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Reliability of a Questionnaire for Women's Reproductive History (여성의 출산력과 초경 및 폐경 연령에 대한 설문지의 신뢰도)

  • Ko, Kwang-Pil;Park, Sue-Kyung;Kim, Yeon-Ju;Bae, Ji-Suk;Jun, Jae-Kwan;Gwack, Jin;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.3
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    • pp.181-185
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    • 2008
  • Objectives : This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. Materials and Methods: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. Results : The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. Conclusions : The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.

Effects of the Nuegra from Male Silkworm Extract on Enhancement of the Masculine Function and Activation of Overall Physical Function

  • Kim, D. C.;Kim, Y. W.;Park, M. S.;J. K. Suh;Lee, D. S.;Lee, S. H.;B. H. Chun;Y. K. Jun
    • International Journal of Industrial Entomology and Biomaterials
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    • v.5 no.1
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    • pp.109-122
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    • 2002
  • The purpose of this investigation is to evaluate the effects of the Nuegra on enhancement of the masculine and physical activities in general through measuring changes of the testosterone, FSH and subjective symptoms like fatigue, insomnia, urinary stream, muscular weakness, libido and erectile dysfunction. Total 168 male subjects were enrolled from 12 urology, internal medicine clinics and general practitioner, During the 6-week investigational period, 2 capsules of Nuegra were given to the subjects right after meal for 4 weeks, and 1 capsule of Nuegra was added each time in subjects with no or minimal effect. Testoster-one and FSH levels were measured at first visit and last visit, for evaluating masculine activities. To avoid bias and standardize the test results, only one clinic was assigned as a central lab, and all blood samples were transferred. General information and subjective symptoms were evaluated at first visit and at 2 weeks interval, week 2, 4 and 6 using VAS (Visual Analogue Scale). The mean age of the subjects were 51.8${\pm}$8.2 years old (range: 36.1-82.1). Based on the subjects who were tested on testosterone and FSH levels at day l and week 6, the means were 4.4${\pm}$1.4 nmol/L (range: 2.6-7.7), 8.6${\pm}$9.6 mIU/mL (range: 0.3-40.4), respectively at day 1. At week 6, the results were 4.9 ${\pm}$1.6 (2.6-8.9 range), 9.4${\pm}$13.1 (1.0-53.9 range), respectively. Marginally significant difference between pre-dose and post-dose was present. Statistically significant differences were revealed in general assessment for subjective symptoms, fatigue, insomnia, erectile dysfunction, etc. In fatigue, response rates were 39.6, 65.4 and 76.4% at week 2, 4 and 6, respectively (P < 0.0001). Response vates for erectile dysfunction were 13.4, 41.2 and 72.7% at week 2, 4, and 6 (P < 0.0001), respectively, Response rates for libido were 13.6, 51.6 and 73.5% at week 2, 4, and 6 (P < 0.0001), respectively. For urinary stream response rates were 26.9, 44.7 and 66.8% at week 2, 4, and 6 (P < 0.0001), respectively. VAS for muscular weakness did not show significant results that response rates were 40, 60 and 80% at week 2, 4, and 6 from 8.2 (P = 0.24), respectively. Response rates for insomnia were 50, 60, 100% at week 2, 4, and 6 (P < 0.0001), respectively. The results shows that Nuegra tends to enhance masculine activities including libido, erectile dysfunction and urinary stream and also effective for improving general conditions especially insomnia, muscular weakness and fatigue. In conclusion, this investigation has demonstrated that Nuegra does not only have tendency to increase masculine activities through increased secretion of the testosterone and FSH but also improve general conditions such as erectile dysfunction, libido, fatigue and muscular power.

The Effect of Six Sigma Activity in Major Trauma Patients on the Time Spent in the Emergency Department (Six Sigma 활동을 통한 중증외상환자의 응급실 체류시간 개선 활동)

  • Kim, Hyun-Soo;Kim, Ok-Jun;Choi, Sung-Wook;Kim, Eui-Chung;Park, Young-Tae;Ko, Tae-I;Cho, Yun-Kyung
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.119-127
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    • 2010
  • Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

The Incidence Rate of Anxiety Disorders in the Korean Military (한국 군 장병에서의 불안장애의 발생률)

  • Lee, Seung-Yup;Yoon, Chang-Gyo;Min, Jung-Ah;Lee, Chang-Uk;Park, Dong-Un;Ahn, Jong-Seong;Lee, Sang Don;Baik, Myung Jae;Jang, Jun Young;Yang, Juyoun;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.10 no.1
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    • pp.59-67
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    • 2014
  • Objective : To obtain the incidence rate of anxiety disorders among the active duty Korean military personnel, who visited the military hospitals from 2011 to 2013, this descriptive epidemiological study was performed. Methods : After acquiring the data for the anxiety disorders from Defense Medical Statistics Information System, the annual incidence rates were analyzed by forces, position status, and specific disease entities. Results : One thousand, nine hundred and thirteen (1,913) active duty male military personnel were diagnosed with any kinds of anxiety disorders in their first visit to the psychiatric outpatient department (OPD). The total OPD visit counts were 7,870 during the same period. Anxiety disorder, NOS was the most frequent disorder, followed by panic disorder. While the incidence rate for anxiety disorder, NOS decreased, panic disorder displayed increasing tendency. Stress-related disorders and obsessive-compulsive disorder were positioned third and fourth, respectively, for the number of first visit and they both showed decreasing tendency in annual incidence rates. Social anxiety disorder, specific phobias, generalized anxiety disorder (GAD) and mixed anxiety-depressive disorder followed next. The annual incidence rates for anxiety disorders showed decreasing tendency, particularly evident in army soldiers. However, naval officers showed higher anxiety disorder incidence rate compared to those of the army and the air forces. Conclusion : Comparing to general population, panic disorder was higher while specific phobias and GAD were lower in the Korean military. It is interesting to observe higher incidence rate for anxiety disorder in naval officers and warrants further evaluation.

A Study on the Existence, Marketing Behavior and Function of Urban Weekly Markets in Taegu City (도시 요일장의 형성과 이용 및 기능에 관한 연구)

  • Lee, Jae-Ha;Park, So-Young
    • Journal of the Korean association of regional geographers
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    • v.2 no.2
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    • pp.113-131
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    • 1996
  • The purpose of this study is to identify the existence, personal characteristics and behavior of market-participants, and function of urban weekly markets in Taegu City through observation, interview and questionnaire survey. There are four weekly periodic markets such as Seongso(Monday), Chilgok(Wednesday), Siji(Thursday), and Chilgok(Friday) which have recently developed near the new apartment areas on the outskirts of Taegu. The major findings of this study can be summarized as follows: These markets originated from the agricultural cooperative's Friday markets, but were substantially established by mobile traders or merchants for the sake of their livelihood. Therefore, the existence of these markets is not explained by Stine's central place perspective but partially explained by Hay's economic locational and Bromley's socio-cultural perspective. Most traders are male, aged 30 to 40 years and have an educational level higher than high school. Most of them are living in Taegu and itinerantly visit more than two markets among the four markets by small truck. And most of them sell agricultural products and other food materials, except some who sell manufactured goods. Most consumers are housewives, aged 20 to 30 years and have an educational level higher than high school. Most of them are living within 1,000m and go there on foot. Most of them visit the markets around 3 to 5 p.m. on every market day. And they mostly buy vegetables, fruits, and fishes. Weekly markets provide employment opportunities for those who want to be merchants, and also contribute to the increase of farmers' income, because some traders(18.8%) are farmers who periodically visit markets to sell agricultural products. On the other hand, they function as a general food materials markets to neighboring residents. From these facts, both traders and consumers want weekly markets sustained. Therefore, these markets need to be protected by institutional assistance in spite of being informal markets.

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A Survey on Acute Traffic Injury Patient's Perception on Korean Herbal Medicine (급성기 교통사고 상해 환자의 한약 복용에 관한 인식 조사)

  • Kim, Soo-yeon;Oh, Seung-ju;Hwang, Kyu-hyun;Jin, Eun-seok;Yeom, Sun-Kyu;Kim, Dong-woo;Kim, Seok-woo;Jin, So-ri;Park, Mu-Jin;Kim, Eun-song;Lee, Hyun-seok
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.165-178
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    • 2020
  • Objectives This survey study is designed to check the awareness and satisfaction of Korean herbal medicine in patients suffering from acute traffic accidents. Methods From May 1 to 20, 2020, patients who visited the hospital within 7 days after the accident and received prescription of Korean herbal medicine for the first-time symptoms were selected. Survey was conducted 10 days after the first visit to confirm the perception of Korean herbal medicine and expected to be used as a prior study to improve the quality of Korean medicine led by Korean herbal medicine. Results Most patients answered that they were aware of the prescribed Korean herbal medicine's dosage and treatment effects. 65% of the patients said they would like to receive other forms of prescription if possible. Most patients answered that portability is convenient and tastes better than normal. 48% of the respondents said that it was the first to time to take Korean herbal medicine, and 68% said that they were willing to take the Korean herbal medicine later. At the time of the first visit, the health condition assessed using EuroQol visual analogue scale (EQ-VAS) was 46.84, but 10 days after the treatment began, it increased significantly to 61.93. Conclusions The improvement of symptoms and high satisfaction with Korean medicine medical services contributed to the patient's willingness to visit the Korean medicine hospital again and to respond that they were willing to take further medication. EQ-VAS elevation suggests that overall patients' subjective health conditions have improved since treatment.

Changing Patterns of Ambulatory Care Utilization of a Rural Community in a Regional Medical Insurance Scheme (지역의료보험 가입자의 외래 의료이용 변화)

  • Yu, Seung-Hum;Cho, Woo-Hyun;Sohn, Myong-Sei;Park, Chong-Yon
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.419-430
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    • 1988
  • This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 : secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug store visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 : and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables. For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.

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Comparing Inhaler Use Technique Based on Inhaler Type in Elderly Patients with Respiratory Disease

  • Lee, Ha Youn;Song, Jin Hwa;Won, Ha-Kyeong;Park, Yeonkyung;Chung, Keun Bum;Lim, Hyo-Jeong;Ahn, Young Mee;Lee, Byoung Jun
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.1
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    • pp.46-54
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    • 2021
  • Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

Factors Associated with the Use of Medical Care at Hospitals among Outpatients with Hypertension: A Study of the Korea Health Panel Study Dataset (2010-2016) (우리나라 고혈압 환자의 병원급 의료기관 외래이용 관련 요인: 한국의료패널자료(2010-2016)를 이용하여)

  • Lee, Sumi;Park, Sohee;Kimm, Heejin;Lee, Yongjae;Chung, Woojin
    • Health Policy and Management
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    • v.30 no.4
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    • pp.479-492
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    • 2020
  • Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

Clinical Characteristics of Failure to Thrive in Infant and Toddler: Organic vs. Nonorganic

  • Yoo, Suk Dong;Hwang, Eun-Ha;Lee, Yeoun Joo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.4
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    • pp.261-268
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    • 2013
  • Purpose: To investigate the clinical characteristics and outcomes among infants and toddlers with failure to thrive (FTT). Methods: This retrospective study was done with 123 patients who had visited Pusan National University Children's Hospital during their first two years of life and had received an FTT diagnosis. We compared the clinical characteristics of the patients based on the causes of their FTT and their ages at the time of first hospital visit. We investigated triggering factors, feeding practices, and outcomes in 25 patients with nonorganic FTT (NOFTT). Results: Eighty cases (65.0%) were NOFTT. The gestational ages, birth weights, and weights at the first visits were significantly lower in patients with organic FTT (OFTT) (p<0.05). Infants who had first visited the clinic at age <6 months had the least z-score. The percentage of patients with severe weight decline was higher in OFTT than in NOFTT (60.0% vs. 17.3%). The z-scores at the follow-up visits were improved after treatment in both of the groups. Preceding infection was the most common triggering factor of NOFTT and persecutory feeding as abnormal behavior of caregiver was observed in 22 cases (88.0%). After treatment with feeding method modification, all patients with NOFTT showed normal growth. Conclusion: Weight decline is more severe in OFTT patients and in younger patients at the first visit. Infants with FTT can attain normal weight gain growth by treating organic diseases and supplying proper nutrition in OFTT, and by correcting abnormal dietary behavior of caregiver in NOFTT.