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Association between Risk of Obstructive Sleep Apnea and Subjective Health and Health-Related Quality of Life of the Korean Middle-Aged and Elderly Population (한국 중고령층의 폐쇄성 수면무호흡증 위험과 주관적 건강 및 건강 관련 삶의 질 간의 연관성)

  • Nu-Ri Jun;Min-Soo Kim;Jeong-Min Yang;Jae-Hyun Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.141-155
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    • 2024
  • Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

Investigation of Microsatellite Markers for Traceability and Individual Discrimination of Korean Native Ducks (한국 토종오리의 개체 식별 및 품종 구분을 위한 Microsatellite 마커 탐색)

  • Seo, Dong Won;Sultana, Hasina;Choi, Nu Ri;Kim, Yeon Su;Jin, Shil;Heo, Kang Nyeong;Jin, Seon Deok;Lee, Jun Heon
    • Korean Journal of Poultry Science
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    • v.42 no.1
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    • pp.1-8
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    • 2015
  • Recently, duck meat consumption has been rapidly increased because consumers recognized duck meat for healthy food. In relation to this, Korean duck industry need to develop Korean native duck (KND) breed for both conservation perspective and self-sufficient of the breeding stocks. In this study, 24 microsatellite (MS) markers were investigated for classification of KND and commercial duck (CD) breeds in the Korean market. Using these MS markers, the calculated number of alleles (K), expected heterozygosity (He) values and polymorphic information contents (PIC) were 1~16, 0~0.865 and 0~0.841, respectively. Also, the expected probability of identical values in random individuals (PI), random sib ($PI_{sib}$) and random half-sib ($PI_{half-sib}$) were estimated as $1.64{\times}10^{-16}$, $2.60{\times}10^{-7}$ and $1.30{\times}10^{-12}$, respectively. The results indicated that the expected probabilities of identity powers were enough for the individual identification. However, KND and CD breeds were not fully discriminated well using the 24 MS markers, which may CD and KND has shared same origin or crossbred. Therefore, further studies will be ultimately needed for developing a genetically pure line of KND breed even though the DNA markers used. Finally, these results will provide useful information for individual traceability system in ducks.

Evaluation of SharpIR Reconstruction Method in PET/CT (PET/CT 검사에서 SharpIR 재구성 방법의 평가)

  • Kim, Jung-Yul;Kang, Chun-Koo;Park, Hoon-Hee;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.12-16
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    • 2012
  • Purpose : In conventional PET image reconstruction, iterative reconstruction methods such as OSEM (Ordered Subsets Expectation Maximization) have now generally replaced traditional analytic methods such as filtered back-projection. This includes improvements in components of the system model geometry, fully 3D scatter and low noise randoms estimates. SharpIR algorithm is to improve PET image contrast to noise by incorporating information about the PET detector response into the 3D iterative reconstruction algorithm. The aim of this study is evaluation of SharpIR reconstruction method in PET/CT. Materials and Methods: For the measurement of detector response for the spatial resolution, a capillary tube was filled with FDG and scanned at varying distances from the iso-center (5, 10, 15, 20 cm). To measure image quality for contrast recovery, the NEMA IEC body phantom (Data Spectrum Corporation, Hillsborough, NC) with diameters of 1, 13, 17 and 22 for simulating hot and 28 and 37 mm for simulating cold lesions. A solution of 5.4 kBq/mL of $^{18}F$-FDG in water was used as a radioactive background obtaining a lesion of background ratio of 4.0. Images were reconstructed with VUE point HD and VUE point HD using SharpIR reconstruction algorithm. For the clinical evaluation, a whole body FDG scan acquired and to demonstrate contrast recovery, ROIs were drawn on a metabolic hot spot and also on a uniform region of the liver. Images were reconstructed with function of varying iteration number (1~10). Results: The result of increases axial distance from iso-center, full width at half maximum (FWHM) is also increasing in VUE point HD reconstruction image. Even showed an increasing distances constant FWHM. VUE point HD with SharpIR than VUE point HD showed improves contrast recovery in phantom and clinical study. Conclusion: By incorporating more information about the detector system response, the SharpIR algorithm improves the accuracy of underlying model used in VUE point HD. SharpIR algorithm improve spatial resolution for a line source in air, and improves contrast recovery at equivalent noise levels in phantoms and clinical studies. Therefore, SharpIR algorithm can be applied as through a longitudinal study will be useful in clinical.

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Maternal and Neonatal Outcome of Twin Pregnancies after in vitro Fertilization and Embryo Transfer (체외수정시술로 출생한 쌍생아의 임상적 경과에 대한 비교 분석)

  • Kim, Kyung-Ah;Min, Uoo-Gyung;Lim, Jae-Woo;Jun, Nu-Lee;Won, Hye-Sung;Kim, Chung-Hoon;Kim, Ellen Ai-Rhan;Lee, Pil-Ryang;Lee, In-Sik;Kim, Ki-Soo;Kim, Ahm;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.224-229
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    • 2003
  • Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

A Study on the Nurse's Response for the Clinical Application of Nursing Diagnosis (간호진단 임상적용을 위한 교육프로그램의 효과 및 간호사의 반응조사 연구)

  • Chun, C.Y.;Lim, Y.S.;Kim, Y.S.;Park, J.W.;Cho, K.S.
    • The Korean Nurse
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    • v.29 no.1
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    • pp.59-71
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    • 1990
  • Although the usefulness and importance of clinical application of nursing diagnosis are well recognized by the academic circle, it is not yet generally practiced. In order to provide data for establishing a policy for clinical nursing diagnosis; a study was made at a seminar, sponsored by the Department of nursing, Severance Hospital, with participation of 190 nurses from 33 hospitals. The objective of the study was to find out; 1) if the nurses agree with the academic community in recognizing the benefits and problems of clinical application of nursing diagnosis; 2) how the nurses evaluate their ability to carry out nursing diagnosis; and 3) if educational programs would help enhance ability of nursing diagnosis among nurses. The summary of findings by the study is as follows; 1. While all nurses responded positively on the question of benefits improving science and quality of nursing, thus elevating credibility and position of nurses, some expressed concern on the practicality of the system in setting up nursing objectiveness, confirming the nursing problems and utilizing patient information. For the 20 questions and the scale of 1~5, the lowest average score was 3.223 and the highest 4.066. 2. The study attempted to find out the opinion of the nurses on the problems that 'would make difficult to adopt the nursing diagnosis in clinics. The result of the study indicates the nurses believe the major problems are the fact that the subject of nursing diagnosis are not well defined and that the form sheets do not match with the ones that are currently being used. However, comparing it with the result of the previous study on the same question (inadequate manpower and insufficienf time allocated for the job were two major problems pointed out then.), it can be said that the opinion of the nurses studied this time was much more positive and it suggests that they believe the system can be adopted without increasing manpower and only by giving additional training and by adjusting the format of nursing record sheets. It suggests that the future for adopting a clinical nursing diagnosis is very bright. 3. As the most urgent problem to be solved for adopting clinical nursing diagnosis, 38. 5% responded that it was "education of nurses, "and 34.2% responded that it was "staffing adequate number of nurses". 4. For the 10 questions asked for self-evaluation of ability to adopt the system, with the scale of 1~5, average score was lower than 3. This indicate that they evaluate their ability to adopt the system is low. 5. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine if such program would cause changes in the response to the effect of clinical application of nursing diagnosis, and it was found that there was statistically significant changes suggesting that the education contributed to positive change in the response. 6. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine how the proble~ ms for adopting nursing system would be effected by such educational programs, and it was found that those problems be not soived with a short course of training. 7. The results of study taken before and after the educational programs for clinical nursing diagnosis were compared with overall score in order to determine if such programs would bring changes in the self-evaluation of nurses on the ability of nursing diagno sis, and it was found that program improve score of self-evaluation their ability of the nursing diagnosis. As seen in the above reports, it was found that the nu'rses are very positive about the clinical nursing diagnosis, that educational program for the clinical nursing diagnosis helps nurses for positively changing their attitude for ,the nursing diagnosis, for their self-confidence on their ability to perform nursing diagnosis. With improved know-how and self"confictence of nurses gained through educational and .training programs, the future of clinical application of nursing diagnosis is very bright.diagnosis is very bright.

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The Contribution of Innovation Activity to the Output Growth of Emerging Economies: The Case of Kazakhstan

  • Smagulova, Sholpan;Mukasheva, Saltanat
    • Journal of Distribution Science
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    • v.10 no.7
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    • pp.33-41
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    • 2012
  • The purpose of this study is to analyse the state of the energy industry and to determine the efficiency of its functioning on the basis of energy conservation principle and application of innovative technologies aimed at improving the ecological modernisation of agricultural sectors of Kazakhstan. The research methodology is based on an integrated approach of financial and economic evaluation of the effectiveness of the investment project, based on calculation of elasticity, total costs and profitability, as well as on comparative, graphical and system analysis. The current stage is characterised by widely spread restructuring processes of electric power industry in many countries through introduction of new technical installations of energy facilities and increased government regulation in order to enhance the competitive advantage of electricity market. Electric power industry features a considerable value of creating areas. For example, by providing scientific and technical progress, it crucially affects not only the development but also the territorial organisation of productive forces, first of all the industry. In modern life, more than 90% of electricity and heat is obtained by Kazakhstan's economy by consuming non-renewable energy resources: different types of coal, oil shale, oil, natural gas and peat. Therefore, it is significant to ensure energy security, as the country faces a rapid fall back to mono-gas structure of fuel and energy balance. However, energy resources in Kazakhstan are spread very unevenly. Its main supplies are concentrated in northern and central parts of the republic, and the majority of consumers of electrical power live in the southern and western areas of the country. However, energy plays an important role in the economy of industrial production and to a large extent determines the level of competitive advantage, which is a promising condition for implementation of energy-saving and environmentally friendly technologies. In these circumstances, issues of modernisation and reforms of this sector in Kazakhstan gain more and more importance, which can be seen in the example of economically sustainable solutions of a large local monopoly company, significant savings in capital investment and efficiency of implementation of an investment project. A major disadvantage of development of electricity distribution companies is the prevalence of very high moral and physical amortisation of equipment, reaching almost 70-80%, which significantly increases the operating costs. For example, while an investment of 12 billion tenge was planned in 2009 in this branch, in 2012 it is planned to invest more than 17 billion. Obviously, despite the absolute increase, the rate of investment is still quite low, as the total demand in this area is at least more than 250 billion tenge. In addition, industrial infrastructure, including the objects of Kazakhstan electric power industry, have a tangible adverse impact on the environment. Thus, since there is a large number of various power projects that are sources of electromagnetic radiation, the environment is deteriorated. Hence, there is a need to optimise the efficiency of the organisation and management of production activities of energy companies, to create and implement new technologies, to ensure safe production and provide solutions to various environmental aspects. These are key strategic factors to ensure success of the modern energy sector of Kazakhstan. The contribution of authors in developing the scope of this subject is explained by the fact that there was not enough research in the energy sector, especially in the view of ecological modernisation. This work differs from similar works in Kazakhstan in the way that the proposed method of investment project calculation takes into account the time factor, which compares the current and future value of profit from the implementation of innovative equipment that helps to bring it to actual practise. The feasibility of writing this article lies in the need of forming a public policy in the industrial sector, including optimising the structure of energy disbursing rate, which complies with the terms of future modernised development of the domestic energy sector.

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A Study of Nursing Manpower Requirements based on the Nursing Times spent in Operating Room of an University Hospital (수술실 간호인력의 수요측정 및 간호제공량분석 - 수술대기시간과 수술시간을 중심으로 -)

  • YooN Ke Sook
    • Journal of Korean Public Health Nursing
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    • v.1 no.1
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    • pp.45-61
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    • 1987
  • This Study was an attempt to estimate the optimum numbers of Operating Room Nursing Manpower by measuring the amount of service hours required by the patients in Operating Room in relation to the service amount actually provided by the nurses. The major concern of this study was placed on the measurement of Nursing Service Requirements by using the Operating Room (O. R) Patient Acuity System recently developed by M. M. Hart to classify the O. R. patients into four groups according to the degree of the complexity of operative procedure and some other elements which increase nursing activities in respect of patient care; Acuity IV group is the one requires nursing services most, on the other hand Acuity I requires least. nu sing The objectives of this study were as follows; 1. To analyze functions of the nursing personnel in O. R. by time unit and to estimate the average time a nurse can activate for productive functions. 2. To measure the actual amount of nursing times provided by nurses to the surgical patients. 3. To develop a patient classification system in order to measure the amount of Nursing services required by the patients. 4. To calculate an appropriate number of nursing manpower to meet the needs of the patients. In order to conduct the research both selected nurses and patients in 'S' University Hospital were Studied by utilizing the O. R. Patient Acuity System as well as the Classification Chart developed by Association of Operating Room Nurses (A. O. R. N) as a means of classifying functions of O. R. nurses. That is; Functions of the 10 selected O. R. nurses observed during the period of June 30 to July 4, 1986, whereas the amount of nursing services required by or provided to the 974 patients who had received surgeries during the period of June 9 to July 4, 1986. The results of this study were as follows; 1) The actual working hours per a nurse averaged 6.7 hours a day. 2) Each nurse's daily routine schedule consists of $71.4\%$ for Technical Functions, $16.1\%$ for Nonprodective Functions, $6.6\%$ for Assessment and Evaluation, $3.9\%$ for Overseeing and Supervision and the rest $2.0\%$ for Patient Preparation respectively. 3) Preoperative waiting time per a patient was 24.1 minutes on the average; for the first case was 10.7 minutes, whereas for the following cases was 32.0 minutes. 4) Total Operation time for the 974 patients during the period of observation for this study amounted to 2759.6 hours, weekly hour was equivalent to 689.9 hours, Whereas daily operation time averaged 130 hours. Meanwhile the average operation time per patient was 2.8 hours ; for the case of Acuity IV was 5.6 hours, 5. 1 hours for the case of Acuity III, 2.3 hours for Acuity II and 1.1 hours for Acuity I. 5) According to the O. R. Patient Acuity System, $64.5\%$ of the whole patients belonged to Acuity II, $23.7\%$ to Acuity III, 11. $3\%$ to Acuity IV and $0.7\%$ to Acuity I respectively. 6) Required amount of nursing times based on the preoperative waiting time and operation time was 7167.8 person hours, which showed that $5.5\%$ of them needed for preoperative nursing care, whereas the rest $94.5\%$ for intraoperative nursing care. In terms of the O. R. Patient Acuity System, $49.7\%$ of total nursing service requirements was needed for Acuity II patients, $27.4\%$ for Acuity III patients, $17.2\%$ for Acuity IV patients and $0.2\%$ for Acuity I patients. 7) The rate of the nursing services provided against the required nursing times was about $81.4\%$ on the average; some departments, like those of Plastic Surgery, Otolaryngology and Ophthalmology whose patients mostly belonged to Acuity II recorded hegher provision rate than average, whereas other departments of Thoracic Surgery. Neurosurgery and Orthopedic Surgery whose patients belonged to Acuity III and Acuity IV as well as Acuity II recorded lower provision rate than average. 8) Subsequently, required numbers of nursing manpower was 10.7 nurses additionally. Based on the above findings the following recommendations will be made; 1) this study recommends, develops. and adopts an accurate and realistic O. R. Patient Acuity System which can help measure the nursing service requirements objectively to elicit the rationales of allocation of nursing personnels. 2) this study proposes storongly place nurses who take the role of preoperative nursing care exclusively for the waiting patients in O. R. and shortening their waiting time by close communication between the designated O. R. and the ward.

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Evaluation of Artifacts by Dental Metal Prostheses and Implants on PET/CT Images: Phantom and Clinical Studies (PET/CT 영상에서의 치과재료에 의한 인공물에 관한 연구)

  • Bahn, Young-Kag;Park, Hoon-Hee;NamKoong, Hyuk;Cho, Suk-Won;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.110-116
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    • 2010
  • Purpose: The X-ray attenuation coefficient based on CT images is used for attenuation correction in PET/CT. The polychromatic X-ray beam can introduce beam-hardening artifact on CT images. The aims of the study were to evaluate the effect of dental metal prostheses in phantom and patients on apparent tracer activity measured with PET/CT when using CT attenuation correction. Materials and Methods: 40 normal patients (mean age $54{\pm}12$) was scanned between Jan and Feb 2010. NEMA(National Electrical Manufactures Association) PET $Phantom^{TM}$ (NU2-1994) was filled with $^{18}F$-FDG injected into the water that insert implant and metal prostheses dental cast. Region of interest were drawn in non-artifact region, bright steak artifact region and dark streak artifact region on the same transaxial CT and PET slices. Patients and phantom with dental metal prostheses and dental implant were evaluated the change rate of CT Number and $SUV_{mean}$ in PET/CT. A paired t-test was performed to compare the ratio and the difference of the calculated values. Results: In patients with dental metal prostheses, $SUV_{mean}$ was reduced 19.64% (p<0.05) in the non-steak artifact region than the brightstreak artifact region whereas was increased 90.1% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In phantom with dental metal prostheses, $SUV_{mean}$ was reduced 18.1% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 18.0% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In patients with dental implant, $SUV_{mean}$ was increased 19.1% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 96.62% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In phantom with dental implant, $SUV_{mean}$ was increased 14.4% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 7.0% (p>0.05) in the non-steak artifact region than the dark streak artifact region. Conclusion: When CT is used for attenuation correction in patients with dental metal prostheses, 19.1% reduced $SUV_{mean}$ is anticipated in the dark streak artifact region on CT images. The dark streak artifacts of CT by dental metal prostheses may cause false negative finding in PET/CT. We recommend that the non-attenuation corrected PET images also be evaluated for clinical use.

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