• Title/Summary/Keyword: Preventive Strategy

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Drinking Pattern and Nonfatal Injuries of Adults in Korea (성인에서 AUDIT와 손상의 연관성)

  • Yoo, In-Sook;Choi, Eun-Mi;Kwon, Ho-Jang;Lee, Sang-Gyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.4
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    • pp.1690-1698
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    • 2012
  • As alcohol use is one of the most important risk factors for injuries, this study was intended to clarify and evaluate any relationship between drinking patterns and the incidence rates/specific characteristics of injuries in adult populations, using a widely accepted tool, the Alcohol Use Disorders Identification Test (chronic alcohol drinking behaviors measurement, hereinafter the AUDIT) developed by the World Health Organization to help to assess the behaviors in a more accurate and reliable manner. This study used the data collected from the 2009 Korea National Health and Nutrition Examination Survey (KNHANES), in which 7,511 of 7,893 adult participants aged ${\geq}19$ years answered the questions about injuries, and excluding 104 non-respondents, 6,258 of participants in the questionnaire survey of drinking patterns were finally analyzed. The incidence rates and specific characteristics of injuries as classified by the AUDIT categories (i.e., body regions, types and mechanisms) were assessed and estimated in terms of their relative risk using t-test, ANOVA, and logistic regression. SPSS 19.0 statistical package software was employed for statistical analyses. These analyses indicate that the incidence rates of overall injuries were significantly higher in male respondents than in female respondents. The risks of alcohol use related injuries were 8.3 times higher in male respondents than in female ones. Regarding educational background, high school graduates showed the highest rates in the AUDIT with significant difference from the other groups. The married group and the group of respondents having monthly income estimated at KRW 2.01 to 3 million also showed the highest rates in the AUDIT compared to the other groups, indicating statistically significant difference. Significantly increased in problematic drinkers and those with alcohol dependence, the incidence rate of injuries body regions was 0.0371 in the head/neck, and with respect to the AUDIT and the mechanisms of external causes of injuries, transport accidents ranked first, followed by slippage, others, crash and fall. In regard to the classified types of injuries, it was statistically significant in others (e.g., laceration, contusion, addiction, or penetrating wound). In conclusion, the mechanisms of external causes of injuries as well as injuries attributed to alcohol use are very important, and a strategy is required to reduce such the injuries in the manner of decreasing the frequency of drinking after motivation by professional counsellors.

The Level of Diabetes Management of Agriculture, Forestry, and Fishery Workers (농림어업인의 당뇨병 관리 수준)

  • Oh, Gyung-Jae;Lee, Young-Hoon
    • Journal of agricultural medicine and community health
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    • v.42 no.3
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    • pp.119-131
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    • 2017
  • Objectives: The purpose of this study was to compare the diabetic management indicators between agriculture, forestry, and fishery workers (AFF) and other occupational adults (non-AFF) in community-dwelling diabetes. Methods: The study population consisted of 22,127 diabetic population ${\geq}19years$ who participated in the 2015 Community Health Survey. Chi-square test and logistic regression analysis was used to compare the diabetic management indicators between AFF and non-AFF. Socioeconomic characteristics such as age, gender, education level, monthly household income, National Basic Livelihood Security status, and marital status was sequentially adjusted. Results: Among total diabetic population, 3,712 people (16.8%) was AFF and 18,415 people (83.2%) was non-AFF. The fully-adjusted odds ratio [OR] (95% confidence interval [CI]) of current non-medical treatment (0.72, 0.66-0.79), measurement of hemoglobin A1c (0.61, 0.55-0.67), screening for diabetic retinopathy (0.76, 0.70-0.83), screening for diabetic nephropathy (0.75, 0.70-0.81), non-alcoholic or moderate drinking (0.70, 0.64-0.78), nutrition label reading (0.83, 0.71-0.98), low salt preference (0.85, 0.78-0.93), dental examination (0.60, 0.54-0.66), scaling experience (0.84, 0.77-0.93), regular toothbrushing (0.66, 0.58-0.76), and diabetes management education (0.84, 0.77-0.92) was significantly lower in AFF compared to non-AFF. In contrast, the fully-adjusted OR (95% CI) of AFF's low stress level (1.39, 1.26-1.52) and adequate sleep duration (1.22, 1.13-1.32) was significantly higher than non-AFF, which are better indicators of diabetic management in AFF. Conclusions: Overall, the level of diabetes management of AFF was not as good as that of non-AFF. In order to improve the level of diabetes management of AFF, a delicate diabetes intervention strategy considering the occupational characteristics of AFF will be needed.

Associations between Socioeconomic Factors and Healthy Life Expectancy at Regional Level in Korea (대한민국 지역단위 건강수명과 사회경제적 요인 간의 연관성 분석)

  • Chung-Nyun Kim;Yoon-Sun Jung;Young-Eun Kim;Minsu Ock;Dal-Lae Jin;Seok-Jun Yoon
    • Health Policy and Management
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    • v.34 no.3
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    • pp.261-270
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    • 2024
  • Background: Various researchers are calculating the health adjusted life expectancy (HALE) at the regional level in South Korea using several methods, most studies merely enumerate the differences in healthy life expectancy based on social characteristics. This study aims to analyze the association between various sociodemographic factors and HALE at the regional level. Methods: To calculate HALE, we utilized the various data sources, including National Health Insurance claims data, and applied the Sullivan's method. We conducted multiple linear regression with regional socioeconomic variables from Korean Statistical Information Service. For the multiple linear regression analysis, we designed three regression models. Model 1 comprised solely socioeconomic variables, model 2 involved both socioeconomic variables and individual health behaviors, and model 3 integrated model 2 with healthcare utilization. Results: The analysis shows that an increase in financial independence (p<0.05), population density (p<0.1), and the number of doctors (p<0.05) associated with an increase in HALE, whereas an increase in the number of beds (p<0.01) was associated with a decrease in HALE. In case of the obesity rate, in model 2 (p<0.1) and model 3 (p<0.05), there was a negative association between HALE and obesity rate. Conclusion: Amidst various variables, it was observed that increased financial independence in specific regions had association with an increase in HALE, highlighting the need for stronger local governance in South Korea. Additionally, the inverse association between hospital beds and HALE suggests several implications, such as the appropriate deployment of healthcare resources. To gain a deeper understanding of the relationship between hospital beds and HALE, further analysis distinguishing different types of hospital beds across healthcare institutions seems necessary.

A Management Plan According to the Estimation of Nutria (Myocastorcoypus) Distribution Density and Potential Suitable Habitat (뉴트리아(Myocastor coypus) 분포밀도 및 잠재적 서식가능지역 예측에 따른 관리방향)

  • Kim, Areum;Kim, Young-Chae;Lee, Do-Hun
    • Journal of Environmental Impact Assessment
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    • v.27 no.2
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    • pp.203-214
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    • 2018
  • The purpose of this study is to estimate the concentrated distribution area of nutria (Myocastor coypus) and potential suitable habitat and to provide useful data for the effective management direction setting. Based on the nationwide distribution data of nutria, the cross-validation value was applied to analyze the distribution density. As a result, the concentrated distribution areas thatrequired preferential elimination is found in 14 administrative areas including Busan Metropolitan City, Daegu Metropolitan City, 11 cities and counties in Gyeongsangnam-do and 1 county in Gyeongsangbuk-do. In the potential suitable habitat estimation using a MaxEnt (Maximum Entropy) model, the possibility of emergency was found in the Nakdong River middle and lower stream area and the Seomjin riverlower stream area and Gahwacheon River area. As for the contribution by variables of a model, it showed DEM, precipitation of driest month, min temperature of coldest month and distance from river had contribution from the highest order. In terms of the relation with the probability of appearance, the probability of emergence was higher than the threshold value in areas with less than 34m of altitude, with $-5.7^{\circ}C{\sim}-0.6^{\circ}C$ of min temperature of the coldest month, with 15-30mm of precipitation of the driest month and with less than 1,373m away from the river. Variables that Altitude, existence of water and wintertemperature affected settlement and expansion of nutria, considering the research results and the physiological and ecological characteristics of nutria. Therefore, it is necessary to reflect them as important variables in the future habitable area detection and expansion estimation modeling. It must be essential to distinguish the concentrated distribution area and the management area of invasive alien species such as nutria and to establish and apply a suitable management strategy to the management site for the permanent control. The results in this study can be used as useful data for a strategic management such as rapid management on the preferential management area and preemptive and preventive management on the possible spreading area.

Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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The Application of Customer Relationship Management for the Effective Prenatal Care (효과적인 산전관리를 위한 고객관계관리(CRM)의 도입)

  • Shin, Sook;Paik, Soo-Kyung;Kang, Sung-Hong;Kim, Yu-Mi
    • Korea Journal of Hospital Management
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    • v.10 no.1
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    • pp.93-114
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    • 2005
  • The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

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Strategic Direction and Road Map of Expanding Prevention of Winter Disease in the Summer (동병하치 확산을 위한 전략적 방향과 이행방안)

  • Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.147-157
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    • 2010
  • Objectives : The purpose of this study was to propose appropriate strategic directions and road maps for successful achievement of programs preventing winter disease in the summer. Methods : Details on programs preventing winter disease in the summer such as clear concept, theoretical basis, current status, intervention or available prescriptions and indication/contraindication/caution were prepared through the related journal review, upon which an observational study was devised and done for simulation to find out even a trivial problem and to guarantee the safety beforehand. The experimental group was divided into 5 groups by the size of pill and the way ginger is treated; 1cm pill with ginger group, 3cm pill group without ginger, 3cm pill group dipped into ginger, 3cm pill group applying ginger to acupoints and 3cm pill group with ginger Results 1. program preventing winter disease in the summer was defined as representative winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis and rheumatoid arthritis, and preventive care in the summer, reinforcing deficient yang qi of five viscera by using exuberant yang qi from summer heat. 2. It was based upon historically established theories which is 'nourishing yang qi in the spring and summer', 'long summer, namely rainy spell in the summer overwhelms the winter, because of earth winning water according to the five phases theory' and 'To replenish yang qi is major principle to treat winter diseases, which can be most appropriately and timely applied to the patient with deficient yang qi of five viscera inherently, especially in the three dog days of the summer, because of exuberant exterior yang qi and deficient interior yang qi in the five viscera'. 3. In the adjacent China and Taiwan, acupoint applying method in the three dog days named 'San Fu Tie' have been stirring a boom throughout the nation, in which Xiaochuan Gao was used as a basic prescription and it mainly was applied at bilateral $BL_{13}$, $_{15}$ and $_{17}$ for about 4 hours. As far as domestic current status, the necessity of adopting the above method prior to Herbal formula was also recognised, because not a few koreans have apprehension for the safety of it including medicinal herbs and are reluctant to take it any more due to negative advertisement of narrow minded doctors' association. 4. Indication of acupoint applying method in the three dog days included most of winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis. contraindication was pregnant woman and the weak such as infants and the old. More attention was paid to grasp firmly the normal reaction following the treatment for preventing side effect and teasing blister. recommendation was also given to abstain from food inducing phlegm and dampness such as meat, shrimp and crab as well as cold drinks and foods 5. In the simulation observational study based upon the above findings following review the related articles, no blister was shown on the acupoints icluding bilateral $BL_{13}$, $_{15}$ and $_{17}$ in every experimental group during 24hr observation following the acupoint applying treatment with pills made by modified and devised prescription. At 4 hr, the effectiveness of it reached a peak showing redness and mild tenderness and there is little difference between groups 3cm pills groups regardless of the way ginger was treated. abdominal distention and growling was found in all the volunteers during the treatment at CV 8. Strategic directions and road maps : Through successful fulfillment of the program preventing winter disease in the summer, Korean traditional medicine should be integrated into mainstream national health care services. Cultural access was thought to be as important as Scientific EBM approach. First of all, To evoke potential cultural homogeneity from campaigns and press advertisement was needed for promoting public awareness about preventing winter disease in the summer by enhancing immunity via acupoint applying treatment in the three dog days, and then indigenous name as Sambokcheop, protocol, Clinical Research Form for data collection of it should be developed and prepared. Once the first step was taken this summer, through a thorough data collection and scrutinized scientific evaluation, drawbacks should be compensted for and the efficacy and safety should be substantiated.

Implementing a Cervical Cancer Awareness Program in Low-income Settings in Western China: a Community-based Locally Affordable Intervention for Risk Reduction

  • Simayi, Dilixia;Yang, Lan;Li, Feng;Wang, Ying-Hong;Amanguli, A.;Zhang, Wei;Mohemaiti, Meiliguli;Tao, Lin;Zhao, Jin;Jing, Ming-Xia;Wang, Wei;Saimaiti, Abudukeyoumu;Zou, Xiao-Guang;Maimaiti, Ayinuer;Ma, Zhi-Ping;Hao, Xiao-Ling;Duan, Fen;Jing, Fang;Bai, Hui-Li;Liu, Zhao;Zhang, Lei;Chen, Cheng;Cong, Li;Zhang, Xi;Zhang, Hong-Yan;Zhan, Jin-Qiong;Zhang, Wen Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7459-7466
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    • 2013
  • Background: Some 60 years after introduction of the Papanicolaou smear worldwide, cervical cancer remains a burden in developing countries where >85% of world new cases and deaths occur, suggesting a failure to establish comprehensive cervical-cancer control programs. Effective interventions are available to control cervical cancer but are not all affordable in low-income settings. Disease awareness saves lives by risk-reduction as witnessed in reducing mortality of HIV/AIDS and smoking-related cancers. Subjects and Methods: We initiated a community-based awareness program on cervical cancer in two low-income Muslim Uyghur townships in Kashi (Kashgar) Prefecture, Xinjiang, China in 2008. The education involved more than 5,000 women from two rural townships and awareness was then evaluated in 2010 and 2011, respectively, using a questionnaire with 10 basic knowledge questions on cervical cancer. Demographic information was also collected and included in an EpiData database. A 10-point scoring system was used to score the awareness. Results: The effectiveness and feasibility of the program were evaluated among 4,475 women aged 19-70 years, of whom >92% lived on/below US$1.00/day. Women without prior education showed a poor average awareness rate of 6.4% (164/2,559). A onetime education intervention, however, sharply raised the awareness rate by 4-fold to 25.5% (493/1,916). Importantly, low income and illiteracy were two reliable factors affecting awareness before or after education intervention. Conclusions: Education intervention can significantly raise the awareness of cervical cancer in low-income women. Economic development and compulsory education are two important solutions in raising general disease awareness. We propose that implementing community-based awareness programs against cervical cancer is realistic, locally affordable and sustainable in low-income countries, which may save many lives over time and, importantly, will facilitate the integration of comprehensive programs when feasible. In this context, adopting this strategy may provide one good example of how to achieve "good health at low cost".

Comparisons of Attitude on Media's Report for Avian Influenza between Poultry Breeder and Non-breeder (언론의 조류인플루엔자 보도에 대한 조류사육업자와 비사육업자의 태도 비교)

  • Oh, Gyung-Jae
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.58-66
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    • 2009
  • Objectives: Active participation of poultry breeder in surveillance system of Avian Influenza (AI) is very important. Therefore this study was conducted to present basis data for active report of AI that is affected by media's coverage in poultry breeder. Methods: Subjects were 88 persons, 28 who were poultry breeder at epidemic area of AI and 60 who were general person at non-epidemic area. Data were collected by the trained investigator from Jul. 1 to Aug. 31, 2008. Respondents were interviewed by means of a structured questionnaire. Results: The third-person effect among perceptions of influence in media's report on the AI was higher in breeder (32.1%) than in non-breeder (10.0%). However, Confidence to media report on the AI was lower in breeder than in non-breeder. Intention to report of the AI was 71.4% in breeder respectively, was 90.0% in non-breeder. There was statistically significant lower in breeder than non-breeder. The cause of avoidance of report was 'economic damage' for 87.5%, which acocounted for the majority of cases. Confidence to media report on the AI were positively correlated with concern on the AI and perception on seriousness of the AI, but negatively correlated with the third-person effect. Conclusions: These results showed that intention to report of the AI of breeder was susceptible to influenced by the third person effect and confidence in media's report on the AI. Therefore we should give a special attention to increase active report of poultry breeder during epidemic period of AI which is consideration of reasonable strategy of media's coverage, including mind and emotion state of poultry breeder.

Related factors on musculoskeletal symptoms in selected Korean female office and blue-collar workers (우리나라 일부 사무직과 생산직 여성근로자에서 근골격계 자각증상과 관련요인)

  • Lee, Kyung-Jae;Han, Sung-Hyun;Ahn, Yeon-Soon;Hwang, Jung-Ho;Kim, Joo-Ja
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.17 no.4
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    • pp.289-299
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    • 2007
  • Objectives : To investigate the related factors on musculoskeletal symptoms among Korean female workers. Methods : A total of 1,875 female workers (1,002 office workers and 873 blue-collar workers) was analyzed. They were randomly selected among female workers by cluster sampling and interviewed by well trained interviewer, who filled out a structured questionnaire on the musculoskeletal symptoms. Other factors such as general and occupational characteristics including workplace location, employment condition, work duration, and working condition were also investigated. Results : Current smokers and drinkers were significantly more common in blue-collar workers than in office workers. Those working full time were significantly more common in blue-collar workers than in office workers. Those working over 8 hours per day were also popular in office workers than in blue-collar workers. Subjective musculoskeletal symptoms were significantly higher in the type of work including excessive repetitive work, work using awkward stretching hand upwards, work using repetitive wrist movements, static work using awkward hand posture, and heavy manual lifting and handling works. The mean score of the symptoms were significantly higher in blue-collar than in office workers. The significantly different working factors between two groups were work duration, employment condition and daily work hours. Conclusion : We suggest that the type of work including awkward and repetitive works as well as job type may be one of the most important factors related to musculoskeletal symptoms of female workers in the workplace. Preventive strategy will be needed to prevent the negative impact on health status of working women in the workplace.