• Title/Summary/Keyword: health determinants

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Underweight Related Factors in School-Aged Children in Daegu (대구지역 초등학생의 저체중 현황파악 및 관련요인 분석)

  • Yun, Young-Hee;Park, Kyong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.10
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    • pp.1592-1599
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    • 2013
  • Despite numerous studies regarding overweight or obese children, only a limited number of studies have investigated the effect of underweight. The purpose of this study is to investigate the determinants of underweight among school-aged children. A total of 493 students (86 underweight and 407 normal weight students) aged 11 to 13 years were included in our study. Socio-demographic characteristics, eating habits, health information, self-perception of weight, weight-control efforts and birth-related information were collected by using survey questionnaires for children and parents. Dietary information was obtained by two 24-hour food records, which were completed by both children and their parents. The prevalence of underweight was significantly higher in girls than boys, and the frequency of medical treatment and flu symptoms were higher in underweight children than normal ones. Overall, girls tended to overestimate their own weight; this misclassification was greater among underweight girls. Birthweight was positively correlated with current weight (P<0.05) and height (P<0.01) in girls, but these correlations were not seen in boys. In conclusion, underweight girls had inappropriate self-perception of weight, and underweight in girls may be related with birthweight and inadequate dietary intakes. Therefore, it is important to build a well-designed framework that integrates efforts of home, school, and community to maintain a healthy weight with balanced diet and exercise throughout the lifetime.

The association of snack consumption, lifestyle factors, and pediatric obesity with dietary behavior patterns in male adolescents (남자 청소년의 식행동 패턴에 따른 간식 섭취, 생활 습관 요인 및 비만과의 연관성 연구)

  • Kim, Min-Ji;Song, SuJin;Park, So Hyun;Song, YoonJu
    • Journal of Nutrition and Health
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    • v.48 no.3
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    • pp.228-235
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    • 2015
  • Purpose: Along with the adaptation of a Western dietary pattern and low physical activity, pediatric obesity is increasing in Korea, especially for boys. The aim of this study was to identify dietary behavior patterns and examine the snack consumption, dietary habit, and pediatric obesity by pattern groups. Methods: Boys aged 15~19 years were recruited from one high school in Seoul. A questionnaire including dietary behaviors and lifestyle factors was administered and height and weight were measured. A total of 932 boys participated except boys who had missing or incomplete response (n = 30). Three dietary behavior patterns were identified by cluster analysis; 'Healthy pattern', 'Mixed pattern' and 'Unhealthy pattern'. Results: Snack consumption differed according to dietary behavior patterns group. The healthy and mixed patterns showed higher frequencies of white milk and fruit consumption while the unhealthy pattern as well as the mixed patterns showed higher frequencies of sweetened snack and ice cream consumption. Food availability at home of each food differed according to pattern groups but showed a similar trend with food consumption. Regarding dietary habits, the mixed pattern showed higher proportion of taking dietary supplement and eating dessert while the unhealthy pattern showed lower proportion of eating regular meals and appropriate amount of meals. When the healthy pattern was set as a reference group, the odds ratio of pediatric obesity was 1.11 (CI 0.65-1.87) in the mixed pattern group and 1.88 (CI 1.14-3.10) in the unhealthy pattern group. Conclusion: In conclusion, dietary behaviors including snack consumption and lifestyle factors were connected. Unbalanced diet and undesirable dietary practice are important determinants in pediatric obesity.

Analysis on Factors Influencing Welfare Spending of Local Authority : Implementing the Detailed Data Extracted from the Social Security Information System (지방자치단체 자체 복지사업 지출 영향요인 분석 : 사회보장정보시스템을 통한 접근)

  • Kim, Kyoung-June;Ham, Young-Jin;Lee, Ki-Dong
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.141-156
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    • 2013
  • Researchers in welfare services of local government in Korea have rather been on isolated issues as disables, childcare, aging phenomenon, etc. (Kang, 2004; Jung et al., 2009). Lately, local officials, yet, realize that they need more comprehensive welfare services for all residents, not just for above-mentioned focused groups. Still cases dealt with focused group approach have been a main research stream due to various reason(Jung et al., 2009; Lee, 2009; Jang, 2011). Social Security Information System is an information system that comprehensively manages 292 welfare benefits provided by 17 ministries and 40 thousand welfare services provided by 230 local authorities in Korea. The purpose of the system is to improve efficiency of social welfare delivery process. The study of local government expenditure has been on the rise over the last few decades after the restarting the local autonomy, but these studies have limitations on data collection. Measurement of a local government's welfare efforts(spending) has been primarily on expenditures or budget for an individual, set aside for welfare. This practice of using monetary value for an individual as a "proxy value" for welfare effort(spending) is based on the assumption that expenditure is directly linked to welfare efforts(Lee et al., 2007). This expenditure/budget approach commonly uses total welfare amount or percentage figure as dependent variables (Wildavsky, 1985; Lee et al., 2007; Kang, 2000). However, current practice of using actual amount being used or percentage figure as a dependent variable may have some limitation; since budget or expenditure is greatly influenced by the total budget of a local government, relying on such monetary value may create inflate or deflate the true "welfare effort" (Jang, 2012). In addition, government budget usually contain a large amount of administrative cost, i.e., salary, for local officials, which is highly unrelated to the actual welfare expenditure (Jang, 2011). This paper used local government welfare service data from the detailed data sets linked to the Social Security Information System. The purpose of this paper is to analyze the factors that affect social welfare spending of 230 local authorities in 2012. The paper applied multiple regression based model to analyze the pooled financial data from the system. Based on the regression analysis, the following factors affecting self-funded welfare spending were identified. In our research model, we use the welfare budget/total budget(%) of a local government as a true measurement for a local government's welfare effort(spending). Doing so, we exclude central government subsidies or support being used for local welfare service. It is because central government welfare support does not truly reflect the welfare efforts(spending) of a local. The dependent variable of this paper is the volume of the welfare spending and the independent variables of the model are comprised of three categories, in terms of socio-demographic perspectives, the local economy and the financial capacity of local government. This paper categorized local authorities into 3 groups, districts, and cities and suburb areas. The model used a dummy variable as the control variable (local political factor). This paper demonstrated that the volume of the welfare spending for the welfare services is commonly influenced by the ratio of welfare budget to total local budget, the population of infants, self-reliance ratio and the level of unemployment factor. Interestingly, the influential factors are different by the size of local government. Analysis of determinants of local government self-welfare spending, we found a significant effect of local Gov. Finance characteristic in degree of the local government's financial independence, financial independence rate, rate of social welfare budget, and regional economic in opening-to-application ratio, and sociology of population in rate of infants. The result means that local authorities should have differentiated welfare strategies according to their conditions and circumstances. There is a meaning that this paper has successfully proven the significant factors influencing welfare spending of local government in Korea.

Variation of Hospital Costs and Product Heterogeneity

  • Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.123-127
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    • 1978
  • The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

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Sexuality, Contraception, and Induced Abortion among Adolescents and Young Adults in the Export Processing Zones of Korea (미혼여성의 성, 피임, 그리고 인공유산 - 수출공단지역의 사례연구)

  • 조성남
    • Korea journal of population studies
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    • v.19 no.1
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    • pp.93-122
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    • 1996
  • This is a study of the determinants of sexual, contraceptive, and abortion behavior among unmarried female adolescents and young adults, which has emerged as a growing and serious health problem in Korea. As part of a larger project, data were gathered in three export zones: Kuro (Seoul), Kumi (Kyngbuk) Masan Changwon (Kyongnam) ; and the study samples are regrouped into three categories: 1) factory workers, i.e. , the reference group serving as program participants, 2) entertainment workers, and 3) ob-gyn patients. This study indicates that entertainment workers are at highest risk of experiencing premarital sex, STDs, contraceptive failure, unwanted pregnancies, and induced abortion. Of them, 20 percent had STDs as a result of first sexual experience: and about seven tenths had two or more pregnancies due to the adoption of low-efficacy methods. The proportion of those who had ever been pregnant was 60 percent for the group as a whole: 36 percent for the program participants: 64 percent for the entertainment workers ; and 91 percent four the ob-gyn patients. These proportions are exactly the same for abortion in each group, which means that all pregnancies ended in induced abortion. Of the respondents who said that they were sexually active at the time of survey, abortions were very high: 1.6 for the program participants, 2.3 for the entertainment workers, and 1.9 for the ob-gyn patients. About 80 percent of the women had abortions during the first trimester, and two thirds of the first abortions took place between the ages of 20 and 23. About one fourth experienced post-abortion complication, which was highest among the program participants (39 percent). Sixty percent of those with complications visited a hospital or took medicine to treat the problem. Even after the experience of induced abortion, the use of contraception was very low, except among the entertainment workers, whose level of use reached 53 percent. The most obvious recommendation, arising from this research, is that 'good-quality' counselling and family planning services be established under the auspices of both national and local government, particularly targeted for the entertainment workers as well as the factory workers in various textile, electronic, manufacturing, and other industrial sectors. We believe that entertainment sectors should be restructured radically so that young women who work for amusement bars and other entertainment sectors obtain protection from the risk of having unwanted pregnancies, STDs, and induced abortion.

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The Effect of Body Mass Index, Fat Percentage, and Fat-free Mass Index on Pulmonary Function Test -With Particular Reference to Parameters Derived from Forced Expiratory Volume Curve- (신체질량지수 및 체지방률, 그리고 제지방지수가 폐기능 검사에 미치는 영향 -노력성 호기곡선을 중심으로-)

  • Park, Ji Young;Pack, Jong Hae;Park, Hye Jung;Bae, Seong Wook;Shin, Kyeong Cheol;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.2
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    • pp.210-218
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    • 2003
  • Background : Sex specific cross sectional reference values for the lung function indices usually employ a linear model with a term for age and height. The purpose of this study was to determine the effects of the body mass index (BMI), the fat percentage of the body mass and the fat-free mass index (FFMI) on the forced expiratory volume curve. Methods : Between January 2000 and December 2001, a total of 300 subjects, 150 men and 150 women (mean age : $45{\pm}13$ years), with a normal lung function were enrolled in the study sample. This study measured the $FEV_1$, FVC and $FEF_{25-75%}$ from the forced expiratory volume curve by a spirometer and the body composition by a bioelectrical impedance method in all subjects. Multiple regression analysis was used in order to examine the effects of the body composition on the parameters derived from the forced expiratory volume curve. Results : After adjusting for age, the BMI and Fat percentage improved the descriptions of the FVC (p<0.05, $r^2=0.491$) and $FEV_1$ (p<0.05, $r^2=0.654$) in women. In contrast, the FFMI contributed significantly to the FVC (p<0.05, $r^2=0.432$) and $FEV_1$ (p<0.05, $r^2=0.567$) in men. The $FEF_{25-75%}$ correlated with the fat percentage in women (p<0.05, $r^2=0.337$). Conclusion : These results suggest that the BMI, the fat percentage and the FFMI are significant determinants of the forced expiratory volume curve. The plmonary function test, when considering the BMI, the fat percentage and the FFMI, might be useful in clinical applications.

The Gap between Social Stratification in the Aftermath of the 1997 Financial Crisis: The Change of Living Conditions and Daily Life as a Consumer. (외환위기 이후 계층의 양극화: 변화된 일상과 소비생활)

  • Nam, Eun-Young
    • Survey Research
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    • v.10 no.1
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    • pp.1-32
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    • 2009
  • This study examines the changes of income, everyday life and living condition of consumer in the aftermath of financial crisis. In this period financial crisis was the crucial factor behind various social problems such as the dissolution of families and individuals. This research explores the range and degree of impact on individuals and social groups after the financial crisis. We explore the social mobility in terns of maintaining middle class and falling into the lower class measured by middle class identification. The 60% of the middle class before the financial crisis maintained the middle class position and the rest of people left out of middle class and fell into lower class. The 60% of those who has been maintained and has just became the members of middle class were college - educated people. The great part of people whose income and assets has increased after financial crisis belongs to college - educated group. Many of those whose income have decreased belong to the high school educated group and blow, the older than 50 years old, self - employed without employee and unpaid family employee. Those whose income and assets decreased and those who experienced downward mobility have undergone changes in everyday life and living conditions as a consumer. Many of them experienced the unemployment, nonpayment or credit - delinquency, dissolution of family, worsening health condition, depression, feeling the impulse to commit suicide simultaneously. The poor consumer disposition, reduction of living expenses, sound consumer culture have expanded to people since economic crisis. The middle class reported that the cost of private education often goes beyond the family ability to pay. The lower class has suffered from the cost of living. In a meanwhile luxury goods preference, consumer consciousness for status symbol have continuously increased among all the classes since 1997. Thus fluctuations of one's income and social mobility during past 10 years were some of the major determinants which brought about the various damaging life events, changes of living conditions and everyday lives as a consumer.

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COPD Patients with Hypercapnic Respiratory Failure : Response to Therapy and Determinant of Intubation (만성폐쇄성폐질환 환자의 고탄산혈증성 호흡부전 : 치료 반응 및 기도삽관의 결정인자)

  • Song, So-Hyang;Kim, Chi-Hong;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.462-472
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    • 2001
  • Background : The determinants of intubation and the response to therapy in COPD patients with hypercapnic respiratory failure were retrospectively reviewed. Methods : This study involved a review of 132 episodes of hypercapnic respiratory failure($PaCO_2\;{\geq}\;50\;mmHg$ and $pH\;{\leq}\;7.35$). The time frame for resolution or the time to intubation of patients who were admitted between 1996 and 1999 was analyzed. Results : Out of 132 hypercapnic episodes, 49(37%) required intubation. A comparison was made with the 83 cases that responded to treatment. Patients requiring intubation had a greater severity of illness, which included a higher APACHE II (Acute Physiology and Chronic Health Evaluation II) score ($20{\pm}5$ vs $14{\pm}4$ ; p<0.01), a higher WBC, a higher serum BUN, and greater acidosis (pH, $7.23{\pm}0.11$ vs $7.32{\pm}0.04$ ; p<0.01). Those with the most severe acidosis(pH<7.20) had the highest intubation rate(87%) and shortest time to intubation($2{\pm}3\;h$). Conversely, those with an initial pH 7.31 to 7.35 were less likely to be intubated(20%), and had a longer time to intubation($97{\pm}121\;h$). The patients with a pH 7.21 to 7.25($4.1{\pm}2.9$ day) required longer period of time to respond to medical treatment than patients with a pH of 7.31 to 7.35($2.2{\pm}3.1$ day). Of those patients requiring intubation, half(55%) were intubated within 8 h of admission, and most (75%) within 24 h. Of those patients responding to treatment medical therapy, half(52%) recovered within 24 h and most (78%) recovered within 48 h. Conclusion: Respiratory acidosis at the initial presentation is associated with an increased likelihood of intubation. This should assist in deciding help with the decision whether to treat patients medically, institute noninvasive ventilation, or proceed to intubation.

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Improvement of the Efficacy Test Methods for Hand Sanitizers (Gel, Liquid, and Wipes): Emerging Trends from in vivo/ex vivo Test Strategies for Application in the Hand Microbiome (손소독제(겔형, 액제형, 와이프형)의 효능 평가법 개선: 평가 전략 연구 사례 및 손 균총 정보 활용 등 최근 동향)

  • Yun O;Ji Seop Son;Han Sol Park;Young Hoon Lee;Jin Song Shin;Da som Park;Eun NamGung;Tae Jin Cho
    • Journal of Food Hygiene and Safety
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    • v.38 no.1
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    • pp.1-11
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    • 2023
  • Skin sanitizers are effective in killing or removing pathogenic microbial contaminants from the skin of food handlers, and the progressive growth of consumer interest in personal hygiene tends to drive product diversification. This review covers the advances in the application of efficacy tests for hand sanitizers to suggest future perspectives to establish an assessment system that is optimized to each product type (gel, liquid, and wipes). Previous research on the in vivo simulative test of actual consumer use has adopted diverse experimental conditions regardless of the product type. This highlights the importance of establishing optimal test protocols specialized for the compositional characteristics of sanitizers through the comparative analysis of test methods. Although the operational conditions of the mechanical actions associated with wiping can affect the efficacy of the removal and/or the inactivation of target microorganisms from the skin's surface, currently there is a lack of standardized use patterns for the exposure of hand sanitizing wipes to skin. Thus, major determinants affecting the results from each step of the overall assessment procedures [pre-treatment - exposure of sanitizers - microbial recovery] should be identified to modify current protocols and develop novel test methods. The ex vivo test, designed to overcome the limited reproducibility of in vivo human trials, is also expected to replicate the environment for the contact of sanitizers targeting skin microorganisms. Recent progress in the area of skin microbiome research revealed distinct microbial characteristics and distribution patterns after the application of sanitizers on hands to establish the test methods with the perspectives on the antimicrobial effects at the community level. The future perspectives presented in this study on the improvement of efficacy test methods for hand sanitizers can also contribute to public health and food safety through the commercialization of effective sanitizer products.

A relationship between food environment and food insecurity in households with immigrant women residing in the Seoul metropolitan area (수도권 거주 결혼이주여성 가구의 식품환경과 식품불안정성 간의 관련성)

  • Sung-Min Yook;Ji-Yun Hwang
    • Journal of Nutrition and Health
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    • v.56 no.3
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    • pp.264-276
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    • 2023
  • Purpose: Food environmental factors related to food insecurity affect household food intake in several socio-ecological aspects. This study explores the relationship between food environment factors and food insecurity in households with married immigrant women. Methods: From November 2018 to February 2020, a survey was conducted enrolling 249 married immigrant women residing in the metropolitan areas of South Korea. In the final analysis, 229 subjects were divided into 2 groups classified as food security (n = 154) and food insecurity (n = 75), as assessed by the score of food security. Three aspects of food environments were measured: built·natural, political·economic, and socio-cultural Results: Food environments were significantly different between food security and food insecurity groups, as follows: the number of foods market and their distance from the home and food status for the last week at home in the built·natural domain; monthly cost of food purchase and experience for food assistance in the political·economic domain; total score of social support, parenting, and cooking skills in the socio-cultural domain. A stepwise multivariate linear regression model showed a negative association between the food insecurity score with social support from family and food inventory status in the last week. After adjusting for confounders, a positive association was obtained between the experience of a food support program. The final regression model explains about 30% of the relationship obtained in the three food environment domains and food insecurity (p < 0.001). Conclusion: Not only economic factors, which are common determinants of household food insecurity, but socio-cultural factors such as social support also affect household food insecurity. Therefore, plans for implementing a food assistance program to improve food insecurity for households with immigrant women should consider financial support as well as other comprehensive aspects, including socio-cultural domain such as social support from family and community.