• 한국노년학
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• v.37 no.2
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• pp.281-291
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• 2017

The present study aimed to investigate the rate of unmet healthcare needs for elderly over the age of 65 years, as well as analyze the relevance between employment status and unmet healthcare needs due to financial reasons. With regard to the study method, a logistic regression analysis was performed to investigate the correlation between employment status and unmet healthcare needs due to financial reasons, targeting 5,528 subjects over the age of 65 years. The results showed that the rate of unmet healthcare needs was 18.9%, in which the rate of unmet healthcare needs due to financial reason was 8.1%. The rate of unmet health needs was higher for temporary workers(ORs=1.75) than for retirement workers. However, the rate of unmet healthcare needs caused by financial reasons was higher among day workers(ORs=1.92). In conclusion, in order to prevent unmet healthcare needs for senior Korean patients, it is necessary to not only improve the income security system for the elderly, but also improve the occupational form and level of income of these economically active citizens, considering the increase in average life expectancy. Moreover, it is also necessary to reinforce health insurance coverage systems for settling medical expenses.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.465-473
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• 2018

Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.

• Journal of Nutrition and Health
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• v.51 no.6
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• pp.580-589
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• 2018

Purpose: The purpose of this study was to evaluate the food insecurity status and dietary behavior and examine the association between the food insecurity status and consumption of processed beverage for secondary school students in Vientiane, capital city of Lao PDR. Methods: The study subjects are 714 students (boys = 307 and girls = 407) in four secondary schools (Chao_Anouvong, Phiavat, Saysetha, and Chansavang) of Vientiane, Lao PDR. Data on study subject's demographic characteristics, dietary behavior, food insecurity, and Mini Dietary Assessment (MDA) index were collected. A "Self-Administered Food Security Survey Module for Children Aged 12 Years and Older" developed by the United States Department of Agriculture (USDA) was used for the food insecurity assessment. Results: As a result, 72.7% of the subjects were in a state of food insecurity, and food security was associated with higher socioeconomic status (higher life satisfaction, higher parent's education attainment, higher item ownership, fewer number of siblings, and having more lunches at the school restaurant than at home). Compared to the food insecurity group, the frequency of breakfast, self-rated diet, and the total score of MDA index were higher in the food security group. On the other hand, multiple logistic regression analysis showed that 'food security' was also associated with a higher consumption of processed beverages (OR 1.544; 95% CI 1.078-2.213; p = 0.018). Conclusion: Improving the quality of the diet is essential for adolescents in both the food insecurity and food security groups in Lao PDR. Therefore, it is necessary to provide well organized nutrition education and establish adequate nutrition policy for adolescents in Lao PDR.

• Journal of agricultural medicine and community health
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• v.43 no.4
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• pp.234-249
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• 2018

This study was performed to identify the impact of awareness and educational experiences on cardiopulmonary resuscitation in the ability to execute of cardiopulmonary resuscitation among Korean adults. This study used original data of 2014 Community Health Data Survey. 228,712 participants in this survey were resident in South Korea who is aged 19 or older on July 2014. Participants in this survey were sampled an average of 900 residents(target error ${\pm}3percent$) per community health center of Korea. Data were analyzed by using R 3.1.3 employing chi-squared test, fisher's exact analysis, and logistic regression analysis. Ability to execute CPR was significantly higher in males(3.34 time), higher the education level (1.61 times), the white color occupation (1.14 times), the higher the income level (1.07 times), the higher the education level (0.91 times), non-hypertensive patients (1.12 times), non-diabetic patients (1.16 times), non-dyslipidemic patients (0.86 times), non-stroke patients (0.30 times), CPR education experience group (3.25 times), CPR experience group with manikin-based training (4.30 times), higher subjective health status (1.08 times, 1.16 times) respectively. This study identified that awareness, educational experience, and mannequin-based learning experience of CPR impacted on the ability to execute CPR. Responding to education-related factors could contribute to reducing the rate of out-of-hospital acute cardiac arrest by improving the ability to execute CPR of the general public.

• Pediatric Infection and Vaccine
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• v.25 no.3
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• pp.148-155
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• 2018

Purpose: The purpose of this study was to investigate the clinical significance of Bacille Calmette-$Gu{\acute{e}}rin$ (BCG) site reaction in terms of diagnosis and outcome prediction in young children with Kawasaki disease (KD). Methods: The incidence of BCG site reaction in the respective age ranges was investigated in 1,058 patients who were admitted at Asan Medical Center between January 2006 and February 2017. The 416 patients under 18 months of age were enrolled as subjects for the analysis of the association between BCG site reaction and other laboratory and clinical findings. The analysis was performed separately in complete and incomplete KD groups. Results: The incidence rate of BCG site reaction was peaked at 6-12 months (83%) and decreased with increasing age after 12 months in 1,058 patients (P<0.001). The incidence rate was above 70% in KD aged less than 18 months and more frequent than those of cervical lymphadenopathy. The logistic regression analyses showed that the principal clinical findings including conjunctivitis (P=0.781), red lips/oral mucosa (P=0.963), rash (P=0.510), cervical lymphadenopathy (P=0.363), changes in extremities (P=0.283) and the coronary artery aneurysm (P=0.776) were not associated with the BCG site reaction. Conclusions: The BCG site reaction could be a useful diagnostic tool independent to principal clinical findings in KD developing in children aged <18 months, who underwent BCG vaccination. Outcome of KD patients was not different between groups with or without the BCG site reaction in both complete KD and incomplete KD.

• Journal of the Korean Society of Radiology
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• v.13 no.3
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• pp.339-348
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• 2019

The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.

• Journal of Nutrition and Health
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• v.52 no.5
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• pp.435-448
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• 2019

Purpose: This study examined the changes in the nutrient intake and the prevalences of obesity and metabolic syndrome according to the eating alone behavior in middle-aged men and women. Methods: The data from the 2013 ~ 2017 Korean National Health and Nutrition Examination Survey were analyzed. A total of 7,728 adults (3,404 male, 4,324 female) aged 40 ~ 64 years old were included. The subjects were classified into three groups according to the number of times eating alone per day (0, 1 ~ 2, and 3 times/day). Dietary data were collected by a 1-day 24-h recall. The nutrient intakes were compared among the three groups. Survey logistic regression analyses were conducted to examine the association of the eating alone behavior with obesity and metabolic syndrome, adjusting for the related confounding variables. Results: In men, eating alone was associated significantly with a lower intake of potassium (p-for-trend = 0.048) and lower intake of calories from protein (p-for-trend = 0.04). In women, the proportion of subjects consuming energy less than 75% of the estimated energy requirement (p = 0.001) and less than the estimated adequate requirement of riboflavin (p < 0.001) differed significantly according to the eating alone behavior. The eating alone behavior was positively associated with an increased risk of developing metabolic syndrome (p-for-trend = 0.033), increased blood pressure (p-for-trend < 0.001), and increased waist circumference (p-for-trend = 0.004). On the other hand, in women, however, the eating alone behavior was associated with a decreased risks of developing obesity (p-for-trend = 0.02). No association was found between the eating alone behavior and the risk of metabolic syndrome in women. Conclusion: These results suggest that the eating alone behavior is a risk factor for the development of metabolic syndrome in middle-aged Korean men.

• Journal of Nutrition and Health
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• v.52 no.5
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• pp.475-487
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• 2019

Purpose: With the increase of going out to eat, reducing the sodium in restaurant foods has a crucial impact on reducing sodium intake. This study aimed to assess the current status and perceptions of restaurant staffs related to reducing sodium use in restaurants. Methods: Restaurant managers and chefs (n = 312) in Seongnam area completed a questionnaire on the current status related to sodium use, the barriers to practice for reducing sodium use, support needs, and the practicability of methods for reducing sodium use in restaurants. Results: The percentage of restaurants in the preaction stage (including the precontemplation, contemplation, and preparation stages) for reducing sodium use was 79.7%. Logistic regression analysis showed that measuring salinity while cooking was associated with measuring seasoning (OR, 4.761; 95% CI, 2.325 ~ 9.751), action/maintenance stages of behavior change (OR, 2.829; 95% CI, 1.449 ~ 5.525) and providing salinity information of restaurant foods (OR, 6.314; 95% CI, 2.964 ~ 13.45). Maintaining taste and hindering the cooking process were the main barriers to reduce sodium use. The total practicability of actions for reducing sodium was higher in staffs who worked in restaurants that measured seasoning and salinity while cooking (p < 0.05 and p < 0.01, respectively). The hardest item to practice was 'purchase foods after comparing sodium content in the nutrition labeling'. 'Avoid serving salt-fermented foods as side dishes', 'serve small portions of kimchi and less salty kimchi', and 'put up promotional materials for reducing sodium intake' were selected as easy items to perform. The majority (82%) was willing to reduce sodium in restaurant foods under the support of local government and they desired the promotion of participating restaurants and education on cooking skills to reduce sodium. Conclusion: Measuring seasoning and salinity while cooking is a meaningful practice that is associated with stages of behavior change and the practicability of actions for reducing sodium. It is necessary to provide support and education with a gradual approach to staffs for reducing sodium in restaurant foods.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.126-134
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• 2020

Objectives : The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods : 182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-to-work support between the patient group and caregiver group (patient's needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results : 34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is "very necessary". The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-to-work support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p=0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions : The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

• 한국노년학
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• v.37 no.1
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• pp.83-102
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• 2017

Expending on a life course perspective, this study explores the long-term and short-term reciprocity in parent-child relationships in Korean context. Since the reasons for providing filial support are believed to differ by gender, we focused on how a child's gender affects both types of reciprocity. Data were collected from middle-aged sons (N=726) and daughters (N=883) with at least one surviving parent. Logistic regression was then conducted in order to examine the relations between the support a child currently provides to parents and the current or previous support received from the parents. Dependent variables are financial and instrumental support that middle-aged child currently provide to the parents. The financial and instrumental support a child received from the parents within a year are included in the model as an independent variable to assess short-term reciprocity. The level of financial support a child has received during the transition to adulthood process is included in the model as a independent variable to explore long-term reciprocity. Result supports the existence of gender differences in the long-term reciprocity. Daughters provided instrumental support in response to the financial support that they had received from parents during the transition to adulthood process. However, for sons, this tendency was not found. When it comes to financial support, long-term reciprocity was observed neither for the sons nor for the daughters. Both sons and daughters are prone to provide financial support to the aged parents regardless of the level of financial support they had received during the transition to adulthood process. Short-term reciprocity was found both in sons and daughters. when they have been receiving a financial or an instrumental support from the aged parents within a year, they tend to provided instrumental support to the parents. This study shows that the aged parents still fulfill the reciprocal relationship to a certain degree. Secondly, we can conclude that the norm of reciprocity interplays with the norm of filial responsibility in contemporary Korea.