• 제목/요약/키워드: Health determinant

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A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System (모자건강관리를 위한 위험요인별 감별평점분류기준 개발에 관한 연구)

  • 이광옥
    • Journal of Korean Academy of Nursing
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    • v.13 no.1
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    • pp.7-21
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    • 1983
  • For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

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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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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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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.

Some Factors Affecting Bone Density of Korean College Women (한국 여대생의 골밀도에 영향을 미치는 요인 분석 연구)

  • 유춘희
    • Journal of Nutrition and Health
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    • v.31 no.1
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    • pp.36-45
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    • 1998
  • Dietary and other factors affecting bone density of 32 Korean healthy college women aged 19-23 years were assessed. Data for food and nutrient intake was obtained by a semiquantitiative food frequency questionnaire. Serum samples were anlayzed for total Ca, P, Ca++, PTH, calcitonin and 25-hydroxycholecalciferol , (25-OH-Vit D3) and BMDs of lumbar spine(L2-L4), femoral neck(FN), ward's triangle (WT) and trochanter(TR) were measured by an XR-series X-ray bone densitometer. Relationships between the factors and BMDs were analyzed by stepwise multiple regression analysis and Pearson's correlation coefficient(r). The results are summarized as follows. Mean daily intake of energy(86.1%), Ca(74.3%), vitamin A (53.75), Fe(49.75) and vitamin B$_2$(86.6%) were lower while other notrients incuding P(126%) were higher than the Korean RDA. The BMDs of lumbar spines and femurs ranged from 0.73g/$\textrm{cm}^2$ to 1.23g/$\textrm{cm}^2$and 0.48g/$\textrm{cm}^2$ to 1.04g/$\textrm{cm}^2$, respectively. Both protein and P intakes were inversely associated with serum total Ca. Furthermore, Ca intake as well as Ca/P ratio (Ca/P) were inversely associated with serum ionized Ca(Ca++) concentration. The intakes of protein P and Ca , however, were not significantly associated with the BMDs measured in this study. There were little association between BMDs and alcoholic beverage or caffeine consumption. The only significant association detected was a positive relationship between caffeine consumption and BMD of WT. It seemed to be noticeable that BMDs of L2-L$_4$, FN and WT were significantly inversely associated with serum P concentration. However, there was no significant association between BMDs and the levels of total Ca to Ca++ in serum. Body weight was positively associated with BMD of lumbar spine and BMI was also positively associated with BMDs of FN and WT. The subjects who had an early menarche appeared to have higher BMDs than those who had had a late mearche. According to stepwise multiple regression analysis. Menarche and BMI were stronger determinants of BMDs in the young women than was diet. P intake appeared to be a more potent dietary determinant than Ca intake. The three factors, menarche, BMI , and P intake , additionally accounted for 24% and 378% of the variance in BMDs of FN and L$_2$-L$_4$, respectively. Further investigation is necessary to determine the factors needed to increase serum P level which negatively affects. BMD in young Korean college women.

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A study on Determinant Factors of Preferred elderly Housing based on Location among Preliminary Elders (예비 고령자의 입지유형별 고령자 주택 선택요인 분석)

  • Kim, Chang-Gon;Won, You-Ho;Lee, Joo-Hyung
    • The Journal of the Korea Contents Association
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    • v.15 no.9
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    • pp.562-575
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    • 2015
  • This study aims to draw a Housing development scheme of elderly housing, including the urban, suburban and resort type according to location type, which is based on a Demanding Characteristics of preliminary elderly for elderly housing. In addition, The comprehensive implication tells that the preliminary elderly who wants the urban elderly housing type have a more personal characteristics than other types. So it should be considered according to personal characteristics. Next, when we choose the suburban elderly housing type and predict the demand for housing development, it should not only considers factors such as the Unmarried children, Health status, Current housing size and Plans for economic activity in old age but also considers factors such as the Accessibility, Convenience, Investment and Environment characteristics of elderly housing preference. Next, when we choose the resort elderly housing type which based on the fact that a few detailed parameters of current housing characteristics exist, it should be based on the current housing characteristics of preliminary elderly. In addition, it should consider a pre-investigation for elderly housing preference in order to select the housing type. Because a comprehensive preference such as the comfort, convenience, safety, investment, environmental characteristics is considered as major determinants factors.

Oxygen Transfer and Hydraulic Characteristics in Bubble Column Bioreactor Applied Fine Bubble Air Diffusing System (미세기포 산기장치를 적용한 타워형 생물반응기의 산소전달 및 수력학적 특성)

  • Lee, Seung-Jin;Ko, Kyeong-Han;Ko, Myeong-Han;Yang, Jae-Kyeong;Kim, Yong-Guk
    • Journal of Korean Society of Environmental Engineers
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    • v.34 no.11
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    • pp.772-779
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    • 2012
  • For improving performance of conical air diffuser generating fine bubble, both experimental and numerical simulation method were used. After adapting diffusers inner real scale bubble column, suitable for various diffuser submergence, the effect of diffuser submergence on oxygen transfer performance such as Oxygen Transfer Coefficient ($K_{L}a_{20}$) and Standard Oxygen Transfer Efficiency (SOTE) was investigated empirically. As flow patterns for various diffuser number and submergence were revealed throughout hydrodynamic simulation for 2-phase fluid flow of air-water, the cause of the change for oxygen transfer performance was cleared up. As results of experimental performance, $K_{L}a_{20}$ was increased slightly by 7% and SOTE was increased drastically by 39~72%, 5.6% per meter. As results of numerical analysis, air volume fraction, air and water velocity in bioreactor were increased with analogous flow tendency by increasing diffuser number. As diffuser submergence increased, air volume fraction, air and water velocity were decreased slightly. Because circulative co-flow is determinant factor for bubble diffusion and rising velocity, excessive circulation intensity can result to worsen oxygen transfer by shortening bubble retention time and amount.

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.

What Makes Husband and Wife Satisfied with their Marriages : A Comparative Analysis of Korea and Japan (한일 부부의 결혼만족도 비교)

  • Chung, Ki-Seon;Kamo, Yoshinori;Yi, Ji-Hye
    • Korea journal of population studies
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    • v.33 no.1
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    • pp.133-160
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    • 2010
  • This study aims to analyze marital satisfaction over the family life course and to find its determinants in Korea and Japan. The data for this study came from nationwide representative sample surveys on family in these two countries including 5,308 Korean and 4,920 Japanese men and women living with their spouses. In order to see the cultural difference and similarity in marital relations, the effects of education, income, employment, marriage gradients (normative patterns between the spouses), family stress, and quality of conjugal interactions on Korean and Japanese couples' marital satisfaction were examined. It was found that the marital satisfaction showed a U-shape pattern for both Korean and Japanese couples. In both countries husbands tend to have higher marital satisfaction than wives over the entire life course. The most important determinants of Korean and Japanese couples' marital satisfaction are good qualities of conjugal interactions including deep trust and concerns for spouse and sex life satisfaction. For Korean couples good conjugal interactions is better predictor of marital satisfaction than sex life, while for Japanese couples sex life is more important determinant of marital satisfaction.