• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7789-7794
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• 2015

Background: This study aimed to evaluate the impact of a community-based health education and communication programme on reducing liver fluke infections caused by the consumption of uncooked fish among people in a high-risk area of Thailand. Materials and Methods: The study was quasi-experimental in nature, with three-stages. Stage 1 involved a situational and capacity analysis of designated communities in Khon Kaen province. This was followed by the development of a model for community-based health education and communication to prevent liver fluke infections among high-risk people, and, lastly, implementation and evaluation of the model were performed. Data were collected using both qualitative and quantitative methods. In total, 390 people were surveyed, and quasi-experimental and comparison groups, each with 90 people, were assessed between May 2011 and April 2012. Analysis was using statistical OR, 95 % CI, the Willcoxon matched pairs signed ranks test, the chi-square test, and the Mann-Whitney U test. Results: The findings showed that most respondents had a high level of knowledge and understanding of liver fluke disease (89.5%, 95% CI:86.0-92.4), and positive attitudes toward the prevention of the disease (94.4%, 95% CI:91.6-96.4). However, with regard to changes in consumption of uncooked fish, most respondents were still in the pre-contemplation phase (55.1%, 95% CI:50.0-60.1), followed by the contemplation phase, 22.6%. Furthermore, four factors were found to be associated with the consumption of uncooked fish - the consumption of alcohol (OR 4.16, 95% CI:1.79-9.65), gender (OR 3.17, 95% CI:1.53-6.54), smoking (OR 3.03, 95% CI:1.31-7.05), and age 40 years and above (OR 2.68, 95% CI:1.02-7.05). After nine months of the health education and communication programme using local media based on local wisdom, culture and persons, the results showed that, compared to the control group, members of the experimental group had a higher level of knowledge, a better attitude and lower levels of ill-advised consumption behaviour. Also, it was found that consumption of uncooked fish, by an assessment of the level of stage of change, was reduced. (p-value 0.002). Conclusions: The health education and communication programme developed as part of the study was effective in changing the consumption of uncooked fish. Therefore, this approach should be promoted in other high-risk areas in Thailand in the future.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.47 no.2
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• pp.43-49
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• 2010

Autonomic nervous system (ANS) acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The activity of the ANS has been assessed by means of the heart rate variability (HRV). It has been reported that HRV is dependent on sex, age, body mass index, and smoking, etc. However, the effects of posture and sleep deprivation on HRV have rarely been reported. Objective of our work was to find out which posture is appropriate for stable HRV. We measured the number of sleep deprivation and HRV using power spectrum in six stages for 30 minutes. Increased low frequency (LF) power and high frequency (HF) power indicate enhanced sympathetic and parasympathetic activity, respectively. We determined the LF/HF ratio to minimize individual difference. It was found that sleep deprivation by awakening up subjects was affected by posture, which resulted in changes of LF/HF. Although LF/HF varied with time, it was more stable in sitting than in supine. In conclusion, we recommend sitting posture when measuring HRV because of less sleep deprivation resulting in less variation in LF/HF.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.423-432
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• 1997

This is a descriptive study to understand the preventive stage for STDs to provide a basis for sex education for college students. The colleges were selected by quota sampling in five representative cities in Korea. but the 1,691 college students were selected by convenient sampling in the cities nationwide, and the data were collected by self-reporting using a questionnaire consisting of 33 items. The results were as follows : 1. Their mean ages were 21.8 for female and 23.3 for male students, 2.78.0% of the males md 46.5% of the females permitted premarital sex, 57.1% of male and 10.3% of female college students had experienced sexual intercourse, 7. l% of males and 2.4% of females had experienced pregnancy, 10.3% of males and 3.4% of females had been infected with STDs, 72.1% of male and 13.8% of female didn't use condoms at the time of infection. 3. Most of the factors related to STDs infection, such as drinking, smoking, frequency of sexual intercourse. pregnancy, knowledge of STDs, the score of STDs prevention were statistically higher in the male student group than in the female group. 4. The students' mean score of knowledge about STDs was similar between the male group(7.80) and the female group(7.84) with a possible score range from 0-18. 5. Only fifteen percent of male and 9.6% of female students expressed that they will do something to prevent STD. 6. The group having the experience of sexual intercourse(t=3.924, P=.048) and the group of having experience of contracting STDs(t=16.638, P=.000) had shown statistically higher STDs prevention score than the group not having that kind of experience. but the group having experience with pregnancy didn't show any difference from. the group not having experience with pregnancy. Considering that 57.1% of males and 10.3% of females had sexual intercourse experience, 78% of male and 46.5% of female permitted premarital sex, 10.3% of male and 3.4% of female had been infected with STDs. It could be concluded that the college students were ignorant about the prevention of STDs and had unrealistic stage of the STDs prevention. Therefore, enforcement of education for the prevention of STDs including the dynamics of the sexual intercourse and STDs infection is needed.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.2
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• pp.52-61
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• 2009

Objectives : The aim of this study was to assess health-related quality of life and evaluate the risk factors affecting severity of menopausal symptoms in early and late postmenopausal women based on the stages of reproductive aging workshop(STRAW) paradigm. Methods : This cross-sectional study examined 497 Korean postmenopausal women aged 41-59 years in Seoul and Gyeonggi province. We divided subjects into early postmenopause group and late postmenopause group. Menopause Rating Scale(MRS) was used to measure the quality of life. MRS scores, sociodemographic variables, smoking, alcohol use, age at menopause, and risk factors such as attitude to menopause, depression, history of premenstrual dysphoric disorder were compared between early and late postmenopause groups. Multiple regression analysis was performed in each group to assess the independent contribution of several variables. Results : Early postmenopause group showed significantly higher MRS scores, more negative attitude toward menopause, higher scores of depressive symptoms than late postmenopause group. Moderate to very severe hot flush group showed significantly, more negative attitude toward menopause, higher score of depressive symptoms, and higher MRS scores than none to mild hot flush groups. Depressive symptoms and attitude toward menopause contributed to the severity of menopausal symptom in both early and late postmenopause groups. Chronological age, age at menopause, history of PMDD contributed to severity of menopausal symptoms in early postmenopause group while marital status and occupation contributed in late postmenopause group. Conclusion : Health-related quality of life in postmenopause women was significantly lower in early postmenopause group than the late. Attitude toward menopause and depressive symptoms contributed significantly to quality of life in both early and late postmenopause groups but other variables contributed differently in each group. Further studies on clinical samples of postmenopausal women in order to confirm quality of life and its risk factor are needed to be done.

• Tuberculosis and Respiratory Diseases
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• v.51 no.2
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• pp.108-121
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• 2001

Background : The $p16^{INK4a}$ (p16) twnor suppressor gene is frequently inactivated in hwnan non-small cell lung cancers (NSCLCs), predominantly through homozygous deletion or in association with aberrant promotor hypermethylation. Death-associated protein kinase (DAPK) gene influences interferon $\gamma$-induced apoptotic cell death and has important role in metastasis of lung cancer in animal model. Hypermethylation of promoter region of DAP kinase gene may suppress the expression of this gene. Methods : This study was performed to investigate the aberrant methylation of p16 or DAP kinase in 35 resected primary NSCLCs by methylation-specific PCR (MSP), and demonstrated frequency, diagnostic value and clinical implication of aberrant methylation of two genes. Results : Thirty-two cases were male patients, and 3 cases were female patients with an average age was 57. $8{\pm}10.5$ years. The histologic types of lung cancer were 22 of squamous cell carcinoma, 12 of adenocarcinoma, 1 of large cell carcinoma. Pathologic stages were 11 cases of stage I (1 IA, 10 IB), 13 cases of stage II (1 IIA, 12 IIB), and 11 cases of stage III (9 IIIA, 2 IIIB). Regarding for the cancer tissue, p16 aberrant methylation was noted in 13 case of 33 cases (39.4%), DAP kinase in 21 cases of 35 cases (60%). Age over 55 year was associated with p16 aberrant methylation significantly (p<0.05). Methylation status of two genes was not different by smoking history, histologic type, size of tumor, lymph node metastasis and disease progression of lung cancer. There was no correlation between p16 and DAP kinase hypermethylation. Conclusion: This investigation demonstrates that aberrant methylation of p16 tumor suppressor gene or DAP kinase showed relatively high frequency (74.3%) in NSCLCs, and that these genes could be a biologic marker for early detection of lung cancer.

• Journal of the Korean Society of School Health
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• v.6 no.1
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• pp.9-44
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• 1993

An explorative and descriptive study in order to determine the effect of family structure and other socio-demographic variables on health behavior, belief, locus, and value and utilization of public health service was carried out. Data were collected from 1,653 subjects randomly sampled in three areas, Seoul, Kyunggi province, and Cheju province. From Seoul 849 subjects were selected, 397 subjects Kyunggi, and 407 subjects from Cheju, respectively. Self-reporting questionaires were administered during the period from March to June, 1992. The major findings were as follows: 1) The subjects visited herb-doctor's at irregular intervals mainly to have tonic medicine prepared. They preferred herb-doctor's rather than with doctors at clinics and hospitals. Statistically significant difference was found among the regions studied (p<0.05). 2) The reason for visiting hospitals was primarily for treatment of diseases. They preferred hospital because they felt that the hospitals offer much highly reliable treatment services as well as medical accessibility. For the purpose of hospital utilization, statistically significant differences existed among sex, educational level, family type and region. However, no significance was found among sex, educational level, and region (p<0.05). 3) The subjects utilized general hospitals mainly for diagnosis and treatment of diseases. They preferred general hospitals because of their much better facilities and reliability. Statistical significance was found among sex, educational level, and region (p<0.05). 4) The subjects visited dentist at irregular intervals basis. They visited once half a year or three to four months. their purpose of visit was mainly for diagnosis and treatment of diseases. Statistical significance differences were found among educational level, region and economic standard (p<0.05). 5) Whenever their illnesses were mild and the pharmacies was located in nearby they visited to pharmacies. They visited once a month and patient medicines. Statistically significant differences were found among sex, educational level and region (p<0.05). 6) The subjects believed that herb medicine was quite efficacious for treatment of some diseases, particularly by information handed down through time-honored tradition and experience. However, they recognized that the efficacy of folk medicine can vary with type and severity of diseases. Statistical significance was among sex, educational level, region and economic standard (p<0.05). 7) The reason why subjects believed that pray and superstition are effective for treatment of certain type of diseases, particularly in neuropathy, was the belief in God's almighty. Statistically significant differences were found among sex, educational level, regions and economic standard (p<0.05). 8) Most of subjects under same condition preferred western medicine because they believed that it is more scientific and prompts in showing therapeutic effect. Statistical significance was not found in the choice of type of public health service among, regions. But significant differences were found among sex, educational level and region (p<0.05). 9) The subjects looked for pharmacy if they thought the symptom was mild. However, they visited hospitals for chronic disease and general hospitals for emergency treatment. Statistical significances were found among educational level, region and economic standard (p<0.05). 10) Although most of students wanted to have a healthy life as for the component of health standard and value, they think that they are not healthy (p<0.05). As for the health behavior, significant difference was found in the proportion of smoking and drinking between educational level and region (p<0.05). The health locus was affected by educational level, and health behavior was influenced by region, sex and educational level. The utilization of type of public health service was influenced by family type and region, and health belief by region and educational level, and the health values by region and economic standard respectively, most of correlation showed statistical significance. Among them, the highest correlation was seen between locus of control and external/internal locus of control, which is quite obvious. The correlation between health belief and behavior was the next highest, but still low (0.343). All the other variables are low but significant except only a few of those. These findings indicate that health education should be incorporated into the curriculum so as to develop desirable health habit, and ability of self-control in accordance with their growth stages. A systematic and scientific understanding on the herb/folk medicine is needed, and greater reliability of the utilization of public health services are is still required. Health policy for equal distribution of health service throughout the country along the hierarchical health service system and complementary mutual assistance and cooperation among various health organizations are also required.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.953-961
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• 1998

Background : In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatment, progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors influencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. Methods: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline: (a) compliants; (b) patients who initially complied but gave up of themselves midway during the course of treatment; (c) noncompliants who refused the treatment. Results: The overall compliance rate was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sex, marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage I and II, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. Conclusion: To enhance the compliance, special care including education programs about therapy including complication and prognosis are necessary, especially for educationally and economically disadvantaged patients.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.447-454
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• 1998

Purpose : This study evaluated the survival, local control, prognostic factor, and failure pattern of patients with esophageal cancer treated with operation and adjuvant radiation therapy to use as fundermental data of postoperative radiation therapy. Materials and Methods : A retrospective analysis was undertaken of 82 patients who had locally advanced esophageal cancer treated with operation and adjuvant radiation therapy from January 1988 to December 1995. According to AJCC staging, stage IIA were in 26 patients, stage IIB in 4 patients, and stage III in 52 patients. Squamous cell carcinoma were in 77 patients, adenosquamous carcinoma in 3 patients, and adenocarcinoma in 2 patients. The patients received radiation therapy ranging from 41.0 Gy to 64.8 Gy. Five patients received neoadjuvant chemotherapy. Results : Two-year survival and local control rates for all patients were 36.8$\%$ and 30.4$\%$ respectively. And they were 9.3$\%$ and 26.3$\%$ respectively at 5 years. According to stages, 2-year survival rates were 50.2$\%$ in IIA, 0$\%$ in IIB and 23.3$\%$ in III (p=0.004). Two-year local control rates were 49.2 $\%$ in IIA, 66.6$\%$ in IIB and 24.7$\%$ in III (p=0.01). Sixty patients developed recurrence, which were 3 tumor margin, 23 lymph node recurrence, 4 tumor margin and lymph node, 1 tumor margin and distant metastasis, 9 lymph node and distant metastasis, 17 distant metastasis and 3 unknown metastatic site. Prognostic factors affecting survival were smoking (p=0.02), T-staging (p=0.0092), N-staging (p=0.0045). Prognostic factors affecting local control were T-staging (p=0.019), N-staging (p=0.047). Conclusion : In spite of post-operative radiation therapy, predominant failure pattern was local failure. Especially regional lymph node failure was major cause of local failure. So strategy of aggresive adjuvant radiation therapy to regional lymph node area in post operative treatment should be proposed.