• Title/Summary/Keyword: Community/public Health

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Obesity in children and adolescents (소아청소년 비만)

  • Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.52 no.12
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    • pp.1311-1320
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    • 2009
  • Childhood obesity has rapidly increased in Korea during the past 20-30 years. Approximately 1 of 10 children and adolescents is obese. Appropriate prevention and intervention measures urgently need. Obesity prevention starts early in life, i.e., obesity prevention and education begins during the period of fetal development in utero. Behavioral changes are the most positively reflected during pregnancy. Infants should be fed breast milk, and inculcated with healthy eating and behavioral habits during infancy to ultimately establish a healthy lifestyle in children. For achieving a lifestyle and behavior that successfully allow children to overcome obesity, although individual motivation is important, active support of parents and family members is also imperative. Health care providers should also make an effort to actively prevent obesity and take necessary intervention actions. Although the efforts of individuals, family, and healthy care providers are important to prevent the rapid increase in obesity, primary prevention should be encouraged at a higher level. Schools should specifically aim at improving nutrition and physical activity by allocating times for healthy eating, playing, and physical education. Moreover, local communities should provide support by funding for safe recreational environments, such as playgrounds and walking tracks. Public health strategies in community and national policies, such as city planning, food marketing, and advertisements, are required for primary prevention of obesity.

Emergency Room access by Population Density and distance of Daegu Metropolitan city (대구광역시의 인구밀집과 거리에 따른 응급실 접근성)

  • Kim, Myung-Gwan;Han, Seung-Woo;Kim, Ki-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.218-223
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    • 2020
  • This study examined the accessibility of emergency rooms according to the population density and distance in Daegu Metropolitan City to help improve the quality and emergency medical accessibility problems in Daegu Metropolitan City. To observe the geographical requirements, the number of population in eup, myeon, dong, available emergency, and available emergency compared to the population were mapped through the S-GIS of Statistics Korea to visualize the data based on the 3km radius. To determine the difference in accessibility to emergency rooms for each district in Daegu Metropolitan City, the data were analyzed by ANOVA and Scheffe. According to the average number of emergencies available in Daegu Metropolitan City within a 3-kilometer radius were 5.7 in Jung-gu, 5.0 in Nam-gu, 1.6 in Buk-gu, 0.4 in Dong-gu, 2.4 in Seo-gu, 0.9 in Suseong-gu, 3.5 in Dalseo-gu, and 0.1 in Dalseong-gun; there was a statistically significant difference (p<.001). The available emergency within a 3km radius and available emergency per 1,000 people were concentrated in the center. Therefore, it may be necessary to institute an urban emergency medical network by establishing a point that serves as an intermediate hub to provide emergency medical care to citizens far from the center.

Development and Validation of a Breast Cancer Risk Prediction Model for Thai Women: A Cross-Sectional Study

  • Anothaisintawee, Thunyarat;Teerawattananon, Yot;Wiratkapun, Cholatip;Srinakarin, Jiraporn;Woodtichartpreecha, Piyanoot;Hirunpat, Siriporn;Wongwaisayawan, Sansanee;Lertsithichai, Panuwat;Kasamesup, Vijj;Thakkinstian, Ammarin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6811-6817
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    • 2014
  • Background: Breast cancer risk prediction models are widely used in clinical practice. They should be useful in identifying high risk women for screening in limited-resource countries. However, previous models showed poor performance in derived and validated settings. Therefore, we aimed to develop and validate a breast cancer risk prediction model for Thai women. Materials and Methods: This cross-sectional study consisted of derived and validation phases. Data collected at Ramathibodi and other two hospitals were used for deriving and externally validating models, respectively. Multiple logistic regression was applied to construct the model. Calibration and discrimination performances were assessed using the observed/expected ratio and concordance statistic (C-statistic), respectively. A bootstrap with 200 repetitions was applied for internal validation. Results: Age, menopausal status, body mass index, and use of oral contraceptives were significantly associated with breast cancer and were included in the model. Observed/expected ratio and C-statistic were 1.00 (95% CI: 0.82, 1.21) and 0.651 (95% CI: 0.595, 0.707), respectively. Internal validation showed good performance with a bias of 0.010 (95% CI: 0.002, 0.018) and C-statistic of 0.646(95% CI: 0.642, 0.650). The observed/expected ratio and C-statistic from external validation were 0.97 (95% CI: 0.68, 1.35) and 0.609 (95% CI: 0.511, 0.706), respectively. Risk scores were created and was stratified as low (0-0.86), low-intermediate (0.87-1.14), intermediate-high (1.15-1.52), and high-risk (1.53-3.40) groups. Conclusions: A Thai breast cancer risk prediction model was created with good calibration and fair discrimination performance. Risk stratification should aid to prioritize high risk women to receive an organized breast cancer screening program in Thailand and other limited-resource countries.

Dustfalls and Various Ion Concentrations in Their Filtrates in an Urban and in a Rural Districts (도시 및 농촌 일부지역의 강하분진과 여과액중의 이온농도)

  • Hong, Yeon-Pyo
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.59-71
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    • 1985
  • During a period from February 1st to November 30th in 1983, measurements were made twice a month on dustfalls and concentrations of various cations ana anions in their filtrates in an urban (Heuksuk-dong, Seoul) and in a rural (Ansung) districts. Standard British Deposit Gauge method was applied for collection of dustfalls and ion chromatographic method using Ion Chromatograph 10 (Dionex, U.S.A.) for determination of cation and anion concentrations. The results obtained were as follows: 1. Annual mean values of dustfalls were $8.30{\pm}5.09tons/km^2/month$ in an urban and $6.20{\pm}0.82tons/km^2/month$ in a rural districts. And annual mean values of pH of filtrates of the collected samples were $5.3{\pm}0.76$ in an urban and $6.0{\pm}0.82$ in a rural districts. 2. Annual mean concentrations of common cations and anions in their filtrates were as follows: urban rural (unit: ppm) $$Na^{+}\;1.7{\pm}1.30\;1.9{\pm}1.86$$ $$NH^{+}_{4}\;2.4{\pm}1.60\;1.3{\pm}1.59$$ $$K^{+}\;0.7{\pm}0.47\;1.5{\pm}3.79$$ $$Ca^{++}\;5.3{\pm}0.95\;3.4{\pm}2.58$$ $$Mg^{++}\;0.7{\pm}0.89\;0.5{\pm}0.83$$ $$Cl^{-}\;2.0{\pm}1.31\;4.0{\pm}2.35$$ $$NO^{-}_{3}\;4.0{\pm}2.35\;2.7{\pm}1.31$$ $$So^{--}_{4}\;16.9{\pm}17.40\;6.8{\pm}8.00$$ Some of anions such as $Br^{-},\;{PO_4}^{-3}\;and\;{NO_2}^{-}$ were scarecely detected and $F^{-}$ was measured at very low concentrations ranging from 0.1 to 0.5 ppm in Feb., Oct. and Nov. in an urban and in Feb. in a rural districts. 3. By two-way analysis of variance with 4 replications for dustfalls, pH and concentrations of various ion by district and month of a year, statistically significant differences were noted in dustfalls (p<0.01), pH (p<0.01) and concentrations of various ion (p<0.01) by month of a year, and in dustfalls (p<0.05) and concentrations of various ion such as ${NH_4}^{+},\;Ca^{++},\;{NO_{3}}^{-}\;and\;{SO_4}^{--}$ (p<0.01) by district. 4. There were statistically significant differences pH in Spring (Feb., Mar and Apr.) (p<0.01) and in ${SO_4}^{--}$ in Autumn (Aug., Sept., Oct. and Nov.) (p<0.05) between the two districts.

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Association of Blood Pressure Levels with Carotid Intima-Media Thickness and Plaques (혈압 수준과 경동맥 내중막 두께 및 동맥경화반의 관련성)

  • Lee, Young-Hoon;Kweon, Sun-Seog;Choi, Jin-Su;Rhee, Jung-Ae;Choi, Sung-Woo;Ryu, So-Yeon;Shin, Min-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.5
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    • pp.298-304
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    • 2009
  • Objectives : The aim of this study was to investigate the association of blood pressure levels with the common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. Methods : Data were obtained from 2,635 subjects, aged 50 years and over, who participated in the Community Health Survey (a population-based, cross-sectional study) in Dong-gu, Gwangju city between 2007 and 2008. Participants were categorized into three groups according to blood pressure levels; normotensives (<120/80 mmHg), prehypertensives (120-139/80-89 mmHg), and hypertensives ($\geq$140/90 mmHg). Prehypertensives were further categorized as low prehypertensives (120-129/80-84 mmHg) and high prehypertensives (130-139/85-89 mmHg). Carotid intima-media thickness and plaques were evaluated with a high-resolution B-mode ultrasound. Statistical analyses were performed using chi-square test, ANOVA, and multiple logistic regression. Results : Prehypertensives had significantly greater maximal CCA-IMT values than normotensives, with a multivariate adjusted odds ratio of 1.78 (95% CI=1.36-2.32) for abnormal CCA-IMT (maximal CCA-IMT$\geq$1.0 mm), and 1.45 (95% CI=1.19-1.77) for carotid plaques. The multivariate adjusted odds ratio of low prehypertensives was 1.64 (95% CI=1.21-2.21) for abnormal CCA-IMT, and 1.30 (95% CI=1.04-1.63) for carotid plaques compared with normotensives. Subject with hypertension had higher frequency of abnormal CCA-IMT (odds ratio, 2.18; 95% CI=1.49-3.18), and carotid plaques (odds ratio, 1.98; 95% CI=1.46-2.67) compared with normotensives after adjustment for other cardiovascular risk factors. Conclusions : Our results indicate that there is a significant increase in the prevalence of carotid atherosclerosis in subjects with prehypertension (even in low prehypertensives) compared with normotensive subjects. Further studies are required to confirm the benefits and role of carotid ultrasonography in persons with prehypertension.

A Convergence Study on Violence, Discrimination and Suicidal Ideation among Person with Disabilities (장애인의 폭력 및 차별경험과 자살생각에 관한 융합연구)

  • Kim, Seokhwan;Lee, Hyunjoo;Kim, Ji hyun
    • Journal of the Korea Convergence Society
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    • v.9 no.10
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    • pp.347-353
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    • 2018
  • The purpose of this study is to investigate the relevance of discrimination and violence experienced by persons with disabilities to suicidal ideation of persons with disabilities. The study data used the 2014 national survey of the disabled persons and 6,332 people were included in the analysis. Suicidal ideation was defined as whether or not suicide was actually attempted in the last year. The reference group was a group without suicidal ideation and logistic regression analysis of violence discrimination and experience was performed. The study found that 18.5%(n=1.171) of people with disabilities had suicidal ideation. The risk of suicidal ideation was higher when there was language violence and mental violence because of being disabled. When adolescents experienced sexual harassment, sexual abuse, and sexual violence, the risk of suicide was 16.7(CI=4.22-66.18) times higher. The risk of suicidal ideation was 5.8(CI=2.34-14.6) times higher for those who did not know the violent offenders and 4.08(CI=2.05-8.12) times higher for coping strategies that ignored or tolerated violence. The risk of suicidal ideation was 1.60(CI=1.24-2.08) times higher in the case of discrimination experienced at the time of marriage and it was 2.73(CI=4.22-66.18) times higher when they had always felt the discrimination due to disability. The suicidal ideation that comes from experiences of violent experience and discrimination can appear as actual suicide. Therefore, it is necessary to support the suicide prevention program at the community level, along with the care and consideration of the family and society of the disabled for the well-being of the disabled.

Risk Factors Associated with Loneliness in the Elderly Living Alone (독거노인의 외로움에 영향을 미치는 위험요인)

  • Lee, Seung Woo;Paik, Ki Chung;Lee, Kyung Kyu;Lee, Seok Bum;Kim, Kyung Min;Kim, Dohyun;Lee, Jung Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.173-180
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    • 2019
  • Objectives : Loneliness is associated with negative mental and physical health. However, little is known about the risk factors of loneliness in the Korean elderly living alone. The aim of this study was to examine sociodemographic and social network related risks for loneliness among the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,091 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview conducted by a trained nurse. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine factors associated with loneliness. Results : The mean score of loneliness was 3.8 (SD=1.7). No family contact (standardized β=0.115, p<0.001), no religious attendance (standardized β=0.057, p=0.028), no gathering with friends (standardized β=0.088, p=0.001) and high score of Short for of Geriatric Depression Scale (standardized β=0.502, p<0.001) were significantly associated with high loneliness in the elderly living alone. Conclusions : Family function, social network and depressive mood could be significant risk factors for high loneliness in the elderly living alone. Public health promotion efforts to reduce loneliness should focus on improving family function, social network and decreasing depression.

Estimation of Smoking Prevalence among Adolescents in a Community by Design-based Analysis (설계기준 분석 방법에 의한 지역사회 청소년 흡연율 추정)

  • Park, Soon-Woo;Lee, Sang-Won;Park, Jung Han;Yun, Yeon-Ok;Lee, Won-Kee;Kim, Jong-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.4
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    • pp.317-324
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    • 2006
  • Objectives: This study was conducted to estimate the unbiased smoking prevalence and its standard errors among adolescents in a large city in Korea, by design-based analysis. Methods: All the students in Daegu city were stratified by grade, gender and region, and then schools as primary sampling units (PSU) were selected by probability proportional to size (PPS) sampling. One or two classes were sampled randomly from each grade, from 5th grade in elementary schools to the 3rd grade in high schools. The students anonymously completed a standardized self-administered questionnaire from October to December 2004. The total number of respondents was 8,480 in the final analysis, excluding the third graders in the general high schools because of incomplete sampling. The sampling weight was calculated for each student after post-stratification adjustment, with adjustment being made for the missing cases. The data were analyzed with Stata 8.0 with consideration of PSU, weighting and the strata variables. Results: The smoking prevalence (%) and standard errors for male students from the fifth grade in elementary schools to the second grade in high schools were $0.93{\pm}0.47,\;1.83{\pm}0.74,\;3.16{\pm}1.00,\;5.12{\pm}1.02,\;10.86{\pm}1.13,\;15.63{\pm}2.44\;and\;17.96{\pm}2.67$, and those for the female students were $0.28{\pm}0.28,\;1.17{\pm}0.73,\;3.13{\pm}0.60,\;1.45{\pm}0.58,\;3.94{\pm}0.92,\;8.75{\pm}1.86\;and\;10.04{\pm}1.70$, sequentially. Conclusions: The smoking prevalence from this study was much higher than those from the other conventional studies conducted in Korea. The point estimates and standard errors from the design-based analysis were different from those of the model-based analysis. These findings suggest the importance of design-based analysis to estimate unbiased prevalence and standard errors in complex survey data and this method is recommended to apply to future surveys for determining the smoking prevalence for specific population.

Appropriate Technology, Responding to the COVID-19 Pandemic - Redefined Roles in a Public Health Crisis (Part I) (COVID-19 대유행에 대응하는 적정기술 : 보건 위기에서 재정의된 역할 - 파트 1)

  • Lee, Sungwoo;Suh, Jungwoo;Kim, Jaeeun;Jang, Dongyoon;Pyun, Nayoon;Shin, Kwanwoo
    • Journal of Appropriate Technology
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    • v.6 no.2
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    • pp.238-255
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    • 2020
  • As COVID-19, which occurred at the end of 2019, has become a global pandemic, it has emerged as an unprecedented event that quickly destroys a nation's medical and healthcare system in both developed and developing countries. In the 21st century, most of the civil society that aimed for hyperconnected society is facing a new crisis that has not been experienced so far. Indeed, lack of personal protective equipment, isolation of clustered communities, disruption of medical systems necessary for diagnosis and treatment, and disruption of educational and economic activities due to social isolation are emerging. Since the COVID-19 has occurred, many of the difficulties that have occurred in the past six months indicate the basic infrastructure a society should have particularly in a pandemic. These include personal protective equipment (PPE), decontamination and quarantine tools essential for effective response, rapid and precise large-scale diagnosis, medical devices required for patient care, and identification and fast and wide on-line networks that can be used in social isolation. In this first part, we would like to introduce some representative examples of 1) personal protective equipment, 2) prevention of personal and community health, 3) social response through big data and networks within the framework of appropriate technology.

Accuracy of Death Certificates Completed by Medical Students (일부 의과대학생들의 사망진단서 작성의 정확성 평가 - 사망진단서 작성법 교육 유형에 따른 비교 -)

  • Kim, Hyun-Ae;Kim, Keon-Yeop;Kam, Sin;Oh, Gyung-Jae;Shin, Min-Ho;Sohn, Seok-Joon;Kim, Soon-Young;Nam, Hae-Sung
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.89-98
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    • 2010
  • Objectives: The purpose of this research was to evaluate the ability of completing death certificates among medical students. Methods: The self-administered questionnaires were completed, during May to August 2007, by 380 medical students in senior. The questionnaire was composed of 10 cases to write the death certificate. The cause-of-deaths written by students were compared with the gold standards and their errors in the certificates also evaluated. Results: Mean agreement score for 10 underlying cause-of-deaths completed on the lowest line of part I in the death certificate (UC1) was $4.8{\pm}1.7$, and for underlying cause-of-death selected by a coder of the death certificates (UC2) was $5.6{\pm}1.5$. The UC1 and UC2 were significantly higher among the students having the case-oriented education for death certificate than others. For the major errors in the certificates completed by students, the students having the error with no antecedent cause were highest, the error with two or more conditions secondly highest. Mean number of errors was significantly lower in the case-oriented education group than others. Conclusions: Errors are common in the death certificates completed by medical students in senior. The accuracy of death certification may be more improved with the case-oriented education than the traditional method.