they have never seen or heard it. 10) To the question 'do you intend to have a 'Beung Gut', 51.7% of respondents answer 'no' strongly, but 48% of them say 'yes' or took a compromising attitude. 11) Generally the respondents differed in perception and attitude to shamanism. In short, females more than males, old aged more than younger aged, lower educated more than higher educated, believers in Buddhism more than believers in any other religion, and blue color more than white color have more positive attitudes to shamanism. Also men living in rural communities have more positive attitude to shamanism than men living in the large cities. Consequently, Shamanism can be understood as an anxiety relieving cultural system even though Shamanism itself looks like a cultural complex.

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Factors related to the short-term and long-term intentions of healthy eating among Chinese adults living in Shanghai and parts of Anhui Province of China using the theory of planned behavior (계획적 행동이론 기반 상하이 및 안후이성 거주 중국 성인의 건강한 식행동의 장단기 의도와 관련된 요인)

  • Liu, Ani;Lee, Seungwoo;Hwang, Ji-Yun
    • Journal of Nutrition and Health
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    • v.55 no.1
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    • pp.188-199
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    • 2022
  • Purpose: This study investigated the relationship between 3 major constructs of the theory of planned behavior (TPB), i.e., attitude, subjective norms and perceived behavioral control (PBC) and past experience of healthy eating and intentions of healthy eating in the short-term and long-term in adults living in Shanghai and parts of Anhui Province, China. Methods: The online study questionnaire for this cross-sectional study was based on previously validated items. A total of 408 Chinese adults (aged 18-64 years) residing in Shanghai and parts of Anhui Province, China were included to examine relationships between 3 major constructs of TPB and past experience of healthy eating, and short-term and long-term intentions of healthy eating. Multiple linear regression model adjusted for age and body mass index (BMI) was employed to test relationships. Results: Only PBC among 3 major constructs of TPB was significantly related to short-term (p < 0.001) and long-term (p = 0.002) intention of healthy eating after adjustment for age and BMI. Past experience of healthy eating was more significantly related to long-term intention (p < 0.001) compared to short-term (p = 0.020) intention of healthy eating. The short-term and long-term intention models explained 70.5% and 48.8% of the variance, respectively. Conclusion: PBC is a potential determinant of both short-term and long-term behavioral intention of healthy eating regardless of past experience of healthy eating in adults residing in Shanghai and parts of Anhui Province, China. Our results indicate that programs promoting healthy eating to Chinese adults incorporate PCB to perform healthy eating under his or her control.

Some Factors Affecting Bone Mineral Density of Korean Rural Women (농촌 성인 여성들의 골밀도에 영향을 미치는 요인 분석 연구)

  • 이정숙
    • Journal of Nutrition and Health
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    • v.32 no.8
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    • pp.935-945
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    • 1999
  • The factors affecting bone mineral density (BMD) of 103 rural women aged 30 to 76 years were investigated. Data for food and nutrient intake was obtained by 24-hour recall method. BMD of lumbar spine(L1-L4), femoral neck, ward's triangle and trochanter was measured by XR-series x-ray bone densitometer. Serum was collected and analyzed for total Ca, P and ionized Ca (Ca++)content. Relationship between the factors and BMDs was analyzed by Pearson's correlation coefficient(r) and multiple regression analysis. The results are summarized as follows. 50% of the subjects under 50 years of age($\leq$49 yr group) and 86.4% of the subjects from 50 up($\geq$50yr group) were classified as osteopenia or osteoporosis. Mean body weight, height and BMI were 153.1cm, 59.1kg and 25.0kg/$m^2$ in $\leq$49 yr group and 151.9cm, 55.9kg, and 24.2kg/$m^2$ in $\geq$50 yr group. BMDs of lumbar spines and femurs ranged from 0.84 to 1.05g/$m^2$ and from 0.67 to 1.16g/$m^2$ in $\leq$49 yr group, and ranged from 0.67 to 0.85kg/$m^2$ and from 0.68 to 0.44g/$m^2$ in $\geq$50 yr group, respectively. On the whole, the BMDs were reduced to 83.8 to 94.2% of peck bone mass in $\leq$49 yr group and 55.2 to 78.9% of those in $\geq$50 yr group. Mean daily intake of Ca was much less than the Korean RDA, \67.2% in $\leq$49 yr group and 62.3% in $\geq$50 yr group. The average concentration of total Ca, P and Ca++ in serum were within normal range in both age group. Both age and height were significantly related with BMD in both age group but the relationship tended to be stronger in $\geq$50 yr group than in $\leq$49 yr group. Body weight was also a potent determinant of BMD only in 50 yr group. In $\leq$49 yr group, total food intake was positively related with BMDs of ward's triangle, L1 and L2 and intake of cereals and grain products, sugars and sweets, milk and dairy products was positively related with BMDs measured in this study. On the contrary, intake of eggs, oil and fats were positively related with a few BMDs in 50 yr group. The BMDs were positively affected by intake of energy, protein, carbohydrate, Ca, P and Fe in $\leq$49 yr group and those of protein, fat Ca, P, vitamin B1, vitamin B2 and vitamin C in $\geq$50 yr group. It was noteworthy that serum Ca++ concentration was positively related with BMDs of lumbar spine in boty age groups. According to multiple regression analysis, the four factors, age, body weight, height and BMI additionally accounted for 21% of the variance in BMD of trochanter in $\leq$49 yr group and only two factors, age and C a intake accounted for 38% of that of femoral neck in $\geq$50 yr group. Further investigation is necessary to make sure of the relations between BMD and serum Ca++ level.

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Nutrients and Salt Consumption of Hypertension Patients According to Treatment Status (고혈압환자에서 치료상태에 따른 영양소 및 나트륨 섭취 양상)

  • Yim Juneeun;Cho Miran;Yin Chanesik;Seo Byune Kwan;Koh Hweone Gyun;Choue Ryowon
    • Journal of Nutrition and Health
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    • v.38 no.9
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    • pp.706-716
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    • 2005
  • High blood pressure is an important determinant of the incidence of coronary heart disease, stroke, congestive heart failure, renal failure, and peripheral vascular disease. Recommendations for control of high blood pressure emphasize lifestyle modification, including weight control, reduced sodium intake, increased physical activity. Subjects who were normotensive (n=19, $47.2\pm9.0$ y, BP l16/81 mmHg) ,treatment hypertensive (n=33, $54.2\pm6.9$ y, BP 132/85 mmHg) and non-treatment hypertensive (n=14, $50.1\pm11.0$ y, 149/94 mmHg) recruited. Anthropometric assessment (height weight waist circumference, hip circumference, fat$\%$, fat mass, and lean body mass) and dietary assessments (using 3-days food records, daily nutrient intakes were inuysed by CAN PRO 2.0 were carried out. Blood and 24-hour urine were collected). Test of recognition for salt taste threshold were performed. In non-treatment hypertensive male subjects, weight, $\%$IBW, BMI, and waist circumference were significantly higher than those of normotensive and treatment hypertensive subjects (p<0.05) .Food habits were not significantly different among the three groups. Intakes of vitamin A, vitamin B,, and vitamin B, were significantly higher in normotensive group (p<0.05). Intakes of sodium and salt taste recognition threshold were the highest in normotensive group and the lowest in treatment hypertensive group (p<0.05). Blood levels of lipids and minerals were not significantly different among the three groups. Urinary calcium level of normotensive group were significantly higher than that of treatment hypertensive and non-treatment hypertensive groups (p<0.05). These results indicate that continuous management of hypertension by drug and non-drug treatment affects salt taste recognition threshold and reduced the consumption of sodium. However, dietary sodium intake exceed recommended sodium intake to prevent and treat hypertension. It is necessary to develop the lifestyle modification program that may have beneficial effects on hypertension treatment.

Antioxidative Status, DNA Damage and Lipid Profiles in Korean Young Adults by Glutathione S-Transferase Polymorphisms (Glutathione S-transferase (GST) 유전자 다형성에 따른 우리나라 젊은 성인의 항산화 상태, DNA 손상 및 지질 양상)

  • Jo, Hye-Ryun;Lee, Hye-Jin;Kang, Myung-Hee
    • Journal of Nutrition and Health
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    • v.44 no.1
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    • pp.16-28
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    • 2011
  • Oxidative stress leads to the induction of cellular oxidative damage, which may cause adverse modifications of DNA, proteins, and lipids. The production of reactive species during oxidative stress contributes to the pathogenesis of many diseases. Antioxidant defenses can neutralize reactive oxygen species and protect against oxidative damage. The aim of this study was to assess the antioxidant status and the degree of DNA damage in Korean young adults using glutathione s-transferase (GST) polymorphisms. The GSTM1 and GSTT1 genotypes were characterized in 245 healthy young adults by smoking status, and their oxidative DNA damage in lymphocytes and antioxidant status were assessed by GST genotype. General characteristics were investigated by simple questionnaire. From the blood of the subjects, GST genotypes; degree of DNA damage in lymphocytes; the erythrocyte activities of superoxide dismutase, catalase, and glutathione peroxidase; plasma concentrations of total peroxyl radical-trapping potential (TRAP), vitamin C, ${\alpha}$- and ${\gamma}$-tocopherol, ${\alpha}$- and ${\beta}$-carotene and cryptoxanthin, as well as plasma lipid profiles, conjugated diene (CD), GOT, and GPT were analyzed. Of the 245 subjects studied, 23.2% were GSTM1 wild genotypes and 33.4% were GSTT1 wild genotype. No difference in erythrocyte activities of superoxide dismutase, catalase, or glutathione peroxidase, and the plasma TRAP level, CD, GOT, and GPT levels were observed between smokers and non-smokers categorized by GSTM1 or GSTT1 genotype. Plasma levels of ${\alpha}$- and ${\gamma}$-tocopherol increased significantly in smokers with the GSTT1 wild genotype (p < 0.05); however, plasma level of ${\alpha}$-carotene decreased significantly in non-smokers with the GSTM1 wild genotype (p < 0.05). DNA damage assessed by the Comet assay was significantly higher in non-smokers with the GSTM1 genotype; whereas DNA damage was significantly lower in non-smokers with the GSTT1 genotype. Total cholesterol and LDL cholesterol levels were significantly higher in non-smokers with the GSTT1 genotype than those with the GSTT1 wild genotype (p < 0.05). In conclusion, the GSTM1 genotype or the GSTT1 wild genotype in non-smokers aggravated their antioxidant status through DNA damage of lymphocytes; however, the GSTT1 wild type in non-smokers had normal plasma total cholesterol and LDL-cholesterol levels. This finding confirms that GST polymorphisms could be an important determinant of antioxidant status and plasma lipid profiles in non-smoking young adults. Further study is necessary to clarify the antioxidant status and/or lipid profiles of smokers with the GST polymorphism and to conduct a study with significantly more subjects.

Estimate of Radiation Doses in MDCT Using Patient Weight (MDCT 검사에서 환자 체중을 이용한 선량 평가)

  • Kwon, Seong-Ohk;Dong, Kyung-Rae;Kweon, Dae-Cheol;Goo, Eun-Hoe;Choi, Ji-Won;Chung, Woon-Kwan
    • Progress in Medical Physics
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    • v.21 no.3
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    • pp.246-252
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    • 2010
  • The purpose of this study provides measurements of radiation dose from MDCT of head, chest, abdomen and pelvic examinations. A series of dose quantities that are measured of patient weight to compare the dose received during MDCT examinations. Data collected included: weight together with CT dose descriptors, volume CT dose index (CTDIvol) and dose length product (DLP). The effective dose was also estimated and served as collective dose estimation data. Data from 1,774 adult patients attending for a CT examination of the head (n=520) or chest (n=531) or abdomen (n=724) was obtained from spiral CT units using a same CT protocol. Mean values of CTDIvol was a range of 48.6 mGy for head and 6.9, 10.5 mGy for chest, abdomen examinations, respectively. And mean values of DLP was range of 1,604 $mGy{\cdot}cm$ for head, 250 $mGy{\cdot}cm$ for chest, 575 $mGy{\cdot}cm$ for abdomen examinations, respectively. Mean effective dose values for head, chest, abdominal CT were 3.6, 4.2, and 8.6 mSv, respectively. The degree of CTDIvol and DLP was a positive correlation with weight. And there was a positive correlation for weight versus CTDIvol ($r^2$=0.62), DLP ($r^2$=0.694) in chest. And head was also positive correlation with weight versus CTDIvol ($r^2$=0.691), DLP ($r^2$=0.741). We conclude that CTDIvol and DLP is an important determinant of weight within the CT examinations. The results for this study suggest that CT protocol should be tailored according to patient weight.