• Journal of Medicine and Life Science
• /
• v.21 no.3
• /
• pp.62-71
• /
• 2024

The incidence of diabetes is continuously increasing worldwide, resulting in a considerable socioeconomic burden. Glycemic control using traditional diabetes medications prevents microvascular complications; however, there is no objective evidence that it prevents macrovascular complications. In the 21st century, concerns have arisen that strict glycemic control and the diabetes drug rosiglitazone might increase mortality. This led the United States Food and Drug Administration to establish guidelines that require that cardiovascular outcome trials (CVOTs) with 3-point major adverse cardiovascular events (3-P MACE) as the primary endpoints be performed for new diabetes drugs. Since then, 20 CVOTs have been reported. Dipeptidyl peptidase 4 inhibitors do not increase the incidence of cardiovascular disease; however, saxagliptin increases the risk of heart failure. Sodium-glucose cotransporter inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs) not only have proven cardiovascular safety but also have shown results beyond expectations by reducing the incidence of cardiovascular diseases. Additionally, SGLT2is have been reported to markedly prevent heart failure and kidney disease. The reduction in 3-P MACE by GLP-1RAs was observed only with long-acting agents; long-acting GLP-1RAs also markedly reduced renal endpoints. However, no preventive effect against heart failure was observed with GLP-1RAs. The preventive effects of both drug types against cardiovascular and kidney diseases appear to be independent of glycemic control. In conclusion, based on CVOT results, it is necessary to actively prescribe SGLT2is and GLP-1RAs to prevent cardiovascular disease in patients with diabetes, regardless of glycemic control.

• Journal of radiological science and technology
• /
• v.34 no.2
• /
• pp.149-156
• /
• 2011

This study is to identify perceptions and response degrees of anxiety for each factor, targeting patients for CT test and analyze the relations between factors. It is to provide scientific fundamental data to reduce anxiety by improving awareness of patients about CT test by analyzing relations between variables. The subjects of this study were surveyed in self-writing type, targeting 263 patients for CT test in the department of radiology at three University hospitals from July to September, 2010. This survey was executed once by a structured self-administered survey type. The targeting patients for CT test of anxiety will investigate for affect. Anxiety by each CT test variables depending on CT test-related features showed independent variable is Expense Responsibility, Economic burden, Sufficient explain, Explain agent, Endoscope, Biopsy, Pre treatment, Previous experience, CT side effect experience, Side effect of contrast medium and dependent variable is physical, Hospital staff, Hospital environment, Socioeconomic These used statistics program SPSS (ver. 13.0). Summarizing the above results of this study, awareness of anxiety and response to it in each variable under CT test appeared significant differences in economic burdens, state anxiety, pre-treatment anxiety, exposure anxiety to radiation, and anxiety of side effect. Therefore, pre-treatment before test and pre-training programs on chemical poison of contrast medium and side effect seem to be able to release patients' anxiety level for CT test. Ways to meditate these anxiety variables and reduce degree of anxiety are needed to be researched more and updated. In addition, impact of patients' economic burdens on CT test anxiety is required to be recognized and solved in society level.

• Tuberculosis and Respiratory Diseases
• /
• v.60 no.2
• /
• pp.205-214
• /
• 2006

Background : Acute exacerbations form a major component of the socioeconomic burden of COPD. As yet, little information is available about the long-term outcome of patients who have been hospitalized with acute exacerbations, although high mortality rates have been reported. The aim of this study was to determine predictors of long-term mortality after hospitalization for acute exacerbation of COPD. Methods : We performed a retrospective cohort study of consecutive patients admitted to the hospital for COPD exacerbation between 2000 through 2004. Patients who had died in hospital or within 6-months after discharge, had tuberculosis scar, pleural thickening or bronchiectasis by chest radiography or had been diagnosed with malignancy during follow-up periods were excluded. Results : Mean age of patients was 69.5 years, mean follow-up duration was 49 months, and mean $FEV_1$ was 1.00L (46% of predicted). Mortality was 35% (17/48). In the multivariate Cox regression analysis, heart rate of 100/min or more (p=0.003; relative risk [RR], 11.99; 95% confidence interval [CI], 2.34-61.44) and right ventricular systolic pressure (RVSP) of 35mmHg or more (p=0.019; RR, 6.85; 95% CI, 1.38-34.02) were independent predictors of mortality. Conclusion : Heart rate and RVSP in stable state may be useful in predicting long-term mortality for COPD patients admitted to hospital with acute exacerbation.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6697-6704
• /
• 2015

Background: The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan. Materials and Methods: A nationwide populationbased cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years. Results: Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening. Conclusions: The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.

• Korea journal of population studies
• /
• v.26 no.1
• /
• pp.115-141
• /
• 2003

The aim of this paper is to describe a long-term trend toward earlier retirement and its reversal since 1985 in the United States, together with changes in socioeconomic conditions and social-policy programs which have contributed to this new development. The American people's recent propensity to retire at relatively younger ages was mainly a result of secular increase in individual wealth that had made it possible for them to enjoy higher standard of living without their participation in labor market activities at older ages. In addition to the introduction of compulsory retirement system, both social security retirement pension program and corporate pension system have also contributed significantly to the declining retirement age and its reversal around the mid-1980s. This paper pays full attention to the set of social policy programs which are currently being used to sustain the recent reversal in ages at retirement. The basic question to be raised here, however, is about whether or not the U. S. government will ave to continue to implement the social policies and programs used to discourage the elderly from retiring at relatively younger ages in the future. In this paper, it is argued that labor productivity growth and improvement in work attitude prior to retirement will help the elderly find little difficulties in having higher standard of living, despite their further lengthening of life expectancy at birth and post-retirement survival chances, the latter being often called the "third life". Most American people hope that the social-policy programs that have promoted early retirement will remain unchanged in the first part of the 21st century while they will put significant financial burden on their future descendants who have to work in the paid labor market. Taking this observation in consideration, this paper concludes that the U. S. government has to focus more on developing the programs that improve work propensity and labor productivity among the currently working-age population rather than continuing to implement the programs that sustain the recent reversal in retirement ages.ment ages.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.1
• /
• pp.109-117
• /
• 2015

Background: Follow-up clinical consultations could improve overall health status as well provide knowledge and education for cancer prevention. Materials and Methods: This is the cross-sectional study using the Korean Community Health Survey (KCHS) 6th edition for 2012, with 115,083 respondents who underwent cancer checkups selected as subjects. Associations between the presence of consultation and the socioeconomic status were determined using statistical methods with the SAS 9.3 statistical package (Cary, NC, USA). Findings: Among the recipients, 32,179 (28.0%) received clinical consultations after cancer screenings. Those in rural areas (odds ratio, OR=0.71, 95% confidence interval (CI), 0.69-0.73) visited follow-up clinics less frequently than did those in urban areas. Starting at the elementary school level, as the education level increased to middle school (OR=1.26, 95% CI: 1.19-1.34), high school (OR=1.29, 95% CI: 1.23-1.36) or college (OR=1.76, 95% CI: 1.65-1.89), the participation rates also increased. When compared with the lowest quartile group, the quartile income level showed a statistical trend and difference as follows: second lowest quartile (OR=1.11, 95% CI: 1.07-1.16), third lowest (OR=1.12, 95% CI: 1.07-1.17) and highest quartile income (OR=1.29, 95% CI: 1.23-1.35). In addition, the people with economic activities (OR=0.87, 95% CI: 0.84-0.90) visited follow-up clinics less frequently than did the others. Current smokers (OR=0.93, 95% CI: 0.89-0.98) and inveterate drinkers (OR=0.88, 95% CI: 0.85-0.94) had a tendency to visit less often than did non-smokers and other drinkers with all cancers combined. Interpretation: We suggest primary prevention through lifestyle modifications including smoking and drinking, and environmental interventions may offer the most cost-effective approach to reduce the cancer burden.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.12 no.10
• /
• pp.4502-4512
• /
• 2011

This study was performed to determine the job satisfaction and its association with sociodemographic and health related characteristics, job-related factors, perception on socioeconomic status, professional job perception, job stress and social support among nursing officers. The survey was administered to 542 nursing officers working at military hospitals of the ROK Armed Forces, from Oct. 1 to Nov. 30. The structured self-administered questionnaires were delivered and they were collected without respondents' personal information. As a results, The job satisfaction of respondents turned out to be significantly higher in the following groups: an elder, married, subjective sleep quality is good, feels they are healthy, higher positional status, a longer job career, satisfied with their work, without consider quitting the job, their physical burden of work is adequate. The survey results showed that respondents' job satisfaction is positively correlated with the professional job perception and social support. while it is negatively correlated with job stress. When analyzed by Covariance Structure, it turned out that the professional job perception is more influential on job satisfaction than job stress and social support. The study found the professional job perception, high social support, and low job stress tends to improve job satisfaction. Meanwhile, the study also found that the professional job perception and high social support reduces job stress.

• Environmental and Resource Economics Review
• /
• v.29 no.2
• /
• pp.113-144
• /
• 2020

Throughout various data sources, it is widely observed that air quality in South Korea has become improved. Koreans, however, insist that their health status and economic burden due to worsened air quality get degenerated. This study aims to explain the mismatch between perception and measured data, air pollution-led medical expenses, and consumption behaviors in the economics perspectives. First, we demonstrated data-driven evidence of mismatch in the perceived severity of air pollution and its enhancement in measured data. Second, using the health demand model, we theoretically derived and empirically showed a co-rising relation between air pollution severity and medical expenses. Last, we analyzed that the perception led to increased defensive expenditures in consumption. This result implies the possibility of overestimation in air pollution impacts on socioeconomic losses and its possible reverse interpretation from increased social benefit after improved air quality. Our results recommend policy consideration to strengthen air quality standards, to support socially vulnerable groups regarding defensive expenditures, and to improve the accessibility and credibility of air pollution information.

• Journal of Preventive Medicine and Public Health
• /
• v.34 no.4
• /
• pp.309-315
• /
• 2001

Objective : To develop a boner understanding of the relationship between weight status and the prevalence of obesity related diseases in the Korean population. Methods : The 1998 Korean National Health and Nutrition Survey was used and 10,880 persons who had previously taken health examinations were selected for study. The Korean Society for the Study of Obesity's classification of weight status was used. Hypertension, diabetes mellitus, dyslipidemia, osteoarthritis, chronic heart disease, stroke were included as obesity related disease. A logistic regression model was developed to estimate the prevalence odds ratio by obesity class adjusted for demographic and socioeconomic factors and we converted the odds ratio to a prevalence ratio using the base line prevalence of disease to aid in the interpretation of the ratios. Results : The prevalence of obesity was 26.3% based on the KSSO classification $(BMI\geq25)$. A graded increase in the prevalence ratio was observed with increasing severity of overweight and obesity for all health outcomes with the exception of chronic heart disease in men and stroke in both men and women. With normal weight individuals as the reference, for men who were younger than 50 years, the prevalence ratios were highest for hypertension BMI<23-25: 1.70(95% CI=1.41-2.05), 25$BMI\geq30$: 4.83(95% CI=3.70-5.84). The prevalence ratios for dyslipidemia were as high as hypertension, but were lower than hypertension for diabetes mellitus and osteoarthritis. Prevalence ratios generally were greater in younger adults. The prevalence of having 2 or more obesity related diseases increased with weight status category, except in people who were older than 50 years. Conclusions : Based on results, obesity is an increasingly important health problem in Korea and the disease burden increases according to weight status. For Korean adults, the strongest relationship was seen between weight status and hypertension and dyslipidemia. In older people the impact of excess weight and obesity is stronger than that seen in younger people. Increased efforts in the study of obesity and prevention and treatment of obesity and obesity related disease are required.

• Journal of Obesity & Metabolic Syndrome
• /
• v.26 no.1
• /
• pp.23-27
• /
• 2017

Background: In Korea, the prevalence of obesity has steadily increased, and the socioeconomic burden of obesity has increased along with it. In 2015, the National Health Insurance Service (NHIS) signed a memorandum of understanding with the Korean Society for the Study of Obesity (KSSO), providing limited open access to its databases so that the status of obesity and obesity management could be investigated. Methods: Using NHIS databases, we analyzed nationwide population-based studies for obesity using the definition of obesity (body mass index ${\geq}25kg/m^2$) in subjects over the age of 20. Age and sex standardization were used for all data. Results: The KSSO released the 'Obesity Fact Sheet 2016' using the 2006-2015 NHIS Health Checkup database. The prevalence of obesity steadily increased from 28.7% in 2006 to 32.4% in 2015, and the prevalence of abdominal obesity also steadily increased from 18.4% in 2009 to 20.8% in 2015. The prevalence of class II obesity steadily increased from 2006 to 2015, such that the total prevalence was 4.8% in 2015 (5.6% in men and 4.0% in women). The highest prevalence of obesity was found in Jeju Island, while the lowest prevalence was found in Daegu City. The highest prevalence of abdominal obesity was also found in Jeju Island, while the lowest prevalence was found in Gwangju City. Conclusion: Based on the Obesity Fact Sheet 2016, a strategy for reducing the prevalence of obesity is needed, especially in Korean men.