• Title/Summary/Keyword: high-risk population

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A Study of Stress and Coping Strategies in School-Age Children (학령기 아동의 스트레스와 대응전략에 관한 연구)

  • 신희선
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.808-819
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    • 1996
  • The purpose of this study was to examine the stressors and coping strategies of school -age children and to explore the relationship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjects consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35 (SD=.86). The Feel Bad Scale(FBS), Schoolager's Coping Strategy Inventory(SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire (HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from .81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov.25 to Dec.19, 1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows : 1. The mean score for the FBS was 204.79(range : 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range : 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range : 0-81) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms ( r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56.78%. The study revealed that stressful life events correlated with health symptoms in school-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.

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Effects of Climatic Condition on Stability and Efficiency of Crop Production (농업 기상특성과 작물생산의 효율 및 안전성)

  • Robert H. Shaw
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.27 no.4
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    • pp.296-313
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    • 1982
  • At a time when world population and food supply are in a delicate balance, it is essential that we look at factors to improve this balance. We can alter the environment to better fit the plant's needs, or we can alter the plant to better fit the environment. Improved technology has allowed us to increase the yield level. For moderately detrimental weather events technology has generally decreased the yield variation, yet for major weather disasters the variation has increased. We have raised the upper level, but zero is still the bottom level. As we concentrate the production of particular crops into limited areas where the environment is closest to optimum, we may be increasing the risk of a major weather related disaster. We need to evaluate the degree of variability of different crops, and how weather and technology can interact to affect it. The natural limits of crop production are imposed by important ecological factors. Production is a function of the climate, the soil, and the crop and all activities related to them. In looking at the environment of a crop we must recognize these are individuals, populations and ecosystems. Under intensive agriculture we try to limit the competition to one desired species. The environment is made up of a complex of factors; radiation, moisture, temperature and wind, among others. Plant response to the environment is due to the interaction of all of these factors, yet in attempting to understand them we often examine each factor individually. Variation in crop yields is primarily a function of limiting environmental parameters. Various weather parameters will be discussed, with emphasis placed on how they impact on crop production. Although solar radiation is a driving force in crop production, it often shows little relationship to yield variation. Water may enter into crop production as both a limiting and excessive factor. The effects of moisture deficiency have received much more attention than moisture excess. In many areas of the world, a very significant portion of yield variation is due to variation in the moisture factor. Temperature imposes limits on where crops can be grown, and the type of crop that can be grown in an area. High temperature effects are often combined with deficient moisture effects. Cool temperatures determine the limits in which crops can be grown. Growing degree units, or heat accumulations, have often been used as a means of explaining many temperature effects. Methods for explaining chilling effects are more limited.

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Medical Expenditure Attributable to Overweight and Obesity in Adults with Hypertension, Diabetes and Dyslipidemia : Evidence from Korea National Health and Nutrition Examination Survey Data and Korea National Health Corporation Data (성인의 고혈압, 당뇨병, 이상지질혈증으로 인한 총 진료비 중 과체중 및 비만의 기여분 : 국민건강영양조사자료와 국민건강보험공단 자료를 중심으로)

  • Kang, Jae-Heon;Jeong, Baek-Geun;Cho, Young-Gyu;Song, Hye-Ryoung;Kim, Kyung-A
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.77-88
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    • 2010
  • Objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with hypertension, diabetes and dyslipidemia using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. Methods: The medical expenditure of hypertension, diabetes and dyslipidemia related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. Results: The medical expenditure attributable to overweight and obesity of hypertension were 456 billion won (men : 215 billion won, women : 241 billion won). Those of diabetes were 282 billion won (men : 148 billion won, women : 135 billion won), and of dyslipidemia were 17 billion won (men : 9 billion won, women : 8 billion won). Consequently, these costs corresponded to 33.3% of total medical expenditure due to hypertension, diabetes and dyslipidemia. Conclusions: We found a substantial medical expenditure due to overweight and obesity of hypertension, diabetes and dyslipidemia were very high. In order to reduce these costs, effective national strategies for prevention and management of overweight and obesity should be established and implemented.

National hospital discharge survey for the hospitals with fewer than 100 beds: A pilot project and evaluation (100병상미만 의료기관대상 퇴원환자조사 시범운영 및 평가)

  • Choi, Haeng-Jeong;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3336-3340
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    • 2010
  • This study has been carried out against hospitals with less than 100 beds, which were excluded from the previous study on the discharged patients from January 1 to December 31, 2007. To analyze the discharged patients, the general characteristics of discharged patients, means of payment for medical costs, type of disease and surgery and current status of the use of medical services have been investigated based on the medical records. During the year of 2007, the number of discharged patients from the hospitals with less than 100 beds reached 4,697,095 (9.7% of total population). In other words, 9,693 people were discharged from a hospital per 100,000 populations with 9.8 days in terms of annual mean length of hospitalization. The number of patients who returned home after hospitalization reached 4,538,861 (male: 1,784,041, female: 2,754,821) while 119,378 patients were evacuated to other hospitals. Among them, 8,970 patients were returned back to the original hospital. Based on the results of this study, they could be used in could be used in planning a project which is aimed to reduce public health costs by investigating high-risk groups with particular injuries and preventing damage. In addition, the injury monitoring data which are continuously collected could be useful in monitoring and evaluating the efficiency of an injury prevention program.

Study on the Health Status of the Residents near Military Airbases in Pyeongtaek City (평택시 군용비행장 주변지역 주민건강조사)

  • Kim, Hyun-Joo;Roh, Sang-Chul;Kwon, Ho-Jang;Paik, Ki-Chung;Rhee, Moo-Yong;Jeong, Jae-Yun;Lim, Myung-Ho;Koo, Mi-Jin;Kim, Chang-Hoon;Kim, Hae-Young;Lim, Jeong-Hun;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.307-314
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    • 2008
  • Objectives : We conducted an epidemiologic survey to evaluate the effect of the aircraft noise exposure on the health of the residents near the military airbases in Pyeongtaek City. Methods : The evaluation of environmental noise level, questionnaire survey, and health examination were performed for 917 residents. The study population consisted of four groups: subjects who lived in the village close to the fighter airbase (high exposure), subjects who lived along the course of fighters (intermediate exposure), and subjects near a helicopter airbase, and the control group. Results : The prevalence of the aircraft noise related accident and irritable bowel syndrome in the exposure groups were higher than that of the control group. The risks of noise induced hearing loss, hypertension and diabetes mellitus were higher in the exposed groups than in the control group. The prevalence of anxiety disorder and primary insomnia were higher in the exposed groups than in the control group. Prevalence odd ratios of the risk for primary insomnia after adjusting age, sex, agricultural noise, and occupation were 4.03 [95% confidence interval (95% Cl) 1.56-10.47] for the subject near the helicopter airbase, 1.23 (95% Cl 0.40-3.76) for those intermediately exposed to fighter noise, and 4.99 (95% Cl 2.14-11.64) for those highly exposed to fighter noise. Conclusions : The results of the present study suggest that the aircraft noise may have adverse effects on hearing function, cardiovascular health and mental health. Therefore, it seems to be needed to take proper measures including the control of the aircraft noise and the management of the exposed people's health.

Tumorigenic Effects of 2,3,7,8-Tetrachlorodibenzo-$\rho$-dioxin in Normal Human Skin and Lung Fibroblasts (사람의 정상 피부세포 및 폐세포의 발암에 미치는 2,3,7,8-Tetrachlorodibenzo-$\rho$-dioxin의 영향)

  • Kang, Mi-Kyung;Ryeom, Tai-Kyung;Kim, Kang-Ryune;Kim, Ok-Hee;Kang, Ho-Il
    • Environmental Mutagens and Carcinogens
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    • v.26 no.3
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    • pp.77-85
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    • 2006
  • 2,3,7,8-Tetrachlorodibenzo-$\rho$-dioxin(TCDD) displays high toxicity in animals and has been implicated in human carcinogenesis. Although TCDD is recognized as potent carcinogens, relatively little is known about their role in the tumor promotion and carcinogenesis. It is known that TCDD can increase of cancer risk from various types of tissue by a mechanism possibly involving the aryl hydrocarbon receptor (AhR) activation. In this study, effects of TCDD on cellular proliferation of normal human skin and lung fibroblasts, Detroit551 and WI38 cells were investigated. In addition, to enhance our understanding of TCDD-mediated carcinogenesis, we have investigated process in which expression of Erk1/2, cyclinD1, oncogene such as Ha-ras and c-myc, and their cognate signaling pathway. TCDD that are potent activators of AhR-mediated activity was found to induce significant increase of cytochrome P4501A1 mRNA expression, suggesting a presence of functional AhR. These results support that CYP1A1 enzyme may be involved in the generation of TCDD-induced toxicity. Moreover mitogen-activated protein kinases (MARKs) phosphorylation and cyclin D1 overexpression are induced by TCDD, which corresponded with the progression of cellular proliferation. However, TCDD did not affected Ha-ras and c-myc mRNA expression. Taken together, it seems that TCDD are could be a part of cellular proliferation in non-tumorigenic normal human cells such as Detroit551 and WI38 cells through the upregulation of MAPKs signaling pathway regulating growth of cell population. Therefore, AhR-activating TCDD could potentially contribute to tumor promotion and Detroit551 and WI38 cells have been used as a detection system of tumorigenic effects of TCDD.

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Breast Cancer Clustering in Kanagawa, Japan: A Geographic Analysis

  • Katayama, Kayoko;Yokoyama, Kazuhito;Yako-Suketomo, Hiroko;Okamoto, Naoyuki;Tango, Toshiro;Inaba, Yutaka
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.455-460
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    • 2014
  • Background: The purpose of the present study was to determine geographic clustering of breast cancer incidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the association between socio-economic factors and any identified cluster. Materials and Methods: Incidence data were collected for women who were first diagnosed with breast cancer during the period from January to December 2006 in Kanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa Cancer Registration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio (SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities (e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female population data. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, persons per household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and other regions. Results: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of 11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that of the remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women was significantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancer deaths were detected (p=0.53). Conclusions: There was a statistically significant cluster of high breast cancer incidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related to the tendency to marry later. This study methodology will be helpful in the analysis of geographical disparities in cancer deaths and incidence.

Comparative Analysis of Surgical Outcomes of C1-2 Fusion Spine Surgery between Intraoperative Computed Tomography Image Based Navigation-Guided Operation and Fluoroscopy-Guided Operation

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Ki, Sung Soon;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.237-247
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    • 2020
  • Objective : Fixation of the C1-2 segment is challenging because of the complex anatomy in the region and the need for a high degree of accuracy to avoid complications. Preoperative 3D-computed tomography (CT) scans can help reduce the risk of complications in the vertebral artery, spinal cord, and nerve roots. However, the patient may be susceptible to injury if the patient's anatomy does not match the preoperative CT scans. The intraoperative 3D image-based navigation systems have reduced complications in instrument-assisted techniques due to greater accuracy. This study aimed to compare the radiologic outcomes of C1-2 fusion surgery between intraoperative CT image-guided operation and fluoroscopy-guided operation. Methods : We retrospectively reviewed the radiologic images of 34 patients who underwent C1-2 fusion spine surgery from January 2009 to November 2018 at our hospital. We assessed 17 cases each of degenerative cervical disease and trauma in a study population of 18 males and 16 females. The mean age was 54.8 years. A total of 139 screws were used and the surgical procedures included 68 screws in the C1 lateral mass, 58 screws in C2 pedicle, nine screws in C2 lamina and C2 pars screws, four lateral mass screws in sub-axial level. Of the 34 patients, 19 patients underwent screw insertion using intraoperative mobile CT. Other patients underwent atlantoaxial fusion with a standard fluoroscopy-guided device. Results : A total of 139 screws were correctly positioned. We analyzed the positions of 135 screws except for the four screws that performed the lateral mass screws in C3 vertebra. Minor screw penetration was observed in seven cases (5.2%), and major pedicle screw penetration was observed in three cases (2.2%). In one case, the malposition of a C2 pedicle screw was confirmed, which was subsequently corrected. There were no complications regarding vertebral artery injury or onset of new neurologic deficits. The screw malposition rate was lower (5.3%) in patients who underwent intraoperative CT-based navigation than that for fluoroscopy-guided cases (10.2%). And we confirmed that the operation time can be significantly reduced by surgery using intraoperative O-arm device. Conclusion : Spinal navigation using intraoperative cone-beam CT scans is reliable for posterior fixation in unstable C1-2 pathologies and can be reduced the operative time.

Association of the Nutritional Status and Essential Amino Acids Intake in Hemodialysis Patients (혈액투석환자에서 영양상태와 필수아미노산 섭취의 관련성 연구)

  • Kim, Hye-Jin;Kim, Su-An;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.39 no.7
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    • pp.617-623
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    • 2006
  • The mortality and morbidity rate of hemodialysis patients (HD) remain high. Among many factors, protein and calorie malnutrition has been shown to be a major risk factor for increased mortality in the HD patients population. Malnutrition can be caused by insufficient amino acid intake, nutrient losses in dialysate, oxidant stress and muscle catabolism. In this study, we evaluated the association of markers of nutritional status and essential amino acids intake in HD patients. We investigated nutritional status of 41 HD patients (mean age: $64.2\;{\pm}\;11.5\;y$, men: 24, women: 27) by measuring anthropometric, biochemical parameters and food intakes by using 24 hr recall methods. Subject's total energy intake and total protein intake were $1,648.0\;{\pm}\;397.31\;kcal/day,\;79.2\;{\pm}\;27.2\;g/day$:, respectively. The animal protein intake was $42.7\;{\pm}\;22.1\;g/day$, essential amino acids intake was $23.4\;{\pm}\;9.92\;g/day$, and the ratio of essential amino acids to total protein intake was $29.6\;{\pm}\;5.42%$. There were significantly positive correlation between muscle mass and lean body mass with serum creatinine level (r=0.435, p<0.01; r=0.435, p<0,01). There were also significant positive correlation in muscle mass and lean body mass with pre hemodialysis blood urea nitrogen (preHD BUN) (r=0.329, p<0.05; r=0.329, p<0.05). There were no significant correlation in total energy intake and total protein intake per kg ideal body weight (IBW) to muscle mass and lean body mass. However, there were significantly positive correlation between the ratio of essential amino acids and muscle mass and lean body mass (r=0.368, p<0.05; r=0.405, p<0.01). And serum hematocrit concentration was positively correlated with the ratio of essential amino acids (r=0.032, p<0.05). The results of this study indicate that strong associations exist in essential amino acid intakes with malnutrition than total protein intakes in HD patient. In conclusion, specialized nutrition education should be necessary to efficiently improve the quality of protein intakes.

Overexpression of Phospholipase A2 Group IIA in Esophageal Squamous Cell Carcinoma and Association with Cyclooxygenase-2 Expression

  • Zhai, Yan-Chun;Dong, Bin;Wei, Wen-Qiang;He, Yan;Li, Xin-Qing;Cormier, Robert T.;Wang, Wei;Liu, Fen
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9417-9421
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    • 2014
  • Background: Esophageal cancer is one of the most frequently occurring malignancies and the seventh leading cause of cancer-related deaths in the world. The esophageal squamous cell carcinoma (ESCC) is the most common histological type of esophageal cancer worldwide. Materials and Methods: Our goal in this study was to detect phospholipase A2 Group IIA (PLA2G2A) and cyclooxygenase-2 (COX-2) immuno-expression in ESCC in a high-risk population in China. Results: Positive expression of PLA2G2A protein was observed in 57.2% (166/290) of the cases, while COX-2 was found in 257 of 290 samples (88.6%), both PLA2G2A and COX-2 being expressed in 153 cases (52.8%), with a significant agreement (Kappa=0.091, p=0.031).Overexpression of PLA2G2A was significantly correlated with the depth of invasion (p=0.001). Co-expression of PLA2G2A and COX-2 not only significantly correlated with the depth of invasion (p=0.004) but also with TNM stage (p=0.04). Conclusions: Our results showed that in patients with ESCC, PLA2G2A overexpression and PLA2G2A co-expression with COX-2 is significantly correlated with advanced stage. The biological role and pathophysiologic regulation of PLA2G2A and COX-2 overexpression in ESCC deserve further investigation.