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Impact of the Utilization Gap of the Community-Based Smoking Cessation Programs on the Attempts for Quitting Smoking between Wonju and Chuncheon Citizen (원주시민과 춘천시민의 지역사회 내 금연프로그램 이용 격차가 금연 시도에 미치는 영향)

  • Kyung-Yi Do;Kwang-Soo Lee;Jae-Hwan Oh;Ji-Hae Park;Yun-Ji Jeong;Je-Gu Kang;Sun-Young Yoon;Chun-Bae Kim
    • Journal of agricultural medicine and community health
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    • v.49 no.1
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    • pp.37-49
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    • 2024
  • Objectives: This study aimed to explore whether there are differences in smoking status between two regions of Wonju-City and Chuncheon-City, Gangwon State, and to determine whether the experience of smoking cessation programs in the region affects quit attempts. Methods: The study design was a cross-sectional study in which adults aged 19 and older living in two cities were surveyed using a pre-developed mobile app to investigate social capital for smoking cessation, and a total of 600 citizens were participated, including 310 in Wonju-City and 290 in Chuncheon-City. The statistical analysis was conducted using chi-square test and logistic regression analysis. Results: Wonju-City had a higher prevalence of current smoking than Chuncheon-City. Among smoking cessation programs operated by local public health centers, Wonju-City had a lower odds ratio for experience with smoking cessation education than Chuncheon-City (OR=0.52, 95% CI=0.33 to 0.81). When examining the effect of smoking cessation program experience on quit attempts, in Wonju-City, citizens who had completed smoking cessation education and used a smoking cessation clinic were more likely to attempt to quit than those who had not (OR=2.31 and OR=2.29, respectively). In Chuncheon-City, citizens who were aware of smoking cessation support services were 2.26 times more likely to attempt to quit smoking than those who were not, but statistical significance was not reached due to the small sample size. Conclusion: Therefore, healthcare organizations in both regions should develop more practical intervention strategies to increase smokers' quit attempts, reduce smoking rates in the community, and address regional disparities.

Association between adolescents lifestyle habits and smoking experience: Focusing on comparison between experienced and non-experienced smokers (청소년의 생활습관과 흡연경험의 연관성: 흡연경험자와 비경험자의 비교 중심으로)

  • Seri Kang;Kyunghee Lee;Sangok Cho
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.2
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    • pp.27-44
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    • 2024
  • Objectives: This study aimed to provide foundational data for preventing adolescents smoking by analyzing the relationship between adolescents' lifestyles and smoking experiences and identifying influencing factors. Methods: Secondary data analysis was conducted using the 17th (2021) Youth Health Behavior Survey data, encompassing 54,848 students from 796 schools. Variables included general characteristics, smoking status, lifestyle habits, physical activity, sleep patterns, and stress perception. Frequency analysis was used to examine general characteristics, while further analysis employed frequency analysis and the Pearson Chi-square test to compare lifestyle differences based on smoking presence. Multinomial logistic regression analysis was employed to determine factors influencing smoking experience, with IBM SPSS Statistics 28 used for all analyses at a significance level of p<.05. Results: Analysis revealed with general characteristics that the group with smoking experience exhibited a higher proportion of male students (67.4%) compared to the non-smoking group (50.1%) (p<.001). Analysis revealed that the smoking group was more likely to skip breakfast (27.7%), not consume fruit (17.8%), and consume fast food more than three times daily (0.9%). Furthermore, a higher percentage of smokers engaged in 60 minutes or more of breathless physical activity (8.4%) seven times a week, reported insufficient fatigue recovery through sleep (21.6%), and experienced very severe normal stress (17.2%) (p<.001). Analysis of the relationship between lifestyle and smoking indicated increased likelihood of smoking with zero breakfast consumption (OR=1.759, p<.001) and increased fruit consumption (OR=1.921, p<.001), while zero fast food consumption decreased smoking likelihood (OR=0.206, p<.001). Adequate sleep-related fatigue recovery reduced smoking likelihood (OR=0.458, p<.001), whereas increased stress elevated it (OR=1.260, p<.05). Conclusion: Adolescents' lifestyle habits significantly correlated with their smoking experiences, highlighting the necessity of considering lifestyle factors in smoking prevention strategies. This study provides crucial insights for promoting healthy lifestyle changes to prevent smoking among youth.

State of Mind in the Flow 4-Channel Model and Play (플로우 4경로모형의 마음상태와 플레이(play))

  • Sohn, Jun-Sang
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.2
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    • pp.1-29
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    • 2007
  • The flow theory becomes one of the most important frameworks in the internet research arena. Hoffman and Novak proposed a hierarchical flow model showing the antecedents and outcomes of flow and the relationship among these variables in the hyper-media computer circumstances (Hoffman and Novak 1996). This model was further tested after their initial research (Novak, Hoffman, and Yung 2000). At their paper, Hoffman and Novak explained that the balance of challenge and skill leads to flow which means the positive optimal state of mind (Hoffman and Novak 1996). An imbalance between challenge and skill, leads to negative states of mind like anxiety, boredom, apathy (Csikszentmihalyi and Csikszentmihalyi 1988). Almost all research on the flow 4-channel model have been focusingon flow, the positive state of mind (Ellis, Voelkl, and Morris 1994 Mathwick and Rigdon 2004). However, it also needs to examine the formation of the negative states of minds and their outcomes. Flow researchers explain play or playfulness as antecedents or the early state of flow. However, play has been regarded as a distinct concept from flow in the flow literatures (Hoffman and Novak 1996; Novak, Hoffman, and Yung 2000). Mathwick and Rigdon discovered the influences of challenge and skill on play; they also observed the influence of play on web-loyalty and brand loyalty (Mathwick and Rigdon 2004). Unfortunately, they did not go so far as to test the influences of play on state of mind. This study focuses on the relationships between state of mind in the flow 4-channel model and play. Early research has attempted to hypothetically explain state of mind in flow theory, but has not been tested except flow until now. Also the importance of play has been emphasized in the flow theory, but has not been tested in the flow 4-channel model context. This researcher attempts to analyze the relationships among state of mind, skill of play, challenge, state of mind and web loyalty. For this objective, I developed a measure for state of mind and defined the concept of play as a trait. Then, the influences of challenge and skill on the state of mind and play under on-line shopping conditions were tested. Also the influences of play on state of mind were tested and those of flow and play on web loyalty were highlighted. 294 undergraduate students participated in this research survey. They were asked to respond about their perceptions of challenge, skill, state of mind, play, and web-loyalty to on-line shopping mall. Respondents were restricted to students who bought products on-line in a month. In case of buying products at two or more on-line shopping malls, they asked to respond about the shopping mall where they bought the most important one. Construct validity, discriminant validity, and convergent validity were used to check the measurement validations. Also, Cronbach's alpha was used to check scale reliability. A series of exploratory factor analyses was conducted. This researcher conducted confirmatory factor analyses to assess the validity of measurements. All items loaded significantly on their respective constructs. Also, all reliabilities were greater than.70. Chi-square difference tests and goodness of fit tests supported discriminant and convergent validity. The results of clustering and ANOVA showed that high challenge and high skill leaded to flow, low challenge and high skill leaded to boredom, and low challenge and low skill leaded to apathy. But, it was different from my expectation that high challenge and low skill didnot lead to anxiety but leaded to apathy. The results also showed that high challenge and high skill, and high challenge and low skill leaded to the highest play. Low challenge leaded to low play. 4 Structural Equation Models were built by flow, anxiety, boredom, apathy for analyzing not only the impact of play on state of mind and web-loyalty, but also that of state of mind on web-loyalty. According the analyses results of these models, play impacted flow and web-loyalty positively, but impacted anxiety, boredom, and apathy negatively. Results also showed that flow impacted web-loyalty positively, but anxiety, boredom, and apathy impacted web-loyalty negatively. The interpretations and implications of the test results of the hypotheses are as follows. First, respondents belonging to different clusters based on challenge and skill level experienced different states of mind such as flow, anxiety, boredom, apathy. The low challenge and low skill group felt the highest anxiety and apathy. It could be interpreted that this group feeling high anxiety or fear, then avoided attempts to shop on-line. Second, it was found that higher challenge leads to higher levels of play. Test results show that the play level of the high challenge and low skill group (anxiety group) was higher than that of the high challenge and high skill group (flow group). However, this was not significant. Third, play positively impacted flow and negatively impacted boredom. The negative impacts on anxiety and apathy were not significant. This means that the combination of challenge and skill creates different results. Forth, play and flow positively impacted web-loyalty, but anxiety, boredom, apathy had negative impacts. The effect of play on web-loyalty was stronger in case of anxiety, boredom, apathy group than fl ow group. These results show that challenge and skill influences state of mind and play. Results also demonstrate how play and flow influence web-loyalty. It implies that state of mind and play should be the core marketing variables in internet marketing. The flow theory has been focusing on flow and on the positive outcomes of flow experiences. But, this research shows that lots of consumers experience the negative state of mind rather than flow state in the internet shopping circumstance. Results show that the negative state of mind leads to low or negative web-loyalty. Play can have an important role with the web-loyalty when consumers have the negative state of mind. Results of structural equation model analyses show that play influences web-loyalty positively, even though consumers may be in the negative state of mind. This research found the impacts of challenge and skill on state of mind in the flow 4-channel model, not only flow but also anxiety, boredom, apathy. Also, it highlighted the role of play in the flow 4-channel model context and impacts on web-loyalty. However, tests show a few different results from hypothetical expectations such as the highest anxiety level of apathy group and insignificant impacts of play on anxiety and apathy. Further research needs to replicate this research and/or to compare 3-channel model with 4-channel model.

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Investigation of Food Safety Knowledge, Attitudes, and Behavior for Analyzing Food Safety Risk Factors in the Elderly (노인들의 식품안전 위험요인 규명을 위한 식품위생 지식, 태도, 행동 조사)

  • Choi, Jung-Hwa;Lee, Yoon-Jin;Lee, Eun-Sil;Lee, Hye-Sang;Chang, Hye-Ja;Lee, Kyung-Eun;Yi, Na-Young;Kwak, Tong-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.5
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    • pp.746-756
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    • 2016
  • The purpose of this study was to investigate food safety knowledge, food safety attitudes, and handling behavior in the elderly. The survey was conducted on 358 individuals over 65 years old in urban and rural areas. Data were analyzed with descriptive analysis and ${\chi}^2$ test analysis of variance using SPSS. From the results on elderly's food safety knowledge, the item 'tangerines should be washed before eating' was correctly answered by urban subjects (75.4%) than rural subjects (49.7%). 'Is it okay to cook meat left on the sink since afternoon in the evening' showed the lowest correct answer rate in both urban (23.1%) and rural (31.9%) subjects. For the item related to food keeping, 'Bacterial cells do not multiply in Samgyetang when it is kept in a refrigerator right after boiling thoroughly', 58.5% of urban and 54.6% of rural elderly answered correctly. Most elderly people showed a tendency to think that boiled foods might be safe to eat. Secondly, for food safety attitudes, urban elderly had more proper attitude regarding the item, 'Namul is very tasty only when mixed with bare hands' (disagree rate 34.9%) than rural elderly (P<0.05)'. On the other hand, rural elderly had more positive attitudes regarding the store principle "first in, first out" compared to urban elderly (P<0.001). Thirdly, regarding food safety behaviors, only 67.9% of urban and 58.7% of rural elderly responded that they washed their hands right after answering the telephone while cooking. Exactly 33.8% of urban and 39.6% of rural older people replied 'defrost meat on top of sink or table' as the defrost method for frozen foods, showing that elderly did not recognize the risk of foodborne illness during improper defrosting at room temperature.

Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model (저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Chun, Eui-Kyung;Chi, Je-Geun;Won, Tae-Hee;Lee, Young-Tak;Chee, Hyun-Keun;Kim, Jun-Woo
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.471-478
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    • 1997
  • Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

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FAMILY DYNAMICS OF INCEST PERCEIVED BY ADOLESECENTS (청소년이 지각한 근친상간의 가족역동)

  • Kim, Hun-Soo;Shin, Hwa-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.56-64
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    • 1995
  • Family is a primary unit of the major socialization processing for children. Parents among the family members are one of the most important figures from whom the child and adolescent acquire a wide variety of behavior patterns, attitudes, values and norms. An organization of family members product family structural functioning. Abnormal family structure is one of the most important reference models in the learning of antisocial patterns of behavior. Therefore incest and child sexual abuse including spouse abuse, elderly abuse, and neglect occurs in the abnormal family structural setting. In particular, incest, a specific form of sexual abuse, was once thought to be a phenomenon of great rarity, but our clinical experiences, especially over the past decade, have made us aware that incest and child sexual abuse is not rare case and on the increasing trend. Therefore, the aim of this study was to determine the family problem and dynamics of incest family, and character pattern of post-incest adolescent victim in Korea. A total of 1,838 adolescents from middle and high school(1,237) and juvenile correctional institute(601) were studied, sampled from Korean student population and adolescent delinquent population confined in juvenile correctional institutes, using proportional stratified random sampling method. The subjects' ages ranged from 12 to 21 years. Data were collected through questionnaire survey. Data analysis was done by IBM PC of Behavior Science Center at the Korea university, using SAS program. Statistical methods employed were Chi-square, principal component analysis and t-test etc. The results of this study were as follows ; 1) Of 1,071 subjects, 40(3.7%) reported incest experiences(sibling incest : 1.6% ; another type of incest : 2.1%) in their family setting. 2) The character pattern of post-incest adolescent victim was more socially maladjusted, immature, impulsive, rigid, anxious and dependent than non-incest adolescent. Also they showed some problem in academic performance and their assertiveness. 3) The other family members of incest family revealed more psychological and behavioral problem such as depression, alcoholism, psychotic disorder and criminal act than the non-incest family, even though there is no evidence of the context between them. 4) The family dynamics of incest family tended to be dysfunctional trend, as compared with non-incest family. It showed that the psychological instability of family member, parental rejection toward their children, coldness and indifference among family member and marital discordance between the parents had significant correlation with incest.

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The Effect of Brand Extension of Private Label on Consumer Attitude - a focus on the moderating effect of the perceived fit difference between parent brands and an extended brand - (PL의 브랜드확장이 소비자태도에 미치는 영향에 관한 연구 : 모브랜드 적합도 인식 차이의 조절효과를 중심으로)

  • Kim, Jong-Keun;Kim, Hyang-Mi;Lee, Jong-Ho
    • Journal of Distribution Research
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    • v.16 no.4
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    • pp.1-27
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    • 2011
  • Introduction: Sales of private labels(PU have been growing m recent years. Globally, PLs have already achieved 20% share, although between 25 and 50% share in most of the European markets(AC. Nielson, 2005). These products are aimed to have comparable quality and prices as national brand(NB) products and have been continuously eroding manufacturer's national brand market share. Stores have also started introducing premium PLs that are of higher-quality and more reasonably priced compared to NBs. Worldwide, many retailers already have a multiple-tier private label architecture. Consumers as a consequence are now able to have a more diverse brand choice in store than ever before. Since premium PLs are priced higher than regular PLs and even, in some cases, above NBs, stores can expect to generate higher profits. Brand extensions and private label have been extensively studied in the marketing field. However, less attention has been paid to the private label extension. Therefore, this research focuses on private label extension using the Multi-Attribute Attitude Model(Fishbein and Ajzen, 1975). Especially there are few studies that consider the hierarchical effect of the PL's two parent brands: store brand and the original PL. We assume that the attitude toward each of the two parent brands affects the attitude towards the extended PL. The influence from each parent brand toward extended PL will vary according to the perceived fit between each parent brand and the extended PL. This research focuses on how these two parent brands act as reference points to one another in the consumers' choice consideration. Specifically we seek to understand how store image and attitude towards original PL affect consumer perceptions of extended premium PL. How consumers perceive extended premium PLs could provide strategic suggestions for retailer managers with specific suggestions on whether it is more effective: to position extended premium PL similarly or dissimilarly to original PL especially on the quality dimension and congruency with store image. There is an extensive body of research on branding and brand extensions (e.g. Aaker and Keller, 1990) and more recently on PLs(e.g. Kumar and Steenkamp, 2007). However there are no studies to date that look at the upgrading and influence of original PLs and attitude towards store on the premium PL extension. This research wishes to make a contribution to this gap using the perceived fit difference between parent brands and extended premium PL as the context. In order to meet the above objectives, we investigate which factors heighten consumers' positive attitude toward premium PL extension. Research Model and Hypotheses: When considering the attitude towards the premium PL extension, we expect four factors to have an influence: attitude towards store; attitude towards original PL; perceived congruity between the store image and the premium PL; perceived similarity between the original PL and the premium PL. We expect that all these factors have an influence on consumer attitude towards premium PL extension. Figure 1 gives the research model and hypotheses. Method: Data were collected by an intercept survey conducted on consumers at discount stores. 403 survey responses were attained (total 59.8% female, across all age ranges). Respondents were asked to respond to a series of Questions measured on 7 point likert-type scales. The survey consisted of Questions that measured: the trust towards store and the original PL; the satisfaction towards store and the original PL; the attitudes towards store, the original PL, and the extended premium PL; the perceived similarity of the original PL and the extended premium PL; the perceived congruity between the store image and the extended premium PL. Product images with specific explanations of the features of premium PL, regular PL and NB we reused as the stimuli for the Question response. We developed scales to measure the research constructs. Cronbach's alphaw as measured each construct with the reliability for all constructs exceeding the .70 standard(Nunnally, 1978). Results: To test the hypotheses, path analysis was conducted using LISREL 8.30. The path analysis for verification of the model produced satisfactory results. The validity index shows acceptable results(${\chi}^2=427.00$(P=0.00), GFI= .90, AGFI= .87, NFI= .91, RMSEA= .062, RMR= .047). With the increasing retailer use of premium PLBs, the intention of this research was to examine how consumers use original PL and store image as reference points as to the attitude towards premium PL extension. Results(see table 1 & 2) show that the attitude of each parent brand (attitudes toward store and original pL) influences the attitude towards extended PL and their perceived fit moderates these influences. Attitude toward the extended PL was influenced by the relative level of perceived fit. Discussion of results and future direction: These results suggest that the future strategy for the PL extension needs to consider that positive parent brand attitude is more strongly associated with the attitude toward PL extensions. Specifically, to improve attitude towards PL extension, building and maintaining positive attitude towards original PL is necessary. Positioning premium PL congruently to store image is also important for positive attitude. In order to improve this research, the following alternatives should also be considered. To improve the research model's predictive power, more diverse products should be included in study. Other attributes of product should also be included such as design, brand name since we only considered trust and satisfaction as factors to build consumer attitudes.

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Health Concern, Health Practice and ADL of The Elderly Who Stay at Home in a Rural Community (농촌(農村) 재택노인(財宅老人)들의 건강관심도(健康關心度), 건강실천행위(健康實踐行爲)와 일상생활동작능력(日常生活動作能力))

  • Eom, Young-Hee;Kam, Sin;Han, Chang-Hyun;Cha, Byung-Jun;Kim, Sang-Soon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.269-289
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    • 1999
  • This study was conducted to examine the relationship among health concern, health practice and ADL of elderly staying at home in a rural community and their affecting factors. Data were collected through direct interviews made with 480 old people aged more than sixty-five from November 15, 1998 to December 20, 1998. Out of 189 male and 291 female, the high-level group that showed high health concern accounted for 44.4%, the medium-level group for 13.1%, and the low-level group for 42.5%, in the health practice, the high-level group accounted for 3.8%, the medium-level group for 18.8%, and the low-level group for 77.5%. In the self-rated health status, the high-level group accounted for 29.0%, the medium-level group for 31.0%, and the low-level group for 40.0%, and in the ADL, the high ADL group accounted for 91.5%, and the low-level ADL group for 8.5%. The result of the chi-square test showed that for male, there was a significant relation between the health concern and the health practice index score. In the relation between the health practice index score and the self-rated health status, there was significant positive relationship between health practice index and self-rated health status, and in the relation between the health practice Index score and the ADL, old people with higher health practices showed good ADL(but not significant). Old people with good ADL also showed good self-rated health status. In the multiple regression analysis where the health practice was used as a dependent variable, the health concern was added to the sociodemographic variables as an independent variables, a formula was formed for male old people only and ones with high concern in health showed good health practice. In the multiple logistic regression analysis where the sociodemographic variables to which the health practices was added were used as an independent variable and the ADL as a dependent variable, the ADL appeared to be not good if for male old people the living costs were born by their sons and daughters and as for female old people their ages increased, but it was good if old people had sources of health information such as hospitals or health centers. The self-rated health status was worse, for male old people, if they had short living costs or diseases and for female old people, if they had spouses, living costs born by their sons and daughters or diseases, but it was better, for male old people, if they had periodical gatherings or carried out health practices a lot, and for female old people, if they had sources of health information such as hospitals or health centers or carried out health practices a lot. In view of the results stated above, the higher the old people had health concern, the more they carried out health practices, and the more they carried out health practices, the better they had ADL and self-rated health status that served as the level of health. Further, the better ADL, the better self-rated health status.

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Factors associated with Experience of Diagnosis and Utilization of Chronic Diseases among Korean Elderly : Focus on Comparing between Urban and Rural Elderly (한국 노인의 만성질환 진단경험 및 의료이용에 관련된 요인 : 도시와 농촌 간 비교를 중심으로)

  • Lee, Min Ji;Kown, Dong Hyun;Kim, Yong Yook;Kim, Jae Han;Moon, Sung Jun;Park, Keon Woo;Park, Il Woo;Park, Jun Young;Baek, Na Yeon;Son, Gi Seok;Ahn, So Yeon;Yeo, In Uk;Woo, Sang Ah;Yoo, Sung Yun;Lee, Gi Beop;Lim, Soo Beom;Jang, Soo Hyun;Jang, In-Deok;Jeon, Jeong-U;Jeong, Su Jin;Jung, Yeon Ju;Cho, Seong Geon;Cha, Jeong Sik;Hwang, Ki Seok;Lee, Tae-Jun;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.44 no.4
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    • pp.165-184
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    • 2019
  • Objectives: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. Methods: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. Results: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092-1.183) for diagnosis of diabetes, 1.278 (1.278-1.386) for diagnosis of dyslipidemia, 0.940 (0.904-0.977) for diagnosis of arthritis, 0.785(0.736-0.837) for treatment of arthritis, 1.159 (1.116-1.203) for diagnosis of cataracts, and 1.285(1.200-1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p <0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p <0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. Conclusion: Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

The Characteristics of REM Sleep-Dependent Obstructive Sleep Apnea and NREM Sleep-Dependent Obstructive Sleep Apnea (렘수면 의존성 수면무호흡증과 비렘수면 의존성 수면무호흡증의 특징)

  • Seo, Min Cheol;Choi, Jae-Won;Joo, Eun-Jeoung;Lee, Kyu Young;Bhang, Soo-Young;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.24 no.2
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    • pp.106-117
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    • 2017
  • Objectives: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is characterized by repetitive collapse or partial collapse of the upper airway during sleep in spite of ongoing effort to breathe. It is believed that OSA is usually worsened in REM sleep, because muscle tone is suppressed during REM sleep. However, many cases showed a higher apnea-hypopnea index (AHI) during NREM sleep than during REM sleep. We aimed here to determine the characteristics of REM sleep-dependent OSA (REM-OSA) and NREM sleep-dependent OSA (NREM-OSA). Methods: Five hundred sixty polysomnographically confirmed adult OSA subjects were studied retrospectively. All patients were classified into 3 groups based on the ratio between REM-AHI and NREM-AHI. REM-OSA was defined as REM-AHI/NREM-AHI > 2, NREM-OSA as NREM-AHI/REM-AHI > 2, and the rest as sleep stage-independent OSA (IND-OSA). In addition to polysomnography, questionnaires related to subjective sleep quality, daytime sleepiness, and emotion were completed. Chi-square test, ANOVA, and ANCOVA were performed. Results: There was no age difference among subgroups. The REM-OSA group was comprised of large proportions of mild OSA and female OSA patients. These patients experienced poor sleep and more negative emotions than other two groups. The AHI and oxygen desaturation index (ODI) were lowest in REM-OSA. Sleep efficiency and N3 percentage of REM-OSA were higher than in NREM-OSA. The percentage of patients who slept in a supine position was higher in REM-OSA than other subgroups. IND-OSA showed higher BMI and larger neck circumference and abdominal circumference than REM-OSA. The patients with IND-OSA experienced more sleepiness than the other groups. AHI and ODI were highest in IND-OSA. NREM-OSA presented the shortest total sleep time and the lowest sleep efficiency. NREM-OSA showed shorter sleep latency and REM latency and higher percentage of N1 than those of REM-OSA and the highest proportion of those who slept in a lateral position than other subgroups. NREM-OSA revealed the highest composite score on the Horne and ${\ddot{O}}stberg$ questionnaire. With increased AHI severity, the numbers of apnea and hypopnea events during REM sleep decreased, and the numbers of apnea and hypopnea events during NREM sleep increased. The results of ANCOVA after controlling age, sex, BMI, NC, AC, and AHI showed the lowest sleep efficiency, the highest AHI in the supine position, and the highest percentage of waking after sleep onset in NREM-OSA. Conclusion: REM-OSA was associated with the mild form of OSA, female sex, and negative emotions. IND-OSA was associated with the severe form of OSA. NREM-OSA was most closely related to position and showed the lowest sleep efficiency. Sleep stage-dependent characteristics could provide better understanding of OSA.