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Medical Care Expenditure of Residents in Urban Poor Area (도시 영세지역의 가계 의료비지출)

  • Hwang, In-Soo;Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.91-102
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    • 1993
  • This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered questionnaires completed by housewives. The survey was conducted from March 1 to May 31, 1992. The mean age was 31.1 years in the poor area and 37.1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The average monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%), while hospital and clinic(37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2.800 Won in the poor area and 6,300 Won in the control area.

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A Study on the Guideline Amounts of Sugar, Sodium and Fats in Processed Foods Met to Children's Taste (어린이 기호식품의 당, 나트륨 및 지방류의 영양기준안 설정에 관한 연구)

  • Choi, Young-Sun;Chang, Nam-Soo;Joung, Hyo-Jee;Cho, Sung-Hee;Park, Hye-Kyung
    • Journal of Nutrition and Health
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    • v.41 no.6
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    • pp.561-572
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    • 2008
  • Currently, Korea is facing dramatic nutrition transition among children, which may increase risk of degenerative diseases due to excessive intakes of fats, sugars and sodium. Promotion of eating healthier foods among children is difficult because the present nutrition label is not easily understood. Therefore, to promote healthier foods this study was aimed at developing guidance of standard amounts of high, medium and low levels of sugars, sodium, fats and other components contained in foods or drinks that are promoted to or formulated for consumption by children. Multipronged approach was used to collecting information, including key word searches in Medline and other databases, internet searches, reports from world organization, and contact of key individuals who work in organizations. We reviewed dietary reference intakes for Koreans, nutrient reference values, nutrient content claims of nutrition labeling, guideline daily amounts of United Kingdom, dietary guidelines and consumption data of nutrients, and selected components for labeling. And we decided goals of guideline daily amounts for children and nutrient criteria to underpin the high, medium and low content of each component. Then we collected data on processed foods sold at 12 middle schools and 11 high schools in Seoul, and classified processed foods into food category. Sales per one student per day were in the order of snacks, breads, and non-carbonated drinks. One hundred forty five mostly consumed products were selected and classified into criteria of high, medium and low total fat or sodium. Eighty five(58.6%) were classified into high fat food and only 11(7.6%) into high sodium food, in case that the base is chosen per 100 g or 100 mL. In conclusion, the nutrient criteria and choice of 100 g base, which we suggest in this study, need to be tested by simulation with more processed foods and refined in view of the practical issues suggested by stakeholders in future.

Effects of Nutrition Education Program Based on Social Cognitive Theory for Low Sodium Consumption among Housewives Living in Certain Regions of Seoul (서울시 일부 지역 주부의 나트륨 섭취 감소를 위한 사회인지이론 기반의 영양 교육 프로그램의 적용 및 평가)

  • Baek, Jae Yeon;Yi, Hae-Yeon;Hwang, Ji-Yun;Kim, Kirang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.10
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    • pp.1243-1252
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    • 2017
  • There are limited programs for low sodium intake based on the nutrition education model for housewives who cook family meals. The objective of this study was to evaluate the effects of model-based nutrition programs for low sodium intake among housewives residing in Seoul by incorporating social cognitive theory. A questionnaire survey before and after education was conducted on 140 housewives who participated in the 'Low Sodium Nutritional Education Program' delivered by a district public health center for 12 weeks from November 2015 to January 2016. The contents of the nutrition education program and program evaluation items were based on the action plans for 'Less Sodium Healthy Practice' suggested by the Ministry of Food and Drug Safety. The results show that program participants showed a lower preference for sodium, higher selection of low sodium dishes from restaurants or cafeteria if available, and increased awareness of the need of restaurants to serve low sodium dishes compared to before. In terms of behavioral changes, there were significant improvements in checking nutrition labeling and selection of foods with low sodium, use of low sodium food products, use of natural seasonings to reduce salt intake, and consumption of fast foods and processed foods. On the other hand, requesting less salty meals when ordering and introducing restaurants or cafeterias with healthy and low sodium menus turned out to be difficult to put into practice. In conclusion, the nutrition education program for sodium intake reduction for housewives was effective in increasing knowledge, environment recognition, and behaviors related to low sodium intake but not behaviors related to physical environmental factors. Therefore, further nutrition education programs and practices for sodium intake reduction should be comprehensively implemented with improvement of physical environments for low sodium intake.

Study on relationship between caffeine intake level and metabolic syndrome and related diseases in Korean adults: 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (한국 성인의 카페인 섭취 수준이 대사증후군 및 관련 질환과의 관련성 연구 : 2013~2016 국민건강영양조사 자료 활용)

  • Lee, Jung-Sug;Park, Hyoung-Seop;Han, Sanghoon;Tana, Gegen;Chang, Moon-Jeong
    • Journal of Nutrition and Health
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    • v.52 no.2
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    • pp.227-241
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    • 2019
  • Purpose: This study examined the relationship between caffeine intake and metabolic syndrome in Korean adults using the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey data (KNHANES). Methods: The caffeine database (DB) developed by Food and Drug Safety Assessment Agency in 2014 was used to estimate the caffeine consumption. The food and beverage consumption of the 24 hr recall data of 2013 ~ 2016 KNHANES were matched to items in the caffeine DB and the daily caffeine intakes of the individuals were calculated. The sample was limited to non-pregnant healthy adults aged 19 years and older, who were not taking any medication for disease treatment. Results: The average daily caffeine intake was 41.97 mg, and the daily intake of caffeine of 97% of the participants was from coffee, teas, soft drinks, and other beverages. Multivariate analysis showed that the caffeine intake did not affect metabolic syndrome, hypertension, low HDL-cholesterol, and abdominal obesity. Diabetes and hypertriglyceridemia, however, were 0.76 (95% CI: 0.63 ~ 0.93), and 0.87 (95% CI: 0.77 ~ 0.98) in third quintile (Q3), and 0.66 (95% CI: 0.53 ~ 0.82) and 0.83 (95% CI: 0.73 ~ 0.94) in fourth quintile (Q4) compared to Q1, respectively. Therefore, caffeine intake of 3.66 ~ 45.81 mg per day is related to a lower risk of diabetes and hypertriglyceridemia. Conclusion: The study showed that adequate caffeine intake (approximately 45 mg) was associated with a lower prevalence of diabetes and hypertriglyceridemia. Therefore, it can be used as a guideline for the adequate level of caffeine intake for maintaining health.

Exposure and Risk Assessments of Multimedia of Arsenic in the Environment (환경 중 비소의 매체통합 노출평가 및 위해성평가 연구)

  • Sim, Ki-Tae;Kim, Dong-Hoon;Lee, Jaewoo;Lee, Chae-Hong;Park, Soyeon;Seok, Kwang-Seol;Kim, Younghee
    • Journal of Environmental Impact Assessment
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    • v.28 no.2
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    • pp.152-168
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    • 2019
  • The element arsenic, which is abundant in the Earth's crust, is used for various industrial purposes including materials for disease treatment and household goods. Various human activities, such as the disposal of soil waste, metal mining and smelting, and combustion of fossil fuels, have caused the pollution of the environment with arsenic. Recently, guidelines for arsenic in rice have been adopted by the Korean ministry of food and drug safety to prevent health risks based on rice consumption. Because of the exposure to arsenic and its accumulation in the human body through various channels, such as air inhalation, skin contact, ingestion of drinking water, and food consumption, integrated multimedia risk assessment is required to adopt appropriate risk management policies. Therefore, integrated human health risk assessment was carried out in this study using integrated exposure assessment based on multimedia (e.g., air, water, and soil) and multi-route (e.g., oral, inhalation, and dermal) scenarios. The results show that oral uptake via drinking water is the most common pathway of arsenic into the human body, accounting for 57%-96% of the total arsenic exposure. Among various age groups, the highest exposures to arsenic were observed in infants because the body weight of infants is low and the surface areas of infant bodies are large. Based on the results of the exposure assessment, the cancer and non-cancer risks were calculated. The cancer risk for CTE and RME is in the range of 2.3E-05 to 6.7E-05 and thus is negligible because it does not exceed the cancer probability of 1.0E-04 for all age groups. On the other hand, the cancer risk for RME varies from 6.4E-05 to 1.8E-04 and from 1.3E-04 to 1.8E-04 for infants and preschool children, exceeding the excess cancer risk of 1.0E-04. The non-cancer risks range from 5.4E-02 to 1.9E-01 and from 1.5E-01 to 6.8E-01, respectively. They do not exceed the hazard index 1 for all scenarios and all ages.

The food and nutrient intakes from daily processed food in Korean adults: based on the 6th Korea National Health and Nutrition Examination Survey data (2013~2015) (한국 성인의 가공식품으로부터의 식품 및 영양소 섭취량 평가 : 제 6기 (2013~2015) 국민건강영양조사를 바탕으로)

  • Ha, Ae Wha;Kim, Woo Kyoung
    • Journal of Nutrition and Health
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    • v.52 no.5
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    • pp.422-434
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    • 2019
  • Purpose: The consumption of processed foods has recently been increasing due to changes in the living environment. The purpose of this study was to identify the contribution of processed food to the nutrient intake of adult Koreans. Methods: A total of 15,760 adult people in the $6^{th}$ National Health and Nutrition Examination Survey (2013 ~ 2015) were included in this study. According to the Korea Food and Drug Administration's classification criteria for processed foods, the 24 hour dietary recall data of the subjects were classified as processed food or natural food. The processed food intake, nutrient intake and major processed food sources by food groups were analyzed. Results: Men consumed more processed foods than did the women. Consumption of processed foods decreased with age, but it increased with the education level and the income level. The total daily processed food intake accounted for 68.1% of the total food intake. The food groups with high processed food intake were beverage, vegetables, cereals and grain products, fruits, and milk and dairy products in this order. The top food source of each food groups were beer, kimchi, bread, processed apple products, and milk. After adjusting for age, gender, and energy intake, all the nutrient intakes and percentage of dietary reference intakes for Koreans, except carbohydrates, were significantly higher in processed foods than in natural foods. The sodium intake from the processed food was 96.3% of total daily sodium intake. The intakes of nutrients from processed foods, excluding vitamins C, dietary fiber, iron, and vitamin A, were higher in men than in women. The intake of sodium from processed foods was highest for people of 30 ~ 49 years of age, and the intake of sodium from processed foods decreased for people over 50. Conclusion: Korean adults consumed more processed food than the natural food, consuming more calories and most of the nutrients from the processed food overall total daily intakes. The intake of processed foods is expected to further increase in the future, and nutritional education and research on the ingestion and selection of healthy processed foods are necessary.

Global Cosmetics Trends and Cosmceuticals for 21st Century Asia (화장품의 세계적인 개발동향과 21세기 아시아인을 위한 기능성 화장품)

  • T.Joseph Lin
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.23 no.1
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    • pp.5-20
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    • 1997
  • War and poverty depress the consumption of cosmetics, while peace and prosperity encourage their proliferation. With the end of World War II, the US, Europe and Japan witnessed rapid growth of their cosmetic industries. The ending of the Cold War has stimulated the growth of the industry in Eastern Europe. Improved economies, and mass communication are also responsible for the fast growth of the cosmetic industries in many Asian nations. The rapid development of the cosmetic industry in mainland China over the past decade proves that changing economies and political climates can deeply affect the health of our business. In addition to war, economy, political climate and mass communication, factors such as lifestyle, religion, morality and value concepts, can also affect the growth of our industry. Cosmetics are the product of the society. As society and the needs of its people change, cosmetics also evolve with respect to their contents, packaging, distribution, marketing concepts, and emphasis. In many ways, cosmetics mirror our society, reflecting social changes. Until the early 70's, cosmetics in the US were primarily developed for white women. The civil rights movement of the 60's gave birth to ethnic cosmetics, and products designed for African-Americans became popular in the 70's and 80's. The consumerism of the 70's led the FDA to tighten cosmetic regulations, forcing manufacturers to disclose ingredients on their labels. The result was the spread of safety-oriented, "hypoallergenic" cosmetics and more selective use of ingredients. The new ingredient labeling law in Europe is also likely to affect the manner in which development chemists choose ingredients for new products. Environmental pollution, too, can affect cosmetics trends. For example, the concern over ozone depletion in the stratosphere has promoted the consumption of suncare products. Similarly, the popularity of natural cosmetic ingredients, the search of non-animal testing methods, and ecology-conscious cosmetic packaging seen in recent years all reflect the profound influences of our changing world. In the 1980's, a class of efficacy-oriented skin-care products, which the New York Times dubbed "serious" cosmetics, emerged in the US. "Cosmeceuticals" refer to hybrids of cosmetics and pharmaceuticals which have gained importance in the US in the 90's and are quickly spreading world-wide. In spite of regulatory problems, consumer demand and new technologies continue to encourage their development. New classes of cosmeceuticals are emerging to meet the demands of increasingly affluent Asian consumers as we enter the 21st century. as we enter the 21st century.

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A Study on Heavy Metal and Selenium Levels in Dried Seafoods (건조수산물의 중금속 및 셀레늄 함량)

  • Kwon, Hye-Jung;Kim, Ki-Cheol;Kim, Kyung-A;Kim, Young-Su;Kang, Suk-Ho;Kwak, Shin-Hye;Kang, Kyung-Ja;Lee, Pil-Suk;Cho, Wook-Hyun;Moh, Ara;Park, Yong-Bae
    • Journal of Food Hygiene and Safety
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    • v.34 no.6
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    • pp.562-570
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    • 2019
  • The heavy metal concentrations in dried seafoods commonly consumed in Gyeonggi-do were analyzed. Concentrations of lead (Pb), cadmium (Cd), mercury (Hg) and selenium (Se) were measured in 95 samples with an inductively-coupled plasma-mass spectrometer (ICP-MS) and an Hg analyzer. The average concentration [mean±SD(minimum-maximum) mg/kg] of heavy metals were as follows: Pb 0.062±0.071(0.002-0.428), Cd 0.083±0.100(0.004-0.540), Hg 0.012±0.012(N.D-0.054) and Se 0.839±0.371(0.362-2.124). All the levels were below the recommended standards of the MFDS (Ministry of Food and Drug Safety). In the comparison of heavy metal content by anchovy size, it was shown that mercury was significantly higher in large anchovy (P<0.05). Selenium levels were found to differ significantly in small anchovy and large anchovy (P<0.05). Pb, Cd and Hg were significantly higher in Tiger prawn among shrimp (P<0.05). The heavy metal and selenium levels of anchovy and shad were highest in the intestine. However, the heavy metal and selenium levels of shrimp were highest in the head. In addition, weekly (monthly) intake of mercury and cadmium from dried seafoods was found to be 0.712% and 2.978% of PTW(M)I (Provisional Tolerable Weekly(Monthly) Intake) respectively. Therefore, it was found that dried seafoods were safe for consumption.

Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

Optimization of Interesterification Reaction for the Continuous Production of trans-Free Fat in a Packed Bed Enzyme Bioreactor with Immobilized Lipase (고정화 리파제를 이용한 충진형 효소생물반응기 내에서의 무-트랜스 유지 연속 생산을 위한 에스테르 교환 반응의 최적화)

  • Kim, Sang-Woo;Park, Kyung-Min;Ha, Jae-Uk;Lee, Jae-Hwan;Chang, Pahn-Shick
    • Korean Journal of Food Science and Technology
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    • v.41 no.2
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    • pp.173-178
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    • 2009
  • Epidemiological studies showed that high trans-fat consumption is closely associated with getting the risks of cardiovascular disease. The objective of this study was to produce trans-free fat through lipase-catalyzed interesterification, as a substitute for the cream margarine commonly used in industry. Optimum conditions for interesterification in a packed bed enzyme bioreactor (PBEB) were determined using response surface methodology (RSM) based on central composite design. Three kinds of reaction variables were chosen, such as substrate flow rate (0.4-1.2 mL/min), reaction temperature (60-70$^{\circ}C$), and ratio of fully hydrogenated canola oil (FHCO, 35-45%) to evaluate their effects on the degree of interesterification. Optimum conditions from the standpoint of solid fat content (SFC) were found to be as follows: 0.4 mL/min flow rate, 64.7$^{\circ}C$ reaction temperate, and 42.8% (w/w) ratio of FHCO, respectively. The half-life of immobilized lipase in PBEB with two stages at 60$^{\circ}C$ ($1^{st}$ stage) and 55$^{\circ}C$ ($2^{nd}$ stage) was about more than 30 days as estimated by extrapolating the incubation time course of tristearoyl glycerol (TS) conversion, whereas the half-life of the enzyme in PBEB with single stage at 65$^{\circ}C$ was only about 15 days. Finally, the results from SFC analysis suggest that trans-free fat produced in this study seems to be a suitable substitute for the cream margarine commonly used in industry.