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The Rehabilitation Services Utilization of People with Disabilities in a Rural Area (농촌지역 재가장애인의 재활서비스 이용실태)

  • Choi, Gyeong-Jin;Kim, Keon-Yeop;Lee, Duck-Hee;Han, Chang-Hyun;Choi, Se-Mook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.227-237
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    • 2011
  • Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010 (제 5기 국민건강영양조사로 추정한 한국 성인의 대사증후군 유병률과 관련 요인)

  • Park, Eunok;Choi, Su Jung;Lee, Hyo Young
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.1-13
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    • 2013
  • Objectives: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. Methods: From the database of the $5^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). Conclusions: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.

Lifestyle, Diet, Self-care, and Diabetes Fatalism of Diabetic Patients with and without Diabetic Foot (당뇨병성 족부질환 여부에 따른 당뇨병 환자의 생활습관, 식습관, 자가관리 및 Diabetes fatalism)

  • Choi, Jungha;Kang, Juhee;Lee, Hongmie
    • Korean Journal of Community Nutrition
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    • v.19 no.3
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    • pp.241-249
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    • 2014
  • Objectives: This study was to determine diabetes fatalism of diabetic patients with and without diabetic foot and its association with lifestyle, diet, and self-care. Methods: The subjects were diabetic patients with (male/female 48/21) and without diabetic foot (male/female 33/26). We administered the questionnaires which were designed to determine diabetes fatalism, lifestyle, diet, and self-care. Diabetes fatalism was determined by Diabetes fatalism scale (DFS), which consisted of total 12 items in three subscales namely, emotional stress, religiou spiritual coping, and perceived self-efficacy. Results: The patients with diabetic foot had undesirable diets more frequently (1.37 and 0.91 days/week respectively) and their desirable diets (2.74 and 3.61 days/week respectively) and foot care (4.61 and 5.53 days/week respectively) were less frequent than those without diabetic foot (p < 0.05). An item analysis of the 12 DFS items revealed a Chronbach' ${\alpha}$ of 0.614 and 0.869, respectively in diabetic patients with and without diabetic foot. Perceived self-efficacy related DFS of subjects without diabetic foot was positively associated with smoking (r=0.350, p<0.01), undesirable diet (r=0.295, p<0.05), and drinking (r=0.257, p<0.05), while its negative association with exercise (r=-0.224, p<0.088) and foot care (r=-0.247, p<0.059) did not reach to statistical significance. Conclusions: This work was the first study reporting the potential usefulness of DFS, especially perceived self-efficacy related subscale as a predictor of lifestyle, diet and self-care on the Korean diabetic patients, at least those without severe diabetic foot to screen those who should be the first target for diabetes education.

A Case Study on High and Low Performance Areas for Family Planning (가족계획 우수.부진지역 사례연구)

  • 홍성열;김태일
    • Korea journal of population studies
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    • v.4 no.1
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    • pp.105-130
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    • 1981
  • This study was conducted to compare the characteristics of high performane areas for family planning with that of low performance areas and to find factors which strongly affected contraceptive practice behavior. For the study, eight areas were selected from 274 rural family planning canvassing areas of Korean Population Policy and Program Evaluation Study, which was an action study operated in all areas of Cheju Island from July 1, 1976 until December 31,1979. As a first step of the action study, Cheju Island was devided up 318 family planning canvasser areas Each area was consisted of 200 households in rural district and 300 households in urhan one Duriog the period of project, each canvassing area had been managed by a female family planning canvasser, selected by director of health center considering several individual conditions needed for family planning activities Basic activities of canvassers were to counsell all the eligihie couples in own charged area about family planning methods and also to distribute contraceptives such as condoms and oral pills. In case couples desire to accept sterilization including vasectomy and tubal-ligation, the canvassers played a linking role connecting potential client with family planning field workers. Canvassng areas shows significant differentce in performance for family planning, nevertheless they are supposed to have almost the same conditions regarding family planning distribution channel. Because the purpose of the Cheju project was to eliminate all the problems that existed in governmental distribution system, that is to remove geographic, economic, cognitive and administrative barriers Accumulated performances of family planning methods accepted by residents in each area were calculated by eligible women aged 14-49. And then canvassing areas were ranked according to performance score. Consequently, 4 areas in extremely high and low family planning performance areas were selected respectively. Major results were obtained by comparing characteristics of high performance area with that of low performance areas, which are as follows: 1. The mean number of living children was about the same both in high and low performance areas for family planning. But respondents' mean age (38.5) in high performance areas was higher than that (37.0) in low performance areas 2. Respondents' perception in the expectant educational level of others' children in high performance areas was higher than that in low performance areas, although respondents educational level, monthly expenditure and ratio of children in high school and above was not different. 3. Ratio of ownerships of TV and newspaper in high performance areas was highen than that in low performance areas 4. The duration of canvasser' charge in high performance areas was longer than that of low performance areas, showing the fact that canvassers didn't move cut in high performance areas 5. In high performance areas, canvassers' houses were relatively located in the center part of the village. And so villagers resided in near distances from the anvasser's house 6. 4H clubs' activities in high performance areas were more active than those in low performance areas Therefore it was assumed that cohesiveness of community in high performance areas were stronger than that in low areas. 7. Canvassers' family planning practice rate was higher than that in low performance areas, and also canvassers' human relationship was more sociable than that of canvassers in low performance areas. 8. Fourteen variables which showed relatively high significance level in $X^2$ and F test were selected as independent variables for stepwise regression analysis. According to the results of regression analysis. five of 14 variables-distributors education level ($R^2$=.4439), duration of distributor's charge ($R^2$=.6166), 4H club activities ($R^2$=.6697), canvasser's contraceptive practice ($R^2$=.7377) and location of distributions house ($R^2$=.8010) explained 80.1 percent of total variance.

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A Study on the Gene Expression of Adipogenic Regulators by an Herbal Composition (생약복합물에 의한 지방세포형성 조절자의 유전자 발현 연구)

  • Lee, Hae-Yong;Kang, Ryun-Hwa;Bae, Sung-Min;Chae, Soo-Ahn;Lee, Jung-Ju;Oh, Dong-Jin;Park, Suk-Won;Cho, Soo-Hyun;Shim, Yae-Jie;Yoon, Yoo-Sik
    • Journal of Life Science
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    • v.20 no.5
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    • pp.729-735
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    • 2010
  • In our previous study, it was reported that an herbal mixture, SH21B, inhibits fat accumulation and adipogenesis both in vitro and in vivo models of obesity. SH21B is a mixture composed of seven herbs: Scutellaria baicalensis Georgi, Prunus armeniaca Maxim, Ephedra sinica Stapf, Acorus gramineus Soland, Typha orientalis Presl, Polygala tenuifolia Willd, and Nelumbo nucifera Gaertner (Ratio 3:3:3:3:3:2:2). The aim of this study was to investigate the detailed molecular mechanisms of the effects of SH21B on various regulators of the adipogenesis pathway. During the adipogenesis of 3T3-L1 cells, SH21B significantly decreased the expression levels of central transcription factors of adipogenesis, such as peroxisome proliferator-activated receptor (PPAR)$\gamma$ and CCAAT/enhancer binding protein (C/EBP)$\alpha$. To elucidate the detailed molecular mechanism of the anti-adipogenic effects of SH21B, we examined the expression levels of the various pro-adipogenic or anti-adipogenic regulators of adipogenesis upstream of $PPAR{\gamma}$ and C/$EBP{\alpha}$. The mRNA levels of Krox20 and Kruppel-like factor (KLF) 15, which are pro-adipogenic regulators, were significantly down-regulated by SH21B treatment, whereas the mRNA levels of C/$EBP{\gamma}$ and KLF5 were not changed. KLF2 and C/EBP homologous protein (CHOP), which are anti-adipogenic regulators, were significantly up-regulated by SH21B treatment. These results suggest that the molecular mechanism of the anti-adipogenic effect of SH21B involves both the down-regulations of pro-adipogenic regulators, such as Krox20 and KLF15, and the up-regulations of anti-adipogenic regulators, such as KLF2 and CHOP, which results in the suppression of central transcription factors of adipogenesis including $PPAR{\gamma}$ and C/$EBP{\alpha}$.

Transcriptome Analyses for the Anti-Adipogenic Mechanism of an Herbal Composition (생약복합물의 지방세포형성억제 기전규명을 위한 전사체 분석)

  • Lee, Hae-Yong;Kang, Ryun-Hwa;Bae, Sung-Min;Chae, Soo-Ahn;Lee, Jung-Ju;Oh, Dong-Jin;Park, Suk-Won;Cho, Soo-Hyun;Shim, Yae-Jie;Yoon, Yoo-Sik
    • Journal of Life Science
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    • v.20 no.7
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    • pp.1054-1065
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    • 2010
  • SH21B is a natural composition composed of seven herbs: Scutellaria baicalensis Georgi, Prunus armeniaca Maxim, Ephedra sinica Stapf, Acorus gramineus Soland, Typha orientalis Presl, Polygala tenuifolia Willd and Nelumbo nucifera Gaertner (Ratio 3:3:3:3:3:2:2). In our previous study, we reported that SH21B inhibited adipogenesis and fat accumulation in 3T3-L1 cells through modulation of various regulators in the adipogenesis pathway. The aim of this study was to analyze the transcriptome profiles for the anti-adipogenic effects of SH21B in 3T3-L1 cells. Total RNAs from SH21B-treated 3T3-L1 cells were reverse-transcribed into cDNAs and hybridized to Affymetrix Mouse Gene 1.0 ST array. From microarray analyses, we identified 2,568 genes of which expressions were changed more than two-fold by SH21B, and the clustering analyses of these genes resulted in 9 clusters. Three clusters among the 9 showed down-regulation by SH21B (cluster 4, cluster 6 and cluster 9), and two clusters showed up-regulation by SH21B (cluster 7 and cluster 8) during the adipogenesis of 3T3-L1 cells. It was found that many genes related to cell proliferation and adipogenesis were included in these clusters. Clusters 4, 6 and 9 included genes which were related with adipogenesis induction and cell cycle arrest. Clusters 7 and 8 included genes related to cell proliferation as well as adipogenesis inhibition. These results suggest that the mechanisms of the anti-adipogenic effects of SH21B may be the modulation of genes involved in cell proliferation and adipogenesis.

Food Safety Knowledge and Home Food Safety Practices of Home-delivered Meal Service Recipients (가정배달 노인급식 수혜자의 위생지식 및 가정에서의 위생관리 습관)

  • Lee, Kyung-Eun;Yi, Na-Young;Park, Jung-Yeon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.5
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    • pp.618-625
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    • 2009
  • The purposes of this study were to evaluate food safety knowledge and to assess home food safety performance of home-delivered meal service recipients. Two facilities providing home-delivered meal services for older adults were located in Seoul. A total of 120 service recipients were surveyed using an individual interview technique and 97 responses were used for data analysis. A statistical data analysis was completed using SPSS program (ver.14) for descriptive analysis, t-test, ANOVA, and correlation analysis. The majority of the participants were 70 years old or older and females. They perceived their health status as poor or very poor and took more than one kind of medicines. An average score of the food safety knowledge test was 11.48 based on 18 points (63.8%). The results revealed that the older adults knew the importance of hand washing but were not aware of when and how to wash hands. There was room to improve knowledge on cleaning and sanitizing fresh fruits and using wiping cloth. The knowledge score for each category was not significantly different by gender and age. The home food safety practices of the older adults was rated as 2.8 out of 4 points; the highest score was associated for proper food handling category and the lowest score was for cleaning and sanitizing. The worst performance was related to managing hand cuts and wounds (1.96). The total knowledge score and an average performance score were significantly correlated (p<0.01). Food safety education programs targeting the older adults who receive home-delivered meal services would improve the recipients' food safety knowledge and practices related to consumption of the meals at home. The programs should focus on not only improving food safety knowledge but also changing food safety practices.

Validation and Calibration of Semi-Quantitative Food Frequency Questionnaire - With Participants of the Korean Health and Genome Study - (반정량식품섭취빈도조사지의 타당성 검증 및 보정 - 지역사회 유전체 코호트 참여자를 대상으로 -)

  • Ahn, Youn-Jhin;Lee, Ji-Eun;Cho, Nam-Han;Shin, Chol;Park, Chan;Oh, Berm-Seok;Kimm, Ku-Chan
    • Korean Journal of Community Nutrition
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    • v.9 no.2
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    • pp.173-182
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    • 2004
  • We carried out a validation-calibration study of the food frequency questionnaire (FFQ) that we had previously developed for a community-based cohort of the Korean Genome and Health Study of the Korea National Genome Research Institute. We have collected a total of 254 3-day diet records (DRs) from 400 subjects, 200 each randomly selected from the two study cohorts of Ansung and Ansan. FFQ was administered at the time of cohort recruitment in 2001, and DRs were collected during a two month period from January through February of 2002. The mean age was 52.2 years. Farming for men and housewife for women were the most common occupations. The majority of the subjects had undergone 6∼12 years of education. The general characteristics including demographic and other data were not different from the total cohort subjects. Absolute levels of consumed nutrients including total energy (energy), protein, fat, carbohydrate, calcium, phosphorus, sodium, potassium, iron, retinol, carotene, vitamin A, thiamin, riboflavin, niacin and vitamin C were compared. The average of energy intake was not significantly different between the data collected by the 2 methods. However, consumptions of protein and fat were higher in data of DRs, whereas that of carbohydrate was higher in FFQ data. Significant correlation of each nutrient consumption between the data sets was observed (p < 0.05) except in the case of iron, while the average correlation coefficient between them was 0.22 ranging from 0.33 for energy to 0.11 for iron. The results of cross classification by quantile for exact classification ranged from 25.2% (carotene) to 35.0% (phosphorus), and from 64.6% (vitamin A) to 76.4% (retinol) for adjacent classification. The proportion of completely opposite classification was 8.1% in average. Calibration slope was estimated by regression and calibration parameters ranged from 0.025 for carotene to 0.423 for niacin. We conclude that the FFQ we have developed is an appropriate tool for assessing the nutrient intakes as ranking exposures in epidemiology studies in view that amounts of consumed nutrients obtained by FFQ were similar to those collected by DRs, that correlations between consumed nutrients collected by these methods were significant, and that classification results were relatively fair. The correlation coefficients, however, were lower than expected, which may be mainly due to the survey season. In fact, any short-term dietary survey cannot accurately reflect the overall dietary intakes that change heavily depending on seasons. Further studies including the analysis of chemical indices would be helpful for the studies of causal relationship between the diet and disease.

Potassium intake of Korean adults: Based on 2007~2010 Korea National Health and Nutrition Examination Survey (한국 성인의 칼륨 섭취 현황 : 2007~2010년 국민건강영양조사 자료 이용)

  • Lee, Su Yeoun;Lee, Sim-Yeol;Ko, Young-Eun;Ly, Sun Yung
    • Journal of Nutrition and Health
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    • v.50 no.1
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    • pp.98-110
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    • 2017
  • Purpose: The purpose of this study was to evaluate the dietary potassium intake, Na/K intake molar ratio, consumption of 18 food groups, and foods contributing to potassium intake of Korean adults as well as the relationships among quartile of potassium intake level and blood pressure, blood biochemical index. Methods: This study was conducted using the Korea National Health and Nutrition Examination Survey, 2007~2010. The total number of subjects was 20,291. All analyses were conducted using a survey weighting to account for the complex survey design. Results: Overall average intakes of potassium were 2,934.7, 3,070.6, 3,078.1, and 3,232.0 mg/day, and they significantly increased by year in Korean adults. The average dietary potassium intake was close to adequate intake (AI), whereas that of women was considerably lower than the AI. The Na/K intake molar ratio in males (2.89~3.23) was higher than in females (2.62~2.95). The major food groups contributing to potassium intake were vegetables, cereals, and fruits/meats. The two major foods contributing to potassium intake were polished rice and cabbage kimchi. The rankings of food source were as follows; polished rice > cabbage kimchi > potato > oriental melon > sweet potato > seaweed > radish > apple > black soybean. In 50~64 year old females, systolic blood pressure (SBP) significantly decreased (p < 0.01) and HDL-cholesterol significantly increased (p < 0.05) as potassium intake increased. Triglyceride (TG) was significantly higher in the other quartile of potassium intake level than in the first quartile (p < 0.05). Conclusion: In conclusion, our study suggests the need for an appropriate set of dietary reference intakes according to caloric intake by sex and age groups and for development of eating patterns to increase potassium intake and decrease sodium intake.

Learning from the USA's Single Emergency Number 911: Policy Implications for Korea (미국 긴급번호 911 운영시스템에 관한 연구: 긴급번호 실질적 통합을 위한 정책 시사점 제시 중심으로)

  • Kim, Hak-Kyong;Lee, Sung-Yong
    • Korean Security Journal
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    • no.43
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    • pp.67-97
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    • 2015
  • In Korea, a single emergency number, such as 911 of the USA and 999 of the UK, does not exist. This issue became highly controversial, when the Sewol Ferry Sinking disaster occurred last year. So, the Korean government has planned to adopt a single emergency number, integrating 112 of the Police, 119 of the Fire and Ambulance, 122 of the Korean Coast Guard, and many other emergency numbers. However, the integration plan recently proposed by the Ministry of Public Safety Security seems to be, what is called, a "partial integration model" which repeals the 122 number, but still maintains 112, 119, and 110 respectively. In this context, the study looks into USA's (diverse) 911 operating system, and subsequently tries to draw general features or characteristics. Further, the research attempts to derive policy implication from the general features. If the proposed partial integration model reflects the policy implications, the model can virtually operate like the 911 system -i.e. a single emergency number system - creating inter-operability between responding agencies such as police, fire, and ambulance, even though it is not a perfect integration model. The features drawn are (1) integration of emergency call-taking, (2) functional separation of call-taking and dispatching, (3) integration of physical facilities for call-taking and dispatching, and (4) professional call-takers and dispatchers. Moreover, the policy implications derived from the characteristics are (1) a user-friendly system - fast but accurate responses, (2) integrated responses to accidents, (3) professional call-taking and dispatching & objective and comprehensive risk assessment, and finally (4) active organizational learning in emergency call centers. Considering the policy implications, the following suggestions need to be applied to the current proposed plan: 1. Emergency services' systems should be tightly linked and connected in a systemic way so that they can communicate and exchange intelligence with one another. 2. Public safety answering points (call centers) of each emergency service should share their education and training modules, manuals, etc. Common training and manuals are also needed for inter-operability. 3. Personal management to enable-long term service in public safety answering points (call centers) should be established as one of the ways to promote professionalism.

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