Objectives: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. Methods: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. Results: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. Conclusions: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.
Intestinal parasitic infections remain a major public health problem in many parts of Thailand, particularly in rural areas. This study aimed to determine the prevalence of intestinal parasitic infections and associated risk factors among the people living in Huai Sai sub-district, Bang Khla district, Chachoengsao Province, central Thailand. A cross-sectional survey was carried out from June 2017 to August 2017 which included a total of 224 participants. Stool samples were examined using a simple direct smear and formalin ethyl acetate concentration technique. Association between risk factors and intestinal parasitic infections was assessed using multivariate logistic regression analysis. The overall prevalence of intestinal parasitic infections was 16.1%. Soil-transmitted helminth infections (14.3%) were more common than protozoan infections (1.8%). The most common intestinal parasites were hookworms (6.7%) followed by Strongyloides stercoralis, (5.0%), Ascaris lumbricoides (1.3%) and Trichuris trichiura (1.3%). Entamoeba histolytica/dispar (1.0%), Giardia intestinalis (0.4%), and Blastocystis hominis (0.4%) were the protozoans identified. A high prevalence of infections was found in male participants of ${\geq}40years$ who raised dogs in the households and did not wear boots while working fields. Multivariate analysis showed a significant association of intestinal parasitic infections with gender with the adjusted odds ratio (OR) of 2.4 and 95% confidence interval (CI) of 1.1-5.2 (P=0.020). The results showed a high prevalence of soil-transmitted helminth infections among adults in rural communities which were particularly apparent regarding the skin-penetrating species of nematodes. A greater focus on intervention is required by improving sanitation and personal hygiene to prevent the spread of intestinal parasitic infections.
Vitamin K intake has been reported as an essential factor for bone formation. The current study was conducted under the hypothesis that insufficient vitamin K intake would affect inflammatory markers and bone mineral density in young adult women. The study was a cross-sectional design that included 75 women in their 20s. Physical assessments, bone mineral density measurements, 24-hr dietary recalls, and biochemical assessments for high sensitivity C-reactive protein (hs-CRP) and percentages of undercarboxylated osteocalcin (%ucOC) were performed. An analysis of vitamin K nutritional status was performed comparing first, second, and third tertiles of intake based on %ucOC in plasma. Vitamin K intake levels in the first, second, and third tertiles were $94.88{\pm}51.48\;{\mu}g$, $73.85{\pm}45.15\;{\mu}g$, and $62.58{\pm}39.92\;{\mu}g$, respectively (P < 0.05). The T-scores of the first and third tertiles were 1.06 and -0.03, respectively, indicating that bone mineral density was significantly lower in the group with lower vitamin K intake (P < 0.05). There was a tendency for different serum hs-CRP concentrations between the first ($0.04{\pm}0.02$) and third tertiles ($0.11{\pm}0.18$), however this was not statistically significant. Regression analysis was performed to identify the correlations between vitamin K nutritional status, inflammatory markers, and bone mineral density after adjusting for age and BMI. Serum hs-CRP concentrations were positively correlated with vitamin K deficiency status (P < 0.05). And bone mineral density, which was represented by speed, was negatively correlated with vitamin K deficiency status (P < 0.05). In conclusion, status of vitamin K affects inflammatory status and bone formation. Therefore, sufficient intake of vitamin K is required to secure peak bone mass in young adult women.
Periodontal disease is a common inflammatory disorder that is being considered as a risk factor for atherosclerotic complication. Recent epidemiological evidence also supports that its potential association with increased blood pressure levels and hypertensive prevalence. Data from cross-sectional studies suggest that in hypertensive patients periodontal disease may enhance the risk and degree of target organ damage. So dental infections have been associated with cardiovascular diseases. There are potential pathophysiologic links between hypertension and periodontits. The role of the inflammatory pathway include C-reactive protein(CRP). CRP is an inflammatory mediator that has been shown to predict the development of hypertension independently of baseline BP and traditional risk factors, has been consistently reported as at least mildly elevated in patients with periodontal disease. Reactive oxygen species produced by locally infiltrating neutrophils participate in periodontal tissue destruction. Periodontits can lead to inflammatory responses in the atrial myocardium, which disturbs the structural and electrophysiologic properties of the atrium and facilitates atrial fibrillation in the animal experiment.
Hur, Junseok W.;Hur, Junho K.;Kwon, Taek-Hyun;Park, Youn Kwan;Chung, Hung Seob;Kim, Joo Han
Journal of Korean Neurosurgical Society
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v.52
no.3
/
pp.215-220
/
2012
Objective : There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the significant radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical significance and pathogenesis of RNRs. Methods : Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy : 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results : RNRs were found in 45 patients (42%) with central LSS. There were no statistically significant differences between the two groups in severity of symptoms. On the other hand, we found statistically significant differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum flavum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion : RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.
Kang, Nam E;Kim, Seung Ju;Oh, Yoon Sin;Jang, Se-Eun
Nutrition Research and Practice
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v.14
no.2
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pp.160-166
/
2020
BACKGROUND/OBJECTIVES: The obese population is rapidly increasing because of reduced physical activity and a Westernized diet; consequently, various chronic diseases are more prevalent. With the increasing interest in body shape and appearance, research on body shape perceptions and accompanying weight control behaviors are needed for healthy weight management. SUBJECTS/METHODS: A cross-sectional survey was conducted on randomly selected 536 (209 men and 327 women) aged 20 to 65 years. Body mass index (BMI), body-shape perception, weight control behavior, quality of sleep, and place of residence were collected using self-reported questionnaires. Multivariable logistic regression analysis was conducted using complex design in each groups. Collected data were analyzed using the SAS 9.4 statistical package, and the significance level was set at P < 0.05. RESULTS: When these two variables were divided into four groups, they were found to influence dieting attempts. People with abnormal weights who were dissatisfied with their body shapes attempted dieting 5.23 times more than those with healthy weights and satisfaction with their body shapes. Further, those with normal weights but dissatisfaction with their bodies attempted dieting 4.45 times more than those who were satisfied with their shapes. Subjects in their 20s attempted dieting 2.53 times more than those in their 30s and 40s, and female subjects attempted dieting 2.24 times more than male subjects. CONCLUSIONS: A correct perception of one's shape can be an important factor for dietary behavior, as body shape perceptions and dieting attempts are strongly related. Additionally, healthy weight management and nutrition education are important elements to incorporate into a weight control program aimed at preventing excessive weight control behaviors and promoting correct perceptions of body shape.
The purpose of this study is to construct a quantitative evaluation method that can analyze the policy effectiveness with the construction of a implicit composite index incorporating spatial econometrics models. In order to propose a methodological framework for the program evaluation, this study conducts an empirical analysis with the application of the Comprehensive Rural Village Development Project (CRVDP) which explicitly claims to achieve comprehensive goal of community development. The present study pays particular attention to quantifying the composite evaluation index and drawing net effect through the application of a series of spatial econometrics models. The spatial unit of the analysis is drawn at Eup-Myeon level in rural areas in Korea, and the time horizon is in between 2005 and 2010. We utilize the Korean Agricultural Census data in 2005 and 2010. Three steps of methodological processes are needed to satisfy the objective of the present study. First, we apply factor analysis to construct the composite index that represents comprehensive settlement environment in rural area. The index should be matched with the main objective of the CRVDP. Second, we apply the derived index to a series of spatial econometrics model as dependent variable. Lastly, utilizing the estimated coefficients of the econometrics models, we apply decomposition technique to estimate CRVDP's net effect from both cross-sectional and longitudinal perspectives. We find that the results of the decomposition analysis by the execution of the CRVDP are positively associated with the explicit object of the project.
Hypertension is a well-known risk factor for cardiovascular disease. Previous studies have shown that changes in diet and lifestyle factors can prevent the development of hypertension, but the combined effects of these modifiable factors on hypertension are not well established. The objective of this study is to investigate associations of diet and lifestyle factors, evaluated both individually and in combination, with prevalent hypertension among Korean adults. We analyzed data obtained from the 2007-2008 Korean National Health and Nutritional Examination Survey, a nationwide cross-sectional study using a stratified, multistage probability sampling design. The associations of 12 nutrient intakes and lifestyle factors with risk of hypertension were explored using restricted cubic spline regression and logistic regression models among 6,351 adults. Total energy and several nutrients and minerals, including, calcium, vitamin A, vitamin C, and sodium, showed non-linear relationships with the risk of prevalent hypertension. In multivariate logistic regression models, dietary score, obesity and alcohol intake were independently associated with the risk of prevalent hypertension, but smoking and physical activity were not. Overall, participants whose dietary habits and lifestyle factors were all in the low-risk group had 68% lower prevalence of hypertension (OR: 0.32, 95 CI: 0.14-0.74) compared to those who were at least one in the high-risk group of any dietary or lifestyle factors. The result suggests that combined optimal lifestyle habits are strongly associated with lower prevalence of hypertension among Korean adults.
Journal of Korean Tunnelling and Underground Space Association
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v.21
no.6
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pp.779-793
/
2019
The ventilation rate (Qreq) requirement in road tunnels is not just a basic information for determining the tunnel cross-sectional area, but also a major factor for the ventilation system selection. The Qreq is predominantly dependent on the vehicle traffic volume, while among others, the vehicle exhaust emissions and permissible standards are critical. This paper analyzes the changes in the Qreq designing criteria and/or recommendations suggested by World Road Association and local authorities over the last 20 years, since the first local designing criteria was established in 1997 by Korea Expressway Corporation. Additionally, based on the updated vehicle emission standards of Ministry of Environment and recent recommendations of the World Road Association (WRA), changes in the Qreq and its effects are studied in terms of the length and grade of the tunnel.
Park, Soo Jin;Lee, Seung Min;Kim, Seon Mee;Lee, Myoungsook
Nutrition Research and Practice
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v.7
no.2
/
pp.139-145
/
2013
There is a lack of data on metabolic risk factors during pre-puberty, which is important for identifying the subgroups of youth, at whom early interventions should be targeted. In this study, we evaluated the prevalence of metabolic risk factors and its subsequent relations with dietary patterns in Korean pre-pubertal children through a cross-sectional sample (n = 1,008; boys = 513) of pre-pubertal children (aged 8-9 years) from a sub-study of the Korea Metabolic Syndrome Research Initiatives (KMSRI) in Seoul, Korea. Measures of anthropometry and blood pressure as well as fasting blood samples were used in the analysis. A three-day food records were collected. The metabolic syndrome was defined according to the age-adjusted National Cholesterol Education Program Adult Treatment Panel III guidelines. An added metabolic risk score was calculated for each subject by summing the quintile values of the five individual risk factors. Among the 5 risk components of metabolic syndrome, high waist circumference (WC) was the major factor (P < 0.001). A significant increasing trend of the added metabolic syndrome risk score was observed with the increase of WC (P (trend) < 0.001) among both genders. The cutoff point for high WC for pre-pubertal children was 61.3 cm for boys and 59.9 cm for girls. The prevalence of high triglyceride (TG) values was significantly higher in girls than it was in boys (P < 0.01). Girls in the highest quintile of balanced dietary pattern scores had lower TG values (P (trend) = 0.032) than did those in the lowest quintile. Moreover, girls in the highest quintile of western dietary pattern scores showed increasing trend for the added metabolic risk score (P (trend) = 0.026) compared with those in the lowest quintile. Adverse associations exist between western dietary patterns and the accumulation of metabolic risks among girls, not in boys, even during pre-puberty.
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