Regional medical center, this country's public health researchers to activate discussion about public health nature of publicness and Regional medical center to identify actual conditions of the present analysis of previous studies based on the experience of researchers and policy factors, environmental factors, financial factors, and self-sustaining factors affecting the activation of the public health by assuming that the four provinces, Chungnam Regional Medical Center conducted the survey to target four factors through empirical analysis and 40 kinds of relationships with sub-variables hypothesis. To empirical analysis as a background element present hypotheses and research model setting, study population and method of analysis of the set, factor analysis and reliability, validity analysis conducted, and Windows 7 operating system SPSS 19.0 analysis tool for Regional Medical Center enable the public health was to investigate the relationship between factors and variables, PLS 2.0 as an analytical tool to test the hypothesis through the analysis of the model was used.
Background: Oesophageal squamous cell carcinoma (ESCC) is endemic in the Eastern Anatolian region of Turkey. The present study was performed to identify risk factors for ESCC that specifically reflect the demography and nutritional habits of individuals living in this region. Materials and Methods: The following parameters were compared in 208 ESCC patients and 200 control individuals in the Eastern Anatolian region: age, sex, place of living, socioeconomic level, education level, smoking, alcohol intake, nutritional habits, and food preservation methods. Results: The mean age of ESCC patients was 56.2 years, and 87 (41.8%) were 65 years-old or older. The ratio of women to men in the patient group was 1.39/1. ESCC patients consumed significantly less fruit and yellow or green vegetables and more hot black tea, 'boiled yellow butter', and mouldy cheese than did control individuals. Residence in rural areas, smoking, and cooking food by burning animal manure were also significantly associated with ESCC. Conclusions: The consumption of boiled yellow butter and mouldy cheese, which are specific to the Eastern Anatolian region, and the use of animal manure for food preparation were identified as risk factors in this region. Further studies are required to potentially identify the carcinogenic substances that promote the development of ESCC in this region.
Background: Promoter hypermethylation is a common event in human cancer. O6-methylguanine-DNA methyltransferase (MGMT) is a gene involved in DNA repair, which is methylated in a variety of cancers. We aimed to explore the methylation status of MGMT gene among the North Eastern population where esophageal cancer incidence and exposure to carcinogens like nitrosamines is high. Materials and Methods: A total of 100 newly diagnosed esophageal cancer cases along with equal number of age, sex and ethnicity matched controls were included in this study. Methylation specific PCR was used to determine the MGMT methylation status in serum samples. Results: Aberrant promoter methylation of the MGMT gene was detected in 70% of esophageal cancer cases. Hypermethylation of MGMT gene was found to be influenced by environmental factors like betel quid and tobacco which contain potent carcinogens like nitrosamines. Tobacco chewing and tobacco smoking habit synergistically with MGMT methylation elevated the risk for esophageal cancer development [adjusted OR=5.02, 95% CI=1.35-18.74; p=0.010 for tobacco chewing and Adjusted OR=3.00, 95% CI=1.22-7.36; p=0.014 for tobacco smoking]. Conclusions: Results suggest that the DNA hypermethylation of MGMT is an important mechanism for MGMT gene silencing resulting in esophageal cancer development and is influenced by the environmental factors. Thus MGMT hypermethylation can be used as a biomarker for esophageal cancer in high incidence region of North East India.
Background: Association of angiotensin converting enzyme (ACE) gene polymorphisms with lung cancer susceptibility remains uncertain and varies with ethnicity. Northeast India represents a geographically, culturally, and ethnically isolated population. The area reports an especially high rate of tobacco usage in a variety of ways of consumption, compared with the rest of the Indian population. Materials and Methods: We conducted a population based case control study in two major high risk region for lung cancer from Northeast India. A total of 151 consecutive lung cancer cases diagnosed histopathologically and equal numbers of controls were recruited with record of relevant sociodemographic information. Blood samples were collected and processed to identify ACE gene polymorphism. Results: Significantly higher (40.4 % vs 29.1%, OR=1.97, CI=1.04-3.72; p=0.037) prevalence of the ACE II genotype was observed among lung cancer cases. Smoking was significantly associated with increased risk of lung cancer (OR=1.70, CI=1.02-2.81; p=0.041). An enhanced risk was also observed for interaction of ACE II genotype with tobacco smoking (OR=4.09, CI=1.51-11.05; p=0.005) and chewing (OR=3.68, CI=1.22-11.13; p=0.021). Conclusions: The present study indicates significant association s of the ACE II genotype with lung cancer in high risk Northeast India.
Journal of the Korean association of regional geographers
/
v.16
no.6
/
pp.653-672
/
2010
This study aimed to examine the characteristics and types of reformation of local administrative districts in a metropolitan area, focused on the experiences of Japan, where municipal mergers were carried out extensively over the last ten years. Local administrative districts substantially have spatial characteristics. Therefore, the reformation of local administrative districts should be followed by a detailed analysis of the characteristics of the local area. Unlike other regions, the metropolitan area of Japan shows discriminative characteristics of finance, population and centrality. In addition, there are many types of regional context within a metropolitan area. These could be categorized by finance, population, centrality and basic industry. In conclusion, I revealed that municipal mergers could be categorized by their background and process and many issues were contained in each category. It had a meaning that municipal mergers had characteristics that expanded the regional inequality. Therefore, different approaches considering regional characteristics would be required for a municipal merger to be a useful way for regional development.
Proceedings of the Korean Institute of Landscape Architecture Conference
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2007.10b
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pp.202-207
/
2007
Recently, the number of 'field-museums(F.Ms.)' in Japan has increased. Although they are very diverse, the essential commonality is that each has a field arranged as a kind of museum. In this study, we examine the 'F.M.' mainly through documents in order to understand the concept of the F.M. and the direction of further studies. Before examining the cases of F.Ms., we explore the history of the F.M. and the role of museums in order to establish the background of the development of F.Ms. The term F.M. first appeared and evolved in 1990s. It is suggested that F.Ms. are positioned on the same lines as development of museums, and that the field of museums and the field of landscaping is beginning to overlap. Concerning the role of museums, we examined the definition of museums in terms of conventional museums and regional planning. Next, the documents of 36 cases of F.Ms. are checked regarding their types and roles. Consequently, we found that while most F.Ms. cases have both the role of conventional museums and the role of regional planning, it is difficult to say that the role has some connection with the type. It seems that F.Ms. emphasize 'education' rather than 'collection', 'pleasure' and 'research', compared with conventional museums. In addition, the role of regional planning is strongly expected. In many cases, the F.M. is expected to be a method of regional management, not merely a museum. In order to use F.Ms. for regional planning and landscaping effectively, it is desirable for F.Ms. to be defined from this viewpoint. For this purpose, it is necessary to determine the extent of F.Ms. The problem is which extent to choose, geographical unity or administrative border. Hence, further comparative research is needed clarify the association between the extent and the identity in order to establish a more effective size of F.Ms.
Jin Won Noh;Jeong Hoe Kim;Hui Won Jeon;Jeong Ha Kim;Hyo Jung Bang;Hae Jong Lee
Health Policy and Management
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v.33
no.1
/
pp.55-64
/
2023
Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.
Nan-He Yoon;Sunghun Yun;Dongmin Seo;Yoon Kim;Hongsoo Kim
Health Policy and Management
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v.33
no.4
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pp.479-488
/
2023
Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion: In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.
Journal of the Korean association of regional geographers
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v.18
no.1
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pp.71-85
/
2012
Marriage Immigrants have greater impact on local communities than migrant workers and foreign students, all the more because their children are relatively more important. Therefore, this study aims to inquire into the fundamental cause on the choice of residential location of marriage immigrants. Residential segregation is often considered to be one of the social problems that intensify locality of residential district. Although migrant workers and foreign students cannot freely decide their residential location at the outset, they could change their residence later on. However marriage immigrants are not free from the residential location choice continuously. The intentional(involuntary) residential segregation brings differential residence of marriage immigrants. The residential segregation of marriage immigrants is concerned with the close relationship of their ethnic background and the community characteristic with focus on Vietnamese and Filipino. The results of this study could be used basic guideline for community development policy for marriage immigrants.
Background: An important function of the regional public hospital is to satisfy the basic medical needs of the community through the stable provision of high-quality medical services. The purpose of this study was to identify the relevance index (RI) of the regional public hospital and to identify the factors that affect the RI. Methods: Data were obtained from the 2017 regional public hospital operation evaluation report and 2017 medical monitoring report for vulnerable area. RI of the regional public hospital was a dependent variable, and multiple regression analysis was performed with observed variables of medical supply-demand condition, medical supply, and medical supply structure. Direct effects and indirect effects were confirmed by the analysis of structural equation models (SEM) to see if there were mediating effects. Results: The RI was 13.1%, and the average of all percentage refined diagnosis-related group (RDRG) was 29.4%. Factors affecting RI were medical supply-demand conditions, medical supply, and medical supply structure. As a result of multiple regression analysis, RI was higher when high percentage RDRG of the regional public hospital (t=4.117, p<0.05), the size of regional public hospital location (t=-2.554, p<0.05), and the population of regional public hospital location (t =-2.415, p<0.05) were smaller. The results of the SEM analysis show that the higher the medical supply-demand conditions, the more direct effect of decreasing the RI and the indirect effect of decreasing the effect of reduction through the medical supply (direct effect=-1.322, total effect=-0.573, p<0.01). The higher the medical supply structure, the more direct effect on the RI (direct effect=1.047, p<0.05) and the higher the medical supply, the more indirect effect of RI through the medical supply structure (total effect=direct effect=0.619, p<0.05). Conclusion: It has been confirmed that the provision of medical services can affect the RI the regional public hospital which should be considered in carrying out future policies.
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