• Journal of Preventive Medicine and Public Health
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• 제43권6호
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• pp.455-458
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• 2010

The Affordable Care Act (ACA) was signed into law on March 23, 2010 and will fundamentally alter health care in the United States for years to come. The US is currently one of the only industrialized countries without universal health insurance. The new law expands existing public insurance for the poor. It also provides financial credits to low income individuals and some small businesses to purchase health insurance. By government estimates, the law will bring insurance to 30 million people. The law also provides for a significant new investment in prevention and wellness. It appropriates an unprecedented $15 billion in a prevention and public health fund, to be disbursed over 10 years, as well as creates a national prevention council to oversee the government's prevention efforts. This paper discusses 3 major prevention provisions in the legislation: 1) the waiving of cost-sharing for clinical preventive services, 2) new funding for community preventive services, and 3) new funding for workplace wellness programs. The paper examines the scientific evidence behind these provisions as well as provides examples of some model programs. Taken together, these provisions represent a significant advancement for prevention in the US health care system, including a shift towards healthier environments. However, in this turbulent economic and political environment, there is a real threat that much of the law, including the prevention provisions, will not receive adequate funding.

• 한국환경성돌연변이발암원학회:학술대회논문집
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• 한국환경성돌연변이발암원학회 2004년도 KSOT/KEMS Fall Annual Meeting
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• pp.48-57
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• 2004

• 한국독성학회:학술대회논문집
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• 한국독성학회 2004년도 KSOT/KEMS fall annual meeting
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• pp.48-57
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• 2004

• 보건교육건강증진학회지
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• 제20권1호
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• pp.147-158
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• 2003

The purpose of this study was to analyze the relationships between variables related to skin health and skin health behavior of female university students in seoul, and to plan effective educational programs for skin health. 322 university women attending women's universities and 363 university women attending co-educational universities were selected to conduct a questionnaire survey; the total number of examines was 685, and the examination period was from October 23rd to November 6th, 2002. The study results are as follows; 1. The score distributions of skin health behavior were as follows; 8.7% of examniees got 20-40 points, 51.6% got 41-60 points, 36.7% got 61-80 points, 0.4% got 81-100 points. The maximum score was 100 points; the lowest score was 22 points and the highest score was 97 points, the average score was 56.9 points. 2. The general characters were as follows; the older subjects were and the higher subjects income levels were : the higher their scores of skin health behavior were. Scores of skin health behavior of students who temporarily stay out of school were higher than those who were enrolled full time. Scores of skin health behavior of university women attending women's universities were higher than those of university women attending co-educational universities. The greater subjects were satisfied with their appearances, the better their health states were, the more subjects were concerned about health problems, the higher their health states were, the more subjects were concerned about health problems, the higher their scores of skin health behavior were. 3. Characters related to skin were as follows; the better subjects skin conditions were, the higher their scores of skin health behavior were. Scores of skin health behavior of university women whose skin types were 'sensitive' were higher than those of university women whose skin was "not sensitive". Scores of skin health behavior of university women who worry about their skin wrinkles or skin color were higher than those of university women who have different kinds of skin troubles. Scores of skin health behavior of university women who get skin-relate information through dermatology clinics or beauty salonspecialists in this area were higher than those of university women who get the information through other sources. Scores of skin health behavior of university women who have experienced adverse effects of beauty products were higher than those of university women who have not experienced adverse effects of beauty products. 4. The relationships between variables related with skin health and skin health behavior were as follow; Skin states, health status and health concerns all had statistically significant correlation with skin health behavior.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9453-9458
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• 2014

Background: Breast cancer is the second leading cause of cancer death for women in the United States. Differences in survival of breast cancer have been noted among racial and ethnic groups, but the reasons for these disparities remain unclear. This study presents the characteristics and the survival curve of two racial and ethnic groups and evaluates the effects of race on survival times by measuring the lifetime data-based half-normal model. Materials and Methods: The distributions among racial and ethnic groups are compared using female breast cancer patients from nine states in the country all taken from the National Cancer Institute's Surveillance, Epidemiology, and End Results cancer registry. The main end points observed are: age at diagnosis, survival time in months, and marital status. The right skewed half-normal statistical probability model is used to show the differences in the survival times between black Hispanic (BH) and black non-Hispanic (BNH) female breast cancer patients. The Kaplan-Meier and Cox proportional hazard ratio are used to estimate and compare the relative risk of death in two minority groups, BH and BNH. Results: A probability random sample method was used to select representative samples from BNH and BH female breast cancer patients, who were diagnosed during the years of 1973-2009 in the United States. The sample contained 1,000 BNH and 298 BH female breast cancer patients. The median age at diagnosis was 57.75 years among BNH and 54.11 years among BH. The results of the half-normal model showed that the survival times formed positive skewed models with higher variability in BNH compared with BH. The Kaplan-Meir estimate was used to plot the survival curves for cancer patients; this test was positively skewed. The Kaplan-Meier and Cox proportional hazard ratio for survival analysis showed that BNH had a significantly longer survival time as compared to BH which is consistent with the results of the half-normal model. Conclusions: The findings with the proposed model strategy will assist in the healthcare field to measure future outcomes for BH and BNH, given their past history and conditions. These findings may provide an enhanced and improved outlook for the diagnosis and treatment of breast cancer patients in the United States.

• Perspectives in Nursing Science
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• 제15권2호
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• pp.49-69
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• 2018

Purpose: The purpose of this study was to derive contextual indicators of medical provider quality and assess their relative importance along with the individual utilization of antenatal care (ANC) and institutional births with a skilled birth attendant (SBA) in India using a multilevel framework. Methods: The 2015~2016 Demographic and Health Survey (DHS) from India was used to assess the outcomes of neonatal, infant, and under-five child mortality. The final analytic sample included 182,980 children across 28,283 communities, 640 districts, and 36 states and union territories. The contextual indicators of medical provider quality for districts and states were derived from the individual-level number of ANC visits (<4 or ${\geq}4$) and institutional delivery with SBA. A series of random effects logistic regression models were estimated with a stepwise addition of predictor variables. Results: About half of the mothers (47.3%) had attended ${\geq}4$ ANC visits and 75.8% delivered in institutional settings with SBAs. Based on ANC visits, 276~281 districts (43.1~43.9%) and 13~16 states (36.5~44.4%) were classified as "low" quality areas, whereas 268~285 districts (41.9~44.5%) and 8~9 states (22.2~25.0%) were classified as "low" quality areas based on institutional delivery with SBAs. Conditional on a comprehensive set of covariates, the individual use of both ANC and SBA were significantly associated with all mortality outcomes (OR: 1.17, 95% CI: 1.08, 1.26, and OR: 1.10, 95% CI: 1.02, 1.19, respectively, for under-five child mortality) and remained robust even after adjusting for contextual indicators of medical provider quality. Districts and states with low quality were associated with 57~61% and 27~43% higher odds of under-five child mortality, respectively. Conclusion: When simultaneously considered, district- and state-level provider quality mattered more than individual access to care for all mortality outcomes in India. Further investigations are needed to assess the importance of improving the quality of health service delivery at higher levels to prevent unnecessary child deaths in developing countries.

• Korean Journal of Health Education and Promotion
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• 제1권1호
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• pp.125-155
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• 1999

The term public health is used today when the health of a population is referred to. Before we look at public health, we should know the meaning of health. It is, however a difficult concept to define. The World Health Organisations definition of health, states that health is a state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity (WHO Constitution 1947). Health, in this context, is placed in an idealistic sphere that is unattainable in everyday life.(omitted)

• 한국학교ㆍ지역보건교육학회지
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• 제12권3호
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• pp.101-109
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• 2011

The purpose of this article is to introduce the Sports, Play, and Active Recreation for Kids (SPARK) physical education curriculum. SPARK is a model for health-related, research-based and evidence-based physical education programs in the United States. The outcome of school physical education can relate to public health, but there exists few evidence-based physical education programs reporting health-related variables. School physical education can provide more opportunities for children and adolescents to be physically active and to learn more about healthy lifestyles. However, physical education programs have been cut and eliminated due to lack of funding in the U.S. as in South Korea. Although facing these problems, SPARK programs have been implemented in over 50% of schools, after school programs and coordinated school health programs in the U.S. This article reviewed: (a) background information of the SPARK program, (b) examples of effective interventions, and (c) methods of dissemination to schools nationally in the U.S. The methods showed in SPARK may use as a model for researching, developing and implementing new physical education(PE) program and after school programs in Korea.

• 대한예방한의학회지
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• 제2권1호
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• pp.231-242
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• 1998

• Structural Monitoring and Maintenance
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• 제3권1호
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• pp.51-69
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• 2016

Monitoring the performance and estimating the remaining useful life of aging civil infrastructure in the United States has been identified as a major objective in the civil engineering community. Structural health monitoring has emerged as a central tool to fulfill this objective. This paper presents a review of the major structural monitoring programs that have been recently implemented in the United States, focusing on the integrity and performance assessment of large-scale structural systems. Applications where response data from a monitoring program have been used to detect and correct structural deficiencies are highlighted. These applications include (but are not limited to): i) Post-earthquake damage assessment of buildings and bridges; ii) Monitoring of cables vibration in cable-stayed bridges; iii) Evaluation of the effectiveness of technologies for retrofit and seismic protection, such as base isolation systems; and iv) Structural damage assessment of bridges after impact loads resulting from ship collisions. These and many other applications show that a structural health monitoring program is a powerful tool for structural damage and condition assessment, that can be used as part of a comprehensive decision-making process about possible actions that can be undertaken in a large-scale civil infrastructure system after potentially damaging events.