• Journal of agricultural medicine and community health
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• v.38 no.1
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• pp.14-24
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• 2013

Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).

• Journal of Korean Dental Hygiene Science
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• v.7 no.1
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• pp.39-52
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• 2024

Background: Dental hygienists provide direct dental care in the closest proximity to the patient, and each practice requires a high level of focus and concentration. These skills are an important human resource that can impact the quality of dental care services. Since more than half of dental clinics provide as overtime work in addition to regular hours, this study aims to determine the association between working overtime and job performance for dental hygienists. Methods: The study was conducted using a combination of online and in-person surveys via Google Forms among 131 employed dental hygienists. The survey consisted of 7 questions on demographic and work characteristics, 16 questions on characteristics related to overtime and the effect of overtime on job security, health, and life, and 10 questions on job performance, for a total of 33 questions. Chi-square analysis and independent samples t-test were used to identify the characteristics of demographic and work characteristics, and descriptive statistics analysis was used for the characteristics of overtime. Independent samples t-test was used to test the difference in the mean of job performance according to whether or not they worked overtime, and linear regression analysis was used to show the association of working overtime and job performance. Results: The study found that 71% of dental clinics worked overtime. The average number of overtime per week was once (78.5%), and the most common problems with overtime were fatigue (52.7%) and lack of personal and leisure time (41.9%). The appropriate number of overtime per week considered by dental hygienists was once a week, which was confirmed to be 94.6%. When comparing job performance by overtime status, those who worked overtime were 3.38 points higher than those who did not (35.45 vs. 32.07). Multiple linear regression analysis of the association of working overtime night and job performance showed that a one-unit increase in worked overtime was associated with a statistically significant increase in job performance of about 3.1 (p<0.01). Conclusion: Working overtime was found to have a positive effect on job performance among dental hygienists. Therefore, as a way to improve the working environment, providing appropriate compensation or welfare for overtime can reduce the negative aspects of overtime and turn it into a positive influence on job performance. This could ultimately raise awareness of the dental hygienist as a professional and effect the efficiency of dental care services.

• Journal of agricultural medicine and community health
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• v.35 no.4
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• pp.370-382
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• 2010

Objectives: The purpose of this study was to investigate the level of health promoting behaviors and the significant factors in rural elderly(young-old vs old-old). Methods: The data was collected using structured questionnaires from June 22th to Sep. 18th, 2009. A total of 556 elderly aged 65 years or over were selected from 14 rural districts in C province, South Korea. Age was divided into two groups as below 65-74 and 75 or older. A structured questionnaire was used to obtain information on the demographic characteristics, their perceived health status, the difficulty of activities of daily living, quality of life, self-efficacy and health promoting behaviors. The health promoting behaviors included nutrition, stress management, interpersonal support, exercise, health responsibility and self-actualization. The scores for health promoting behaviors were used mean and standard deviation. The data was analyzed using SPSS Win 12.0. Results: Of the 556 subjects, we found that the young-old(65-74 aged) were 359 and the old-old elderly(over 75 aged) were 197. We found that the level of health promoting behavior was higher for young-old ($2.75{\pm}0.374$) compared to old-old elderly people ($2.67{\pm}0.399$). In multiple linear regression, quality of life, self-efficacy, living with spouse, and number of generation living together for the young-old, and quality of life for old-old elderly were significantly associated with health promoting behaviors. Conclusions: The study findings indicate that there are age differences in associated factor of health promoting behaviors. Therefore our findings may provide useful assistance in developing effective intervention programs to improve health promoting behavior of the elderly in rural areas according to their age differences.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.32-37
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• 2017

Objectives: A supine sleep position increases sleep apneas compared to non-supine positions in obstructive sleep apnea syndrome (OSAS). However, supine position time (SPT) is not highly associated with apnea-hypopnea index (AHI) in OSAS. We evaluated the correlation among sleep-related variables and SPT in OSAS. Methods: A total of 365 men with OSAS were enrolled in this study. We analyzed how SPT was correlated with demographic data, sleep structure-related variables, OSAS-related variables and heart rate variability (HRV). Multiple linear regression analysis was conducted to investigate the factors that affected SPT. Results: SPT had the most significant correlation with total sleep time (TST ; r = 0.443, p < 0.001), followed by sleep efficiency (SE ; r = 0.300, p < 0.001). Snoring time (r = 0.238, p < 0.001), time at < 90% SpO2 (r = 0.188, p < 0.001), apnea-hypopnea index (AHI ; r = 0.180, p = 0.001) and oxygen desaturation index (ODI ; r = 0.149, p = 0.004) were significantly correlated with SPT. Multiple regression analysis revealed that TST (t = 7.781, p < 0.001), snoring time (t = 3.794, p < 0.001), AHI (t = 3.768, p < 0.001) and NN50 count (t = 1.993, p = 0.047) were associated with SPT. Conclusion: SPT was more highly associated with sleep structure-related parameters than OSAS-related variables. SPT was correlated with TST, SE, AHI, snoring time and NN50 count. This suggests that SPT is likely to be determined by sleep structure, HRV and the severity of OSAS.

• Sleep Medicine and Psychophysiology
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• v.22 no.1
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• pp.11-19
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• 2015

Objectives: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. Methods: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; $PSQI{\leq}5$) and group B (n = 160; PSQI > 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. Results: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI ($r_p=0.313$, p = 0.008), AI ($r_p=0.339$, p = 0.004), ODI ($r_p=0.289$, p = 0.015) and ATI ($r_p=0.256$, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. Conclusion: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.

• Journal of Korean Society of Environmental Engineers
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• v.30 no.3
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• pp.302-313
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• 2008

The purposes of this study are to investigate the concentration levels of fine particles, so called PM$_{2.5}$, to identify the affecting sources, and to estimate quantitatively the source contributions of PM$_{2.5}$. Ambient air sampling was seasonally carried out at two sites in Pohang(a residential and an industrial area) during the period of March to December 2003. PM$_{2.5}$ samples were collected by high volume air samplers with a PM$_{10}$ Inlet and an impactor for particle size segregation, and then determined by gravimetric method. The chemical species associated with PM$_{2.5}$ were analyzed by inductively coupled plasma spectrophotometery(ICP) and ion chromatography(IC). The results showed that the most significant season for PM$_{2.5}$ mass concentrations appeared to be spring, followed by winter, fall, and summer. The annual mean concentrations of PM$_{2.5}$ were 36.6 $\mu$g/m$^3$ in the industrial and 30.6 $\mu$g/m$^3$ in the residential area, respectively. The major components associated with PM$_{2.5}$ were the secondary aerosols such as nitrates and sulfates, which were respectively 4.2 and 8.6 $\mu$g/m$^3$ in the industrial area and 3.7 and 6.9 $\mu$g/m$^3$ in the residential area. The concentrations of chemical component in relation to natural emission sources such as Al, Ca, Mg, K were generally higher at both sampling sites than other sources. However, the concentrations of Fe, Mn, Cr in the industrial area were higher than those in the residential area. Based on the principal component analysis and stepwise multiple linear regression analysis for both areas, it was found that soil/road dust and secondary aerosols are the most significant factors affecting the variations of PM$_{2.5}$ in the ambient air of Pohang. The source apportionments of PM$_{2.5}$ were conducted by chemical mass balance(CMB) modeling. The contributions of PM$_{2.5}$ emission sources were estimated using the CMB8.0 receptor model, resulting that soil/road dust was the major contributor to PM$_{2.5}$, followed by secondary aerosols, vehicle emissions, marine aerosols, metallurgy industry. Finally, the application and its limitations of chemical mass balance modeling for PM$_{2.5}$ was discussed.

• Journal of Preventive Medicine and Public Health
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• v.42 no.2
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• pp.89-95
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• 2009

Objectives : To assess the protective effects of wearing protective devices among the residents and volunteers who participated in the cleanup of the Hebei Spirit oil spill. Methods : A total of 288 residents and 724 volunteers were surveyed about symptoms, whether they were wearing protective devices and potential confounding variables. The questionnaires were administered from the second to the sixth week following the accident. Spot urine samples were collected and analyzed for metabolites of 4 volatile organic compounds(VOCs), 2 polycyclic aromatic hydrocarbons(PAHs), and 6 heavy metals. The association between the wearing of protective devices and various symptoms was assessed using a multiple logistic regression adjusted for confounding variables. A multiple generalized linear regression model adjusted for the covariates was used to test for a difference in least-square mean concentration of urinary biomarkers between residents who wore protective devices and those who did not. Results : Thirty nine to 98% of the residents and 62-98% of volunteers wore protective devices. Levels of fatigue and fever were higher among residents not wearing masks than among those who did wear masks(odds ratio 4.5; 95% confidence interval 1.23-19.86). Urinary mercury levels were found to be significantly higher among residents not wearing work clothes or boots(p<0.05). Conclusions : Because the survey was not performed during the initial high-exposure period, no significant difference was found in metabolite levels between people who wore protective devices and those who did not, except for mercury, whose biological half-life is more than 6 weeks.

• Analytical Science and Technology
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• v.31 no.4
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• pp.161-170
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• 2018

The epidemic of disorders associated with synthetic stimulants, such as methamphetamine (MA) and amphetamine (AP), is a health, social, legal, and financial problem. Owing to the high potential of their abuse and addiction, reliable analytical methods are required to detect and identify MA, AP, and their metabolites in biological samples. Thus, a dilute-and-shoot liquid chromatography-tandem mass spectrophotometry (LC-MS/MS) was developed for simultaneous determination of MA, 4-hydroxymethamphetamine (4HMA), AP, and 4-hydroxyamphetamine (4HA) in urine. Urine sample ($100{\mu}L$) was mixed with $50{\mu}L$ of mobile phase consisting of 0.4 % formic acid and methanol and $50{\mu}L$ of working internal-standard solution. Aliquots of $8{\mu}L$ diluted urine was injected into the LC-MS/MS system. For all analytes, chromatographic separation was performed using a C18 reversed-phase column with gradient elution and a total run time of 5 min. The identification and quantification were performed by multiple reaction monitoring (MRM). Linear least-squares regression was conducted to generate a calibration curve, with $1/x^2$ as the weighting factor. The linear ranges were 2.0-200, 1.0-800, and 10-2500 ng/mL for 4HA and 4HMA, AP, and MA, respectively. The inter- and intraday precisions were within 6.6 %, whereas the inter- and intraday accuracies ranged from -14.9 to 11.3 %. The low limits of quantification were 2.0 ng/mL (4HA and 4HMA), 1.0 ng/mL (AP), and 10 ng/mL (MA). The proposed method exhibited satisfactory selectivity, dilution integrity, matrix effect, and stability, which are required for validation. Moreover, the purification efficiency of high-speed centrifugation was clearly higher than 6-15 % for QC samples (n=5), which was higher than that of the membrane-filtration method. The applicability of the proposed method was tested by forensic analysis of urine samples from drug abusers.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.17-26
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• 2012

Purpose: This study mainly focuses on the patients treated with chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO (d,l-hexamethylpropylene amine oxime) which yielded reduced image quality due to a decreased brain extraction rate. $^{99m}Tc$-HMPAO will be examined further to determine whether this product may be accounted as a factor for this cause. Material and Methods: From January 2010 until December 2010, out of 272 patients who were all subjected to $^{99m}Tc$-HMPAO brain blood flow SPECT scans resulting from Cerebral Infarction; 23 patients(ages $55.3{\pm}9$, 21 males, 3 females) with decreased tissue extraction rate were examined in detail. The radiopharmaceutical product $^{99m}Tc$-HMPAO was used on patients with normal brain tissue exchange rate as well as those with reduced rate in order to prove its' chemical stability. The patients' age, sex, blood pressure, existence of diabetes, drug use, current health status, known side effects from CT/MRI, examination of the patients' past SPECT before/after images were accounted to determine the factors and correlations affecting the rate of blood tissue extractions. Result: After multiple linear regression analysis, there were no unusual correlations between the 6 factors excluding sex, and before/after examination images. Male subjects showed reduced brain tissue extraction rate than the females ($p$ > 0.05) 91.3% male, 8.7% female. Wilcoxon Matched-Pairs Signed-Ranks Test was used on the before/after images which yielded a value of 0.06, which did not indicate a significant amount of difference on the 2 tests ($p$ > 0.05). As a result, the before/after images indicated similar brain tissue extraction rates, and there were variations depending on the individual patient. Conclusion: The effects of the chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO depended on the patient's personal characteristics and status, therefore was considered to be a factor in reducing brain tissue extraction rate. The related articles of $^{99m}Tc$-HMPAO cerebral blood flow SPECT speculates a cerebrovascular disease and factors resulting from portal veins, and it was not possible to pin point the exact cause of decreasing brain tissue extraction rate. However, the $^{99m}Tc$-HMPAO cerebral blood flow SPECT scan proved to be extremely useful in tracking and inspecting brain diseases, as well as offering accurate results from patients suffering from reduced brain tissue extraction rates.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.669-685
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• 1997

Previous studies, reporting the inverse relationship between osteoarthritis and osteoporosis suggest the existence of possible pathophysiologic mechanisms between them. To examinine the hypothesis that 'bone mineral densities of women with osteoarthritis are significantly higher than that of women without osteoarthritis in Korea', subjects from the health and nutritional examination survey in Kuri city were sampled. Samples were selected through multi-stage sampling frame using established clusters in Kuri city. From August 18 to September 10,1997, the survey was conducted. Among the. total number of selected sample population (1,656 people), response .ate was 52.4 percent (348 men and 519 women). 420 women who took BMD measurement, radiologic exam, and anthropometric exam were selected for the analysis. The analytic results are as follows. 1. General characteristics: Mean BMD was $0.493g/cm^2$, mean age was 43.0, mean BMI was $23.9kg/m^2$. The number of women who experienced menopause was 106, hysterectomy was 19. There were 0 case of osteoarthritis of hip, 64 cases of osteoarthritis of knee, and 2 cases of osteoarthritis of hand. 2. Univariate analysis results: Mean BMD of women with the osteoarthritis of knee was significantly lower than that of women without the osteoarthritis of knee(0.4269 vs. $0.5057g/cm^2$). But, there were too few cases of osteoarthritis of hip and hand, so comparative studies of BMD in osteoarthritis of hip and hand could not be conducted. There were significant differences of BMD among pre-menopause group(0.5204), post-menopause group(0.4206), and hysterectomy group(0.4881). Additionally, there were significant differences of BMD among diabetes group(0.4297), impaired glucose tolerance group(0.4874), and normal group(0.5057). Furthermore, age, parity, BMI, bioimpedance were significantly related with BMD. 3. Multivariate analysis results: To examinine the relationship between osteoarthritis and BMD while controlling the other variables' effects which were significant in the univariate analyses, multiple linear regression analysis was done. But, it was found that osteoarthritis of knee was not a significant variable to BMD anymore. While age and menopause had significant negative relationship with BMD. Diabetes, parity, BMI, and bioimpedance did not have significant relationships with BMD. After stratification of subjects according to menopause, multiple linear regression analyses were done to each strata. Consequently, age in post-menopause group, age and osteoarthritis of knee in hysterectomy group showed significant negative relationship with BMD. The results did not support the many results of other previous studies done with white men and women. further studies of biological plausibility to Korean women are recommended. Also it is suggested that longitudinal study to verify the relationship between osteoarthritis and BMD will be valuable.