Journal of agricultural medicine and community health
/
v.37
no.2
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pp.84-95
/
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.
Journal of agricultural medicine and community health
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v.35
no.2
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pp.134-150
/
2010
Objectives: This study was for analyzing the research about international marriage immigrant women and a trial to find the right direction for future research. Methods: Sixty articles published from June, 2004 to June, 2009 were reviewed and analyzed according to the general characteristics, major of author, and theme of health domains. Results: Most of them were master's thesis(71.7%) and journals(21.7%) and doctoral dissertation(6.7%) have been published mostly after thesis. Among 83.3% for quantitative research, descriptive(33.3%) and descriptive correlation(41.7%) methods were the most used and there were some qualitative researches(16.7%). The most frequently used data gathering method was questionnaire(81.7%) and the next was interview(16.7%). The major rates of the author were 61.7% for social welfare and 2.1% for nursing. The investigated variables in social health domain were adaptation(28.3%), and communication(1.7%). In psychological health domain, marriage satisfaction(16.7%), life satisfaction(11.7%), and depression(10.0%) were most researched. Utilization of medical center(5.0%) and health promotion behavior(1.7%) were investigated in physical health domain. Conclusions: Above this, most articles were researched about the adaptation of international marriage immigrant women. But the life in foreign countries can cause physical and psychosocial unhealthy conditions, so many-sided health related researches are supposed to be conducted for adaptation and prevention health problems of international marriage immigrant women.
Journal of Korean Home Economics Education Association
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v.15
no.3
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pp.89-103
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2003
The purpose of this study was to investigate to relation of necessity and practice of contents of clothing and textiles education(classify them into four units, choice and dressing of clothes, textile and management of clothes, design and sewing of clothes, knitting and embroidery). Method of posing a questionnaire is adopted to obtain stochastic data required for pertinent analysis. This is the investigation of which 400 (high school students 204, university students 196) girl students located in Choongnam and Junrabookdo province. In this statistical analysis, SPSS 10.0 for Windows Program was utilized to calculate percentage, mean and standard deviation. Also, these materials were verified by t-test, One-way Anova, Pearson's correlation coefficient. The results of this research were as follows. First, girl students' necessity mean point were higher than practice mean point about the contents of clothing and textiles education. And necessity had a positive relationship with practices of contents of clothing and textiles education. Second, there was a significant difference in necessity and practice of contents of clothing and textiles education according to demographic variables. These results should be provide fundamental information for improving students' critical practice in their real life. Since this study has touched only limited research on the topic of clothing and textiles education, it is essential that further research covering a wider array of themes be done in the future. this study has touched only limited research on the topic of clothing and textiles education, it is essential that further research covering a wider array of themes be done in the future.
Objective : Patients with sleep apnea should be diagnosed with polysomnography(PSG). However, it is not easy to recommend PSG for all patients suspected with sleep apnea in practice. Therefore, we tried to develop the screening test for referral of PSG. Method : 140 patients with snoring and sleep apnea syndrome were studied by the PSG. Sleep apnea questionnaire. Zung's scale for depression. Stanford Sleepiness Scale(SSS), insomnia scale and neuropsychological test were administered. Also, blood pressure, height, weight and neck circumference were measured and some histories were taken. Correlations between respiratory disturbance index(RDI) and various parameters mentioned above and discriminant coefficients of the parameters to RDI were computed. And, we investigated sensitivities of screening tests for selection of the patients with RDI above 20. Results : Using six parameters(neck circumference, systolic blood pressure before sleep, degree of alcohol drinking, frequency of breath-holding during sleep, degree of dry mouth during sleep, sleep apnea score), the patients with RDI above 20 could be discriminated in 92.8% sensitivity. In case of more than two among six parameters(neck circumference of above 40cm, systolic blood pressure of above 125mmHg, frequent alcohol drinking, frequent breath-holding during sleep, frequent dry mouth during sleep, sleep apnea score of above 35), same patients could be discriminated in 87.6% sensitivity. And, in case of more than one among four parameters(neck circumference of above 40cm. systolic blood pressure of above 125mmHg, frequent alcohol drinking, body weight of above 80kg), discrimination sensitivity was 83.5%. Conclusions : Patients with RDI above 20 could be discriminated by above parameters with high sensitivity. Therefore, the screening test using above parameters can be applied in selection of the patients with sleep apnea for PSG in practice.
Purpose: The only curative treatment for gastric carcinoma is surgery and it is still under debate which reconstruction method is better after performing gastrectomy for gastric carcinoma. The typical reconstruction methods after distal gastrectomy are Billroth I, Billroth II and Roux-en Y reconstruction. Yet it is difficult to compare these methods and not so much is known about which reconstruction is better in terms of the physiologic and nutritional function. With this background, we compared two reconstruction methods after distal gastrectomy (Billroth I versus Roux-en Y reconstruction) in terms of the long term physiologic function and nutritional status to create a reference for selecting reconstruction methods after distal gastrectomy. Materials and Methods: Between 1999 and 2002, 663 patients who underwent distal gastrectomy for early gastric carcinoma filled out questionnaires every six months after operation, and these questionnaires evaluated the physiologic function. To evaluate their nutritional status, blood tests were performed every six months to check their albumin, protein and hemoglobin levels, and we checked the body weight every 6 months as well. Results: The total score of the 15 questions on the questionnaire concerned with the physiologic function showed no difference between the two groups at every evaluation time, and both groups showed very low total scores, indicating tolerable physiologic function after operation. When comparing each question between two the groups, only symptoms of regurgitation and food passage showed a difference between the two groups, showing that the Roux-en Y group had better function in terms of these two symptoms. The Billroth I group showed a better nutrition status, indicating that the level of albumin, protein and hemoglobin were higher in the Billroth I group, with statistical significance. Body weight loss was severe in the Roux-en Y group. Conclusion: The physiologic function is slightly better in the Roux-en Y group in terms of some symptoms such as regurgitation and food passage. However, the nutritional status is better in the Billroth I group. In conclusion, because we cannot definitely ascertain which reconstruction is better when we consider both the physiologic and nutritional functions, it is reasonable that surgeon should choose reconstruction methods according to their experience and preference.
Background: Overexposure to sunlight in childhood and the adolescent period and associsated sunburns significantly increase the risk of skin cancer in adulthood. In Turkey, the incidence of skin cancer in the general population is 0.8%. The incidence is 0.6% and the mortality rate is 0.4% for men, while these rates are 1.0% and 0.7%, respectively, for women. If skin cancer is found early, its treatment is facilitated. Therefore, personal skin examination is important for early diagnosis. Objectives: Our aim was to determine the effects of training for raising consciousness among adolescents to protect against skin cancer by influencing skin self examination behavior. Method: This quasi experimental intervention study was conducted between February and April 2012 in Izmir. The study population consisted of students attending $6^{th}$, $7^{th}$ and $8^{th}$ classes of a primary school (n:302). No sampling was performed. Data were collected with a form developed by the researchers based on the literature. The first part of form is aimed to determine demographic characteristics of adolescents (3 questions) and their risk status of skin cancer (6 questions). The second part was prepared for skin cancer risks of adolescents (8 questions) and indications of skin cancer (12 questions). The last part was intended to determine their knowledge about skin self examination (4 questions) and behavioral stages of skin self examination (1 question). Data collection was achieved with a questionnaire form in three phases. In the 1st phase, data about demographic characteristics of students, risk status of skin cancer, knowledge level of skin cancer and behavior stages were collected. In the $2^{nd}$ phase, skin self examination training based on the transtheoretical model was performed within the same day just after obtaining preliminary data. In the $3^{rd}$ phase, adolescents were followed up three times to establish the efficacy of the training (on the $15^{th}$ day after training program and at end of the $1^{st}$ and $2^{nd}$ months). Follow-up data were evaluated by questioning skin self examination performing behavior stages through electronic mail. Results: Half of the adolescents (50.5%) are male, and 58.4% of them are 13 years old with a mean age of $12{\pm}1.15$ years. About 29.4% of adolescents had brown hair color, 37.9% had brown/hazel eye color, 29.4% had white skin, and 47.2% had fewer than 10 moles in their body. The pretest mean score on knowledge level about risks of skin cancer was found to be $4.19{\pm}1.96$, while the post-test mean score was $6.79{\pm}1.67$ (min:0, max:8).The pretest mean score about indications of skin cancer was $7.45{\pm}3.76$, while the post-test mean score was $10.7{\pm}2.60$ (min:0, max:12). The increases were statistically significant (p<0.05). The behavior "I do not perform skin self examination regularly in every month and I do not think to perform it in the next 6 months" was reduced from 52.8 to 35.5% after training. Conclusion: The training program organized to raise consciousness among adolescents for protection against skin cancer increased the knowledge level about risks and indications of skin cancer and it also improved the behavior of performing skin self examination.
The purpose of this study is as follows. First, we investigate empirically the effects of social network properties such as social network density and centrality of a franchisee on its information sharing with various subjects such as the franchisor and other franchisees in the franchise system. Second, we examine exploratively if tie strength between a franchisee and its franchisor plays a moderating role on the relationship between social network properties and information sharing. The study model was established as shown in
This study aims to validate a web-based neuropsychological testing tool developed by Kwak(2007) and to suggest solutions to potential problems that can deteriorate its validity. When it targets a wider range of subjects, a web-based neuropsychological testing tool is challenged by high drop-out rates, lack of motivation, lack of interactivity with the experimenter, fear of computer, etc. As a possible solution to these threats, this study aims to redesign the user interface of a web-based attention testing tool through three phases of study. In Study 1, an extensive analysis of Kwak's(2007) attention testing tool was conducted to identify potential usability problems. The Heuristic Walkthrough(HW) method was used by three usability experts to review various design features. As a result, many problems were found throughout the tool. The findings concluded that the design of instructions, user information survey forms, task screen, results screen, etc. did not conform to the needs of users and their tasks. In Study 2, 11 guidelines for the design of web-based attention testing tools were established based on the findings from Study 1. The guidelines were used to optimize the design and organization of the tool so that it fits to the user and task needs. The resulting new design alternative was then implemented as a working prototype using the JAVA programming language. In Study 3, a comparative study was conducted to demonstrate the excellence of the new design of attention testing tool(named graphic style tool) over the existing design(named text style tool). A total of 60 subjects participated in user testing sessions where their error frequency, error patterns, and subjective satisfaction were measured through performance observation and questionnaires. Through the task performance measurement, a number of user errors in various types were observed in the existing text style tool. The questionnaire results were also in support of the new graphic style tool, users rated the new graphic style tool higher than the existing text style tool in terms of overall satisfaction, screen design, terms and system information, ease of learning, and system performance.
This study investigated associations between calcium intake, exercise behaviors, lumbar bona mineral density (BMD), and bone mineral content (BMC) among 79 premenopausal women (mean age = 41yr). The BMD and BMC of the lumbar spine (L$_2$-L$_4$) were measured by dual energy x-ray absorptiometry. Nutrient intake was estimated by the convenient method and a quantitative food frequency questionnaire was designed for this study that included the most commonly consumed floods sources of Ca. Participants were asked to identify all activities of exercise they had participated in including estimation of number of years of participation, number of weeks per year, number of times per week, and the number of hours per session. Participants were then categorized into the exercise group or nonexercise group (control). To meet the criteria for inclusion in the exercise group, the subjects participated more than 3 sessions per week and more than 30 minutes per session and the length of the exercise participation was at least more then 6 months. The participants were also grouped by calcium intake. The total calcium intake of all participants was estimated by dietary calcium intake and then the subjects were divided into quartiles to assess the lumbar BMD and BMC of the upper 25% (average calcium intake = 910 mg) and the lower 25% (average calcium intake = 414 mg). Results indicated that there were no significant differences in energy and calcium intake, and that there were no significant differences in lumbar BMD and BMC between participants in exercise group and the nonexercising control group. However, the exercise group had significantly lower ALP concentration than the nonexercise group. The upper 25% calcium intake group had significantly greater lumbar bone mineral density and bone mineral content than the lower 25% calcium intake group. Also the upper 25% calcium intake group had significantly lower ALP concentration than the lower 25% calcium intake group. Correlation analysis revealed that the spinal BMB was positively associated with body weight, while calcium intake was negatively associated with ALP concentration in nonexercising women. However, neither body weight nor dietary calcium intake were associated with both spinal BMD or ALP concentration in exercising women. These results suggest that calcium intake positively influence bone mineral density and bone mineral content in nonexercisulg premenopausal women. Exercise group did not affected by body weight and dietary calcium, but decreased ALP concentration than nonexercising group. Both exercise and calcium intake positively influence bone mineral density and bone mineral content in premenopausal women.
This study was conducted to investigate dietary and other factors affecting bone mineral density in young Korean collage women. Thirty subjects were recruited; the mean age was 22.1 years and the mean age at menarche was 12.6 years. Bone mineral density (BMD) was measured in the spine (LS), femoral neck (FN), ward's triangle (WT), and femoral trochanter (FT) by Dual Energy X-ray Absorptiometry (DEXA), and physical activity was assessed by a questionnaire. Dietary intake data were obtained 8 times by using a 24 hour recall method to evaluate the subjects' usual diet. Bone mineral densities of lumbar spine, femoral neck, ward's triangle and femoral trochanter were 1.149 g/$\textrm{cm}^2$, 0.980 g/$\textrm{cm}^2$, 0.936 g/$\textrm{cm}^2$ and 0.759 g/$\textrm{cm}^2$ respectively. The met energy intake of subjects was 1,790 kcal, and calcium and iron intakes were found to be inadequate compared to the Korean RDA. The BMD of the lumbar spine was significantly and positively related to the BMI and intake of vitamin C, carbohydrate, potatoes, fruits and plant food. The BMD of the femur (FN, WT, FT) was positively related to the BMI, to carbohydrate and fruit intake, and to the percentage of plant food in total food intake. Multiple recession analysis showed that fruit intake was significantly related to the BMD of the LS. The subjects'ages and fruit intakes were significantly related to the BMD of the femur (FN, WT, FT). These results indicate that higher fruit intakes may have a beneficial effect on bone mineral density.
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