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Sputum Smear Conversion During mDOT (Modified Directly Observed Treatment) (변형된 복약확인 치료(mDOT) 수행 후의 균음전율에 대한 연구 부제: 보건소 균양성 폐결핵 환자를 대상으로)

  • Hwang, Taik Gun;Kim, Soon Deok;Yoo, Se Hwa;Shin, Yoo Chul
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.485-494
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    • 2004
  • Background : To assess the effects of mDOT implementation on sputum smear conversion for AFB (Acid fast bacilli) positive pulmonary tuberculosis patients, modified Directly Observed Treatment (mDOT) was started on October 8th 2001 at a health center in Seoul. mDOT was defined through weekly interviewing and supervising of a patient by a supervisor (doctor, nurse, or lay health worker). The sputum smear conversion of a mDOT group was compared with that of a self-medication (self) group. Methods : This study included 52 AFB positive pulmonary tuberculosis patients registered at a health center in Seoul between October 8th 2001 and April 23rd 2002. 24 and 28 patients were enrolled in the mDOT and self medication groups, respectively. Paired (1:1) individual matching, by gender, extent of disease, relapse and age-matching variables, was performed between the two groups, resulting in 20 paired matches. This prospective study was planned as an unblinded, non-randomized quasiexperimental pilot project. Outcomes were identified from results of sputum smear examinations for AFB in both groups at 2 weeks, and 1 and 2 months. The paired matching data were analyzed using the SAS program version 8.1 by McNemar test. Results : At the end of 2 weeks of treatment, the sputum smear conversion of the mDOT group was somewhat higher than that of the self medication group (78.57 vs. 50%, p-value=0.289), and after 1 month of treatment no statistically significant difference was shown between the two groups (83.33 vs. 50, p-value=0.125). At the end of 2 months of treatment (initial intensive phase), the sputum smear conversions of the mDOT and self groups were 95 and 75%, respectively (p-value=0.219). Conclusions : The implementation of mDOT did not result in clinically significant increases in the sputum smear conversion at 2 weeks, and 1 and 2 months compared with that of the self medication group. However, the increases experienced might contribute to diminishing the infectious period of AFB positive patients, and this approach may act as a guide for a specific group of patients. In this study, mDOT was performed for one hundred percent of the intensive treatment phase. It can also be an effective treatment for pulmonary tuberculosis patients, and may be useful for some high risk tuberculosis patients.

Perceptions on the Nature Trail in the National Park in the City - Focused on the Seoulite's Perception on Dullegil in Bukhansan National Park, Korea - (도시형 국립공원 둘레길 조성에 대한 시민 인식 - 북한산국립공원 둘레길에 대한 서울 시민의 인식을 중심으로 -)

  • Kim, Jeong-Min
    • Korean Journal of Environment and Ecology
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    • v.25 no.1
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    • pp.102-110
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    • 2011
  • The study aims to provide future implications for planning nature trails called Dullegil in the national park located in the city in Korea as new visiting culture for sustainability of environment and use. The telephone survey used quota sampling with 300 Seoulite ages from 20 to 69 by area, gender, and age, which was conducted to find out the perception on a Dullegil in Bukhansan National Park. The result shows more than 65% of Seoulite go climbing and aiming the mountain top as a general visitor behavior. The intention to use Dullegil was very high at 58%, which forecasts the use of Dullegil as a substitute for a trail to the intensified mountain top. However, the effectiveness of Dullegil to divert intensive use could be limited as the major group of climbers showed relatively low intention to use Dullegil as an alternative. As for the management direction, majority favors balanced management between use and conservation, even if conservation was preferred to use. Most important guiding principle for building Dullegil was conservation of environment, the planning direction should be oriented to conserve the ecological environment of Bukhansan, and to enjoy its value. Facilities for visitor safety was most needed. Most preferable time and length were 1~3 hours and 11~20km, each. This study has a limitation as the site was limited to Bukhansan and potential demand for use was analyzed with the sample of Seoulite only. To come up with the results generally applicable, more detailed future researches by the visitor segmentation, use behavior, and demand are needed.

Perceptions of school meal services of middle school students and dieticians/dietetic teachers in Gwangju area according to the conversion of free meal services (무상급식 전환에 따른 광주지역 중학생과 영양(교)사의 학교급식에 대한 인식)

  • Kim, Sook-Wha;Heo, Young-Ran;Ro, Hee-Kyong
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.113-121
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    • 2015
  • Purpose: The purpose of this study was to investigate satisfaction with and perception of the school meal service according to middle school students and dieticians/dietetic teachers in Gwangju area who experienced change to the free meal service and the main contents were as follows. Methods: The research subjects were 197 students (99 boys and 98 girls) and 42 dieticians/dietetic teachers were recruited. Results: Compared to the free meal service before, satisfaction of students was high (53.8%), and 69.9% of students said there was no change in the school meals, however a significant difference was observed between gender. Overall 80.2% of middle school students said that there was no change in menu, 70.6% were no change in the frequency of food with high preference, and 64.0% were no change in leftover of meals. 85.7% of dieticians/dietetic teachers said that there was no change in the student's satisfaction according to the conversion of free meal services; 59.5% of dieticians/dietetic teachers said that there was no change in the frequency of foods with high preference, the variety of vegetables was increased in the qualitative change item of food materials, and 95% of them were not aware of change in the amount of students' leftover foods. Dieticians/dietetic teachers had limitations in selecting menus with purchase and costs of food materials (26.2%) by conversion of the free meal service and their priority considered was the food cost (45.2%) when they selected menus. Change in feeding affairs was office work management (26.2%) and recipe research and development (19.0%). Conclusion: With the results of this study, the satisfaction with the school meal service was not changed in the awareness of students and dieticians/dietetic teachers. Therefore further study is needed to determine the middle school's satisfaction with school meals based on a variety of factors including the environmental food meal services.

Impact of Indoor Air Quality on the Eye Conditions of Occupants in Newly-built University Buildings (새 학교 건물 내 실내공기질이 재실자의 안구에 미치는 영향)

  • Kim, Woo-Jae;Kim, Sun-Duk;Kim, Hyojin;Kim, Ho-Hyun;Lee, Cheol-Min;Kim, Yoon-Shin
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.2
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    • pp.201-207
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    • 2011
  • Purpose: This study was to find out the influence on eyes of indoor air quality in college students taking course, such as Sick-building syndrome symptoms and effects on the eye in new-built university buildings. Methods: We selected a new building in a university located in Metro Seoul and college students in a department for the study. The number of total participants was 33, to whom questionnaire surveys were conducted in advance to check individual traits (gender, age, whether to smoke, whether to wear contact lenses, or whether to drink). The first questionnaire surveys and checking of ocular symptoms to first indoor hazardous materials were conducted in October and two months later the second surveys and checking were carried out in December. The indoor air quality was measured when conducting the first questionnaire surveys and the second questionnaire surveys; especially measurements of gaseous materials such as aldehydes and VOCs in the indoor air were conducted. Results: Indoor air quality of the new building was as follows: formaldehyde level was 22.90 μg/m3 in the first measurement and 16.79 μg/m3 in the second measurement. In addition, most materials showed higher value in the first measurement. The level of TVOC was statistically significant (p<0.05) decreased on 448.54 μg/m3 in the first and 62.55 μg/m3 in the second. In clinical assessments to check ocular symptoms caused by eye irritations, dry eye syndrome was found in the first and second exposures. When comparing the first and second assessments, dry eyes deteriorated in the morning of the second attempt compared to the first one. Conclusions: In the survey of ocular symptoms and the measurement of indoor air quality, the level of formaldehyde was measured higher in the second attempt than the first; thus, it was confirmed the influence of indoor air quality in a new building upon ocular symptoms of occupants.

Perceptions of Caregivers and Medical Staff toward DNR and AD (Do Not Resuscitate (DNR)와 Advance Directives (AD)에 대한 환자 보호자와 의료인의 인식)

  • Lee, Sun Ra;Shin, Dong-Soo;Choi, Yong-Jun
    • Journal of Hospice and Palliative Care
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    • v.17 no.2
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    • pp.66-74
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    • 2014
  • Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR χ2=44.56, P=0.001; AD χ2=16.23, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (χ2=7.41, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

An Empirical Study on the Dual Burden of Married Working Women : Testifying the Adaptive Partnership, Dual Burden and Lagged Adaptation Hypotheses (근로기혼여성의 이중노동부담에 관한 실증연구: 가사노동분담에 관한 협조적 적응, 이중노동부담, 적응지체 가설의 검증)

  • Kim, Jin-Wook
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.51-72
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    • 2005
  • The purpose of this article is to empirically testify three hypotheses on the relation between married women's employment and the allocation of unpaid domestic work within households - i.e., adaptive partnership (AP), dual burden (DB) and lagged adaptation (LA) models. The AP hypothesis assumes that, when wives are employed, husbands spend more time doing housework in order to compensate for their wives' increased responsibility. The DB model, by contrast, indicates that, even if married women are employed, their burden on domestic work does not decrease. In this case, therefore, the dual burden of married women can be expected. Between these two opposite views, the third, alternative hypothesis has been suggested recently. The LA model argues that the behaviours of households are adaptive to the changing environments but over a period of many years and even across generations. The article has analysed the total work time as well as unpaid domestic work time to testify these three hypotheses, utilising 1999 Time Use Survey data of the National Statistical Office. The research results can be summarised as follows. First, married working women worked 100 minutes more than their male spouses. Second, the average domestic work time of married men, 23-25 minutes per day, was no more than 5-10% of that of women. Third, the effects of age and women's employment were not statistically significant in multiple regression models, which means that the DB hypothesis explains the situation of married working women in Korea. Based on these findings, the article suggested the expansion of the public social service system to mitigate the dual burden of married working women, the introduction of compensatory credit for caring work, and the directions of further empirical research using the time use survey data.

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Effects of Feeding and Processing Methods of Diets on Performance, Morphological Changes in the Small Intestine and Nutrient Digestibility in Growing-Finishing Pigs

  • Yang, J.S.;Jung, H.J.;Xuan, Z.N.;Kim, J.H.;Kim, D.S.;Chae, B.J.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.14 no.10
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    • pp.1450-1459
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    • 2001
  • These experiments were conducted to investigate the effects of different feeding and processing methods of diets on performance, morphological changes in the small intestine and nutrient digestibility of growing-finishing pigs. One-hundred fifty growing pigs (Yorkshire×Landrace×Duroc; initial body weight of 23.33±0.75kg) and one-hundred twenty finishing pigs (Yorkshire×Landrace×Duroc; initial body weight of 59.22±0.56kg) were used in Exp. 1 and Exp. 2, respectively. Pigs were grouped on the basis of body weight and gender, and randomly allotted into 6 different treatments with 5 replications in each treatment in a 2×3 factorial arrangement. Treatments were 1) dry feeding with a mash diet (DM), 2) dry feeding with a pelleted diet (DP), 3) dry feeding with an expanded crumble diet (DEC), 4) dry/wet feeding with a mash diet (WM), 5) dry/wet feeding with a pelleted diet (WP), and 6) dry/wet feeding with an expanded crumble diet (WEC). In Exp. 1 (growing phase), there was no significant difference in average daily gain (ADG) and average daily feed intake (ADFI) among treatments during the entire experimental period, but feed conversion ratio (FCR) was significantly (p<0.05) improved in pigs fed pelleted diets regardless of feeding method. FCR was best in pigs fed a DP diet and worst in pigs fed a WM diet. Pigs fed a pelleted diet showed a 6.2% or 4.0% improvement in FCR compared with those fed a mash diet or an expanded crumble diet. Water disappearance was not significantly affected by dry/wet feeding or feed processing. Significant differences in villus height were not found among treatments, but villus height tended to be improved by dry/wet feeding. Dry/wet feeding or feed processing did not affect crypt depth. Digestibilities of calcium and phosphorus were significantly (p<0.05) improved in pigs fed an expanded crumble diet compared with pigs fed mash diets. Especially, pigs fed a WEC diet digested 8.1% more P than those fed a DM diet. Feed cost per kg weight gain (FCG) tended to be increased by dry/wet feeding rather than dry feeding. In Exp. 2 (finishing phase), ADG and ADFI were not significantly different among treatments, but a significant difference in FCR was found among feed processing forms. The best FCR was obtained in pigs fed a pelleted diet. Pigs fed a DP diet showed a 11.3% improvement compared with those fed a DEC diet. Water disappearance was significantly (p=0.0408) decreased by feeding the mash diet. However, water disappearance was not affected by dry/wet feeding during the finishing period. The villus height and crypt depth were not significantly different among treatments. However, crypt depth tended to be decreased by dry/wet feeding at the mid part of the small intestine. Fat digestibility was improved by dry feeding rather than dry/wet feeding, and was improved by 4.8% by feeding pellet diets compared with expanded crumble diets. Except for carcass grade, carcass characteristics were not significantly (p<0.05) different among treatments. Carcass grade was the best in pigs fed a WP diet. Feed cost per kg weight gain (FCG) was significantly decreased in pigs fed a pelleted diet compared with those fed an expanded crumble diet, and tended to be decreased by dry/wet feeding. In conclusion, these studies suggest that feeding the pelleted diet to growing-finishing pigs can be beneficial in terms of FCR and production cost. Dry/wet feeding can be helpful for the maintenance of villus height, but may not be reflected in improved growth performance or reduction of production costs.

Association of instant noodle intake with metabolic factors in Korea: Based on 2013~2014 Korean National Health and Nutrition Examination Survey (성인 남녀에서 라면 섭취에 따른 대사적 지표 평가 : 2013~2014 국민건강영양조사 자료를 이용하여)

  • Yeon, Jee-Young;Bae, Yun-Jung
    • Journal of Nutrition and Health
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    • v.49 no.4
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    • pp.247-257
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    • 2016
  • Purpose: The aim of this study was to investigate the relationship between instant noodle intake and metabolic factors in Korean adults. Methods: Study subjects were 5,894 (male 2,293, female 3,601) aged 19~64 years who participated in the 2013~2014 KNHANES. Information on frequency and consumption of instant noodles was obtained by the food frequency questionnaires method in KNHANES (Korean National Health and Nutrition Examination Survey), and subjects were classified according to age, sex, and instant noodle consumption (INC). Results: The frequency and consumption of instant noodles was 1.2 times/week and 1.2 servings in subjects. High INC group (1 serving/week) was significantly younger in age compared with the low INC group (< 1 serving/week). However, the high INC group had significantly higher waist circumference, metabolic factors (triglyceride, cholesterol, and HDL-cholesterol), and dietary intake (energy intake, fat, and sodium density) compared with the low INC group. Hyperglycemia showed association with higher risk of highest quartile of INC after adjustments for multiple confounding factors, including age, gender, household income, education, smoking, and alcohol compared with the lowest quartile (OR: 1.4, 95% CI: 1.1-1.8). In female, abdominal obesity showed association with higher risk of highest quartile of INC after adjustments for multiple confounding factors compared with the lowest quartile (OR: 1.6, 95% CI: 1.2-2.2). Conclusion: Consumption of instant noodles was associated with increased prevalence of abdominal obesity and hyperglycemia in women. These findings suggest an association of instant noodle consumption status with metabolic risk.

The Relationship between Fish Consumption and Blood Mercury Levels in Residents of Busan Metropolitan City and Gyeongnam Province (부산, 경남 일부 지역 주민들의 생선 섭취량과 혈중 수은 농도의 관련성)

  • Kim, Chan Woo;Kim, Young Wook;Chae, Chang Ho;Son, Jun Seok;Kim, Ja Hyeon;Park, Hyoung Ouk;Kang, Yune-Sik;Kim, Jang-Rak;Hong, Young Seoub;Kim, Dae-Seon;Jeong, Baek Geun
    • Journal of agricultural medicine and community health
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    • v.37 no.4
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    • pp.223-232
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    • 2012
  • Objectives: The objective of this study was to identify the relationship between fish consumption and blood mercury levels in a sample of adult Koreans. Methods: The study subjects were 299 residents of Busan (male: 65, female: 234) and 185 residents of Namhae (male: 69, female: 116), South Korea. Demographic characteristics, current smoking, current drinking, fish consumption per week, past history of amalgam treatment, and residential district were recorded by trained interviewers in June and July, 2009. We considered a portion of fish to be equivalent to 70 gm weight, and calculated amounts of fish consumed per week. Using chi-square tests, t-tests, ANOVA, and multiple linear regression analysis, we estimated the relationships between blood mercury levels and amount of fish consumed per week and other factors. Results: The mean blood mercury level of our subjects was 6.61 μg/L, higher than the criterion defined by the United States Environmental Protection Agency (EPA) (5.8 μg/L). In multiple linear regression analysis, residential district and amount of fish consumed per week were associated with blood mercury levels. However, marital status, current drinking, and gender, and age were not associated with blood mercury levels. Conclusions: In conclusion, we suggest the implementation of systematic and periodic population-based studies to decrease the risks of mercury poisoning among South Koreans who consume fish as a regular part of the diet.

Vitamin D Deficiency and Related Factors in Patients at a Hospice (일개 호스피스 병동에서 비타민 D 결핍 현황 및 관련인자)

  • Moon, Kyoung Hwan;Ahn, Hee Kyung;Ahn, Hong Yup;Choi, Sun Young;Hwang, In Cheol;Choi, Youn Seon;Yeom, Chang Hwan
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.27-33
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    • 2014
  • Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, H2 blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), H2 blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, H2 blocker users, and patients with elevated ALT levels.