• Health Policy and Management
• /
• v.34 no.2
• /
• pp.141-155
• /
• 2024

Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

• Journal of Environmental Health Sciences
• /
• v.33 no.4
• /
• pp.227-234
• /
• 2007

Recent epidemiologic studies show that gestational exposure to air pollution adversely affects pregnancy outcomes including low birth weight in preform birth. In this study, we evaluated the effect of air pollutants on LBW (low birth weight) on firstborn fetus throughout the gestational period using the birth cohort between 1999 and 2003 in Seoul. Using birth cohort data from the National Statistics Office of Korea we identified 288,346 firstborn births (excluded missing data on lack of information for birth weight and discordance between residential and certificated address from a total of 316,451) during 1999 to 2003 with complete covariate (gender, parity, date of birth, gestational age, parental age and educational level, maternal occupation etc.) and maternal residential history data. Our subjects were defined as more than 37 weeks and less than 44 weeks of completed gestation and we identified 5,457 persons (1.89%) by low birth weight (<2.5 kg) in this study. Using logistic regression, we estimated the risk of mean (entire pregnancy and trimester period) air pollution concentrations for CO, $O_3,\;PM_{10},\;NO_2\;and\;SO_2$. In terms of trimester-specific exposure, we found that some air pollutants exposure in each trimester would increase the risk for LBW. Results also showed that the effect size of air pollutants exposure during the first and third trimester is higher than during the second trimester. In all trimester, the estimated risk of LBW was 1.831 (95% CI=1.573-2.132) with unit increase for CO, 1.139 (95% CI=1.107-1.172) for 50, and 1.009 (95% CI=1.001-1.017) for $O_3$. Our results suggest that exposure during the gestation period to relatively low levels of some air pollutants may be associated with a reduction in birth weight on first-born fetus. These findings implicate the effective risk management strategies should be applied to minimize the public health impacts for pregnant women.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.31 no.1
• /
• pp.5-25
• /
• 2020

Objectives: Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. Methods: The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. Results: According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners' Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. Conclusion: The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.

• Journal of Environmental Health Sciences
• /
• v.43 no.4
• /
• pp.334-348
• /
• 2017

Objectives: We investigated the impacts of indoor plants on indoor air quality and occupational health, focusing on allergic rhinconjunctivitis and stress among employees in new office buildings. Methods: A total of 34 employees working at new public office buildings were enrolled as subjects (n=17, with indoor plants) and as a control (n=17) group. Before and after introducing indoor plants for three months, indoor air quality measurements including VOCs and aldehydes and questionnaires on sick building syndrome, AR symptoms (ARIA based), stress (DASS 42, KOSS, and SACL), and indoor characteristics were performed and statistically analysed. Results: Among the 34 enrolled subjects, 19 were included in the probable AR subject group (subjects with indoor plants, n=8, control n=11) and completed all questionnaires. Statistical analyses were done for total, AR subject groups, and controls. As a result, it was confirmed that major indoor air pollutants decreased after the introduction of indoor plants (p<0.5). Among major symptoms of allergic rhinoconjunctivitis, watery rhinorrhea, nasal stuffiness, and nasal itching indexes decreased (p<0.5, respectively). A decrease was noted in some areas of work-related stress indexes (mainly KOSS) among the subject group (total and AR) and a decrease of indoor environmental attractiveness among the control group (total and AR) (p<0.5, for all). Conclusions: Indoor plants may help reduce indoor air pollutants and decrease AR symptoms and work-related stress of employees in newly built office buildings. Various further follow-up studies on the mechanism of environmental, physical, and emotional influences and utilization of indoor plants in association with allergic diseases will be needed.

• Journal of Preventive Medicine and Public Health
• /
• v.28 no.1 s.49
• /
• pp.207-223
• /
• 1995

A new medical delivery system which regulated outpatient department(OPD) use from tertiary care hospitals was adopted in 1989. Under the new system, patients using tertiary care hospital OPD without referral slip from clinics or hospitals could not get any insurance benefit for the services received from the tertiary care hospital. This study was conducted to evaluate the Patient Referral System(PRS) with respect to health care expenditures and utilization. Two data sets were used in this study. One was monthly data set(from January 1986 to December 1992) from the Annual Report of Korea Medical Insurance Corporation(KMIC). The other was monthly joint data set composed of personal data of which 10% were selected randomly with their utilization data of KMIC from January 1988 to December 1992. The data were analyzed by time-series intervention model of SAS-ETS. The results of this study were as follows: 1. There was no statistically significant changes in per capita expenditures following PRS. 2. Utilization episodes per capita was increased statistically significantly after implementation of PRS. The use of clinics and hospitals increased significantly, whereas in tertiary care hospitals the use decreased significantly immediately after implementation of PRS and increased afterwards. 3. Follow-up visits per episode were decreased statistically significantly after implementation of PRS. The decrease of follow-up visits per episode were remarkable in clinics and hospitals, whereas in tertiary care hospitals it was increased significantly after implementation of PRS. 4. There was no statistically significant changes in prescribing days per episode following PRS. Futhermore, clinics and hospitals showed a statistically significant decrease in prescribing days per episode, whereas in tertiary care hospital it showed statistically significant increase after implementation of PRS. 5. Except high income class, the use of tertiary care hospitals showed statistically significant decrease after implementation of PRS. The degree of decrease in the use of tertiary care hospitals was inversely proportional to income. These results suggest that the PRS policy was not efficient because per capita expenditures did not decrease, and was not effective because utilization episodes per capita, follow-up visits per episode. and prescribing days per episode were not predictable and failed to show proper utilization. It was somewhat positive that utilization episodes per capita were decreased temporarily in tertiary care hospitals. And PRS policy was not appropriate because utilization episodes per capita was different among income groups. In conclusion, the PRS should be revised for initial goal attainment of cost containment and proper health care utilization.

• Journal of Korean society of Dental Hygiene
• /
• v.11 no.3
• /
• pp.301-311
• /
• 2011

Objectives : In order to identify the awareness of influenza A (H1N1) having currently high frequency and risk as an infectious disease, to find problems and to reflect them on curriculum improvements from students before/after clinical practices. Methods : The data was collected from 279 dental hygiene students of 1st and 2nd years at G health college university from December 6th 2010 to December 10th 2010. The questionnaire were consisted of awareness of influenza A (H1N1), preventive attitude, sociodemographic characteristics. Results : 1. 1st year was 51.6%, the case having dental experience was 51.2%, in the infection control training experience 'had' was 46.6%. In the route acquiring the information, the mass media was 70.6%, in obtained information, personal hygiene was 82.1%. In the impact on human body, 'great impact' was 58.1%. In terms of the most need for response and preparedness, vaccination was the highest, 67.4%. People who experienced influenza A (H1N1) were 10.7%. 2. Awareness of influenza A (H1N1) was 0.71 points, and treatment and spreading mechanism was 0.78 points, prevention was 0.63 points, causes and definition was 0.53 points. 3. In the attitude for infection prevention of influenza A (H1N1), 'washing hands before practice' was the highest, 0.99 points and 'wear the mask only in case of contact with patient within 1~2 meters upon occurrence of no aerosol' was the lowest, 0.72 points. 4. Awareness of influenza A (H1N1) according to sociodemographic characteristics showed the significant differences upon the impacts on systemic health (p<0.05). Preventive attitude didn't show a significant difference in grade, clinical experience, experience in infection control training, acquiring rmation routes, the possibility for occurrence, impact on systemic health, the most need for prevention, experience in influenza A (H1N1) (p>0.05). 5. The significantly correlated between awareness of influenza A (H1N1) and preventive attitude(p<0.01). Conclusions : Information and preventive attitude for influenza A (H1N1) as well as systematic training programs to identify actual affecting factors and to improve the practice are needed. Also government's institutional support is needed.

• Journal of Appropriate Technology
• /
• v.6 no.2
• /
• pp.256-270
• /
• 2020

The collapse of the medical and healthcare system in the pandemic is resulting in the voluntary participation of civil society and a new way of responding. Some of new countermeasure can be immediately utilized at the forefront of the health crisis. Appropriate technology is no longer an intermediate technology, demonstrating its role as a technology capable of overcoming the crisis of not only developing countries but also any countries where the health system has collapsed. In this Part 2, examples of health fields such medical devices as negative pressure chambers and ventilators, diagnostic chips, and diagnostic techniques, are being discussed as a quick response to the collapse of health systems under COVID-19, within the framework of appropriate technologies. Finally, the important role of scientists and engineers is discussed for the prevention of severe impacts on the vulnerable people in terms of socioeconomic status.

• Korean Journal of Ecology and Environment
• /
• v.53 no.3
• /
• pp.241-254
• /
• 2020

Three introduced fish species, Japanese white crucian carp (Carassius cuvieri Temminck and Schlegel, 1846), bass (Micropterus salmoides Lacepède, 1802) and bluegill (Lepomis macrochirus Rafinesque, 1819), are dominant fishes in Korean freshwater ecosystem. In this study, we analyzed habitat environment conditions of these three species and their impacts to fish communities in streams across South Korea. Fish community data were obtained from the database of the Stream/River Ecosystem Survey and Health Assessment program maintained by the Ministry of Environment and the National Institute of Environmental Research, Korea. Our results showed that species richness and Shannon diversity of fish were higher at the presence sites of introduced fish than at the absence sites. However, when the abundance of these introduced fish species was increased, the species richness and abundance of fish were decreased. An association analysis showed that the introduced fish species had a low similarity in their appearance with some indigenous fishes such as Siniperca scherzeri and Channa argus and some endemic fishes of Korea such as Zacco koreanus, Sarcocheilichthys variegatus wakiyae, and Acheilognathus yamatsutae. In addition, the introduced fish species had a low appearance similarity with a large number of fishes in their association networks. Finally, our results presented that these introduced fish species influenced the negative impacts to the stream fish communities, and they were potential risk factors for fish community in Korean freshwater ecosystem. Therefore, it is necessary that continuous monitoring and establishment of management strategy for introduced fish species to preserve fish resource and biodiversity in the Korean streams.

• Proceeding of Spring/Autumn Annual Conference of KHA
• /
• 2006.11a
• /
• pp.237-241
• /
• 2006

The Qualitative improvements of outdoor spaces are unsatisfactory in comparison with that of indoor environment in existing apartments. Lately construction companies are differentiating the outdoor spaces of apartment complexes to meet needs of residents. However, high-rise buildings inherently have limitations on providing exposure to the outdoor settings and inappropriate lightings could have serious impacts on physical and psychological health of residents. Therefore, the purpose of this study is to provide useful information for the luminous environment of outdoor spaces through the analysis of current apartment complexes' lighting plans. Outdoor space of branded apartment complexes in Seoul, built after the year 2003, were researched. Through site visits, illumination level and lighting plans were investigated classified into entry area, passage area, plaza, rest area, exercise area, and play area. With the result, illumination level of apartment complexes researched was lower than KS illumination standard in all areas and the lighting plans were mostly shown in different condition of first intended lighting plan because of insufficiency of maintenance in lighting system. Therefore, it is need to provide better luminous environment to make outdoor space more lively and energetic at the night time.

• BMB Reports
• /
• v.48 no.4
• /
• pp.209-216
• /
• 2015

Stress is now recognized as a universal premorbid factor associated with many risk factors of various chronic diseases. Acute stress may induce an individual's adaptive response to environmental demands. However, chronic, excessive stress causes cumulative negative impacts on health outcomes through "allostatic load". Thus, monitoring the quantified levels of long-term stress mediators would provide a timely opportunity for prevention or earlier intervention of stressrelated chronic illnesses. Although either acute or chronic stress could be quantified through measurement of changes in physiological parameters such as heart rate, blood pressure, and levels of various metabolic hormones, it is still elusive to interpret whether the changes in circulating levels of stress mediators such as cortisol can reflect the acute, chronic, or diurnal variations. Both serum and salivary cortisol levels reveal acute changes at a single point in time, but the overall long-term systemic cortisol exposure is difficult to evaluate due to circadian variations and its protein-binding capacity. Scalp hair has a fairy predictable growth rate of approximately 1 cm/month, and the most 1 cm segment approximates the last month's cortisol production as the mean value. The analysis of cortisol in hair is a highly promising technique for the retrospective assessment of chronic stress. [BMB Reports 2015; 48(4): 209-216]