• Title/Summary/Keyword: Older patients

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Prevalence and Management of Dyslipidemia, Hypertension, Diabetes Among Adults in Gangwon-do, Korea: the 2013-2014 KNHSP (강원도 성인의 이상지질혈증, 고혈압, 당뇨병의 유병률과 관리: 국가건강검진(2013-2014) 자료의 분석결과와 시사점)

  • Jang, Sungok;Lee, Jongseok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.625-636
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    • 2017
  • Dyslipidemia, hypertension, and diabetes are well-established risk factors for cardio-cerebrovascular disease (CVD). Although the prevalence of dyslipidemia among Korean adults is very high, its management is known to be poor. The aim of this study was to assess the prevalence, awareness, treatment, and control rates of dyslipidemia among adults aged 30 years and older in Gangwon-do, Korea. Analysis included 58,121 adults (29,123 males and 28,998 females) participating in the 2013-2014 Korea National Health Screening Program (KNHSP). Dyslipidemia was defined according to the treatment criteria rather than the diagnostic criteria in Korea. Therefore, high-low-density lipoprotein cholesterol (LDL)-cholesterolemia was deemed present in individuals with LDL-cholesterol levels that exceeded the appropriate risk-based threshold. The age-standardized prevalence was highest in dyslipidemia (32.5%), followed by hypertension (25.1%), and diabetes (9.4%). The awareness rate was 76.7% for hypertension and 74.7% for diabetes, but only 10.6% for dyslipidemia. The lowest patient treatment was found for dyslipidemia (9.4%). The control rate among those undergoing treatment was highest for hypertension (75.8), followed by dyslipidemia (63.3%), and diabetes (43.9%). The higher CVD-risk categories showed lower control rates of hyper-LDL-cholesterolemia. The prevalence of dyslipidemia was higher than hypertension and diabetes, but awareness and treatment rates were lower. Our findings indicate there is a wide gap between the prevalence of dyslipidemia and subsequent treatment, which suggests that effective strategies are required to improve dyslipidemia management. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the KNHSP, especially for the high risk group of CVD.

Effects of Nordic Walking Exercise on muscular strength, Flexibility, Balance and Pain in Older Woman with Knee Osteoarthritis (노르딕 워킹이 퇴행성 무릎 관절염 노인여성의 근력과 유연성, 균형 및 통증에 미치는 영향)

  • Oh, Yoo-Sung;Kim, Ji-sun;Jang, Woo-Seong
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.4
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    • pp.1312-1326
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    • 2019
  • The purpose of this study is to examine whether the 12-week Nordic walking can improve the physical function and arthritis pain of elderly women with osteoarthritis This study were divided into randomly assigned Nordic Walking Exercise Group (n=9) and Control Group (n=7) for 16 Elderly women diagnosed with Osteoarthritis (age: 73±3.79 year, height: 154.3±4.09 cm). The exercise group used Nordic sticks to carry out 30 minutes of Nordic walking exercise three times a week for 12 weeks, and the kinetic intensity was set at 40-60% of HRR. The control group maintained daily life for the same period. Body composition (weight, percentage body fat, skeletal muscle mass), muscular strength, Flexibility (muscular strength of upper and lower limbs, flexibility of upper and lower limbs), balance ability (static balance, dynamic balance) and pain level were measured as subordinate variables. These indicators were measured twice before and after the exercise program. The study shows that percentage body fat and skeletal muscle mass in the body composition function over 12 weeks of Nordic walking exercise have significant effects after the exercise than before (p=004)(p=.003), and it also shows significant interaction effects between the groups and timings(p=.018)(p=.005). In muscular strength, Flexibility factors, there were significant effects between the groups and timings in the upper limb muscular strength and the lower limb flexibility (p=.009)(p=.036), and a significant difference between the exercise group and the control group(p=.006) in the lower limb muscular strength. In addition, in the upper limb flexibility, there was a more significant difference after the exercise than before(p=.020). There were improvement effects after the exercise than before in the balance ability and the static balance(p=.016), but no difference in the dynamic balance(p>.05). In pain, there was a significant improvement after the exercise than before(p=.022), and a significant difference between the exercise group and the control group(p=.013). In conclusion, the 12-week Nordic walking exercise has positive effects on the body composition functions of the elderly women with Osteoarthritis, and has a positive effect on the improvement of upper limb muscular strength and lower limb flexibility in the health fitness factors. These effects are believed to have contributed effectively to the improvement of the level of pain by contributing to the improvement of physical and motor functions of the elderly women with Osteoarthritis. Therefore, it is considered that Nordic walking exercise, which enhances stability and balance of the patients with Osteoarthritis by using poles, is an effective exercise method for the improvement of the body and motor functions by lowering the pain of the joints and reducing the muscular strength and percentage body fat.

Treatment Status and Its Related Factors of the Hypertensives Detect ed Through Community Health Promotion Program (지역사회 보건사업에서 발견된 고혈압환자의 치료실태와 관련요인)

  • Kam, Sin;Kim, In-Ki;Chun, Byung-Yeol;Lee, Sang-Won;Lee, Kyung-Eun;Ahn, Soon-Ki;Jin, Dae-Gu;Lee, Kyeong-Soo
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.133-146
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    • 2001
  • The purpose of this study was to investigate the treatment status and its related factors of the newly detected rural hypertensives through community health promotion program. A questionnaire survey and blood pressure measurement were performed to 6,977 residents of a rural area, and 282 hypertensives detected by blood pressure measurement were selected as subjects of the study. The study employed the health belief model as a hypothetical model. The major results of this study were as follows: The proportion of person experienced treatment among hypertensives was 12.0%. Treatment experience rate was significantly related with age and educational level(p<0.01). That is, if they were older, lower educational level, the treatment experience rate was higher. The major reasons of no treatment were 'they had not hypertensive symptoms ' (45.6%), 'their blood pressure was not high so much that they received treatment ' (43.2%). The chief facilities for treatment were public health institutions(57.9%) such as health center and health subcenter, and hospital/ clinics(29.8%). The treatment experience rate was higher when they had higher perceived severity for hypertension, lower perceived barrier to treatment, although statistically not significant. Treatment experience rate was significantly related with cues to action and health education experience(p<0.05). That is, if they had hypertension related symptoms such as headache previously, patients suffered from hypertension complication and health education experience for hypertension, the treatment experience rate was higher. In multiple logistic regression analysis for treatment experience, having a cerebrovascular patient in their acquaintance and the experience of health education for hypertension were significant variables. On consideration of above findings, it would to be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

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Relationship between Expression of XIAP Protein in Operable Non-small Cell Lung Carcinomas and Apoptosis Index and Postoperative Prognosis (비소세포폐암조직에서 XIAP 발현과 고사지수 및 수술 후 예후와의 관계)

  • Kim, Sang Hyun;Lee, Chang Hun;Sol, Mee Young;Song, Jin Mi;Lee, Jong Hyub;Lee, Min Ki;Kim, Jong Min
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.480-489
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    • 2005
  • Background : Dysregulation of apoptosis plays an important role in carcinogenesis, tumor progression, and resistance to chemotherapy. X-linked inhibitor of apoptosis (XIAP) is considered to be the most potent caspase inhibitor of all known IAP (inhibitor of apoptosis) family members. This study was designed to assess the pattern of expression and the prognostic value of XIAP in radically resected non-small cell lung carcinoma (NSCLC) patients. Method : The expression of XIAP and its relationship with clinicopathologic parameters (patient age, TNM stage, TNM-pT, TNM-pN, histologic type, VEGF expression, microvessel density, PCNA index) and overall survival were analysed with formalin-fixed, paraffin-embedded blocks from eighty cases of NSCLC. In addition, the apoptotic index (AI) was also assessed. Results : In a regard to histologic type, squamous cell carcinoma (SCC) showed XIAP expression in 91.3%(42/46) and adenocarcinoma (AC) in 61.8%(21/34). The difference was significant(p=0.001). There was no correlation between XIAP expression and other parameters. In the group of AC, XIAP expression showed the signifcant correlation with older age group ${\geq}58years$ and VEGF expression(p=0.028, p=0.014, respectively). The AI in the group with or without XIAP expression were $2.5{\pm}4.9%$ and $18.5{\pm}28.9%$, respectively(p=0.001). Both groups just aforementioned showed no significant difference in median survival time (42.5 months, 29.8 months, respectively). Conclusion : This study suggests that the XIAP expression in NSCLCs could have relation to inhibition of apoptosis, and show differential expression according to histologic type. However, its prognostic role during the progression of NSCLC needs to be further defined.

A Study on the Administrative Enhancement for Health Center Activities (보건소(保健所) 행정(行政)의 기선을 위(爲)한 연구(硏究))

  • Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.3 no.1
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    • pp.97-110
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    • 1970
  • This survey was conducted to evaluate not only the present status of health center directors-their personal histories, their will to private practice in the future, their responses to governmental policies, -but also the distribution of doctorless myons, budget and subsidy, and director's opinions to the enhancement of health center activities. This survey questioned 116 health center directors and 16 health personnel from August to October of 1970 and obtained the following results; 1) The average ages of directors of kun, city, and total health centers were $43.2{\pm}7.8,\;42.1{\pm}7.7,\;and\;42.9{\pm}10.3$ respectively. 2) The average family sizes of directors of kun, city, and total health centers were $5.6{\pm}2.7,\;5.6{\pm}2.1,\;and\;5.6{\pm}2.6$ respectively. 3) Directors holding M. D. degrees were 79.3%, those holding qualified M. D. degrees ('approved director') were 20.7%. 4) M. P. H., M. S., and Ph. D. holders were 6.0%, 6.1%, and 4.3% respectively. 5) The average duration of present directorship in kun and city were 30.2 months and 20.4 months respectively. 6) The majority of directors had been employed in related fields before assuming current position : directorship at other health center 26.7%, army 22.4%, health subcenter 21.6%, private practice 19.0%. 7) Average length of directorship is 41.8 months. Average length of public health career, including health subcenter and present position, is 56.5 months. 8) Both rural and urban experience in health centers for regular directors is 16.3% and for approved directors, 12,5%. A total of 15.5% of all survey directors had experience in both rural and urban health center. 9) A total of 70.7% of health center directorships were staffed by local doctors. 10) Nearly 40% wanted to quit the directorships within 3 years and 60.3% had already experienced private practice. 11) Of the regular directors 17.4% felt strongly about devoting their lives to public health fields, but only 4.1% of the approved approved directors felt so. 12) There wire 432 doctorless myons among 996 respondent myons and 4.5 doctorless myons per kun. 13) The percentage of doctorless myon by Province are as follows, Cholla buk-do 57.2%, Cholla nam-de 55.0%, Kyungsang nam-do 52.0%, Kyungsang buk-do 49.7%, Chungchong but-do 42.4%, Kyonggi-do 32.9%. Cheju-do 30.8%, Kangwon-do 25.8%. 14) Two thirds of health critters have experienced the abscence of the director for a certain period since 1966 and the average span of the abscence was 18.2 months. 15) The percentage of doctorless myons increased proportionally with the span of the director's abscence. 16) The average budgets of health centers, kun, city and ku, were $W15.03\;million{\pm}W4.5\;million,\;W22.03\;million{\pm}W17.80\;million,\;W13.10\;million{\pm}W7.9\;million$ respectively. 17) Chunju city had the highest health budget per capita(W344) while Pusan Seo ku had the lowest(W19). 18) Director's medical subsidies are W30,000-50,000 in kun, and roughly W20,000 in city. 19) The older of priority in health center activities is T.B. control(31.1%), Family Planning and M. C. H.(28.0%), prevention of acute communicable disease and endemic disease (18.2%) and clinical care of patients(14.3%). 20) Nearly 32% opposed in principle the governmental policy of prohibiting medical doctors from going abroad. 21) Suggestions for immediate enhancing the position of director of health centers and subcenters: (1) Raise the base subsidy (48.2%), (2) Provide more opportunities for promotion (20.7%), (3) Exemption from army services(12.1%), (4) Full scholarship to medical students for this purpose only (7.8%). 22) A newly established medical school was opposed by 56.9% of the directors, however 33.6% of them approved. 23) Pertaining to the division of labor in Medicine and Pharmacy, the largest portion (31.9%) urged the immediate partial division of antibiotics and some addictive drugs to be given only by prescription. 24) More than half wanted a W70,000 level for the director's medical subsidies, white 36.2% stated W50,000. 25) Urgently needed skills in the kun are clinical pathologist (38.6%) and doctor (health center director) (25.5%); while in the city nurse (37.1%), doctors(clinical)(31.4%) and health educators(14.4%) are needed. 26) Essential treatment for the better health center administration; raising the base subsidy (22.7%), obtaining the power of personal management (19.3%) and the establishment of a Board of Health (14.3%). etc.

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Comparison of Oral Health Status according to Glycated Hemoglobin A1c (당화혈색소에 따른 구강건강상태 비교)

  • Ju, On-Ju;Lee, Hye-Kyung;Jung, Jin-Ah
    • Journal of dental hygiene science
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    • v.17 no.4
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    • pp.290-297
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    • 2017
  • The purpose of this study was to compare dental health status of South Korean adults, according to the control protocol of glycated hemoglobin A1c (HbA1c). From the measurements of HbA1c levels of 4,991 individuals over the age of 19 who participated in the sixth Korea National Health and Nutrition Examination Survey, the following conclusions were obtained. Glycated hemoglobin was 7.2% in the HbA1c ${\geq}6.6$ diabetic group and 5.9% in women and 8.5% in men. The ratio in the glucose non-control group was higher in the older age group, the lower average monthly household income group, and the lower education level group. Both the tissue health index and functioning teeth index indices were slightly higher in both men and women in the glucose control group. The tissue health index was higher in the younger age group, in the higher average monthly household income group, and in the higher education level group. The missing teeth (MT) index was greater among women (3.775 pieces) than among men (2.317 pieces) in the glucose non-control group. Higher age correlated with a greater number of MT, while higher income and education levels correlated with a lower number of MT. In conclusion, we will continue to provide counseling and education on oral health problems, thereby widening the awareness of the importance of oral health care and providing a variety of media and education methods related to medical and oral health that can manage diabetic patients according to the level of HbA1c It should be developed.

The Correlation of Verbal Expression of Stool, Bristol Stool Form Scale and Colon Transit Time for Children with Gastrointestinal Symptoms (소화기 증상이 있는 환아의 대변표현형, Bristol 대변형태척도 및 대장통과시간검사와의 상관관계)

  • Lee, Yong Ju;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.130-136
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    • 2005
  • Purpose: The aim of this study was to evaluate the correlation among descriptions regarding one's stool, Bristol stool form scale and colon transit time (CTT) in children with gastrointestinal symptoms, along with the clinical significance of Bristol stool form scale. Methods: 489 patients treated in the pediatric department of Severance hospital with gastrointestinal symptoms between May 2002 to May 2004 were included. We analyzed their age, sex, verbal descriptions of stool, Bristol stool form types, and CTT measured by Metcalf's method. Results: 116 children were under 5 years of age, 202 children between 5.1~10, and 171 children 10 years of age or older. Their mean age was $8.2{\pm}3.9years$. Stools were described as loose in 65 children (13.3%), normal in 221 (45.2%), hard in 188 (38.4%), and mixed (loose+hard) in 15 (3.1%). According to Bristol stool form scale, 57 children(11.7%) were classified as type 1, 66 (13.5%) as type 2, 203 (41.5%) as type 3, 109 (22.3%) as type 4, 36 (7.4%) as type 5, 18 (3.7%) as type 6, and 1 (0.2%) as type 7. Their mean CTT was checked $35.9{\pm}19.5hours$. Though no significant relationship was observed between age and CTT (p=0.4), a significant relationship was noted among patient's stool description, Bristol stool form scale and CTT (p<0.001). However, concordance between stool description and Bristol stool form was relatively low in the loose stool group (29%) and normal stool group (37%) while high in the hard stool group (87%). Conclusion: Bristol stool form scale could be used in the estimation of CTT in clinical practice.

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A Survey Research on Family Health Care : Focusing on Married Women in Seoul (가족 건강관리 행위에 관한 조사연구 -서울시내 일부 기혼부인들을 대상으로-)

  • 주혜진;김초강
    • Korean Journal of Health Education and Promotion
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    • v.13 no.1
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    • pp.1-27
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    • 1996
  • Recently diseases related to personal health habit and lifestyle have become common in modern industrial society. These kinds of diseases can be prevented simply by changing one's lifestyle to be more healthy. As a result of realization our interest in general health has become stronger. The most basic environment for human-being in society is the home. Humans secure their livelihood, physically. mentally, and socially at home. Therefore health care at home is very important. In modern society the responsibility for this task is traditionally given to housewives. The purpose of this study was to measure the degree of the health knowledge, health concern, health behavior and family health care of the married women and to analyze its related factors. The subjects for this study. 1,100 married women who studied at social education institutes and who had children attending an elementary school or a kindergarten, were surveyed with questionnaires. The preliminary survey was carried out from Aug. 7, to Aug. 19, 1995. With complement of questions, the main survey was carried out from Sep. 11, to Sep. 30, 1995. The data was analysed by using the SAS program. The results were as follows. 1. General Characteristics (1) In the individual characteristics of the respondents, the married women aged 30-39 were 54.8%, the average age was 39.8 years old. 33.8% of respondents had 6-10 years of marriage period, and the average marriage period was 14.9 years. Most of them(96.5%) lived with their husband. Those who graduated from college and graduate school were 53.4%. And 68.3% of respondents had no job. (2) In the family characteristics, 69.3% of the married women had 3 or 4 family members and the average family size was 4.1 person. 60.0% of the respondents had 2 children. Most of the respondents(90.9%) had no married children. 84.8% of the respondents lived with their parents. Those who reported that the total family income was more than 2,500,000 won a month were 32.3%. When making the decisions, 68.5% of the married women discussed the family matter with their husband. (3) In the individual characteristics of the respondents, 51.5% answered they were in good health. 61.7% of the married women answered they obtained the health knowledge through mass media. 24.3% of the women answered they had patients in their family in these days. 67.5% of the respondents answered they could generally control their health by themselves. 2. The Health Knowledge, Concern and Behavior. (1) For the health knowledge, the average score was 11.8. The lowest percent of correct answer(27.8%) was in the item about the skin tests for tuberculosis. And the highest percent(97.%) was in the item about taking a rest. (2) For the health concern, the married women had the highest concern about washing hands. But they were indifferent to smoking. (3) For the health behavior, the highest score was in "changing socks and underwear everyday", and the lowest one was in "taking a regular dental examination". 3. The Family Health Care (1) For the family health care, the item of "using a drug with the order of doctor or pharmacist" had the highest grade(4.78), and "consulting with the family physician about the health problem" had the lowest grade(2.03). (2) Older women and the women with a longer period of marriage had the highest level of the family health care(p<0.001). The married women who had 3 children had the highest level of the family health care(p<0.001). Those who had 5 or 6 family member and higher income had the highest level had the high level of the family health care(p<0.01). Women in good health and those who had the health knowledge from health experts had a high level of the family health care. (3) For the correlation of the family health care and other variables, the health behavior showed the highest correlation with family heath care practice(r=0.74) and the second was health concern(r=0.43). The variables which could explain the family health care were health behavior, the health concern and married women's health status(r²=55.87). The most closely associated with family health care was health behavior(r²=54.93)

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Analysis of Sports Injuries in Kendo (검도 운동에서 발생된 스포츠 손상의 분석)

  • Song, Hyun-Seok;Park, Sung-Jin;Han, Suk-Ku;Nah, Ki-Ho;Cheung, Hyung-Kook;Choi, Woo-Hyuk;Choi, Nam-Yong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.122-127
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    • 2005
  • Purpose: To study the mechanism of injuries or discomfort during kendo and to analyze the causes of injury, injured parts of body, treatments modalities, and degree of return to the pre-injury activity level. Materials and Methods: We studied ninety-eight kendo players who had played at three gymnasium of Korean Kumdo Association, were older than high-school age, had been playing kendo for more than six months, and had any pain or discomfort after playing kendo. We analyzed the questionnaire and interviewed the patients concerning the injured parts of body, symptoms, treatments. Results; The mean age was 30.2 years old, and the onset of symptoms was between two weeks and six months after starting the kendo. Many of them were injured during attacking(32.2%). The injuries of feet were increased on players who exercised for less than 1 year. Only fifty-nine players(60.2%) were treated within one month. Among them, thirty-eight percent were treated by oriental medicine or other departments and only thirty-six percent were treated by orthopaedic surgeons. The prevalence of injuries of the foot and ankle was highest(38.8%), and there were the wrist(13.1%), shoulder(11.9%), knee(11.9%) in order of prevalence. Fifty percents of them could return to the pre-injury activity level. Conclusion: The prevalence of injuries of the foot and ankle was highest(38.8%), and were increased on players who exercised for less than 1 year. Sixty percents of players were treated with any proper modalities, and only thirty-six percent were treated by orthopaedic surgeons.

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Trends in Serotype Distribution of Clinical Isolates of Streptococcus pneumoniae: A Single Center Experience from 2001 to 2006 (임상검체에서 분리된 폐구균 혈청형의 변동추이)

  • Lee, Taek Jin;Chun, Jin Kyong;Choi, Kyoung Min;Yong, Dong Eun;Lee, Kyoung Won;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.115-123
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    • 2006
  • Purpose : We investigated whether there had been any change in the epidemiology of Streptococcus pneumoniae in Korea before and after introduction of heptavalent pneumococcal conjugate vaccine(PCV7). Methods : Between September 2001 and August 2006, clinical isolates were collected from patients with pneumococcal infection in Severance Hospital, Seoul, Korea. We analyzed trends in serotype distribution and antibiotic resistance before and after the introduction of PCV7. Results : There were 363 strains of Streptococcus pneumoniae isolated from clinical specimens; 143 before and 220 after PCV7 introduction. The predominant serotypes, in order of decreasing frequency, were 19F, 19A, 23F, 6B, 6A, 3, 9V, 14, 11A, 4, 29, and 18C; 152 isolates(41.9%) belonged to types included in PCV7. The proportion of clinical isolates that were nonsusceptible to penicillin increased from 58.8% in 2001 to 83.6% in 2006(P=0.046). There was no significant diminution in pneumococcal infection caused by vaccine serotypes after the introduction of PCV7. In children younger than age 2 years, the proportion of clinical isolates that were vaccine serotypes was higher than in persons older than age 15 years (59.3% vs 37.8%, P=0.004). Conclusions : There was no significant diminution in pneumococcal infection caused by vaccine serotypes after the introduction of PCV7, therefore more universal pneumococcal immunization program is recommended especially for children younger than age 2 years.

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