• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.84-95
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• 2012

Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.87-104
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• 2004

This study selected the fifth and sixth graders of elementary school in Jeollanamdo who can express their opinions of safety consciousness and understand the items of questionnaire as the population. It selected 10 elementary schools under the supervision of Jeonnam Board of Education and sampled 700 students randomly from 2-3 classes in the 5th and the 6th grade. One preliminary survey was conducted to revise and complement the contents and forms of questionnaire with 70 students of a school from Apr. 1 to 6, 2004 and this study was conducted from Apr. 10 to 30, 2004. Data of this study were collected by explaining the purport of study to subjects after obtaining approval of principal and teacher of the school and distributing questionnaires. Total 700 questionnaires were distributed and 681 were collected (97%) and 602 were used for final analysis except 79 lacking responses. The results of this study are as follows. According to demographical characteristics of subjects, 'male' students were 302(50.%) and 'female' students were 300(49.8%) by sex and 'the 5th graders' were 285(47.3%) and 'the 6th graders' were 317(52.7%) in grade distribution. Residents at 'apartment house' were 406(67.4%) in residence type, 'going to school by foot' was 477 students(79.2%), 'high school graduates' were 297(49.3%) in fathers' education, 'high school graduates' were 366 (60.8%) in mothers' education, 'professional and office workers' were 231(38.4%) in fathers' job, 'full-time workers' were 283(47.0%) in mothers' job, and the number of siblings was one except myself in 343 students(57.0%). Respondents on the level of class showing 'good' were 340(56.5%) and those on the degree of adaptation to school life showing 'active' were 349(58.0%). On the characteristics related to safety education, 360(59.8%) responded it was 'very necessary', on the frequency of safety education at school for last one year, 339(56.3%) responded they had 'once or twice', on the frequency of safety education by parents, 279(46.3%) responded they 'often' had it, on the level of safety practice by parents, 347(57.6%) responded they practiced it 'frequently', on the source of knowledge of safety, 223(37.0%) responded they got it from 'parents, siblings and relatives', on the degree of recognizing the need of safety education textbooks, 295(38.5%) responded 'it was needed', on the recognition of necessity of teacher for safety education, 271(45.0%) answered it was very necessary', and on the recognition of qualification of teacher for safety education, 370(61.5%) answered it was 'paramedic'. The mean score of safety consciousness of subjects was 2.72 (SD. 21) of full score 3, having high score over mean score. According to each area, the area showing the highest safety consciousness was safety of fire(2.83), followed by home safety(2.76) and first-aid treatment(2.76), traffic safety(2.71), play and leisure safety(2.66) and school safety(2.56). Items showing statistical differences in the degree of safety consciousness according to demographical characteristics were sex(t=-3.11, p=.002), education(t=2.33, p=.021) and number of siblings(F=3.729, p=.011). In the difference of safety consciousness between both sexes, 'female' students(2.75) showed higher safety consciousness than 'male' students (2.69), and the former also showed higher safety consciousness than the latter in all six areas of school safety, play and leisure safety, traffic safety, fire safety, home safety and first-aid treatment, and there were statistical differences in the areas of play and leisure safety, traffic safety, fire safety and first-aid treatment. According to the differences of safety consciousness by grade, 'the fifth graders'(2.74) showed higher safety consciousness than 'the sixth graders'(2.70) and the former also showed higher safety consciousness than the latter in all six areas of school safety, play and leisure safety, traffic safety, fire safety, home safety and first-aid treatment, and there were statistical differences in the areas of fire safety and home safety. In the safety consciousness by the number of siblings, 'single son or daughter' (2.78) was highest and their safety consciousness was also highest in all six areas of school safety, play and leisure safety, traffic safety, fire safety, home safety and first-aid treatment, and there were statistical differences in the areas of school safety, fire safety and home safety, There were statistically remarkable differences in degree of adaptation to school life (F=15.349, p=.000) and perceived schooling level(F=9.552, p=.000). According to the degree of safety consciousness related to characteristics of safety education, there were statistical differences at the degree of recognizing the need of safety education(F=9.797, p=.000), degree of safety education at school(F=2.595, p=.006), degree of safety education by parents(F=12.709, p=.000), degree of practicing safety by parents(F=17.579, p=.000), source of knowledge of safety education (F=2,715, p=.044), necessity of safety education textbooks(F=3.972, p=.008), need of safety teacher(F=4.137, p=.006) and qualification standard of safety teacher(F=3.016, p=.029).

• Journal of the Korean Geographical Society
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• v.43 no.4
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• pp.620-637
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• 2008

$Che{\breve{o}}n$ (提堰) refers to the irrigation facilities used to provide water to the land on which rice is farmed. As the maintenance of $Che{\breve{o}}n$ required great amounts of capital, labor, and technology, the construction and maintenance of such facilities was controlled by the government. $Che{\breve{o}}n$ was perceived as being of particular importance during the $Che{\breve{o}}n$ era, which adopted agriculture as the basis of state management. Therefore, the management of $Che{\breve{o}}n$ was considered to be one of the main state policies. This is why $Che{\breve{o}}n$-related records can often be found in the historical documents written during the $Che{\breve{o}}n$ era. As such historical documents in the form of Jiriji (地理誌, geographical descriptions) include detailed descriptions of the number, size, and location of $Che{\breve{o}}n$ in individual counties($kunby{\breve{o}}n$), these help to conduct comprehensive analysis of the state of $Che{\breve{o}}n$ during the $Che{\breve{o}}n$ era. Based on these facts, this study attempts to establish a database of the $Che{\breve{o}}n$-related contents included in the <$Y{\breve{o}}jitos{\breve{o}}$(與地圖書)> published during the latter period of $Che{\breve{o}}n$, and using the established database, to identify the regional characteristics of $Che{\breve{o}}n$. More precisely, by analyzing the state of the distribution of $Che{\breve{o}}n$ at the national level, an effort was made to review the regional characteristics of $Che{\breve{o}}n$ in terms of their distribution and of the natural geographical conditions found in the locales where $Che{\breve{o}}n$ were located, as well as of the interrelation between such $Che{\breve{o}}n$ and socioeconomic factors such as the scale of the population and the size of the area under cultivation. Other factors which were delved into included matters related to the size of $Che{\breve{o}}n$ such as their perimeter, length, and scale of the area which they irrigated, the characteristics of the locales where $Che{\breve{o}}n$ were located, and the regional differences in the characteristics of $Che{\breve{o}}n$.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.2951-2957
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• 2014

Background: Gastric carcinogenesis is a complicated process that involves environmental and genetic factors like interleukin-4 (IL-4) and IL-8. Single nucleotide polymorphisms in their genes are associated with changed levels of gene expression. Here, we investigated the association between IL4-590 C>T and IL8-251T>A and gastric cancer (GC) risk in Sichuan of Southwestern China. Materials and Methods: We surveyed the research subjects using a self-designed questionnaire with questions on demographic factors and putative risk factors. Approximately 2-5ml of whole blood was collected after field survey to analyze IL4-590 C>T and IL8-251T>A genotypes using MALDI-TOF MS. Results: Our study recruited 308 pairs of GC patients and controls, including 224 (72.7%) men and 84 (27.3%) women in each group. There were 99 cardia and 176 noncardia GC patients in the case group. The case and control groups had an average age of $57.7{\pm}10.6$ ($mean{\pm}SD$) and $57.6{\pm}11.1$ years. GC patients reported a significantly greater proportion of family history of cancer (29.9% vs 10.7%, p<0.01) and drinking (54.6% vs 43.2%, p<0.01) than did controls. Variant genotypes of IL-4-590 C>T and IL-8-251 T>A were not associated with overall GC risk (adjusted OR, 0.89; 95%CI, 0.61-1.28 for CT or CC vs TT; adjusted OR, 1.14; 95%CI, 0.86-1.79 for TA or AA vs TT). Stratification analysis of two SNPs for risk by subsites only found that variant IL-8-251 TA or AA genotype was associated with increased noncardia GC risk (adjusted OR, 2.58; 95%CI, 1.19-5.57). We did not observe interactions between the IL-8-251 T>A genotype and smoking (adjusted OR, 0.38; 95%CI, 0.08-1.79) or drinking (adjusted OR, 0.36; 95%CI, 0.08-1.65) for risk of noncardia GC. Conclusions: Our data indicate no association between the two SNPs of IL-4-590 and IL-8-251 with overall GC risk, while the IL-8-251 TA or AA genotype conferred risk of cardia GC. Our findings contribute to the evidence body for risk of SNPs associated with the development of gastric cancer in this region.

• Journal of Nutrition and Health
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• v.42 no.2
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• pp.119-127
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• 2009

Malnutrition of hospitalized patients can adversely affect clinical outcomes and cost. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those possess practical pitfalls of requiring much time and labor to administer and may not be highly applicable to a Korean population. This study sought to develop and evaluate a Nutrition Risk Screening Tool (NRST) which is simple and quick to administer and widely applicable to Korean hospitalized patients with various diseases. The study was also designed to generate a screening tool predictable of various clinical outcomes and to validate it against the Nutritional Risk Screening 2002 (NRS 2002). Electronic medical records of 424 patients hospitalized at a general hospital in Seoul during a 14-month period were abstracted for anthropometric, medical, biochemical, and clinical outcome variables. The study employed a 4-step process consisting of selecting NRST components, searching a scoring scheme, validating against a reference tool, and confirming clinical outcome predictability. NRST components were selected by stepwise multiple regression analysis of each clinical outcome (i.e., hospitalization period, complication, disease progress, and death) on several readily available patient characteristics. Age and serum levels of albumin, hematocrit (Hct), and total lymphocyte count (TLC) remained in the last model for any of 4 dependent variables were decided as NRST components. Odds ratios of malnutrition risk based on NRS 2002 according to levels of the selected components were utilized to frame a scoring scheme of NRST. A NRST score higher than 3.5 was set as a cut-off score for malnutrition risk based on sensitivity and specificity levels against NRS 2002. Lastly differences in clinical outcomes by patients' NRST results were examined. The results showed that the NRST can significantly predict the in-hospital clinical outcomes. It is concluded that the NRST can be useful to simply and quickly screen patients at high-nutritional risk in relation to prospective clinical outcomes.

• Journal of Nutrition and Health
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• v.47 no.4
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• pp.268-276
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• 2014

Purpose: The aim of this study is to estimate total sugar intake and identify major food sources of total sugar intake in the diet of the Korean population. Methods: Dietary intake data of 33,745 subjects aged one year and over from the KNHANES 2008-2011 were used in the analysis. Information on dietary intake was obtained by one day 24-hour recall method in KNHANES. A database for total sugar content of foods reported in the KNHANES was established using Release 25 of the U.S. Department of Agriculture National Nutrient Database for Standard Reference, a total sugar database from the Ministry of Food and Drug Safety, and information from nutrition labeling of processed foods. With this database, total sugar intake of each subject was estimated from dietary intake data using SAS. Results: Mean total sugar intake of Koreans was 61.4 g/person/day, corresponding to 12.8% of total daily energy intake. More than half of this amount (35.0 g/day, 7.1% of daily energy intake) was from processed foods. The top five processed food sources of total sugar intake for Koreans were granulated sugar, carbonated beverages, coffee, breads, and fruit and vegetable drinks. Compared to other age groups, total sugar intake of adolescents and young adults was much higher (12 to 18 yrs, 69.6 g/day and 19 to 29 yrs, 68.4 g/day) with higher beverage intake that beverage-driven sugar amounted up to 25% of total sugar intake. Conclusion: This study revealed that more elaborated and customized measures are needed for control of sugar intake of different subpopulation groups, even though current total sugar intake of Koreans was within the range (10-20% of daily energy intake) recommended by Dietary Reference Intakes for Koreans. In addition, development of a more reliable database on total sugar and added sugar content of foods commonly consumed by Koreans is warranted.

• Journal of Nutrition and Health
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• v.47 no.4
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• pp.258-267
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• 2014

Purpose: The current study was designed to investigate the relationship of dietary calcium and riboflavin and their main dietary source (milk and dairy products) with the risk of periodontitis using data from 2007 to 2010 Korea National Health and Nutrition Examination Surveys. Methods: A total of 1,690 adults aged ${\geq}40$ years were included. We used results of dental examination regarding all sextant information on probing depth of at least two index teeth, nutritional assessment by a single 24-hour dietary recall, and demographic and medical information. The periodontitis group was defined as those who had 3-4 points, and the normal group was defined as those who had 0 points of Community Periodontal Index at all locations of six examination sites using a probe. Results: Using multiple logistic regression analysis, after adjustment for age, body mass index, energy intake, income, smoking, and alcohol drinking, we found an inverse relationship between consumption of dairy products and risk for periodontitis (OR: 0.465, 95% CI: 0.224-0.964) and between dietary riboflavin intake more than the estimated average requirements and risk for periodontitis (OR: 0.535, 95% CI: 0.300-0.954) in males. Conclusion: Adequate intake of milk dairy products and riboflavin may be recommended for prevention of periodontitis in the Korean male population.

• Journal of Korean Society of Forest Science
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• v.87 no.3
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• pp.328-333
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• 1998

To obtain basic information for establishing a pest control strategy for insect pest management system, changes in the population densities of the black-tipped sawfly(Acantholyda posticalis posticalis Matsumura) and damage patterns in tree growth were investigated in national forests in Hoigok-ri, Kapyung-gun, Kyunggi-do, where the pest control measures were taken. The results obtained were as follows ; 1. The larval density in the soil of the forests where the insecticides were applied have been kept below economic threshold for about 7 years. The density was the highest in the middle of slopes and similar to the level of the early stage of the insect outbreak. 2. After the pest control by insecticides, reduction in tree height and diameter growth lasted for 2-3 years in trees defoliated by over 70%. 3. The diameter growth of the trees damaged by black-tipped sawfly recovered faster in upper stem than in the lower. 4. volume growth of the trees defoliated over 70% by the insect decreased for three to four years. The volume loss of trees defoliated by 70% and 90% was 19.6% and 54.0%, respectively. 5. Maintaining the rate of defoliation below 50%, which is the economic threshold, by chemical control measures had an effect of reducing the tree volume loss by $40m^2/ha$ as compared with a stand defoliated by 90%.

• Journal of Global Scholars of Marketing Science
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• v.18 no.4
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• pp.33-59
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• 2008

This paper aims to analyse the preference for German farm tourism among the German population. For this reason, we conducted an empirical study in Germany during summer 2007 and we applieda structural equation model based on partial leasts quares(PLS) to analyse the data. In the following chapters we will introduce the literature review and our conceptual frame work. We will then outline the procedures we adopted and the results of the empirical analysis. In the final part so me conclusions will be presented and a discussion will follow in order to draw the future directions of our research. According to our hypotheses, the possibility that agri-tourism enters in the evoked set of an individual is higher: H1: The higher the information degree about it. H2: The lower the influence of the social stimuli. H3: The higher the physical exposure to it (experience). H4: The higher the wellness image of agri-tourism. H5: The higher the traditional image of agri-tourism. H6: The higher the exciting image of agri-tourism. H7: The higher the perceived value for money. Our further hypotheses affirm that the possibility that agri-tourism enters in the evoked set of an individual is higher: H8: The lower the perceived risk. H9: The higher the motive to enjoy a holiday in the nature. H10: The higher the motive to enjoy a sport holiday. H11: The lower the motive to have an organized holiday. H12: The lower the motive to have a holiday abroad. H13: The lower the motive of action and night life. H14: The higher the motive to spend a holiday with the family. H15: The lower the motive to spend a city holiday. Finally, our model has some socio-demographics data. As we mentioned before, German agri-tourism has traditionally been the travel destination of large-size families, with low-to-middle income. For that reason, our final hypothesises are the following: the possibility that agri-tourism enters in the evoked-set of an individual is higher: H16: The higher the number of family members. H17: The lower the family income. Since in this study we use a path model with a PLS approach, we are able to state some interrelations among the exogenous latent variables: H18: The motive of sport holiday has a positive influence towards nature motives. H19: The physical exposition to agri-tourism has a positive influence toward information. H20: The motive of family holiday has a negative influence toward the motive of action and night life. H21: Social stimuli have a positive influence towards individuals risk perceptions. H22: Social stimuli have negative influence towards experience. Data for this study were gathered via administrated questionnaires during the summer 2007 within the frame of an academic "marketing research" course. The corresponding t-values are assessed using the bootstrapping method with 500 re-samples. In our model 61% of the degree of appreciation of German agri-tourism (evoked set) is explained by five independent variables: value for money ($0.335^{{\ast}{\ast}{\ast}}$) (H7) experience ($0.267^{{\ast}{\ast}}$) (H3), exciting image ($0.204^{\ast}$) (H6) organisation ($-0.162^{\ast}$) (H11) and holiday abroad ($-0.156^{\ast}$) (H12). The variance explained ($R^2$) for the other endogenous variables are the following: nature 24.3%, information 14.1%, action holiday 13.8%, risk perception 5.8% and experience 2.4%. An overview can be inferred from table 5. The results also allow us to test each of the proposed hypotheses. With exception of organization and abroad, none of the others travel style factors (H9 to H15) seem to have any significant impact towards evoked set which leads to the rejection of the respective hypotheses. As expected, social stimuli have a significant influence on individuals' risk perception (H21 accepted), however neither the former nor the latter have a valuable impact on evoked set (rejection of H2 and H8). Besides, since the influence of social stimuli towards experience is not significant, also H22 has to be rejected. Experience influences information (H19 accepted) but the latter does not affect significantly the evoked set (H1 rejected). Both H4 as well as H5, referring respectively to the perceived images of German agri-tourism as a wellness destination and the traditional image of the German farm tourism have to be rejected. Finally, none of the demographic data included in the model explains significantly the variance of the factor evoked set. Therefore neither H16 nor H17 has been accepted. As far as the interrelation between sport and nature (H18) and family and action (H20) are concerned, the stated relationship among these variables has been statistically confirmed. Our path model based on partial least squares shows the factors influencing the preference for farm tourism in Germany. Among others value for money and experience are the most significant ones. Practical implications are discussed.

• Journal of Nutrition and Health
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• v.48 no.6
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• pp.519-529
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• 2015

Purpose: The purpose of this study was to examine the prevalence of food insecurity in Korean elderly and to analyze the health status as well as food and nutrient intakes according to food insecurity status. Methods: A total of 939 elderly subjects (over 65 years old) were used in our analysis from the fifth 2010 Korean National Health and Nutrition Examination Survey (KNHANES V-1). The variables consisted of general characteristics, physical and mental health, nutrient intake, rate of deficient intake of energy and nutrients compared with Dietary Reference Intakes for Koreans (KDRIs) and food quality and diversity according to the status of food insecurity. Food insecurity status was measured using a self-reported food security questionnaire on the dietary situation in the previous year, and participants were classified according to three groups: food secure group, mildly food insecure group, and moderately/severely food insecure group. Results: The proportion of the food insecure group was approximately 67% and the food insecure group had lower income and educational status than the food secure group. Food insecurity was associated with worse physical and mental health status after adjusting potentially confounding variables. The results showed that food insecurity in Korean elderly significantly affected mental health (including stress cognition, depression experience, and suicide thoughts) which exceeded stages of physical health. In addition, food insecurity showed significant association with low nutrient intake and high rate of deficient intakes of energy and nutrients compared with KDRIs, and a reduction of dietary quality and diversity was indicated in the food insecure group. Conclusion: This study concludes that the prevalence of food insecurity may affect the physical and mental health as well as dietary intake of the elderly Korean population. Therefore, food insecurity should be considered as an important public health issue in Korea.