• Korean Journal of Community Nutrition
• /
• v.28 no.1
• /
• pp.38-47
• /
• 2023

Objectives: This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community. Methods: Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI). Results: Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44). Conclusions: Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.

• Korean Journal of Culture and Social Issue
• /
• v.15 no.1
• /
• pp.95-132
• /
• 2009

Can money buy happiness? If not, what are the factors that influence happiness? What makes people happy? What are the factors that influence happiness among Korean adults? How can we better explain factors that influence happiness? These are the research questions that led to the analyses of psychological, relational, financial resources that influence happiness. To examine differences in socio-economic status, adults and elderly from three different districts that vary wealth and income were interviewed in their own home. A total of 313 respondents (male=133, female=180) between the ages of 20 through 80 completed a questionnaire that contained background information, emotional support scale and happiness scale developed by the present researcher and resiliency of efficacy developed by Bandura(1995). The results are as follows. First, monthly income influence happiness to some extent, but when the variable was excluded from the path analysis, the goodness-of-fit did not change significantly. Although those who have more money can be happier, those without much money can also be happy. These results indicate that financial resource has limited influence on happiness. In addition, monthly income did influence self-efficacy of respondents indicating that those with more money were not necessarily more confident about themselves. Second, an important factor influencing happiness is the relational resource. Emotional support was the most powerful predictor of happiness, four to five times more important than monthly income. Third, self-efficacy influenced happiness. Those respondents with higher resiliency of efficacy had higher happiness scores and the influence was two times greater than monthly income. Moreover, self-efficacy played a mediating role between emotional support and happiness. Fourth, those respondents with higher occupational achievement reported higher happiness score and the influence was two times greater than monthly income. Fifth, success of children influenced happiness score and the influence was 1.5 times greater than monthly income. Sixth, education did not directly influence happiness, but had an indirect influence through self-efficacy and occupational achievement. Seventh, age was not related to self-efficacy and happiness.

• Journal of agricultural medicine and community health
• /
• v.22 no.1
• /
• pp.1-18
• /
• 1997

This study was carried out to reveal the status of health examination among farmers and to attract more attention to the health care system for farmers. Ten pre-trained medical students interviewed the rural residents 18 years of age and older in eight villages which were randomly selected from a county near Taegu city in Korea, in August 1996. Finally 751 persons were interviewed of whom the percentages of male and female were 41.8%, 58.2% respectively. Among the subjects, 361(48.3%) were fully engaged in farming, 184(24.4%) were partly engaged, and the remaining 206(27.3%) were not engaged in farming at all. The overall prevalence of farmer's disease was 23.0% and there was no significant difference between the group of fully engaged in farming(23.3%) and the group of not-fully engaged(22.9%). But the prevalence of farmer's disease in female subjects(27.8%) was significantly higher than that in male(16.2%)(p<0.01). Among the 288 farmer engaged in spraying pesticide, 113(39.2%) had experienced one or more pesticide related symptoms during last one year, but only 18(15.9%) of them had visited medical facilities due to their symptoms. The experience of receiving education about pesticide was significantly correlated with the degree of wearing protectors during pesticide spraying(p<0.001). Among the 736 persons excluding non-respondents, 281(38.2%) received health examination during last one year ; 176(62.6%) of them received free health examination, and 105(37.4%) received charged one. Among the 533 persons 40 years age and older, only 124(23.3%) had received the 'health examination for the elderly' during last one year, which is provided for the 40 years age and older by Korea medical insurance corporation and medical insurance societies. Most of all beneficiaries of self-employed medical insurance thought the imposed contributions as very expensive(77.4%) or moderately expensive(13.2%). The great majority of farmers are exposed to various health risk factors including pesticide, high temperature, overwork etc. comparable to industrial workers. But farmers are excluded from the regular yearly worker's health examination because of not belonging to a company despite they pay relatively more medical insurance contributions compared with the industrial workers and the urban self-employed medical insureds. It is necessary to develop special health management program for farmers such as the special health examination for the industrial workers exposed harmful agents.

• Radiation Oncology Journal
• /
• v.18 no.4
• /
• pp.257-264
• /
• 2000

Purpose: For early stage non-small-cell lung cancer, surgical resection is the treatment of choice. But when the patients are not able to tolerate it because of medical problem and when refuse surgery, radiation therapy is considered an acceptable alternative. We report on the treatment results and the effect of achieving local control of primary tumors on survival end points, and analyze factors that may influence survival and local control. Materials and Method : We reviewed the medical records of 32 patients with medically inoperable non-small cell lung cancer treated at our institution from June, 1987 through June, 1997. All patients had a pathologic diagnosis of non-small cell lung cancer and were not candidate for surgical resection because of either patients refusal (4), old age (2), lung problem (21), chest wail invasion (3) and heart problems (3). In 8 patients, there were more than 2 problems. The median age of the patients was 68 years (ranging from 60 to 86 years). Histologic cell type included souamous (24), adenocarcinoma (6) and unclassiried squamous cell (2). The clinical stages of the patients were 71 in 5, 72 in 25, 73 in 2 patients. Initial tumor size was 3.0 cm in 11, between 3.0 cm and 5.0 cm in 13 and more than 5.0 cm in 8 patients. Ail patients had taken chest x-rays, chest CT, abdomen USG and bone scan. Radiotherapy was delivered using 6 MV or 10 MV linear accelerators. The doses of primary tumor were the ranging from 54.0 Gy to 68.8 Gy (median; 61.2 Gy). The duration of treatment was from 37 days through 64 days (median; 0.5 days) and there was no treatment interruption except 1 patient due to poor general status. In 12 patients, concomitant boost technique was used. There were no neoadjuvant or adjuvant treatments such as surgery or chemotherapy. The period of follow-up was ranging from 2 months through 93 months (median; 23 months). Survival was measured from the date radiation therapy was initiated. Results : The overall survival rate was 44.6$\%$ at 2 years and 24.5$\%$ at 5 years, with the median survival time of 23 months. of the 25 deaths, 7 patients died of intercurrent illness, and cause-specific survival rate was 61.0$\%$ at 2 years and 33.5$\%$ at 5 years. The disease-free survival rate was 38.9$\%$ at 2 years and 28.3$\%$ at 5 years. The local-relapse-free survival rate was 35.1$\%$, 28.1$\%$, respectively. On univariate analysis, tumor size was significant variable of overall survival (p=0.0015, 95$\%$ C.1.; 1.4814-5.2815), disease-free survival (P=0.0022, 95$\%$ C.1., 1.4707-5.7780) and local-relapse-free survival (p=0.0015, 95$\%$ C.1., 1.2910- 4.1197). 7 stage was significant variable of overall survival (p=0.0395, 95$\%$ C.1.; 1.1084-55.9112) and had borderline significance on disease-free survival (p=0.0649, 95$\%$ C.1.; 0.8888-50.7123) and local-relapse-free survival (p=0.0582, 95$\%$ C,1.; 0.9342-52.7755). On multivariate analysis, tumor size had borderline significance on overall survival (p=0.6919, 955 C.1., 0.9610-5.1277) and local-relapse-free survival ( p=0.0585, 95$\%$ C.1.; 0.9720-4.9657). Tumor size was also significant variable of disease-free survival (p=0.0317, 95% C.1.; 1.1028-8.4968). Conclusion : Radical radiotherapy is an effective treatment for small (71 or f3 cm) tumors and can be offered as alternative to surgery in elderly or infirmed patients. But when the size of tumor is larger than 5 cm, there were few long-term survivors treated with radiotherapy alone. The use of hypefractionated radiotherapy, endobronchial boost, radisensitizer and conformal or IMRT should be consider to improve the local control rate and disease-specific survival rate.

• Journal of Korean Academy of Nursing
• /
• v.30 no.6
• /
• pp.1488-1502
• /
• 2000

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

• Sleep Medicine and Psychophysiology
• /
• v.24 no.1
• /
• pp.38-45
• /
• 2017

Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

• Journal of Chest Surgery
• /
• v.38 no.4 s.249
• /
• pp.263-270
• /
• 2005

In recent years, a combination of two demographic phenomena, an increased number of older people in the population and an increase in the incidence of lung cancer with age, has made it mandatory to develop therapeutic modalities with less toxicity for the treatment of inoperable elderly patients with lung cancer. Therefore, we investigated the correlation between COX-2 expression and cytotoxicity of Nimesulide, a specific COX-2 inhibitor. Material and Method: Immunohistochemical staining of COX-2 was performed. After exposure of Nimesulide, XTT analysis, FACS analysis and Hoechst staining were carried out. Result: COX-2 protein was expressed in non-treated A549 cells strongly, but not in H1299. Cytotoxicity of Nimesulide against A549 cell and H1299 cell were similar and $IC_{50}$ of Nimesulide in both cell lines were $70.9{\mu}M$ in A549 cell line and $56.5{\mu}M$ in H1299 cell line respectively. FACS analysis showed $G_0/G_1$ arrest in both cell lines and the S phase cell fraction was decreased. Morphologic assessment of apoptosis by Hoechst 33258 staining, many apoptotic cells were detected in both cell lines. Conclusion: Selective COX-2 inhibitor, Nimesulide, can inhibit the proliferation of non-small cell lung cancer cell lines in vitro. Inhibitory effect of Nimesulide are induction of apoptosis and $G_0/G_1$ arrest. There is no correlation between COX-2 expression and cytotoxicity of Nimesulide, a specific COX-2 inhibitor. Therefore, highly selective COX-2 inhibitors such as Nimesulide can be expected to lead to even greater efficacy of their use as adjuncts to various anticancer angents and radiation therapy for the treatment of high-risk patients.

• Journal of Chest Surgery
• /
• v.38 no.9 s.254
• /
• pp.616-621
• /
• 2005

Background: In the resection of lung cancer, pneumonectomy occupied $20 {\~}35\%$ of all resections, and significantly high operative mortality is reported in right pneumonectomy ($10{\~}25\%$). The aim of this study is to identify the characteristics of morbidity, operative mortality and factors affecting operative mortality after pneumonectomy. Material and Method: This study recruited the database which performed pneumonectomy for lung cancer in Korea Cancer Center Hospital from Aug 1987 to Apr 2002. Result: Total of 386 pneumonectomies were peformed in that period. Sidedness were left in 238, right in 148; and the procedures were standard resection in 207, and extended resection in 179. Morbidity occurred in 115 cases ($29.8\%$, 115/386). Mortality occurred in 12 cases ($3.1\%$, 12 in 386). This mortality rate was similar to that of lobectomy ($2.1\%$, 13 in 613) during the same period. Morbidity consisted of 42 hoarseness, 17 (9) pneumonia and ARDS, 8 empyema, 5 (1) broncho-pleural fistula, 5 reoperation for bleeding, 5 (1) arrhythmia, 1 (1) pulmonary edema, and 25 others (The number in the parenthesis is the number of mortality case for that morbidity). Several factors affecting the operative mortality were evaluated. At first, extended procedure ($3.3\%$, 6 in 179) affected the operative mortality similar to the standard procedure ($2.9\%$, 6 in 207)(p=0.812). Second, the rate of operative mortality in an elderly group over 60 years ($5.5\%$, 10 in 182) was significantly higher than the younger group under 60 years ($1\%$, 2 in 204)(p=0.016). Third, sidedness of resection affects to operative mortality. Right pneumonectomy ($6.8\%$, 10 in 148) showed higher operative mortality than that of left pneumonectomy ($0.8\%$, 2 in 238)(p=0.002). The group over 60 years showed higher incidence of respiratory morbidity ($11.0\%$, 20 in 182) than that of the group under 60 years ($3.4\%$, 7 in 204)(p=0.005). Right pneumonectomy also showed significantly higher incidence ($11.5\%$, 17 in 148) than that of left pneumonectomy ($4.2\%$, 10 in 238)(p=0.008). Conclusion: Age and sidedness of pneumonectomy were the risk factors of operative mortality and respiratory complications, Therefore, careful selection of patients and more attention perioperatively were demanded in right pneumonectomy. However, because the operative mortality is acceptable, pneumonectomy could be done safely if the pneumonectomy is necessary for curative resection of lung cancer.

• Clinics in Shoulder and Elbow
• /
• v.10 no.1
• /
• pp.92-98
• /
• 2007

Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

• Journal of dental hygiene science
• /
• v.6 no.4
• /
• pp.271-276
• /
• 2006

This study set out to analyze the relationships between the senior citizens' dental health activities and dental health conditions, to provide basic data to develop a program for their better dental health, and finally to search for the ways to improve their life quality through dental health care. The subjects were 142 senior citizens(58 were male and 84 were female) who were 65 years old or older and visited a dental hospital or clinic in the Seoul metropolitan area from April 17 to April 28, 2006. With the cooperation from the dentists, the investigators examined their dental conditions and conducted one-on-one interviews to collect the information about their demographic characteristics, dental health activities, and subjective dental health conditions. The collected data were analyzed with T-test, ANOVA and Pearson's correlation coefficient using the SPSS WIN 11.5 program. The analysis results were summarized as follows: First, 58 men(40.8%) and 84 women(59.2%) consisted of the subject group, where percentage of the female participants was bigger Those who were aged from 65 to 69 made the biggest age group in the subjects, accounting for 58.5% with 83. Second, those who had three dental caries or less and then didn't treat them or treated them(F) accounted for the biggest percentage with 117(82.4%) and 72(50.7%) respectively. As for the remaining teeth, the biggest number of them(40 subjects, 28.2%) had three or less remaining. Third, it turned out the female subjects had a higher level of dental health activities than their male counterparts(P = 0.00). As for living expenses, those who were paid salary or earned income themselves carried out their dental health activities in a higher level than those who lived on the benefit from the government(p = 0.02). Fourth, the subjects' subjective dental health conditions had negative correlations with their dental caries not treated. And there were positive correlations between their dental caries not treated and dental caries lost and between their dental caries treated and remaining teeth. Fifth, those subjects who earned their living expenses themselves had the most dental caries treated at 5.4(p = 0.02), and there was statistically significant difference with the numbers. Sixth, those subjects who brushed their teeth in their own manner had 11.8 teeth lost(p = 0.05), which was more than the number of those who brushed their teeth in other methods. And there was statistically significant difference among them. The remaining teeth were found most at 17.3(p = 0.00) among those who brushed their upper and lower teeth separately. In addition, those who visited the public health center often had significantly more teeth treated(4.3) than others(p = 0.00).