• Title/Summary/Keyword: Drinking Population

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Environmental Changes after Timber Harvesting in (Mt.) Paekunsan (백운산(白雲山) 성숙활엽수림(成熟闊葉樹林) 개벌수확지(皆伐收穫地)에서 벌출직후(伐出直後)의 환경변화(環境變化))

  • Park, Jae-Hyeon
    • Journal of Korean Society of Forest Science
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    • v.84 no.4
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    • pp.465-478
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    • 1995
  • The objective of this study was to investigate the impacts of large-scale timber harvesting on the environment of a mature hardwood forest. To achieve the objective, the effects of harvesting on forest environmental factors were analyzed quantitatively using the field data measured in the study sites of Seoul National University Research Forests [(Mt.) Paekunsan] for two years(1993-1994) following timber harvesting. The field data include information on vegetation, soil mesofauna, physicochemical characteristics of soil, surface water runoff, water quality in the stream, and hillslope erosion. For comparison, field data for each environmental factor were collected in forest areas disturbed by logging and undisturbed, separately. The results of this study were as follows : The diversity of vegetational species increased in the harvested sites. However, the similarity index value of species between harvested and non-harvested sites was close to each other. Soil bulk density and soil hardness were increased after timber harvesting, respectively. The level of organic matter, total-N, avail $P_2O_5$, CEC($K^+$, $Na^+$, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$) in the harvested area were found decreased. While the population of Colembola spp., and Acari spp. among soil mesofauna in harvested sites increased by two to seven times compared to those of non-harvested sites during the first year, the rates of increment decreased in the second year. However, those members of soil mesofauna in harvested sites were still higher than those of non-harvested sites in the second year. The results of statistical analysis using the stepwise regression method indicated that the diversity of soil mesofauna were significantly affected by soil moisture, soil bulk density, $Mg^{{+}{+}}$, CEC, and soil temperature at soil depth of 5(0~10)cm in the order of importance. The amount of surface water runoff on harvested sites was larger than that of non-harvested sites by 28% in the first year and 24.5% in the second year after timber harvesting. The level of BOD, COD, and pH in the stream water on the harvested sites reached at the level of the domestic use for drinking in the first and second year after timber harvesting. Such heavy metals as Cd, Pb, Cu, and organic P were not found. Moreover, the level of eight factors of domestic use for drinking water designated by the Ministry of Health and Welfare of Korea were within the level of the first class in the quality of drinking water standard. The study also showed that the amount of hillslope erosion in harvested sites was 4.77 ton/ha/yr in the first year after timber harvesting. In the second year, the amount decreased rapidly to 1.0 ton/ha/yr. The impact of logging on hillslope erosion in the harvested sites was larger than that in non-harvested sites by seven times in the first year and two times in the second year. The above results indicate that the large-scale timber harvesting cause significant changes in the environmental factors. However, the results are based on only two-year field observation. We should take more field observation and analyses to increase understandings on the impacts of timber harvesting on environmental changes. With the understandings, we might be able to improve the technology of timber harvesting operations to reduce the environmental impacts of large-scale timber harvesting.

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A Preliminary Study for the Application of Michigan Alcoholism Screening Test-Geriatric Version in Korea (한국에서 노인용 미시간주정의존선별검사의 적용을 위한 예비연구)

  • Cheon, Jin-Sook;Oh, Byoung-Hoon;Choi, Young-Tai
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.102-110
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    • 1999
  • Objectives : The alcohol dependence in elderly people has been prevalent because of increase in geriatric population. However, it is difficult to find out alcohol dependence in the aged, because they have less specific clinical features as compared with adult alcoholics. The aims of this study were to screen alcohol dependence among elderly Koreans and to know the clinical characteristics of Korean delerly alcoholics. Methods : The questionnaires translated into Korean such as Michigan Alcoholism Screening Test(MAST-K), the Brief MAST and the MAST-Geriatirc Version (MAST-KG) were used to screen alcohol dependence in the elderly alcoholic inpatients aged over 60(N=43), adult alcoholic inpatients within 20-59 Yrs of age(N=60), which were compared with age matched normal healthy aged(N=18) or adult controls(N=45). The demographic data such as sex, age, education, occupation, socioeconomic status, marital status, numbers of children, dwelling and religion as well as alcohol history such as duration of alcohol drinking, onset age, family history, impulsivity, somatic illness and motivation were also obtained to identify characteristic features of Korean aged alcoholics by structured interviews. Results : 1) The aged alcoholics had the charateristic features of more in males, lower age, low education levels, more in blue-collar workers, lower socioeconomic class, more in single, few babies, more living alone, having no religion without statistical significance. 2) The onset age of alcohol dependence was significantly higher in the aged alcoholics($45.3{\pm}13.6Yrs$) than in the adult alcoholics($27.7{\pm}8.7Yrs$)(p<0.0001). The duration of problematic alcohol drinking was significantly longer in the aged alcoholics($22.0{\pm}15.1Yrs$) than in adult alcoholics($14.2{\pm}8.4Yrs$)(p<0.01). Otherwise, there were no significant difference between aged and adult alcoholics in the family history, imulsivity, somatic illness and motivation. 3) The mean score of the MAST-K was significantly higher in the aged alcoholics($20.6{\pm}5.4$) than in the normal aged($6.7{\pm}4.4$)(p<0.0001), which was significantly lower than in the adult alcoholics($26.2{\pm}8.0$) and in normal adult controls($9.5{\pm}3.2$)(p<0.05). The mean score of the Brief MAST was significantly lower in the aged alcoholics($9.3{\pm}3.5$) than in the adult alcoholics($14.5{\pm}6.6$)(p<0.0001). The mean score of the MAST-KG was significantly higher in the aged alcoholics($10.6{\pm}3.5$) than in the normal aged($4.8{\pm}4.3$)(p<0.0001). The former was significantly lower than in the adult alcoholics($12.9{\pm}4.3$)(p<0.005), and the mean score was $4.5{\pm}2.8$ in normal adult controls. 4) The items which showed statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K(items 2, 3, 4, 5, 11, 14, 17, 21, 22 and 23), 2 items of the Brief MAST(items 2 and 9), and 7 items of the MAST-KG(items 6, 13, 18, 19, 22, 23 and 24)(p<0.01). Conclusions : The scores of the MAST-K, the Brief MAST and the MAST-KG were significantly lower in the aged alcoholics than those in the adult alcoholics (p<0.05). The statistically significant differences between aged alcoholics and normal aged controls could be found in 10 items of the MAST-K, 2 items of the Brief MAST and 7 items of the MAST-KG. Therefore, a briefer rating scales around 10 items are needed to screen alcohol dependence among Korean elderly people.

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Associations between the Practice of Health Behaviors and Awareness of Metabolic Syndrome among Adults (19-64 years) in the Gwangju-Jeonnam Area: 2010 Community Health Survey (광주 전남지역 성인의(19-64세) 건강생활실천과 대사증후군 인지와의 관련성 - 2010년 지역사회건강조사 자료를 이용하여 -)

  • Chun, In Ae;Ryu, So Yeon;Park, Hyeon Hui;Park, Jong;Han, Mi Ah;Choi, Seong Woo
    • Journal of agricultural medicine and community health
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    • v.38 no.4
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    • pp.217-228
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    • 2013
  • Objective: This study was performed to identify associations between the practice of health behaviors and awareness of metabolic syndrome (MetS) among adults aged 19 to 64 years in the Gwangju-Jeonnam area. Methods: This study utilized data from the 2010 Community Health Survey (CHS). Health behaviors considered in this study were smoking, alcohol drinking, physical activity, low-salt diet, and perception of stress. The index for the health behaviors was calculated as the sum of the practice of each health behavior (range: 0-5). The analysis was weighted with a complex sampling design, and the chi-square test and multiple logistic regression analysis were used to identify the association between the practice of health behaviors and awareness of MetS. Results: A total of 19.8% of the population were aware of MetS. The perception of MetS was statistically significantly associated with healthy behaviors, including nonsmoking (aOR = 1.33, 95% CI = 1.14-1.56), non-high-risk drinking (aOR = 1.54, 95% CI = 1.27-1.88), engagement in physical activity (aOR = 1.48, 95% CI = 1.28-1.72), and a low-salt diet (aOR = 1.30, 95% CI = 1.13-1.51). The ORs of the perception of MetS were significantly higher in patients with a health behavior index of 2 to 3 (aOR = 1.64, 95% CI = 1.01-2.66) and in those with an index of ${\geq}4$ (aOR = 2.47, 95% CI = 1.51-4.04) than in those with an index of 0. Among all health behaviors, physical activity had the highest OR for the perception of MetS (aOR = 1.50, 95% CI = 1.29-1.74). Conclusions: This study revealed associations between health behaviors, especially physical activity, and awareness of MetS. Therefore, integrated health promotion programs may be needed to enhance awareness of MetS and to effectively prevent MetS and non-communicable diseases.

CHANGES IN WATER USE AND MANAGEMENT OVER TIME AND SIGNIFICANCE FOR AUSTRALIA AND SOUTH-EAST ASIA

  • Knight, Michael J.
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 1997.11a
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    • pp.3-31
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    • 1997
  • Water has always played a significant role in the lives of people. In urbanised Rome, with its million people. sophisticated supply systems developed and then fled with the empire. only to be rediscovered later But it was the industrial Revolution commencing in the eighteenth century that ushered in major paradigm shifts In use and altitudes towards water. Rapid and concentrated urbanisation brought problems of expanded demands for drinking supplies, waste management and disease. The strategy of using water from local streams, springs and village wells collapsed under the onslaughts of rising urban demands and pollution due to poor waste disposal practices. Expanding travel (railways. and steamships) aided the spread of disease. In England. public health crises peaks, related to water-borne typhoid and the three major cholera outbreaks occurred in the late eighteenth and early nineteenth century respectively. Technological, engineering and institutional responses were successful in solving the public health problem. it is generally accepted that the putting of water into pipe networks both for a clean drinking supply, as well as using it as a transport medium for removal of human and other wastes, played a significant role in towering death rates due to waterborne diseases such as cholera and typhoid towards the end of the nineteenth century. Today, similar principles apply. A recent World Bank report Indicates that there can be upto 76% reduction in illness when major water and sanitation improvements occur in developing countries. Water management, technology and thinking in Australia were relatively stable in the twentieth century up to the mid to late 1970s. Groundwater sources were investigated and developed for towns and agriculture. Dams were built, and pipe networks extended both for supply and waste water management. The management paradigms in Australia were essentially extensions of European strategies with the minor adaptions due to climate and hydrogeology. During the 1970s and 1980s in Australia, it was realised increasingly that a knowledge of groundwater and hydrogeological processes were critical to pollution prevention, the development of sound waste management and the problems of salinity. Many millions of dollars have been both saved and generated as a consequence. This is especially in relation to domestic waste management and the disposal of aluminium refinery waste in New South Wales. Major institutional changes in public sector water management are occurring in Australia. Upheveals and change have now reached ail states in Australia with various approaches being followed. Market thinking, corporatisation, privatisation, internationalisation, downsizing and environmental pressures are all playing their role in this paradigm shift. One casualty of this turmoil is the progressive erosion of the public sector skillbase and this may become a serious issue should a public health crisis occur such as a water borne disease. Such crises have arisen over recent times. A complete rethink of the urban water cycle is going on right now in Australia both at the State and Federal level. We are on the threshold of significant change in how we use and manage water, both as a supply and a waste transporter in Urban environments especially. Substantial replacement of the pipe system will be needed in 25 to 30 years time and this will cost billions of dollars. The competition for water between imgation needs and environmental requirements in Australia and overseas will continue to be an issue in rural areas. This will be especially heightened by the rising demand for irrigation produced food as the world's population grows. Rapid urbanisation and industrialisation in the emerging S.E Asian countries are currently producing considerable demands for water management skills and Infrastructure development. This trend e expected to grow. There are also severe water shortages in the Middle East to such an extent that wars may be fought over water issues. Environmental public health crises and shortages will help drive the trends.

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Interleukin-4 and -8 Gene Polymorphisms and Risk of Gastric Cancer in a Population in Southwestern China

  • Pan, Xiong-Fei;Wen, Ying;Loh, Marie;Wen, Yuan-Yuan;Yang, Shu-Juan;Zhao, Zhi-Mei;Tian, Zhi;Huang, He;Lan, Hui;Chen, Feng;Soong, Richie;Yang, Chun-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.2951-2957
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    • 2014
  • Background: Gastric carcinogenesis is a complicated process that involves environmental and genetic factors like interleukin-4 (IL-4) and IL-8. Single nucleotide polymorphisms in their genes are associated with changed levels of gene expression. Here, we investigated the association between IL4-590 C>T and IL8-251T>A and gastric cancer (GC) risk in Sichuan of Southwestern China. Materials and Methods: We surveyed the research subjects using a self-designed questionnaire with questions on demographic factors and putative risk factors. Approximately 2-5ml of whole blood was collected after field survey to analyze IL4-590 C>T and IL8-251T>A genotypes using MALDI-TOF MS. Results: Our study recruited 308 pairs of GC patients and controls, including 224 (72.7%) men and 84 (27.3%) women in each group. There were 99 cardia and 176 noncardia GC patients in the case group. The case and control groups had an average age of $57.7{\pm}10.6$ ($mean{\pm}SD$) and $57.6{\pm}11.1$ years. GC patients reported a significantly greater proportion of family history of cancer (29.9% vs 10.7%, p<0.01) and drinking (54.6% vs 43.2%, p<0.01) than did controls. Variant genotypes of IL-4-590 C>T and IL-8-251 T>A were not associated with overall GC risk (adjusted OR, 0.89; 95%CI, 0.61-1.28 for CT or CC vs TT; adjusted OR, 1.14; 95%CI, 0.86-1.79 for TA or AA vs TT). Stratification analysis of two SNPs for risk by subsites only found that variant IL-8-251 TA or AA genotype was associated with increased noncardia GC risk (adjusted OR, 2.58; 95%CI, 1.19-5.57). We did not observe interactions between the IL-8-251 T>A genotype and smoking (adjusted OR, 0.38; 95%CI, 0.08-1.79) or drinking (adjusted OR, 0.36; 95%CI, 0.08-1.65) for risk of noncardia GC. Conclusions: Our data indicate no association between the two SNPs of IL-4-590 and IL-8-251 with overall GC risk, while the IL-8-251 TA or AA genotype conferred risk of cardia GC. Our findings contribute to the evidence body for risk of SNPs associated with the development of gastric cancer in this region.

Effect of Raw Broun Rice and Job식s Tear Supplemented Diet on Serum and Hepatic Lipid Concentrations, Antioxidative System, and Immune Function of Rats (현미 및 율무 함유 생식이 영양불균형이 유도된 흰쥐의 체내 지질농도, 항산화체계 및 면역기능에 미치는 영향)

  • 박진영;양미자;전혜승;이진희;배희경;박태선
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.2
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    • pp.197-206
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    • 2003
  • Physiological functions of raw grain diet composed of brown rice and Job's Tear (1 : 1) were evaluated in rats raised with nutritionally unbalanced diet including 1% cholesterol, high proportion of animal lipids (lard: soybean oil : 8 : 2), sub-optimal levels of vitamin and mineral mixture along with 0.5% ethanol in drinking water for 4 weeks. Control rats were fed the AIN-93G diet for 9 weeks, and nutritionally unbalanced rats were divided into 3 groups, and fed one of the following diets with 0.5% ethanol in drinking water for another 5 weeks: unbalanced control diet (UCD), raw grain diet (RGD) (UCD +20% brown rice and Job's Tear mixture, and cooked grain diet (CGD)(autoclaved RGD at 121$^{\circ}C$ for 3 hours). Feeding UCD for 5 weeks significantly lowered the food efficiency ratio (FER) of rats than the value for control animals, and dietary supplementation of brown rice and Job's Tear mixture to UCD significantly restored the FER. Serum total cholesterol concentration was significantly lowered in rats fed RGD (24% decrease) or CGD (16% decrease) compared to the value for rats fed UCD. Feeding RGD for 5 weeks significaly lowered the serum LDL+VLDL-cholesterol concentration (26% decrease), as well as the hepatic cholesterol level (16% decrease) than the values for UCD rats. Animals fed CGD (38% decrease) or RGU (59% decrease) showed significantly lower level of hepatic thiobarbituric acid reactive substances (TBARS) compared to the value for rats fed UCD (p<0.05), although hepatic activities of antioxidative enzymes were not influenced by dietary supplementation. Feeding RGD for 5 weeks significantly increased CD4$^{+}$ T-cell population along with CD4$^{+}$/CD8$^{+}$ ratio of mesenteric lymph nodes compared to those for UCD rats (p<0.05). In conclusion, dietary supplementation of brown rice and Job's Tear mixture as raw grains exhibited superior activity lowering blood and hepatic levels of cholesterol, and improving mesenteric lymph nodes immune function of rats to the cooked grain mixture of identical ingredients.

Oral Health and Related Factors for the Elderly (Structural Equation Modeling을 통한 노인(老人)의 구강건강(口腔健康) 관련요인(關聯要因) 분석(分析))

  • Seung, Jeung-Hee
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.91-95
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    • 2004
  • This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

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The Relationship between Fish Consumption and Blood Mercury Levels in Residents of Busan Metropolitan City and Gyeongnam Province (부산, 경남 일부 지역 주민들의 생선 섭취량과 혈중 수은 농도의 관련성)

  • Kim, Chan Woo;Kim, Young Wook;Chae, Chang Ho;Son, Jun Seok;Kim, Ja Hyeon;Park, Hyoung Ouk;Kang, Yune-Sik;Kim, Jang-Rak;Hong, Young Seoub;Kim, Dae-Seon;Jeong, Baek Geun
    • Journal of agricultural medicine and community health
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    • v.37 no.4
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    • pp.223-232
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    • 2012
  • Objectives: The objective of this study was to identify the relationship between fish consumption and blood mercury levels in a sample of adult Koreans. Methods: The study subjects were 299 residents of Busan (male: 65, female: 234) and 185 residents of Namhae (male: 69, female: 116), South Korea. Demographic characteristics, current smoking, current drinking, fish consumption per week, past history of amalgam treatment, and residential district were recorded by trained interviewers in June and July, 2009. We considered a portion of fish to be equivalent to 70 gm weight, and calculated amounts of fish consumed per week. Using chi-square tests, t-tests, ANOVA, and multiple linear regression analysis, we estimated the relationships between blood mercury levels and amount of fish consumed per week and other factors. Results: The mean blood mercury level of our subjects was 6.61 ${\mu}g/L$, higher than the criterion defined by the United States Environmental Protection Agency (EPA) (5.8 ${\mu}g/L$). In multiple linear regression analysis, residential district and amount of fish consumed per week were associated with blood mercury levels. However, marital status, current drinking, and gender, and age were not associated with blood mercury levels. Conclusions: In conclusion, we suggest the implementation of systematic and periodic population-based studies to decrease the risks of mercury poisoning among South Koreans who consume fish as a regular part of the diet.

Characterization of Water Quality and the Aerobic Bacterial Population in Leachate Derived from Animal Carcass Disposal (가축 매몰지 침출수에 대한 수질 특성 및 호기성 미생물 분포에 관한 연구)

  • Choi, Nag-Choul;Choi, Eun-Ju;Kim, Bong-Ju;Park, Jeong-Ann;Kim, Song-Bae;Park, Cheon-Young
    • The Journal of Engineering Geology
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    • v.23 no.1
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    • pp.37-46
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    • 2013
  • Leakage of leachate from animal carcass disposal is a significant issue because disease can easily spread to humans and other livestock. In this study, we analyzed the physicochemical properties of leachate and tested for the presence of aerobic bacteria in leachate using molecular biology methods, for 16 animal carcass disposals in the first stage (after burial for 5 months). Leachate physicochemical analysis revealed higher total coliforms, TOC, $NH^{4+}$, and $NO^{3-}$ concentrations compared with previously published data. In most leachate samples, the concentrations of $NH^{4+}$ and $NO^{3-}$ exceeded the Korean guideline values for drinking water. In 16S rRNA sequence analysis of the distribution of leachate under aerobic conditions, Bacillus pumilus, Lysinibacillus sphaericus, and B. sphaericus were observed with high frequency, whereas no food-poisoning-related bacteria such as B. cereus or Salmonella were detected. The present findings improve our knowledge of the transport of leachate from animal carcass disposal sites through geologic media, and are useful in risk analysis and for subsequent studies.

A Survey on the Difference in Perceptions on Educational Need in Patients with Epilepsy and Medical Personnel (간질 환자와 의료인이 인지하는 간질 환자를 위한 교육 요구도 비교조사)

  • 최미리;김연희;소연자;윤선무;이근숙;임상순;김금순;최스미
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1400-1410
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    • 2000
  • Purpose : To determine whether there is a discrepancy between the medical professions perception of what patients should know and that of the patients themselves, we studied patients need to be informed about different aspects of epilepsy and compared findings with medical personnels perceptions of the issue. Methods : Our study population consisted of 39 patients with epilepsy from the inpatient epilepsy unit, and 51patients from the outpatients clinic of the S. University Hospital between July and November 1997. However, the patients who declined to participate or who were not able to understand the directions and content of the questionnaire were excluded. The medical personnel participated in this study were 56 residents or nurses who were working in either Neurology or Neuro surgery Units. The questionnaire with 5 indicating the highest need. The data were analyzed with descriptive statistics, students t-tests, and chi-square. Results : Of the 90 patients and 56 medical personnel studied, the need for lifestyle information such as smoking, drinking, sleep, driving, employment, and marriage was significantly higher from medical personnel than that of the patients(p=0.00). Regarding medical knowledge about epilepsy, the patients group had higher scores in the need for information on the structure of the brain (p=0.00), whereas medical personnel had higher scores on the symptoms of epilepsy. There was no correlation between the length of epilepsy and the need for information on every item on the questionnaire. The patients had higher rank regarding diet, although it was not significantly different from the medical personnel. Regarding antiepileptic drugs and what to do when there is an attack, medical personnel scored higher. The items on which the patients group scored higher than 4.5 were the possibility of inheritance, the factors that might reduce the number of attacks, the period of usage of AED, and the food they have to avoid or the food they have to take to reduce seizure attacks. Conclusions : Our study indicates that the patients group requires higher educational need in the structure of the brain, diet, and surgical treatment, but less in lifestyles and what to do when there is an attack. The educational program for the patients with epilepsy should emphasize medical knowledge with regard to brain anatomy, what to eat and what to avoid, and details of surgical treatment.

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