• Health Policy and Management
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• v.30 no.4
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• pp.479-492
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• 2020

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

• Korean Journal of Community Nutrition
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• v.28 no.1
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• pp.48-60
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• 2023

Objectives: The purpose of this study was to compare the sex-associated differences in the dietary intake of gastric cancer patients in Korea. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) the 7^th (2016-2018) were analyzed in the present study. The subjects included 122 gastric cancer patients aged over 40 years (75 male, 47 female). General characteristics (age, marital status, household income, education, food security, comorbidities, alcohol drinking, and smoking), anthropometric characteristics (height, weight, body mass index, and blood pressure), blood biochemical characteristics [fasting plasma glucose (FPG), blood urea nitrogen (BUN), creatinine, triglyceride, total cholesterol, and HDL-cholesterol)], and quantity and quality of dietary intake were compared between male and female participants. Results: Males had higher rates of having a spouse, prevalence of hypertension, alcohol drinking, and smoking than females. The proportion of males with a normal range of FPG, BUN, and HDL-cholesterol was lower than that in females. The total cholesterol levels above the normal range were higher in females than in males. We also found that females had a higher percentage of intakes below the estimated energy requirement (EER) and intakes below the estimated average requirement (EAR) for carbohydrates, niacin, phosphorus, and iron than males. The index of nutritional quality (INQ) for phosphorus and folate, nutrient adequacy ratio (NAR) for vitamin C, thiamine, niacin, folate, calcium, and phosphorus, and the mean adequacy ratio (MAR) were lower in females than males. Conclusions: In Korean gastric cancer patients, management of comorbidities such as diabetes and hypertriglyceridemia, lowering FPG, and raising HDL-cholesterol level management is required for males, whereas management of lowering total cholesterol and raising hematocrit is required for females. The quantitative and qualitative nutritional intakes were poor in gastric cancer patients, especially in females, who had a lower nutritional intake than males. We suggest that nutritional interventions are needed to improve the overall nutritional intake in both male and female gastric cancer patients. In particular, we propose that support is urgently needed for females whose nutritional intake is lower than that of males. In addition, family, social, and national support for nutritional management of female gastric cancer patients is highly necessary.

• Korean Circulation Journal
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• v.53 no.7
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• pp.425-451
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• 2023

Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA₂DS₂-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

• Journal of Digital Convergence
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• v.13 no.8
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• pp.375-385
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• 2015

This study aims to identify geographical variations and factors that affect smoking rates. The data are collected from the Community Health Survey conducted between 2009 and 2011 by Korea Centers for Disease Control and Prevention and other government organizations. Correlation and multiple regression analysis were used to examine the factors influencing smoking rates. For the purpose of investigating regional variations, we employed a decision tree model. The study has found that the significant factors associated with geographical variations in the smoking rates were the rate of hazardous drinking, the completion rate of hypertension education, the experience rate of anti-smoking campaigns, stress awareness rate, hypertension prevalence, health insurance cost, diabetes prevalence, obesity rate, and strength training rate. Convergence-based analysis on geographical variations of the smoking rates is highly important when the regionally customized healthcare programs is implemented. In the future, it is necessary to develop effective program and customized approach for the regions of high smoking rates. Our study is expected to be used as meaningful data for the design of effective health care programs and assessments to lead effective non-smoking program.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.1
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• pp.107-127
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• 2018

Objectives : The present study investigated the anti-obese and blood flow improvement activities of aqueous extracts of ginseng berry (GBe) on the mild diabetic obese mice as compared with metformin. Methods : After end of 56 days of continuous oral administrations of GBe 150, 100 and 50 mg/kg, or metformin 250 mg/kg, anti-obese and blood flow improvement effects - the changes of body weights, body and abdominal fat density by in live dual-energy x-ray absorptionmetry (DEXA), tail bleeding time, prothrombin time (PT), activated partial thromboplastin time (aPTT), serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) levels, aorta and serum cyclic guanosine monophosphate (cGMP), nitric oxide (NO) and endothelin (ET)-1 levels, aorta phosphorylated PI3K (pPI3K), phosphorylated Akt (pAkt) and phosphorylated p38 MAPK (pp38 MAPK) levels were systemically analyzed. In addition, aorta vascular dilation and constriction related gene mRNA expressions - PI3K, Akt, eNOS, p38 MAPK and ET-1 were also analyzed by realtime RT-PCR. Results : The obesity and related blood flow impairment, induced by 84 days of continuous HFD supply, were significantly inhibited by 56 days of continuous oral treatment of GBe 150, 100 and 50mg/kg, dose-dependently, and they also dramatically normalized the changes of the aorta vascular dilation and constriction related gene mRNA expressions, also dose-dependently. Especially, GBe 150 mg/kg constantly showed favorable inhibitory activities against type II diabetes related obesity and vascular disorders through PI3K/Akt pathway and p38 MAPK mediated cGMP, NO and ET-1 expression modulatory activities, as comparable to those of metformin 250 mg/kg in HFD mice. Conclusion : By assessing the key parameters for anti-obese and blood flow improvement activities on the HFD-induced mild diabetic obese mice, the present work demonstrated that GBe 150, 100 and 50 mg/kg showed favorable anti-obese and blood flow improvement effects in HFD-induced type II diabetic mice, through PI3K/Akt pathway and p38 MAPK mediated cGMP, NO and ET-1 expression modulatory activities.

• The Korean Journal of Community Living Science
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• v.17 no.3
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• pp.159-174
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• 2006

The purpose of this study is to provide information searching for health promotion, nutrition improvement, and health care of the impaired elderly by ADL(Activity of Daily Living) and IADL(Instrumental Activity of Daily Living). The subjects were divided into the Assistant Needed Group and No Assistant Needed Group for living in line with the responses of ADL(10 items like dressing, washing, move etc.) and IADL(10 items like housekeeping, using transportation, shopping, Phone call etc.). Survey was made for health behavior, health risk habit, dietary management status and diet intake by 24 hr-recall and questionnaire method. 242 subjects were collected in 12 cities or Gun districts in Gyeonggi Province, S. Korea. Survey was carried out by regional home extension workers using interview method. Statistical analyses were made using SAS (Version 8.1). Chi-Square Tests and General Linear Models. The subjects of impaired ADL elderly was 26.5% and it composed 30% of the total male and 22.2% of the total female. The demographic status of the impaired ADL elderly showed no difference from that of the normal elders, elementary school educated (73.4%), with spouse (43.8%) or with adult children(37.5%), using monthly living cost of 500-1,000 thousand won(35.9%). Mean age was 74.05 years compared to 72.25 years of normal elders. However, there was no significant difference from the normal and impaired ADL group, regular exercise(60.0%), with walking (90.0%), no-smoke(54.7%) and no-drink(48.4%). Kind of disease was not different from the one in impaired and normal group, with cardiovascular disease(32.3%), with diabetes mellitus(8.1%), joint lumbago neuralgia(32.3%) and osteoporosis(9.7%). Gastrointestinal complaints of the impaired ADL group were nausea(57.8%), chronic indigestion (23.4%), constipation (14,0%) and vomiting(3.7%). Sleeping time required for the impaired was longer than that for the normal group by 10hours(4.7%) or 8-10hours(20.3%), which consisted 1.7% and 16.6% respectively. Nutrient intake of the impaired ADL group was low compared to normal range elders: Energy(1260kca1), Protein(52.75g). There was gender difference in nutrient intake; the male impaired group showed no significant difference from the normal group but it was significantly lower in female impaired group. These results suggest that low quality of life and low economic status of the impaired ADL elderly require congregate meal in village hall to cover the lack of side dishe variety. And nutrition education program including community assistance would be required for the impaired ADL elderly together with the sufficient food and exercise practice. By operating nutrition education program, the impaired ADL elderly would maintain more enhanced quality of life and ameliorate the ADL capability.

• Journal of the Korean Society of Food Culture
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• v.6 no.4
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• pp.351-367
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• 1991

This research was attempted to investigate the correlation between food habits as well as preferences and health conditions of middle-aged people. 380 people living in Dae-gu, kimch$\breve{o}$n and k$\breve{u}$mr$\breve{u}$ng gun in the 40's or 50's were selected for this research as subjects from July 1 to August 15, 1990. The data analysis was made by way of frequency, percentage, ${\chi}^2-test$ and Pearson correlation using SAS package. The summarized results are as follows. 1. Among the total subjects of this research, 200 people (52.6%) were male and 180 people (47.4%) were female. The regional distribution was like this; 115 people (30.3%) lived in large city, 154 people (40.5%) in small and medium city and 111 people (29.2%) in rural region. 2. The survey on food life attitude on the subjects showed that they had a relatively good attitude, and there were little significant differences (p<.05) between men and women. But there were significant differences (p<.001) between rural region and city. 3. On the preferences for taste, food and cooked food the subjects showed the lowest preferences for processed milk-fat food and the highest for soybean and processed soybean food. 4. The research on health condition 1) 30.8% of the subjects were obesity. And this research showed that the percentage of obesity was higher among men (33.5%) than women (27.8%), and higher in cities (40.4, 34.4%) than rural region (16.2%), (p<.05, p<.01). 2) 90.8% of the subjects showed negative according to Diabetes inspection. 3) 2.0% of the subjects were hypertensive, and the percentage was higher among women than men, and higher in rural region than cities. 4) 12.6% of the subjects were anemia, and the percentage was higher among women (17.8%) than men (8.0%), and higher in rural region (23.4%) than cities (7.0, 9.1%). 5) DMFT index and DMF rate of dental caries was higher among women (DMFT index; 10.6 DMF rate; 88.9) than men (DMFT index; 7.3 DMF rate; 81.5), and higher in rural region (DMFT index; 11.8 DMF rate; 90.1) than cities (DMFT index; 7.4, 7.9 DMF rate; 79.1, 85.7). 6) According to the survey on self-diagnosed health status of subjects, the percentages of articular·neuralgia (48.9%) was the highest. And that of stomach digestion troubles (31.1%), headache (22.4%), anxiety excitement (12.9%), spastic constipation (12.4%), insomnia (9.7%), melancholia (7.9%) and etc (1.6%) followed. 7) People had allergied food which contained animal protein such as pork, chicken, mackerel, siakworm pupa, clam and so on. 8) In female cases, 46.7% of women became already menopausal and 13.3% of them was under menopause. 5. This research showed that there were significant correlation between food life attitude and health condition in obesity, anemia and dental caries but not in blood pressure. 6. And this research also showed that there were significant correlations between food preference and health condition in obesity, anemia and dental caries but not in blood pressure.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.83-91
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• 2012

The obesity is a medical condition in which excess body fat has accumulated to the extent. It may have an adverse effect on health, leading to reduced life expectancy and increased health problems such as lifestyle disease, hypertension, and diabetes. Furthermore, it may cause the mental illness such as depression, bipolar disorder, anorexia, hyperphagia, and so on by shrinking psychologically. So, it is regarded as the serious worldwide social problem. Recently, although there are many general obesity care methods with various approaches, these can't be the radical obesity care because of the side effects such as surgery aftereffect, drug addiction, and so on. For these reasons, a methodical approach with a consideration of individual obesity pattern is strongly demanded. In this study, complex obesity care and management system which is overcome the weakness of non-surgical obesity treatment is proposed. And the individually adapted obesity treatment system with the far-infrared therapy module, oxygen therapy module, color therapy module, and microwave therapy module was developed. The complex obesity treatment system which is proposed in this study, could improve the efficiency of treatment by suggesting the various treatment protocols. And proposed system could be the foundation of the high quality obesity treatment system.

• Journal of the East Asian Society of Dietary Life
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• v.19 no.6
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• pp.928-934
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• 2009

The purpose of this study was to examine the possibility of making functional sulgitteok with Goami 2 rice, which is a rich that is high in dietary fiber. Sulgitteok was made by adding various amounts of Goami powder(25, 50, 75, and 100 %) to rice powder. Then, the sensory tests and other tests to measure color, texture and hardness were examined as a function of time and the moisture content in sulgitteok was measured to determine the quality and characteristics of different types of sulgitteok. The conclusions of these tests were as follows : In the sensory evaluation preference test of sulgitteok made with various amounts of Goami powder, the overall preference was the highest in sulgitteok made with 50% Goami powder (S2). In the difference test, the higher the amount of added Goami powder, the lower the grades were. The S4 group, which was made with Gomai powder, had a strongly unique odor compared with those made with rice powder, which smelled weaker. In terms of the color values of Gomai added sulgitteok, the higher the amount of added Gomai powder, the lower the lightness value of sulgitteok, where group S4 had the lowest value. In addition, the S4 group, which was made with Goami powder, had the hightest red and yellow color. The texture test indicated that sulgitteok containing a large amount of Goami powder were considerably harder compared with the control group. While every group containing Goami powder (S1, S2, S3 and S4) became harder during the first to the third day of the test, their hardness tended to drop after longer storage times. In the control group, the hardness continued to grow from the start up to the fifth day. After five days' there was a noticeable change in the moisture content in the different types of sulgitteok, with more water evaporating in the S3, S2, and S1 groups than in the S4 groups, which contained the highest amount of Goami powder. Group C, which contained no Goami powder, had the largest water evaporation. Sulgitteok that contained more Goami powder turned out to be more savory than baekseolgi made solely of rice powder. However, they were less preferable overall, since they were rated lower in terms of color, texture and other characteristics. Therefore, utilize Goami tteok as a functional ingredient in food for people with diabetes or obesity, further studies on additives that can provide a sticky texture and favorable color should be conducted. In addition, different types of ttoek such as pounded or boiled ones may be preferable to sulgitteok.

• Research in Community and Public Health Nursing
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• v.7 no.1
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• pp.154-169
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• 1996

Parish nursing is a community health nursing role developed in 1983 by Lutheran chaplain Granger Westberg. An increasing emphasis on holistic care, personal reseponsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment and nurturance of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The autors conducted a study on pastor's expectations from parish nurses. Results of this study will be useful to those instrumental in planning, initiating, supporting, and evaluating a parish nurses program The research was done on 130 pastors in Taegue and Kyong Sang Buck Do, of various ages ranging from their 20's to 60's: and pastoring churches of various sizes, ranging from under 100 to over 300 members. 94.6% agreed that they needed a parish nurse on their staff; and 86.2% said they wanted to start a parish nurse program in their churches if certain basic conditions were met. The pastors responded that some would hire the nurses on a full-time basis(22.3%), a part -time basis (37.7%) or use volunteer nurses (40%). The pastors said they would expect the following from a parish nurse: health counselling (80.0%) regular health check-ups (78.5%) health care for the elderly (78.5%) health information and education (72.3%) hospice care (72.3%) visiting sick church members at home (69.2%) arranging and training volunteers to help the seek (59.2%) health care for expectant mothers (50.0%) introducing and taking people to health care facilities (46.2%) The pastors were surveyed about specific areas of health education they would want the parish nurse to teach(for example, high blood pressure and heart disease prevention and management(76.2%) ; stress management(74.6%); and diabetes prevention and management(73.8%). The pastors were surveyed about specific areas of health counselling they would expect the parish nurse to do (for example, drug abuse, (73.1), alcohol abuse(64.6%), marriage conflict(60.0%), recovery after the loss of a loved one(56.9%), and women's conflict with parents-in-law(53.8%). The pastors were surveyed about types of things they would want included in regular health check-ups, what they would want a parish nurse to do on home visits, and what they would want included in home care for the elderly. They were also surveyed on what kind of spiritual care they would like parish nurses to give. Most (90.7%) wanted their parish, parishioners to be involved in the parish nurses program as volunteers, and in a variety of ways(such as visiting sick in their homes(68.5%) and helping with housework(63.1%) and taking sick people to health facilities(60%). Parish nurses role, activities, and boundaries of practice should be continuously monitored and refined and a 'case manager' should be conceptualized as an additional or all-encompassing role. An initial parish / community needs and readiness assessment should be done prior to establishing a program to detemine if the congregation is ready, willing, and able to support such a position for at least a 2 to 3 year period.