• Title/Summary/Keyword: Population health

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Accuracy of the 24-hour diet recall method to determine energy intake in elderly women compared with the doubly labeled water method (에너지 섭취 조사를 위한 24시간 회상법의 정확도 평가: 여자노인을 대상으로 이중표식수법을 이용하여)

  • Park, Kye-Wol;Go, Na-Young;Jeon, Ji-Hye;Ndahimana, Didace;Ishikawa-Takata, Kazuko;Park, Jonghoon;Kim, Eun-Kyung
    • Journal of Nutrition and Health
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    • v.53 no.5
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    • pp.476-487
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    • 2020
  • Purpose: This study evaluated the accuracy of the 24-hour diet recall method for estimating energy intakes in elderly women using the doubly labeled water (DLW) method. Methods: The subjects were 23 elderly women with a mean age of 70.3 ± 3.3 years and body mass index (BMI) of 23.9 ± 2.8 kg/㎡. The total energy expenditure (TEEDLW) was determined by using the DLW and used to validate the 24-hour diet recall method. The total energy intake (TEI) was calculated from the 24-hour diet recall method for three days. Results: TEI (1,489.6 ± 211.1 kcal/day) was significantly lower than TEEDLW (2,023.5 ± 234.9 kcal/day) and was largely under-reported by -533.9 ± 228.0 kcal/day (-25.9%). The accurate prediction rate of elderly women in this study was 8.7%. The Bland-Altman plot, which was used to evaluate the TEI and the TEEDLW, showed that the agreement between them was negatively skewed, ranging from -980.8 kcal/day to -86.9 kcal/day. Conclusion: This study showed that the energy intake of elderly women was underreported. Strategies to increase the accuracy of the 24-hour diet recall methods in the elderly women should be studied through analysis of factors that affect underreporting rate. Further studies will be needed to assess the validity of the 24-hour diet recall method in other population groups.

Energy expenditure of physical activity in Korean adults and assessment of accelerometer accuracy by gender (성인의 13가지 신체활동의 에너지 소비량 및 가속도계 정확성의 남녀비교)

  • Choi, Yeon-jung;Ju, Mun-jeong;Park, Jung-hye;Park, Jong-hoon;Kim, Eun-kyung
    • Journal of Nutrition and Health
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    • v.50 no.6
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    • pp.552-564
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    • 2017
  • Purpose: The purpose of this study was to measure energy expenditure (EE) the metabolic equivalents (METs) of 13 common physical activities by using a portable telemetry gas exchange system ($K4b^2$) and to assess the accuracy of the accelerometer (Actigraph $GT3X^+$) by gender in Korean adults. Methods: A total of 109 adults (54 males, 55 females) with normal BMI (body mass index) participated in this study. EE and METs of 13 selected activities were simultaneously measured by the $K4b^2$ portable indirect calorimeter and predicted by the $GT3X^+$ Actigraph accelerometer. The accuracy of the accelerometer was assessed by comparing the predicted with the measured EE and METs. Results: EE (kcal/kg/hr) and METs of treadmill walking (3.2 km/h, 4.8 km/h and 5.6 km/h) and running (6.4 km/h) were significantly higher in female than in male participants (p < 0.05). On the other hand, the accelerometer significantly underestimated the EE and METs for all activities except descending stairs, moderate walking, and fast walking in males as well as descending stairs in females. Low intensity activities had the highest rate of accurate classifications (88.3% in males and 91.3% females), whereas vigorous intensity activities had the lowest rate of accurate classifications (43.6% in males and 27.7% in females). Across all activities, the rate of accurate classification was significantly higher in males than in females (75.2% and 58.3% respectively, p < 0.01). Error between the accelerometer and $K4b^2$ was smaller in males than in females, and EE and METs were more accurately estimated during treadmill activities than other activities in both males and females. Conclusion: The accelerometer underestimated EE and METs across various activities in Korean adults. In addition, there appears to be a gender difference in the rate of accurate accelerometer classification of activities according to intensity. Our results indicate the need to develop new accelerometer equations for this population, and gender differences should be considered.

Human Risk Assessment of Polybrominated Diphenyl Ethers by Breast Milk Feeding of Infants (영유아의 모유 섭취에 따른 폴리브롬화디페닐에테르의 위해성 평가)

  • We, Sung-Ug;Cho, Bong-Hui;Cho, Yu-Jin;Yoon, Cho-Hee;Choi, Shi-Nai;Min, Byung-Yun
    • Journal of Korean Society of Environmental Engineers
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    • v.34 no.2
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    • pp.109-118
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    • 2012
  • This study achieves results from 22 maternity breast milk samples in total to demonstrate exposure level and risk assessment of PBDEs in Seoul area. PBDEs were detected in all the breast milk samples of the present study, indicating that general population in these Seoul area are widely exposed to these chemicals. Residue levels of total PBDEs (sum PBDEs from tri- to hepta-BDE) ranged of 0.84~13.1 ng/g lipid with an arithmetic mean and median of 3.56 ng/g lipid and 2.6 ng/g lipid, respectively. Global comparison shows that the levels of total PBDEs were relatively similar to those of China, Taiwan and European country (Sweden), and somewhat higher than those in some Asian (Vietnam, Philippines, and Indonesia). In the present study, however, the levels of total PBDEs in human milk are still one to two orders of magnitude lower than those in North America. Contribution rate of each congener appeared to be predominant with BDE-47, followed by BDE-153, BDE-100, BDE-99, BDE-154 and BDE-183. The sum of BDE-47 and BDE-153 accounted for more than 65% of total PBDEs in most samples. From the result of the human risk assessment of infants for total PBDEs and BDE-47 by breast milk feeding, we could find out that the average daily doses and hazard index (95th percentile) were 16.5 ng/kg bw/day and $1.2{\times}10^{-1}$ each other when nursing for 6 months after infants born. However, it was concluded that the infant health hardly had adverse seriously effects under this research condition.

Serial Survey on Group A beta-Hemolytic Streptococcal Carrier Rate and Serotyping in Elementary School Children in 1996~1998 (3년간(1996~1998) 초등학생의 A군 연쇄구균 보균율과 혈청학적 분류에 관한 연구)

  • Kim, Ji-Hyun;Kim, Ju-Ye;Kang, Hyeon-Ho;Cha, Sung-Ho;Lee, Young-Hee
    • Pediatric Infection and Vaccine
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    • v.7 no.1
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    • pp.143-151
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    • 2000
  • Purpose : The accuracy of bacteriologic diagnosis of beta-hemolytic streptococcal pharyngotonsillitis depends on the degree of carrier rate in that area where the throat swabs are obtained and the evaluation of serological T typing as an epidemiologic marker is important to understand epidemiology of streptococcal infection. The purpose of this study is to know the carrier rates of group A streptococcus in normal children form four different areas and to find out the epidemiologic characteristic in distribution of the serotypes for 3 years. Method : Throat swabs were obtained from the tonsillar fossa of normal school children in four different areas(Uljin, Seoul, Osan, Kunsan) from March to May 1996, in Uljin in April 1997, and in Uljin in April 1998. The samples were plated on a 5% sheep blood agar plate and incubated overnight at $37^{\circ}C$ before examination for the presence of beta-hemolytic colonies. All isolated beta-hemolytic streptococcus were grouped and serotyped by T agglutination. Results : The carrier rate of beta-hemolytic streptococci and group A streptococci in 1996 were 27.6%, 18.6% at Uljin; 16.4%, 2.7% at Seoul; 33.0%, 26.0% at Osan; 20.0%, 12.3% at Kunsan, respectively. Among 1,192 normal school children from 4 different areas, we obtained 179 strains of group A streptococci. Fifty two percent of the strains were typable by T agglutination in 1996. Common T-type in 1996 were NT, T1, T3, T2 at Uljin; T12, T25 at Seoul; NT, T6, T28 at Osan; T25, T4, NT, T5 at Kunsan, in decreasing order, respectively. At Uljin, T1, T3, T25 accounted for 69% of strains in 1996, T1, T12, T25 accounted for 70% in 1997, and T12, T4 accounted for 88% in 1998. Conclusion : Higher carrier rates were found in Uljin and Osan, where there are a lower population density with scanty of medical facilities compared with another areas. We supposed that low carrier rates is likely to be related to antibiotic abuse or some epidemiologic factor. The periodic and seasonal serotyping analysis is important in monitoring and understanding the epidemiologic patterns of group A streptococci.

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Risk Factors of Non-alcoholic Steatohepatitis in Childhood Obesity (비만아에서 비알코올성 지방간염의 위험요인)

  • Yun, Eun-Sil;Park, Yong-Hun;Choi, Kwang-Hae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.179-184
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    • 2007
  • Purpose: Obesity has recently emerged as a significant health problem in the pediatric population, and the prevalence of non-alcoholic fatty liver disease is increasing in tandem with a significant rise in childhood obesity. Therefore, this study was conducted to clarify the risk factors of non-alcoholic steatohepatitis in obese children. Methods: We enrolled 84 obese children who visited the pediatric obesity clinic at Yeung-Nam university hospital. The patients were divided into two groups based on their alanine aminotransferase (ALT) level (separated at 40 IU/L), and the mean of ages, total cholesterol levels, HDL-cholesterol levels, LDL-cholesterol levels, triglyceride (TG) levels, as well as the mean obesity index, and body fat percentage of the two groups were then compared. Results: When the mean of ages ($10.5{\pm}1.6$ vs. $10.7{\pm}2.0$ years), total cholesterol levels ($183.0{\pm}29.1$ vs. $183.7{\pm}31.3$ mg/dL), HDL-cholesterol levels ($53.0{\pm}10.2$ vs. $55.7{\pm}13.0$ mg/dL), LDL-cholesterol levels ($113.4{\pm}30.2$ vs. $113.0{\pm}30.0$ mg/dL), triglyceride levels ($99.4{\pm}62.9$ vs. $114.2{\pm}47.3$ mg/dL), obesity indexes ($44.7{\pm}12.2$ vs. $47.9{\pm}15.1%$), and body fat percentages ($32.7{\pm}5.0$ vs. $34.0{\pm}4.8%$) of group 1 (ALT${\leq}$40 IU/L) were compared with those of group 2 (ALT${\geq}$41 IU/L), no significant differences were observed (p>0.05). However, hypertriglyceridemia (TG${\geq}$110 mg/dL) was more frequent in group 2 than in group 1 (p=0.023). Conclusion: TG may be an important risk factor in non-alcoholic steatohepatitis and further study regarding the risk factors in non-alcoholic steatohepatitis is required.

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Establishment of Reference Range of Proinsulin (Proinsulin 참고치 설정에 관한 연구)

  • Nam, Yee Moon;Shin, Yong Hwan;Kim, Ji Young;Seok, Jae Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.76-79
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    • 2013
  • Purpose: It is very important to establish the appropriate reference range in the laboratory for preventing mistakes like false positive or false negative. Because the reference range in the laboratory is standard of patient test results interpretation. Proinsulin is precursor hormone of insulin, and the importance is increasing for diagnosing diabetes or insulinoma. Proinsulin reagent used in our laboratory is produced in the USA, and the reference range provided by manufacturer was adapted to our reference range after the validation test. But, it is generally recommend for the every laboratory to establish the their own reference range. So, we decided to re-evaluate the reference range with our patients' test results. Materials and Methods: Among 737 patients who had been to health promotion center in our hospital between Dec. $8^{th}$ 2011 and Dec. $21^{st}$ 2011, 563 patients are chosen with exception of diabetics patients and patients showing abnormal test results in Fasting Glucose, HbA1c, Insulin, and C-peptide. The 563 test results (275 males and 288 females) were classified with three groups(entire, male, female), and analysis of normal distribution was performed with aid of SPSS(version 19.0). Because Each group didn't show normal distribution, the reference range was set from the lowest limit of 2.5% to the highest limit of 97.5% with Percentile method used in non-normal distribution. Results: When evaluation values are sorted in ascending order, the entire range is 4.5~52.0 pM and 5.3~51.9 pM for male and 4.5~52.0 pM for female. The calculated reference range with percentile method shows 6.7~26.5 pM for entire group, 6.8~26.5 pM for male and 6.7~26.5 pM for female, respectively. Conclusion: The reference range provided by reagent manufacturer is 6.4~9.4 pM and the one established in this study is 6.7~26.5 pM. This difference might be caused by racial characteristics between Western people and Koreans. So an ideal reference range can be gotten with normal population visiting to every hospital. Our hospital has been using the newly re-establishing reference range under consultation with the department of endocrinology since Aug. $1^{st}$ 2012.

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Favorable Outcome in Elderly Asian Patients with Metastatic Renal Cell Carcinoma Treated with Everolimus: The Osaka Urologic Oncology Group

  • Inamoto, Teruo;Azuma, Haruhito;Nonomura, Norio;Nakatani, Tatsuya;Matsuda, Tadashi;Nozawa, Masahiro;Ueda, Takeshi;Kinoshita, Hidefumi;Nishimura, Kazuo;Kanayama, Hiro-Omi;Miki, Tsuneharu;Tomita, Yoshihiko;Yoshioka, Toshiaki;Tsujihata, Masao;Uemura, Hirotsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1811-1815
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    • 2014
  • Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.

A study on Empowerment of the Clinical Dental Hygienists (임상치과위생사의 임파워먼트에 관한 연구)

  • Shin, Seon-haeng
    • Journal of dental hygiene science
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    • v.10 no.3
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    • pp.185-190
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    • 2010
  • This study was conducted to collect the basic data to provide for the purpose of the development of dental field. This research is to find the relationship between the level of recognized empowerment of hygienists working in dental clinics and the factors influencing on work achievement in the system of dental clinics. The population of the research is some randomely chosen dental clinics located in Seoul City during the period from March 22 to April 30, 2010, and the sample of 256 female dental hygienists working in the field were recruited as the analysis object group. The data on general characteristics and empowerment were collected by a questionnaire survey. The collected data were analyzed with the SPSS WIN 12.0 program. The following shows the results of this study. 1. The empowerment level of the analysis subject group was 3.63. It is significant statistically that the longer working career or higher annual salary, the higher empowerment level (p<0.05). 2. It shows the high level of empowerment in the group of hygienists who are in education counsel (p<0.01), and who have a permanent job (p<0.05) than others. 3. There is a significant correlation among capability, age, career, annual salary (p<0.01). 4. There is a significant correlation among self determination, age(p<0.05), career (p<0.01), annual salary (p<0.05). 5. In regression analysis, career is proved as one of the significant factors that is related to the empowerment in dental hygienists (p<0.05). This finding shows high level of empowerment in dental hygienists who hold high level of career, annual salary, education counsel jobs, or permanent jobs. Therefore, I suggest with the result of the study that the organization of dental clinic needs to improve its capability and efficiency with the efficient manpower management. Particularly, there need to be various kinds of leadership-trainning and education-program development to enhance empowerment in hygienists as professionals through independent self-decision making experiences and role do experiences.

Prevalence of Antibodies to Hepatitis A in the Healthy Children in Inchon-Kyunggi Prefecture (경인 지역 소아의 A형 간염 항체 보유율)

  • Kwon, Young Se;Hong, Young Jin;Choe, Yon Ho;Kim, Soon Ki;Son, Byong Kwan;Kang, Moon Su;Pai, Soo Hwan;Hong, Kwang Sun
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.239-244
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    • 1998
  • Purpose : The incidence of hepatitis A virus infection in Korea has decreased recently. However, the prevalence in children and young adults is on an increasing trend in Inchon-Kyunggi prefecture. Economic development that leads to better living conditions and improves hygiene facilities has reduced the rate of HAV infection. This study was designed to evaluate the recent seroprevalence rate of hepatitis A in children and adolescents. Methods : Study population consisted of 612 children and adolescents aged 1 to 17 years in Inchon-Kyunggi prefecture. Serum samples were collected between 1996 and 1997 and tested for anti HAV by Microparticle Enzyme Immunoassay(MEIA). Results : According to age, the seropositive rates were 10.5%(male 13%, female 6.7%) in 1 year-old group, 0% in 3, 5, 11 and 13 year-old group, 6%(male 8%, female 4%) in 15 year-old group, and 11%(male 14%, female 8%) in 17 year-old group. Conclusion : This study showed that seropositive rate of HAV infection increased with age. While it revealed extremely low incidence of HAV infection in children less than 13 years old, they are also likely 10 be exposed 10 the infection. Our findings suggest that the effective administration of vaccination is needed in selected and high risk groups.

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A Study on the Safety Consciousness of Elementary Students (초등학생의 안전의식에 관한 연구)

  • Park, Dae-Sung;Lee, Young-Hyun
    • 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).

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