• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5063-5069
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• 2016

Background: Breast cancer is the most common cancer among women in most countries of the world. It is ranked first in females in Morocco (accounting for 33.4% of the total cancer burden) and more than 60% of cases are diagnosed at stage III or IV. During the last decade, health-related quality of life (HRQOL) has become an important aspect of breast cancer treatment. The objective of this study was to describe self-reported HRQOL in patients with breast cancer and to investigate its associations with sociodemographic and clinical variables. Methods: A prospective study was carried out in the main oncology centers in Morocco. Quality of life was measured using the Moroccan Arabic versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C 30 (EORTC QLQ C30) and the Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Statistical analyses were performed using descriptive statistics and multivariate analyses. Results: A total of 1463 subjects were included in the study, with a mean age of 55.6 (SD. 11.2) years, 70% being married. The majority had stage II (45.9%) and a few cases stage IV (12.9%) lesions. The participants' global health mean score was 68.5 and in "functional scales", social functioning scored the highest (Mean 86.2 (SD=22.7)). The most distressing symptom on the symptom scale was financial difficulties (Mean 63.2 (SD=38.2)). Using the disease specific tool, it was found that future perspective scored the lowest (Mean 40.5 (SD=37.3)). On the symptom scale, arm symptoms scored the highest (Mean 23.6 (SD=21.6)). Significant mean differences were noted for many functional and symptom scales. Conclusion: Our results emphasized that the general HRQOL for our study population is lower than for corresponding populations in other countries. This study provided baseline information on the quality of life for a large sample of Moroccan women diagnosed with breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3435-3442
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• 2015

Objective : To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and Methods: A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Results: Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear guidelines and policies for HPV vaccination. Conclusion: Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2991-2999
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• 2013

Background: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves. Materials and Methods: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique. Results: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%. Conclusions: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.

• Journal of Korean Neurosurgical Society
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• v.63 no.4
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• pp.433-443
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• 2020

Objective : Osteoporosis is a disease of unbalanced bone metabolism that results in low bone mineral density with increased bone fragility and propensity for fractures. The increased rate of bone fracture due to osteoporosis places a significant burden on public health care expenditures. Therefore, numerous studies have been designed and performed to identify the drugs or health foods that can improve the bone quality or quantity. This study was designed to evaluate and analyze the therapeutic effects of rutin on histomorphometric values of the spine and femur in an osteoporotic mouse model induced by bilateral ovariectomy. Methods : Thirty female ICR mice (8 weeks old) underwent either a sham operation (only abdominal incision, sham group, n=10) or bilateral ovariectomy (n=20). The ovariectomized (OVX) animals were randomly divided into two groups : untreated OVX group (OVX-C, n=10), or rutin-administered group (OVX-R, n=10). The OVX-C group received weight-adjusted doses of saline vehicle and the OVX-R group received 50 mg/kg of rutin intraperitoneally, starting 1 day after surgery. At 4 and 8 weeks after surgery, serum estrogen, osteocalcin, alkaline phosphatase (ALP), and the telopeptide fragment of type I collagen C-terminus (CTX-1) were analyzed. Interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor (TNF)-α were also analyzed. Bone histomorphometric parameters of the 4th lumbar vertebra and femur were determined by micro-computed tomography. Results : In OVX-C group, ALP, osteocalcin, CTX-1, IL-1β, IL-6, and TNF-α levels were significantly increased at 4 and 8 weeks compared to sham operation group. Rutin administration after OVX statistically significantly reduced ALP, CTX-1, IL-1β, IL-6, and TNF-α levels at 4 and 8 weeks. Rutin administration also improves bone histomorphometric parameters including trabecular bone volume fraction, trabecular thickness, and trabecular number. Trabecular separation was also decreased in OVX-R group compared to OVX-C group. Conclusion : The present study demonstrated that rutin has therapeutic effects on improving bone histomorphometric values in an OVX mouse model. The improvement in histomorphometric values may be associated with the reduction of osteoclastic activity via inhibition of IL-1β, IL-6, and TNF-α. In future studies, the mechanism for the effect of rutin on osteoporosis should be demonstrated more clearly to use rutin in human osteoporosis.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.1
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• pp.51-60
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• 2003

This study was a descriptive research in search of a nursing intervention scheme to improve stroke patients' quality of life by understanding the relationship of stroke patients' ADL, depression, self-efficacy and quality of life with various variables and identifying factors that affect their quality of life. Each subject was interviewed one to one based on a structured questionnaire. With regard to research tools, Modified Barthel Index (MBI: Fortinsky et al., 1981), which was translated by Choi, Hye-sook (1996), was used in measuring ADL, Randloff's (1977) tool, which was translated by Choi, Soon-hee, was used in measuring depression, and the tool developed by Sherer et al. (1982), which is to measures self-efficacy under general conditions not limited to specific conditions, and modified by O, Bok-ja (1994) was used in measuring self-efficacy. The quality of life was measured using the scale of satisfaction of life developed by Diener et al. (1985). The results of this study were as follows: 1. The means of ADL of the subjects was $79.5{\pm}31.9$, depression $26.8{\pm}10.4$, self-efficacy $47.1{\pm}25.7$, and the quality of life $12.3{\pm}4.9$. 2. The subjects' quality of life showed a statistically significant difference according to gender (t=7.9, p= .006), satisfaction with income (F=5.8, p= .004), the burden of medical fee (F=3.7, p= .028) and the period of disease (F=2.8, p= .042). 3. With regard to relationship among ADL, depression, self-efficacy and the quality of life, ADL was in a relatively low positive correlation (r= .293, p= .003) with and the quality of life, depression in a high negative correlation (r=- .634, p= .000) with the quality of life, and self-efficacy in a positive correlation with the quality of life (r= .388, p= .000). 4. Factors that made a significant influence on the quality of life were depression (B=- .309, p= .001) and satisfaction with income (B=-2.611, p= .001). Based on these results, this study made following suggestions: 1. It is necessary to run rehabilitation programs to improve stroke patients' ADL, depression and self-efficacy. 2. It is necessary to perform research of monitoring stroke patients' quality of life in various areas using measuring tools.

• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.1-9
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• 2017

Objectives: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. Results: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). Conclusions: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.

• Journal of Food Hygiene and Safety
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• v.29 no.2
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• pp.85-91
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• 2014

Deoxynivalenol (DON) and related trichothecene mycotoxins are extensively distributed in the cereal-based food and feed stuffs worldwide. Recent climate changes and global grain trade increased chance of exposure to more DON and related toxic metabolites in poorly managed production systems. Monitoring the biological and environmental exposures to the toxins are crucial in protecting human and animals from toxicities of the hazardous contaminants in food or feeds. Exposure biomarkers including urine DON itself are prone to shift to less harmful metabolites by intestinal microbiota and liver metabolic enzymes. De-epoxyfication of DON by gut microbes such as Eubacterium strain BBSH 797 and Eubacterium sp. DSM 11798 leads to more fecal secretion of DOM-1. By contrast, most of plant-derived DON-glucoside is also easily catabolized to free DON by gut microbes, which produces more burden to body. Phase 2 hepatic metabolism also contributes to the glucuronidation of DON, which can be useful urine biomarkers. However, chemical modification could be very typical depending on the anthropologic or genetic background, luminal bacteria, and hepatic metabolic enzyme susceptibility to the toxins in the diet. After toxin exposure, effect biomarkers are also important in estimating the linkage and mechanisms of foodborne diseases in human and animal population. Most prominent adverse effects are demonstrated in the DON-induced immunological and behavioral disorders. For instance, acutely elevated interleukin-8 from insulted gut exposed to dietaty DON is a dominant clinical biomarker in human and animals. Moreover, subchronic exposure to the toxins is associated with high levels of serum IgA, a biological mediator of IgA nephritis. In particular, anorexia monitoring using mouse models are recently developed to monitor the biological activities of DON-induced feed refusal. It is also mechanistically linked to alteration of serotoin and peptide YY, which are promising biomarkers of neurological disorders by the toxins. As animal-alternative biomonitoring, huamn enterocyte-based assay has been developed and more realistic gut mimetic models would be useful in monitoring the effect biomarkers in resposne to toxic contaminants in the future investigations.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.136-143
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• 2021

Objectives : The coronavirus disease 2019 (COVID-19) outbreak is a global medical crisis imposing particular burden on public sector employees. The aim of this study was to investigate the psychiatric distress among public sector workers amid the COVID-19 pandemic. Methods : We conducted a cross-sectional study with 531 public sector workers in Gwangmyung city who completed Korean versions of the Perceived Stress Scale (PSS), Patient Health Questionnaire-9 (PHQ-9), and Impact of Event Scale-Revised-Korean (IES-R-K). Results : The results revealed more than moderate levels of stress (85.2%), depressive symptoms (22.2%), and posttraumatic stress symptoms (38.8%). PSS total score was significantly correlated with PHQ-9, IES-R-K total scores as well as IES-R-K subscale scores. Total scores on the PSS, PHQ-9, and IES-R-K were all inversely correlated with age. Conclusions : COVID-19-related workers experience considerable stress and depressive symptoms, with self-rated stress correlating significantly with depression scores. Age may serve as a protective factor against occupational stress and burnout. These findings highlight the need for adequate psychiatric screening and intervention for public sector workers.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.603-613
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• 2018

Background/Aims Functional dyspepsia (FD) is one of the most common gastrointestinal disorders, and FD imposes social and economic burden worldwide. The aim of this study is to identify the prevalence and risk factors of FD in health check-up population in tertiary centers in Korea. Methods A nationwide multicenter prospective study was performed at 9 tertiary healthcare centers in Korea between September 2016 and June 2017. A total of 2525 subjects were investigated based on endoscopic findings and questionnaires with the Rome III criteria, and Helicobacter pylori serology (IgG). Results A total of 1714 subjects without organic disease were enrolled. The mean (${\pm}SD$) age was 51.5 (${\pm}12.7$) years, and 917 patients (53.5%) were female. The proportion of H. pylori seropositivity was 51.0% (874/1714). The prevalence of FD was 10.3% (176/1714), and the subtypes of postprandial distress syndrome alone, epigastric pain syndrome alone, and postprandial distress syndromeepigastric pain syndrome overlap were 4.8%, 3.0%, and 2.5%, respectively. Multivariate analysis showed that female gender (OR, 1.58; 95% CI, 1.14-2.21) and education below college level (OR, 1.45; 95% CI, 1.01-2.07) were related to FD. Multivariate analysis based on age 60 showed female gender as a significant (OR, 2.90; 95% CI, 1.06-7.94) factor in the group ${\geq}60$ years. Conclusions The prevalence of FD was 10.3% in the health check-up population in Korea. Female sex and education below college level were risk factors for FD. Female sex is a risk factor for FD in old age, underscoring the need for close attention in this age group.

• The Journal of the Korea Contents Association
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• v.19 no.4
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• pp.41-53
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• 2019

As the paradigm of healthcare shifts from the center of treatment to the center of prevention, products and services related to disease prevention are emerging at domestic and abroad. The government considers the smart healthcare industry as a solution to healthcare problems such as an increase in the number of chronic illnesses and an increase in the burden of medical expenses. The purpose of this study is to explore the factors affecting the use of smart healthcare products and services focusing on Health Literacy and health related personal characteristics and to provide policy implications. The subjects of the questionnaire are 1,027 adults over 20 in the nation, and conducted an online survey. In addition, the factors were analyzed by decision tree method. As a result, most of the respondents(76.9%) did not have experience using Smart Healthcare products and services. However, in the Health Literacy question, there was a difference in use experience depending on the degree of difficulty in using the mass media information. Other factors were the degree of intention to use new technology, the understanding of counseling about family members and friends, and health checkups. In order to enable self-healthcare through smart healthcare products and services, the ability of consumers to explore and utilize health information from the mass media should be improved. In addition, government and enterprise efforts are needed to achieve this.