Objectives: The purpose of this study was to determine if smoking cessation programs (SCPs) are effective for adults through a systematic review of the results of such programs in large randomized controlled trials (RCTs). Methods: The PICO (Patient, Intervention, Comparator, Outcome) strategy was established, 1,160 literature from domestic and foreign electronic databases was reviewed, and 22 references were selected based on the inclusion and exclusion criteria. The quality of each reference was evaluated using the Scottish Intercollegiate Guidelines Network tool, and meta-analysis was carried out. Results: The SCPs were significantly effective for adult smokers. Smoking cessation counseling, education, and smoking cessation medications such as nicotine patch were more effective than the other interventions. However, the results showed short-term effects (within six months), and differences were observed among the SCPs. For the outcome measures for SCPs, the abstinence rate of seven days was mainly used, but differences were identified between the CO level and the cotinine-verified abstinence rate of smoking cessation. Conclusions: For a smoking cessation program for adult smokers, the strength of the evidence of the program's effectiveness in RCTs that provide the identified intervention strategies should be considered.
Objectives: Rural-urban differences in suicide have been observed in many settings. However, there has been little research addressing what factors can explain these differences. The purpose of this study was to analyze which compositional factors and contextual factors in local areas might be related to local suicide. Methods: The study design was cross-sectional. The data for 251 primary local governments on their age-standardized suicide mortality and their predefined indicators of compositional factors and contextual factors were obtained from Korean Statistical Information Service as of year 2010. Bivariate analysis including one-way ANOVA and chi-square test were used to identify the differences in local features by area type. Seven poisson regression models for each of total, males, and females were used to analyze which compositional and contextual factors were related to suicide. Results: There were differences in suicide between gu and goon in total, male, and female groups. For total, compositional factors including divorce and smoking rate, and contextual factors including financial independency, water and waterwaste coverage, and number of wastewater discharge factories were found to explain the urban-rural differences. Conclusions: This study provided some evidence that contextual factors at the local level as well as compositional factors are useful for predicting local suicide mortality.
The purpose of this study was to identify the degree and the relationship of the Knowledge, Attitude and Practice of industrial health care services of workers. This information will provide useful data for an effective industrial health care service. The was collected from 600 data employees in Kwang-ju city & Chonnam province. The data was gathered by questionnaire from Dec 20, 1992 to Jan 20, 1993. The questionnaire was developed by the Academic Affairs of Community Health Nursing Academy. Data was analyzed by using the statistical computer package, SPSS to manipulate the data along with percentages, means, standard deviations, modes, t-test and ANOVA. The results in this study were summarized as follows: 1. General characteristics of workers: Distributions of workers was laborer(76.2%). in the 25-34 age group(50.2%), married(63.3%), males comprised(77.5%), the educational level with the highest percentage was high school graduates (71.1%), with a monthly income of 300-700 thousand won(43.8%), and has been working in the present career over seven years (31.5%). 2. The Knowledge, Attitude and Practice levels of employees about industrial health care services The levels were measured according to a five point scale. The total mean score of knowledge was 2.92 points out of 4. The following are the scores of Knowledge of special medical examination and location of industrial clinic(3.48), periodic medical examination (3.18), occupational disease(3.08), personal protective equipment (2.92), and health education(1.37). The total mean score of Attitude was 2.77 point out of 4. The following are the scores of Attitude in order of working environment (3.35), necessity of periodic medical examination and health education(3.15), the worker's perception influence on the working environment to health was high(3.11). But, the level of satisfaction in the content of periodic medical examination was low(2.19). The total mean score of Practice was 2.70 points out of 4. The scores of Practice in order were, practice of periodic medical examination(3.70), utilization of industrial clinic(2.92), and to participate in health education(1.47). 3. The relationship of general characteristics to Knowledge, Attitude, and Practice of workers: Knowledge had a significant difference by sex (P<.01), marital status(P<.01), education level (P<.05) and monthly income(P<.01). Attitude was significantly different with sex(P<.05) and Practice was significantly related to monthly income (P<.01).
Methyl bromide has been used as a representative fumigant for quarantine, and several poisoning cases have occurred recently by this chemical in Korea. The purpose of this study is to evaluate workers' exposures to airborne methyl bromide in the importing and exporting plant products quarantine companies. Air samples were collected 400/200 mg Anasorb 747TM and were analyzed by gas chromatograph /flame ionization detector according to the Occupational Safety and Health Agency (OSHA) Method PV2040. Geometric mean (GM) and arithmetic mean (AM) of total 27 workers' exposure concentrations to airborne methyl bromide were 1.12 ppm and 0.24 ppm, respectively. Two exposures(12.1 ppm and 12 ppm as 8hr-TWA) of total 27 workers' exposures exceeded the Korean standard (5 ppm) of Ministry Labor, while 4 exposures (15%) exceeded the Threshold Limit Value (TLV) (1 ppm) of American Conference of Governmental Industrial Hygienists (ACGIH). Seven samples (11%) of total 63 short-term air samples exceeded the OSHA Permissible Exposure Limit (PEL) 20 ppm (Ceiling). The opening (management) task in wood fumigation by tent showed the highest short-term exposure concentrations (AM: 18.6 ppm, GM: 0.58 ppm, maximum: 340.7 ppm). The maximum level in treatment task of the same process was 2.01 ppm. Methyl bromide concentrations in opening operation was significantly higher than that in treatment operation (p<0.05). In conclusion, the GM of workers' 8hr-TWA exposures to airborne methyl chloride in the importing/exporting plant quarantine industry was estimated below the ACGIH TLV (1 ppm). However, opening task in the fumigation of wood being covered with tent or fumigation of pant products in container showed the levels exceeding ACGIH TLV (1 ppm), and opening task in the fumigation of wood being covered with tent showed the level exceeding the Korean standard of Ministry of Labor (5 ppm).
Background: In 2006, three farmers died at the bottom of an agricultural shallow well where the atmosphere contained only 6% oxygen. This study aimed to document the variability of levels of oxygen and selected hazardous gases in the atmosphere of wells, and to identify ambient conditions associated with the low-oxygen situation. Methods: A cross-sectional survey, conducted in June 2007 and July 2007, measured the levels of oxygen, carbon monoxide, hydrogen sulfide, and explosive gas (percentage of lower explosive limit) at different depths of the atmosphere inside 253 wells in Kamphaengphet and Phitsanulok provinces. Ambient conditions and well use by farmers were recorded. Carbon dioxide was measured in a subset of wells. Variables independently associated with low-oxygen condition (<19.5%) were identified using multivariate logistic regression. Results: One in five agricultural shallow wells had a low-oxygen status, with oxygen concentration decreasing with increasing depth within the well. The deepest-depth oxygen reading ranged from 0.0% to 20.9%. Low levels of other hazardous gases were detected in a small number of wells. The low-oxygen status was independently associated with the depth of the atmosphere column to the water surface [odds ratio (OR) = 13.5 for 8-11 m vs. <6 m], depth of water (OR = 0.17 for 3-<8 m vs. 0-1 m), well cover (OR = 3.95), time elapsed since the last rainfall (OR = 7.44 for >2 days vs. <1 day), and location of well in sandy soil (OR = 3.72). Among 11 wells tested, carbon dioxide was detected in high concentration (>25,000 ppm) in seven wells with a low oxygen level. Conclusion: Oxygen concentrations in the wells vary widely even within a small area and decrease with increasing depth.
Women's health is directly related to economic and developmental level of their nations, and it is very much effected by socio-cultural factors which are related to gender discrimination. women's health needs have been oppressed and neglected in male-dominated society. For maintenance and promotion in women's health and improve of quality of life, the common idea of gender discrimination in our society and preference of having son rather than daughter from its certain from must be banished. Though the common idea of gender discrimination was a basic ideology in liberation of women, recently the aspect of difference rather than discrimination is an important matter and unique characteristics of women are strongly pointed and additionally harmonic living with men is getting to be a man idea in women's health. The social idea in gender discrimination was from christian culture in the western society and confucianism related the social norms of "Namzonyobe" (means men are honorable and women are low), "Samzongzido" (means women ought to obey certain three rules for the family), "Chilgeziak" (means seven wickedness of housewife) in this country, korea. Those ideas deprived women's ability in health management and in the decision making process for their health. Because of those cultural influences, still many pregnant women are experiencing artificial abortion when they know the fetus is a girl through ultrasound and amniocentesis. Nowadays there are many health problems of women in korea. The reasons are that Korea culture has complicatedly mixing with confucianism and western culture. Under the these cultural influences, change in value of beauty and trend of liberation in sexuality have brought out health problems, alcohol, smoking, and drug abuse in young women. In order to solve the women's health problem, first of all women have to come out of the passive manner of dependency on man. Also they should have the insight and the management and/or intervention ability of caring their health. It can be obtained through the family-society-nation wide approach as well as the approach for women themselves.
The degree of benefits of living services related to the quality of life can solve the depopulation problem, and it is necessary to be able to quantitatively analyze problems related to the quality of life in rural areas in order to cope with the rural depopulation. The purpose of this study was to develop the assessment model of a village-level rural living service that reflects the regional characteristics of rural villages to evaluate the level of rural living services for response rural depopulation. Based on the review of previous related studies, the evaluation index was composed of seven sectors of education, health, welfare, culture, environment, safety, and convenience, and the assessment model of a rural living service was established. This model was evaluated through a sample survey of 90 villages in Nonsan-si, Seongju-gun, and Pyeongchang-gun. As a result of the rural life services evaluation by Si and Gun, Seongju-gun, which is affected by nearby large cities, has the largest variation by village level and is assessed at a lower level overall than other Si and Gun. As a result of the rural life services evaluation by 7 sectors, in the case of health and welfare, low scores were shown in the assessment model, but the level of residents' satisfaction was mid-level. In particular, in the case of Seongju-gun, there were significant differences in the assessment model and the survey results of the level of residents' satisfaction in the health and welfare sectors due to the influence of nearby large cities. As a result of analyzing the number of villages corresponding to the top 30% and the bottom 30% of the evaluation results for each sector, it was analyzed that the villages with the highest evaluation results in Pyeongchang-gun in both the assessment model and the level of residents' satisfaction. It implies that quantitative analysis of data based index and accessibility as well as level satisfaction of residents are necessary.
The Organization for Economic Cooperation and Development, which has continuously evaluated the performance of healthcare systems, has recently invested much effort into hospital performance measurement. The purpose of this paper is to introduce the hospital performance measurement programs operated by international organizations or at the national level based on the OECD's hospital performance project. Health Insurance Review & Assessment service (HIRA)'s quality assessment was analyzed based on the analytical framework of the OECD's hospital performance project. The hospital performance measurement programs of WHO, Canada, Australia, United States and United Kingdom are briefly explored, in view of the conceptual framework, key performance dimensions and indicators that are currently in use. The OECD suggested seven key dimensions of hospital performance: timeliness, efficiency, continuity, effectiveness and appropriateness, staff orientation, patient orientation and safety. The analysis of the quality assessment program of HIRA, which operates 36 diseases and procedures and 347 indicators, shows that the numbers of indicators are relatively small in the areas of safety, patient centeredness and efficiency. Continuity of care and staff orientation are not fully developed also, but the situations are similar in other countries. In conclusion, hospital performance measurement using stable and comprehensive data should be developed to improve overall system performance, and discussions on a conceptual framework that can lay out directions and key performance domains need to take into place.
Objectives: Preservatives are commonly used in pharmaceuticals, cosmetics and other products to extend the expiration date and prevent the growth of microorganisms. Preservatives are generally effective in controlling mold and inhibiting yeast growth, and against a wide range of bacterial attacks as well. They also adversely affect the quality of sperm and cause precocious puberty in children. This study was performed to analyze seven preservatives used in pharmaceuticals and personal care products. Methods: Five kinds of pharmaceuticals and personal care products (PPCPs) were examined for analysis with a high performance liquid chromatography-diode array detector. Each sample was homogenized and the targeted compounds were extracted with methanol. The suspended particulate was removed by syringe filter. Next, the sample was injected into an HPLC system. The separation of the seven preservatives was achieved with a C18 column and gradient mode. The accuracies were between 73% and 120% and precision was lower than 11.58% (RSD). Results: All of the calibration curves showed good linearity with a coefficient of determination ($r^2$) over 0.999. Among the PPCP samples, the detection rate of preservatives was 32.5% for pharmaceuticals, 44.8% for toothpaste, 76.9% for mouthwash, 40.0% for body lotion and 56.0% for wet tissues. The average concentrations of the preservatives in PPCPs were BA 1141.0 mg/kg, MP 709.8 mg/kg, EP 624.9 mg/kg, PP 216.9 mg/kg, BP 167.8 mg/kg, and TCS 538.2 mg/kg. The most frequently detected preservatives in pharmaceuticals and personal care products were BA, MP and PP. The concentrations of preservatives exceeded Korean regulatory standards in 11 samples of medicines, three of mouthwash and two of body lotion. Conclusion: We found that most of the PPCP samples contained various preservatives. It is necessary to identify which preservatives were used and to determine the level of preservatives in PPCPs and to assess the health risk to susceptible populations such as children.
Objectives : Our objective is to review and summarize the previous studies on the health effects of exposure to oil spills in order to make suggestions for mid- and long-term study plans regarding the health effects of the Hebei Spirit oil spill occured in Korea. Methods : We searched PubMed to systemically retrieve reports on the human health effects related to oil spill accidents. The papers' reference lists and reviews on the topic were searched as well. Results : We found 24 articles that examined seven oil spill accidents worldwide over the period from 1989 to August 2008, including the Exxon Valdes, Braer, Sea Empress, Erika, Nakhodka, Prestige and Tasman Spirit oil spills. Most of the studies applied cross-sectional and short-term follow-up study designs. The exposure level was measured by assessing the place of residence, using a questionnaire and environmental and personal monitoring. Studies on the acute or immediate health effects mainly focused on the subjective physical symptoms related to clean-up work or residential exposure. Late or mid-term follow-up studies were performed to investigate a range of health effects such as pulmonary function and endocrine, immunologic and genetic toxicity. The economic and social impact of the accidents resulted in the socio-psychological exposure and the psychosocial health effects. Conclusions : Studies of the health effects of exposure to oil spills should consider a range of health outcomes, including the physical and psychological effects, and the studies should be extended for a considerable period of time to study the long-term chronic health effects.
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