• 정보관리학회지
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• 제33권4호
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• pp.7-26
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• 2016

본 연구는 모바일 개인건강기록(Personal health record: PHR) 어플리케이션의 장단점을 분석하고 그 어플리케이션의 사용이 소비자 건강정보행태에 미치는 영향을 파악하고자 하였다. 본 연구를 위해 총 27명의 대학생들이 3개월 동안 PHR 어플리케이션을 사용하였으며, 그 경험을 바탕으로 서면인터뷰를 실시하였다. 내용분석 결과, 시각적 인터페이스를 통한 예방 차원의 건강관리 및 건강 향상을 위한 동기부여와 구체적 가이드라인의 제공, 가족과의 데이터 공유 및 간병인(caregiver)의 환자 건강관리지원, 무엇보다도 환자와 의료전문가와의 상호작용 강화 등이 PHR의 혜택으로 부각되었다. 반면 근력운동과 같은 콘텐츠의 미비 내지는 타 기기와의 호환성 미흡 등이 문제점으로 지적되었다. PHR의 도움으로 건강을 향상시키고자 하는 소비자들은 감정적 지원을 받는가 하면, 수면장애극복, 금주, 금연, 그리고 체중감량 및 식습관의 변화 등 건강행태를 변화시키고자 하는 동기부여가 생겼으며, 실제로 건강행태의 변화를 성취함으로써 자기효능이 증가하기도 하였다. 본 연구는 국내 연구에서는 도입단계인 PHR에 대한 연구를 시도했다는 것에 학문적 의의가 있으며, 헬스케어분야의 패러다임 변화에 대응하기 위한 건강 및 의료정보서비스를 모색하는데 통찰력 있는 시사점을 제공한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4107-4111
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• 2016

Background: Oral cancers account for approximately 2% of all cancers diagnosed each year; however, the vast majority (80%) of the affected individuals are smokers whose risk of developing a lesion is five to nine times greater than that of non-smokers. Tobacco smoke contains numerous carcinogens that cause DNA damage, including oxidative lesions that are removed effectively by the base-excision repair (BER) pathway, in which poly (ADP-ribose) polymerase 1 (PARP-1), plays key roles. Genetic variations in the genes encoding DNA repair enzymes may alter their functions. Several studies reported mixed effects on the association between PARP-1 variants and the risk of cancer development. Till now no reported studies have investigated the association between PARP-1 variants and oral squamous cell carcinoma (OSCC) risk in an Indian population. Materials and Methods: In the present case control study 100 OSCC patients and 100 matched controls were genotyped using PARP1 single nucleotide peptides (SNP's) rs1136410 and rs3219090 using TaqMan assays. Results: The results indicated significantly higher risk with PARP1 rs1136410 minor allele "C" (OR=1.909; p=0.02942; CI, 1.060-3.439). SNP rs1136410 also showed significantly increased risk in patients with smoking habit at C/C genotype and at minor allele C. Conclusions: The PAPR-1 Ala762Val polymorphism may play a role in progression of OSCC. Larger studies with a greater number of samples are needed to verify these findings.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.837-846
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• 2012

Breast cancer (BCa) is the leading type of cancer in Mexican women. Genetic factors, such as single nucleotide polymorphisms (SNP) of P450 system, have been reported in BCa. In this report, and for the first time in the literature, we analyzed the rs3735684 (7021 G>A), rs11553651 (15016 G>T) and rs56195291 (60020 C>G) polymorphisms in the CYP2W1, 4F11 and 8A1 genes in patients with BCa and in healthy Mexican women to identify a potential association between these polymorphisms and BCa risk. Patients and controls were used for polymorphism analysis using an allelic discrimination assay with TaqMan probes and confirmed by DNA sequencing. Links with clinic-pathological characteristics were also analyzed. Statistical analysis was performed using the standard ${\chi}^2$ or Fisher exact test statistic. No significant differences were observed in the distributions of CYP2W1 (OR 8.6, 95%CI 0.43-172.5 P>0.05; OR 2.0, 95%CI 0.76-5.4, P>0.05) and CYP4F11 (OR 0.3, 95%CI 0.01-8.4 P>0.05) genotypes between the patients and controls. Only the CYP8A1 CC genotype was detected in patients with BCa and the controls. All polymorphism frequencies were in Hardy-Weinberg Equilibrium (HWE) in the controls (P>0.05). We found a significant association between BCa risk and smoking, use of oral contraceptives or hormonal replacement therapy (HRT), obesity, hyperglycemia, chronic diseases, family history of cancer and menopausal status in the population studied (P<0.05). Tobacco, oral contraceptive or HRT, chronic diseases and obesity or overweight were strongly associated with almost eight, thirty-five, nine and five-fold increased risk for BCa. Tobaco, obesity and hyperglycemia significantly increased the risk of BCa in the patients carrying variant genotypes of CYP2W1 (P<0.05). These results indicate that the CYP2W1 rs3735684, CYP4F11 rs11553651 and CYP8A1 rs56195291 SNPs are not a key risk factor for BCa in Mexican women. This study did not detect an association between the CYP2W1, 4F11 and 8A1 genes polymorphisms and BCa risk in a Mexican population. However, some clinico-pathological risk factors interact with CYP2W1 genotypes and modifies susceptibility to BCa.

• Journal of Nutrition and Health
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• 제48권6호
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• pp.468-475
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• 2015

우리나라 일부 건강한 유아를 대상으로 Mn-SOD Val16Ala, GSTP1 Ile105Val, GSTT1 present/null, GSTM1 present/null 유전자 다형성 분포를 살펴본 결과, Mn-SOD Val/Val형, GSTP1 Ile/Ile형, GSTT1 null 형, GSTM1 null 형이 주된 (major) 유전자형인 것으로 나타났다. 이 중 Mn-SOD Val/Val형은 Val/Ala 또는 Ala/Ala형에 비해 소변 8-OHdG 수준이 유의적이지는 않으나 높은 경향을 나타내었고, GSTP1 Ile/Ile형은 Ile/Val 또는 Val/Val형에 비해 소변 8-OHdG 수준이 유의적으로 낮았다. 간접흡연에의 노출 여부와 간접흡연-유전자 다형성의 상호 작용이 산화손상지표에는 유의적인 영향을 미치지 않는 것으로 나타났다. 이상의 결과로 볼 때 건강한 유아에서 GSTP1 Val allele 보유한 경우 산화적 손상에 대해 취약할 수 있음을 제시하며, 추후 대규모 연구를 통한 검증 및 이들 유전자형을 보유한 대상자를 위한 효과적인 영양 중재방안에 대한 고려가 필요할 것으로 사료된다.

• 보건행정학회지
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• 제22권1호
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• pp.1-28
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• 2012

Since its establishment in 1948, World Health Organization (WHO) has tried and facilitated international cooperation of public health under the goal of "the highest attainable health," and gained outcomes like the eradication of smallpox and polio, turning itself into the representative of international public health. However, there was discord between member nations during the cold war era, and the status of WHO experienced rise and fall after its establishment. WHO, the representative international health organization, also has not been freed from influences from international regime changes, which means that the discussion on the internal causes of WHO functionings should be expanded more. In this study, functionalism was tested as one of international relations theory that tries to explain the establishment and role of WHO. Especially, this study analyzed the problems and problem-solving process that WHO had to face by using Imber's five steps theory that arranged chronologically the theory of Mitrany. We mainly investigated the secondary source that described historic facts on the rise and fall of WHO in terms of roles and functionings during establishment of WHO, the cold war era, and international cooperation of public health. The roles of WHO were analyzed by selecting the gains of WHO in the post cold war era. The functionalism arrangement of Imber was appropriate to some extent in explaining the establishment and role of WHO. The first step was International Sanitary Conference in 1851 that made nations to recognize international cooperation of public health, and the second step was the establishment of WHO that handles public health as an international organization. Recent cases of the Framework Convention on Tobacco Control and International Health Regulations showed that each nation agreed with an international norm that they had to cooperate each other to tackle infectious diseases and smoking, and this implies that these were emergence of global governance. This process was the third step of Imber's theory (nations had a gain from international cooperation would agree with the expansion of authority of international organization). However, the last two steps of the theory are still not realized. The partial success of WHO was based on the functional elements that WHO deals with non-political elements, human resources centering on professionals, and democratic decision making process. This essential and non-political characteristics mean that necessity of international cooperation catalyzed by WHO would continue despite of the global governance era when global health governance get faced more challenges.

• 한국산학기술학회:학술대회논문집
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• 한국산학기술학회 2010년도 춘계학술발표논문집 2부
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• pp.1209-1212
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• 2010

본 연구는 제주지역 일부 초, 중학생들의 간접흡연 실태와 그로 인한 현재 흡연 여부 관계를 분석하여 초, 중학생들의 흡연 예방 교육 계획 및 수립에 기초 자료를 제공하고자 본 연구를 시도하였다. 자료 수집 기간은 2009년 6월 29일부터 7월 11일까지 제주특별자치도내 초등학교 5, 6학년 아동 464명과 중학생 475명을 대상으로 설문지를 이용하여 조사하였다. 연구 대상자들의 간접흡연 노출 관련성은 가정불화, 성적, 친구관계스트레스가 있는 대상자에게서 높게 조사되었고, 가족 및 주변인의 흡연유무에 따른 간접흡연 실태는 부모 및 친구의 흡연으로 간접흡연에 노출되었으며 통계적으로 유의한 차이를 보였다. 간접흡연의 주제공자는 아버지며, 주 간접흡연 피해 장소는 집으로 나타났다. 간접흡연 노출 유무를 종속변수로 한 로지스틱 회귀분석 결과는 흡연하는 아버지를 둔 대상자가 그렇지 않은 대상자에 비해 간접흡연 노출이 높았으며, 흡연하는 친구를 둔 대상자는 그렇지 않은 대상자에 비해 간접흡연 노출이 높게 나타났다. 현재흡연 여부를 종속변수로 한 로지스틱 회귀분석의 결과는 남학생이 여학생에 비해, 중학생이 초등학생에 비해 현재흡연율이 높았고, 엄한 가정 분위기 속에서 생활하고 있는 대상자와 흡연하는 친구를 둔 대상자는 그렇지 않은 대상자에 비해 현재흡연율이 높았으며, 간접흡연에 노출 되었던 대상자에게서 현재흡연율이 높게 나타났다. 이상의 결과를 종합하여 볼 때 초, 중학생의 간접흡연 실태는 심각한 사회문제이다. 또한 대상자들의 현재 흡연은 간접흡연 노출과 관련이 있는 것으로 볼 수 있었다. 이러한 간접흡연의 노출 및 그로 인한 흡연율을 줄이기 위해서는 가정 및 학교와 공공장소 등에서 간접흡연에 노출되지 않는 제도적 및 환경적인 조치들이 우선되어야 할 것이며, 학생들을 대상으로 간접흡연에 대한 간접흡연 예방 교육 및 대처방안 교육이 조기에 지속적으로 실시되어야 하겠다. 또한 유치원에서부터 고등학교에 이르기까지 모든 학생들에게 필수적으로 흡연예방 교육을 수강하게 하고, 교사들을 위한 연수교육 실시, 학교 흡연예방사업에 부모나 가족을 참여, 흡연예방 사업의 정기적인 평가 실시 등 국가적인 정책이 동반되어야 할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4517-4525
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• 2016

Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG, and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.391-395
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• 2014

Background: We aimed to evaluate the role of genetic polymorphisms in tobacco carcinogen-metabolizing genes and their interactions with smoking in a hospital-based case-control study of Japanese subjects. Materials and Methods: We examine the associations of pancreatic cancer risk with genetic polymorphisms in GSTM1, GSTT1 and GSTP1, phase II enzymes that catalyze the conjugation of toxic and carcinogenic electrophilic molecules. The study population consisted of 360 patients and 400 control subjects, who were recruited from several medical facilities in Japan. Unconditional logistic regression methods were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between genotypes and pancreatic cancer risk. Results: Among the control subjects, the prevalence of the GSTM1-null genotype and the GSTT1-null genotype was approximately 56% and 48%, respectively. Cases and controls were comparable in terms of GSTM1 and GSTT1 genotype distributions. Neither of the deleted polymorphisms in GSTM1 and GSTT1 was associated with the risk of pancreatic cancer, with an age- and sex-adjusted OR of 0.99 (95%CI: 0.74-1.32) for the GSTM1-null genotype, and 0.98 (95%CI: 0.73-1.31) for the GSTT1-null genotype. The OR was 0.97 (95%CI: 0.64-1.47) for individuals with the GSTM1 and GSTT1-null genotypes compared with those with the GSTM1 and GSTT1- present genotypes. No synergistic effects of smoking or GST genotypes were observed. Conclusions: Our results indicate no overall association between the GSTM1 and GSTT1 deletion polymorphisms and pancreatic cancer risk in the Japanese subjects in our study.

• 농촌의학ㆍ지역보건
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• 제28권2호
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• pp.31-48
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• 2003

30세 이상, 80세 미만 농촌지역 주민 1,754명을 연구 대상자로 선정하여 개인의 건강관련 행태를 알아보기 위해 본 연구진이 고안한 설문지를 이용하였다. 모든 자료는 전산입력 하였고 성별에 따른 건강관련 행태는 연령보정 후 카이 제곱 검정을 시행하여 통계적 유의성을 검정하였고, 연령에 따른 건강관련 행태의 차이는 경향성에 대한 카이 제곱 검정을 시행하였다. 모든 자료의 분석은 SPSS 10.0 for windows 통계 프로그램을 이용하였다. 연령보정 흡연율은 남성에서는 56.1%, 여성에서는 6.8%로 남성에서 여성보다 유의하게 높았다(p<0.01). 연령보정 음주율은 남성에서는 65.4%, 여성에서는 21.6%로 남성에서 여성보다 유의하게 높았다(p<0.01). 연령보정 운동 미실시율은 남성에서는 72.6%, 여성에서는 76.6%로 여성에서 남성보다 유의하게 높았다(p<0.01). 연령보정 비만율은 남성에서는 23.3%, 여성에서는 28.2%로 여성에서 남성보다 유의하게 높았다(p<0.01). 연령보정 B형 간염 미실시율은 남성에서는 45.1%, 여성에서는 53.4%로 여성에서 남성보다 유의하게 높았다(p<0.01). 연령보정 육식 선호율은 남성에서는 48.0%, 여성에서는 30.0%로 남성에서 여성보다 유의하게 높았다(p<0.01). 연령보정 짠 음식 선호율은 남성에서는 40.8%, 여성에서는 28.3%로 남성에서 여성보다 유의하게 높았다(p<0.01). 연령을 보정한 육체적 휴식이 부족한 비율은 남성에서는 19.2%, 여성에서는 24.1%로 여성에서 남성보다 유의하게 높았다(p<0.01). 연령보정 정신적 휴식이 부족한 비율은 남성에서는 15.7%, 여성에서는 23.6%로 여성에서 남성보다 유의하게 높았다(p<0.01). 연령보정 스케일링 미실시율은 남성에서는 61.5%, 여성에서는 71.1%로 여성에서 남성보다 유의하게 높았다(p<0.01). 연령보정 양치질 미실시율은 남성에서는 3.7%, 여성에서는 1.5%로 남성에서 여성보다 유의하게 높았다(p<0.01). 연령보정 위암 검사 미실시율은 남성에서는 49.3%, 여성에서는 51.4%로 여성에서 남성보다 높았으나 유의하지 않았다. 연령보정 간암 검사 미실시율은 남성에서는 64.0%, 여성에서는 70.7%로 여성에서 남성보다 유의하게 높았다(p<0.01). 연령보정 대장암검사 미실시율은 남성에서는 88.9%, 여성에서는 87.5%로 남성에서 여성보다 높았으나 유의하지 않았다. 연령 보정 종합건강진단 미실시율은 남성에서는 58.3%, 여성에서는 59.1%로 여성에서 남성보다 높았으나 유의하지 않았다. 앞으로 농촌지역 주민들의 건강관련 행태를 변화시키기 위한 건강증진 프로그램은 지역사회를 기반으로 성별 및 연령의 특징에 맞게 실시하는 것이 바람직하다고 생각한다.

• Korean Journal of Health Education and Promotion
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• 제2권1호
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• pp.31-61
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• 2000

Introduction. Despite the fact that half of premature deaths are caused by unhealthy lifestyles such as smoking tobacco, sedentary lifestyle, alcohol and drug abuse and poor nutrition, there are no theoretical models which accurately explain these health promotion related behaviors. This study tests a new model of health behavior called the Model of Health Promotion Behavior. This model draws on elements and frameworks suggested by the Health Belief Model, Social Cognitive Theory, the Theory of Planned Action and the Health Promotion Model. This model is intended as a general model of behavior but this first test of the model uses amount of exercise as the outcome behavior. Design. This study utilized a cross sectional mail-out, mail-back survey design to determine the elements within the model that best explained intentions to exercise and those that best explained amount of exercise. A follow-up questionnaire was mailed to all respondents to the first questionnaire about 10 months after the initial survey. A pretest was conducted to refine the questionnaire and a pilot study to test the protocols and assumptions used to calculate the required sample size. Sample. The sample was drawn from 2000 eligible participants at two blue collar (utility company and part of a hospital) and two white collar (bank and pharmaceutical) companies located in Southeastern Michigan. Both white collar site had employee fitness centers and all four sites offered health promotion programs. In the first survey, 982 responses were received (49.1％) after two mailings to non-respondents and one additional mailing to secure answers to missing data, with 845 usable cases for the analyzing current intentions and 918 usable cases for the explaining of amount of current exercise analysis. In the follow-up survey, questionnaires were mailed to the 982 employees who responded to the initial survey. After one follow-up mailing to non-respondents, and one mailing to secure answers to missing data, 697 (71.0％) responses were received, with 627 (63.8％) usable cases to predict intentions and 673 (68.5％) usable cases to predict amount of exercise. Measures. The questionnaire in the initial survey had 15 scales and 134 items; these scales measured each of the variables in the model. Thirteen of the scales were drawn from the literature, all had Cronbach's alpha scores above .74 and all but three had scores above .80. The questionnaire in the second mailing had only 10 items, and measured only outcome variables. Analysis. The analysis included calculation of scale scores, Cronbach's alpha, zero order correlations, and factor analysis, ordinary least square analysis, hierarchical tests of interaction terms and path analysis, and comparisons of results based on a random split of the data and splits based on gender and employer site. The power of the regression analysis was .99 at the .01 significance level for the model as a whole. Results. Self efficacy and Non-Health Benefits emerged as the most powerful predictors of Intentions to exercise, together explaining approximately 19％ of the variance in future Intentions. Intentions, and the interaction of Intentions with Barriers, with Support of Friends, and with Self Efficacy were the most consistent predictors of amount of future exercise, together explaining 38％ of the variance. With the inclusion of Prior Exercise History the model explained 52％ of the variance in amount of exercise 10 months later. There were very few differences in the variables that emerged as important predictors of intentions or exercise in the different employer sites or between males and females. Discussion. This new model is viable in predicting intentions to exercise and amount of exercise, both in absolute terms and when compared to existing models.