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1.
Micromachines (Basel) ; 12(10)2021 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-34683196

RESUMEN

With the downscaling in device sizes, process-induced parameter variation has emerged as one of the most serious problems. In particular, the parameter fluctuation of the dynamic random access memory (DRAM) sense amplifiers causes an offset voltage, leading to sensing failure. Previous studies indicate that the threshold voltage mismatch between the paired transistors of a sense amplifier is the most critical factor. In this study, virtual wafers were generated, including statistical VT variation. Then, we numerically investigate the prediction accuracy and reliability of the offset voltage of DRAM wafers using test point measurement for the first time. We expect that this study will be helpful in strengthening the in-line controllability of wafers to secure the DRAM sensing margin.

2.
J Texture Stud ; 48(5): 362-369, 2017 10.
Artículo en Inglés | MEDLINE | ID: mdl-28967219

RESUMEN

As part of the aging process, multiple oral physiologic changes occur and these changes may cause individuals to reduce food intake or switch the types of food texture. Thus, the need to develop food products for the elderly has increased. To evaluate the suitability of the food products for the elderly, the evaluation method should be verified and it is important to identify the parameters of mastication and swallowing. Therefore, the purpose of this study was to compare the differences of mastication and swallowing parameters between the young adults and the elderly depending on the varying hardness of rice food product. Subjects included 20 young adults and 40 elderly and bolus transit times of video-fluoroscopic swallowing study (VFSS) were used. Four types of rice products with different hardness were provided including cooked rice, soft-boiled rice, rice gruel and thin rice gruel. In the elderly group, the chewing number, oral processing time, post-faucial aggregation time, valleculae aggregation time (VAT), first subsequence duration and total duration were significantly different according to the changes in food hardness. Of the bolus transit times, the VAT and the second subsequence duration (S-S2) were significantly different between the two groups. These results suggest that VAT and S-S2, key VFSS parameters, as well as the chewing number and total duration are useful tools for evaluating the effect of aging on mastication and swallowing of solid foods. PRACTICAL APPLICATIONS: In Korea, the aging population is rapidly increasing. According to recent surveys, a large number of elderly Koreans have reported chewing difficulties and many of them are in the state of under-nutrition. As aging progresses, multiple physiologic changes occur in mastication and swallowing functions. These changes may cause individuals to reduce their food intake or switch to soft food products. Therefore, the development of texture-modified food products for the elderly is needed and they should be developed based on the understandings of the physiology of mastication and swallowing according to different rheological properties of food products consumed in Korea, which are quite different from those of the western countries. In this study, we compared the differences of mastication and swallowing parameters between the young adults and the elderly depending on the varying hardness of rice food product.


Asunto(s)
Deglución/fisiología , Alimentos , Dureza , Masticación/fisiología , Oryza/química , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Femenino , Fluoroscopía , Alimentos/clasificación , Humanos , Masculino , República de Corea , Almidón/química , Propiedades de Superficie , Grabación en Video , Adulto Joven
3.
Osong Public Health Res Perspect ; 8(4): 247-254, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28904846

RESUMEN

OBJECTIVES: Many economically advanced countries have attempted to minimize public expenditures and pursue privatization based on the principles of neo-liberalism. However, Korea has moved contrary to this global trend. This study examines why and how the Korean health care system was formed, developed, and transformed into an integrated, single-insurer, National Health Insurance (NHI) system. METHODS: We describe the transition in the Korean health care system using an analytical framework that incorporates such critical variables as government economic development strategies and the relationships among social forces, state autonomy, and state power. This study focuses on how the relationships among social forces can change as a nation's economic development or governing strategy changes in response to changes in international circumstances such as globalization. RESULTS: The corporatist Social Health Insurance (SHI) system (multiple insurers) introduced in 1977 was transformed into the single-insurer NHI in July 2000. These changes were influenced externally by globalization and internally by political democratization, keeping Korea's private-dominant health care provision system unchanged over several decades. CONCLUSION: Major changes such as integration reform occurred, when high levels of state autonomy were ensured. The state's power (its policy capability), based on health care infrastructures, acts to limit the direction of any change in the health care system because it is very difficult to build the infrastructure for a health care system in a short timeframe.

4.
Osong Public Health Res Perspect ; 7(1): 56-62, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26981344

RESUMEN

OBJECTIVES: The purpose of this study was to investigate the correlation between nursing workload and nurse-perceived patient adverse events. METHODS: A total of 1,816 nurses working in general inpatient units of 23 tertiary general hospitals in South Korea were surveyed, and collected data were analyzed through multilevel logistic regression analysis. RESULTS: Among variables related to nursing workload, the non-nursing task experience had an influence on all four types of patient adverse events. Nurses with non-nursing tasks experienced patient adverse events-falls [odds ratio (OR) = 1.31], nosocomial infections (OR = 1.23), pressure sores (OR = 1.16), and medication errors (OR = 1.23)-more often than occasionally. In addition, when the bed to nurse ratio was higher, nurses experienced cases of pressure sores more often (OR = 1.35). By contrast, nurses who said the nursing workforce is sufficient were less likely than others to experience cases of pressure sores (OR = 0.78). Hospitals with a relatively high proportion of nurses who perceived the nursing workforce to be sufficient showed a low rate of medication error (OR = 0.28). CONCLUSION: The study suggested that the high level of nursing workload in South Korea increases the possibility of patient adverse events.

5.
Health Policy ; 119(7): 899-906, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25445062

RESUMEN

OBJECTIVES: The purpose of study is to find relevance between unmet healthcare needs and employment status and if factors have relevance to unmet healthcare needs due to "economic burden" and "no time to spare". METHODS: The study conducted a survey of 9163 respondents who said they needed a medical treatment or checkup were asked why the need for care was unmet. RESULTS: 22.9% of the respondents said they did not receive a medical treatment or checkup they needed at least once. The rate of unmet healthcare needs caused by "economic burden" was higher among temporary workers (ORs=2.13), day workers (ORs=1.92). However, the rate of unmet needs due to "no time to spare" was lower for temporary workers (ORs=.58) than for regular workers, studies (ORs=.33), housework (ORs=.26), early retirement (ORs=.19) and disease or injury (ORs=.07). CONCLUSION: Non-regular waged workers were more likely to have an unmet need for healthcare due to "economic burden" than regular waged workers. On the other hand, regular waged workers were less likely to receive necessary healthcare services due to "no time to spare" than non-regular waged workers and economically inactive people.


Asunto(s)
Empleo/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Factores de Tiempo
6.
J Prev Med Public Health ; 47(5): 258-65, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25284197

RESUMEN

OBJECTIVES: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. METHODS: Among the 11 731 nurses who participated in the Korea Health and Medical Workers' Union's educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. RESULTS: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses' job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses' turnover intention. CONCLUSIONS: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses' job satisfaction. However, the nursing practice environment was not related to nurses' turnover intention.


Asunto(s)
Satisfacción en el Trabajo , Personal de Enfermería en Hospital/psicología , Reorganización del Personal , Adulto , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Encuestas y Cuestionarios
7.
J Prev Med Public Health ; 47(5): 273-80, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25284199

RESUMEN

OBJECTIVES: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. METHODS: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. RESULTS: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician- nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. CONCLUSIONS: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.


Asunto(s)
Enfermeras y Enfermeros/psicología , Calidad de la Atención de Salud , Accidentes por Caídas , Accidentes de Trabajo , Adulto , Infección Hospitalaria/etiología , Femenino , Hospitales , Humanos , Modelos Logísticos , Masculino , Errores de Medicación , Persona de Mediana Edad , Oportunidad Relativa , Úlcera por Presión/etiología , Encuestas y Cuestionarios
8.
J Prev Med Public Health ; 47(2): 104-12, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24744827

RESUMEN

OBJECTIVES: To date, studies have not comprehensively demonstrated the relationship between stroke incidence and socioeconomic status. This study investigated stroke incidence by household income level in conjunction with age, sex, and stroke subtype in Korea. METHODS: Contributions by the head of household were used as the basis for income levels. Household income levels for 21 766 036 people were classified into 6 groups. The stroke incidences were calculated by household income level, both overall within income categories and further by age group, sex, and stroke subtype. To present the inequalities among the six ranked groups in a single value, the slope index of inequality and relative index of inequality were calculated. RESULTS: In 2005, 57 690 people were first-time stroke patients. The incidences of total stroke for males and females increased as the income level decreased. The incidences of stroke increased as the income level decreased in those 74 years old and under, whereas there was no difference by income levels in those 75 and over. Intracerebral hemorrhage for the males represented the highest inequality among stroke subtypes. Incidences of subarachnoid hemorrhage did not differ by income levels. CONCLUSIONS: The incidence of stroke increases as the income level decreases, but it differs according to sex, age, and stroke subtype. The difference in the relative incidence is large for male intracerebral hemorrhage, whereas the difference in the absolute incidence is large for male ischemic stroke.


Asunto(s)
Clase Social , Accidente Cerebrovascular/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Hemorragia Cerebral/fisiopatología , Femenino , Humanos , Incidencia , Renta/estadística & datos numéricos , Masculino , Persona de Mediana Edad , República de Corea , Factores Sexuales , Accidente Cerebrovascular/clasificación , Accidente Cerebrovascular/psicología
9.
Asian Nurs Res (Korean Soc Nurs Sci) ; 7(3): 128-35, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25030250

RESUMEN

PURPOSE: Based on the Revised Nursing Work Index (NWI-R), this research aimed to develop a Korean Hospital General Inpatient Unit-Nursing Work Index (KGU-NWI). This study also aimed to compare the common points and differences between the subfactors of the KGU-NWI and the subfactors from previous studies. METHODS: Based on opinions from 3,151 nurses in Korean hospital general inpatient unit, this research used 57 items of NWI-R and the principal axis factor analysis for deriving subfactors. We evaluated the convergent validity through factor analysis and the content validity of KGU-NWI in terms of the association between nurses' job outcome and the subfactors derived. RESULTS: Six subfactors and 26 items for KGU-NWI were derived from NWI-R. Among them, 'physician-nurse relationship', 'adequate nurse staffing' and 'organizational support and management of hospital' were the same with results from previous studies. In addition, two subfactors, 'participation of decision-making processes' and 'education for improving quality of care', which were similar with results from previous Korean studies, were newly added by using Korean hospital cases. In contrast to previous Korean studies, a unique subfactor this study found was 'nursing processes'. This research confirmed that the six subfactors were highly correlated with job satisfaction, intention to leave, and quality of health care, which represented a nurse's job outcome. CONCLUSION: KGU-NWI including six subfactors and 26 items is an applicable instrument to investigate nurse work environment in Korean hospital general inpatient unit.

10.
Int J Health Serv ; 41(1): 51-66, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21319720

RESUMEN

This study explores income inequalities in the utilization of medical care by cancer patients in South Korea, according to type of medical facilities and survival duration. The five-year retrospective cohort study used data drawn from the Korean Cancer Registry, the National Health Insurance database, and the death database of the Korean National Statistical Office. The sample consisted of 43,433 patients diagnosed with cancer in 1999. The authors found significant quantitative inequalities as a function of income in the patients' utilization of medical care. Cancer patients from the highest income class used inpatient and outpatient care more frequently than did patients from the lowest income class. Those with higher incomes tended to use more inpatient and outpatient services at major tertiary hospitals, which were known as providing better medical care than other types of hospitals and clinics. Moreover, horizontal inequality in cancer-care expenditures favoring those with higher incomes was observed during earlier periods of treatment. In conclusion, income substantially affects the utilization of inpatient and outpatient services, amount of medical expenditures, and type of medical facilities.


Asunto(s)
Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud , Renta , Neoplasias/terapia , Adulto , Anciano , Atención Ambulatoria/estadística & datos numéricos , Femenino , Servicios de Salud/economía , Hospitalización/estadística & datos numéricos , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , República de Corea/epidemiología , Estudios Retrospectivos , Distribución por Sexo , Tasa de Supervivencia
11.
J Health Popul Nutr ; 29(6): 574-82, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22283031

RESUMEN

Pneumonia and influenza are leading causes of morbidity and mortality across the globe. Korea has established the national health-insurance system to cover the entire Korean population since 1989. The aim of this study was to describe the epidemiologic trends in pneumonia and influenza-associated hospitalizations and deaths using the Korean National Health Insurance databases and national vital statistics. During 2002-2005, 989,472 hospitalizations and 10,543 deaths due to pneumonia and influenza were recorded. Eighty-one percent of the hospitalizations were related to diagnoses with unspecified aetiology. The average annual rate of hospitalizations due to pneumonia and influenza was 5.2 per 1,000 people [95% confidence interval (CI) 5.2-5.3], and the hospitalization rate increased by 28% (from 4.5 to 5.8 per 1,000 people) during the four-year study period. In addition, deaths due to pneumonia and influenza increased by 48% (2,829 during 2003, 3,522 during 2004, and 4,192 during 2005). Overall, the national burden of hospitalizations and deaths due to pneumonia and influenza in Korea was high, and it increased for all age-groups during the study period. A comprehensive review of potential interventions by the government authorities should aim to reduce the burden of pneumonia and influenza.


Asunto(s)
Hospitalización/estadística & datos numéricos , Gripe Humana/epidemiología , Neumonía/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Vacunas contra la Influenza , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Análisis de Supervivencia , Adulto Joven
12.
J Clin Gastroenterol ; 43(9): 869-75, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19398926

RESUMEN

BACKGROUND AND AIMS: Obesity has been postulated as contributing to the risk of nonalcoholic steatohepatitis. With the surging obesity epidemic, an ensuing epidemic of nonalcoholic steatohepatitis and its sequelae is of concern. The objectives of this clinical research study were to examine the association between body mass index (BMI) and serum aminotransferase levels. METHOD: A study was carried out on 1,166,847 Koreans (731,560 men and 435,287 women), 30 to 95 years of age, who received health insurance from the National Health Insurance Corp and had a biennial medical evaluation from 1992 to 1995. RESULTS: Across the range of BMI values (<18.5 to >or=32 kg/m) in men, alanine aminotransferase (ALT) was estimated to increase by 18.8 U/L and aspartate aminotransferase (AST) increased by 7.1 U/L. In women, ALT increased by 9.9 U/L, whereas AST increased by 4.5 U/L. In men, interactions between BMI and alcohol consumption were significant (P<0.001) for ALT and AST, but the degree of effect modification was quantitatively minor. However, ALT and AST levels were somewhat higher in heavy alcohol drinkers than in nondrinkers. For women, the relationship of aminotransferase levels with BMI did not vary by alcohol consumption. The relationship of BMI with aminotransferase weakened with increasing age. CONCLUSIONS: In Korea, ALT and AST are strongly associated with BMI and increased progressively from the lowest to the highest strata of BMI. The association of BMI with aminotransferase levels was modified by age and sex.


Asunto(s)
Alanina Transaminasa/sangre , Pueblo Asiatico/estadística & datos numéricos , Aspartato Aminotransferasas/sangre , Índice de Masa Corporal , Pruebas Enzimáticas Clínicas , Hígado Graso/etiología , Obesidad/complicaciones , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/etnología , Biomarcadores/sangre , Estudios Transversales , Hígado Graso/diagnóstico , Hígado Graso/etnología , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Obesidad/etnología , Oportunidad Relativa , Estudios Prospectivos , República de Corea , Medición de Riesgo , Factores de Riesgo , Factores Sexuales
13.
Int J Health Plann Manage ; 24(2): 131-46, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-18157794

RESUMEN

To explore the determinants of public satisfaction with the National Health Insurance, this study re-analyzed the 2004 public satisfaction survey with the Korean National Health Insurance (KNHI) conducted by Korean National Health Insurance Corporation (KNHIC). One thousand samples were selected with probability proportional to population size (by region/sex/age). The data collected by home-visit interview were transformed into the final data set by matching them to the insured's benefit database and the qualification database. The results showed that metropolitan residence, insured type, relationship between respondent and householder, subjective health status, benefit-cost ratio, and attitudes toward KNHI were direct determinants of satisfaction with KNHI. In addition, various demographic and socioeconomic variables and the health status of the respondent's family indirectly influenced satisfaction with KNHI. Among these variables, the attitude toward KNHI was the most vital factor to determine public satisfaction. The study results show that equity in monthly contributions and an enhanced quantity and quality of medical services are required to improve public satisfaction with KNHI. Furthermore, it is important to improve the public perception of social values and solidarity for increased public satisfaction with KNHI.


Asunto(s)
Actitud Frente a la Salud , Comportamiento del Consumidor/estadística & datos numéricos , Programas Nacionales de Salud , Análisis Costo-Beneficio , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Factores Socioeconómicos
14.
Atherosclerosis ; 203(2): 550-6, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19013571

RESUMEN

Tooth loss has been suggested as a potential risk factor for stroke. We conducted a prospective cohort study of stroke in Korea on hypertension, diabetes, smoking, and tooth loss to characterize their independent effects and interactions. The overall risk of stroke and the risk of different subtypes of stroke were evaluated in relation to tooth loss using Cox proportional hazards models among 867,256 Korean men and women, aged 30-95 years, who received health insurance from the National Health Insurance Corporation and were medically evaluated between 1992 and 1995, with tooth loss measured. The overall prevalence of having at least one tooth removed among the people in the study was 29.8% (31.9% for men and 22.3% for women). During a 14-year follow-up, 28,258 strokes with 5105 fatal strokes occurred. For men and women, tooth loss was associated with total stroke and stroke subtypes. In a multivariable model adjusting for selected covariates, a graded association between higher tooth loss and higher risk of total stroke was observed in men [> or =7 lost teeth versus 0 (hazard ratio (HR)=1.3; 95% confidence interval (CI), 1.2-1.4)] and in women (HR=1.2; 95% CI, 1.0-1.3). The HRs for ischemic and hemorrhagic stroke were also similar in men and women. There was evidence of interaction of hemorrhagic stroke risk with hypertension and tooth loss. Tooth loss is independently associated with increased risk of stroke and hypertension does interact antagonistically, particularly for hemorrhagic stroke.


Asunto(s)
Hipertensión/complicaciones , Accidente Cerebrovascular/complicaciones , Pérdida de Diente/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/epidemiología , Corea (Geográfico) , Masculino , Persona de Mediana Edad , Prevalencia , Modelos de Riesgos Proporcionales , Riesgo , Accidente Cerebrovascular/epidemiología , Pérdida de Diente/epidemiología , Resultado del Tratamiento
15.
Gerontology ; 55(1): 106-13, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19023194

RESUMEN

BACKGROUND: Most studies on caregiver burden have been conducted in Western countries, while few studies on the correlates of caregiver burden have been performed in Korea. OBJECTIVE: To suggest better policies for the care of dementia patients by using a nationwide database to identify factors that affect caregiver burden in Korea. METHODS: The database of the Korean National Health Insurance (KNHI) and National Medical Aid (NMA) programs, which covers all Koreans, was used. A sample of 609 dementia patients and their caregivers was selected from a total of 85,281 dementia patients in 2004 and interviewed to evaluate the total cost of care and caregiver burden. Stepwise multiple linear regression analysis was then performed to identify significant independent predictors of caregiver burden. RESULTS: Among caregiver-related factors, caregiver burden was higher in those who were female, had a history of home care during the previous year, and had less education. Among patient-related factors, poor ADL/IADL function was significant. The most interesting result was that subjective sense of socioeconomic status (good/fair/poor) was a stronger predictor of caregiver outcome than actual economic costs. CONCLUSION: The results of this study suggest that interventions to assist patients with dementia should focus on female caregivers, especially those considered likely to be suffering from an economic burden. Interventions should also aim to improve the ADL and IADL capacities of patients.


Asunto(s)
Envejecimiento/psicología , Cuidadores/psicología , Demencia/terapia , Actividades Cotidianas , Adulto , Anciano , Anciano de 80 o más Años , Cuidadores/economía , Bases de Datos Factuales , Demencia/economía , Demencia/fisiopatología , Familia , Femenino , Humanos , Corea (Geográfico) , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis de Regresión , Clase Social
16.
Arch Phys Med Rehabil ; 89(8): 1460-7, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18674981

RESUMEN

OBJECTIVE: To determine disparities in antihypertensive medication adherence between persons with disabilities and those without disabilities in South Korea. DESIGN: The study compared antihypertensive medication adherence between persons with disabilities and those without disabilities using medical claims data of the National Health Insurance (NHI). SETTING: We obtained data from claims submitted to the NHI, which covers almost the entire Korean population. Persons who were prescribed antihypertensive medication during the calendar year 2004 were identified. PARTICIPANTS: The study comprised data from persons with disabilities (n=85,098) and persons without disabilities (n=2,368,636). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A cumulative medication adherence (CMA) greater than or equal to 80% was defined as an appropriate medication adherence. Multiple logistic regression was used to identify differences in antihypertensive medication adherence between persons with disabilities and without disabilities. Estimates were adjusted for demographic characteristics (sex, age), type of medical insurance, insurance contribution a month as a proxy for household income, residential area, and clinical characteristics (medication duration, comorbid conditions). RESULTS: People with disabilities had lower CMAs than those without (median CMA, 83.6% vs 85.7%; appropriate medication adherence, 54.5% vs 57.5%). Results of the multiple logistic regression adjusting other factors indicated that people with disabilities had decreased probabilities of appropriate adherence. CONCLUSIONS: Medication adherence is reduced by various types of disability and impairment such as those involving mobility and communication. Much effort should be made to investigate how and why these disparities take place and develop health policies to remove these disparities if they exist.


Asunto(s)
Antihipertensivos/uso terapéutico , Enfermedad Crónica/epidemiología , Personas con Discapacidad/estadística & datos numéricos , Hipertensión/tratamiento farmacológico , Cooperación del Paciente/estadística & datos numéricos , Actividades Cotidianas , Adulto , Anciano , Enfermedad Crónica/clasificación , Comorbilidad , Intervalos de Confianza , Personas con Discapacidad/clasificación , Femenino , Humanos , Corea (Geográfico)/epidemiología , Masculino , Cuerpo Médico de Hospitales , Persona de Mediana Edad , Programas Nacionales de Salud/estadística & datos numéricos , Oportunidad Relativa
17.
J Clin Oncol ; 26(8): 1302-9, 2008 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-18323554

RESUMEN

PURPOSE: The aim of this study was to investigate whether a diagnosis of cancer has an impact on the cancer patients' job loss and re-employment and to identify the factors affecting job loss and re-employment during 6 years of follow-up of Korean employees with cancer. PATIENTS AND METHODS: All employees except for the self-employed in Korea who were diagnosed with cancer during the 2001 calendar year (n = 5,396) were identified as the first baseline patients and were followed every 3 months over 6 years to estimate the time taken to job loss. Patients who lost their job within the first year after a diagnosis of cancer (n = 1,398) were identified as the second baseline patients and were followed up over 5 years to estimate the time taken to re-employment using the National Health Insurance claims data. Patient demographic, socioeconomic, and clinical variables were investigated as factors that affected job loss and re-employment. RESULTS: Among the first baseline cancer patients, 47.0% lost their job, and among the second baseline patients, 30.5% were re-employed over 69 to 72 months of follow-up. Female sex, younger age and older age, company employee, lower income, blood cancer, and brain and CNS, lung, and liver cancer were significant predictors of early job loss or delayed re-employment. CONCLUSION: The diagnosis of cancer affects cancer patients' employment status differently according to different factors: sex, age, type of job, income, and cancer site. Efforts should be made to support re-employment and reduce unnecessary work cessation and disparity between different demographic and socioeconomic groups of cancer survivors.


Asunto(s)
Pueblo Asiatico/psicología , Empleo/psicología , Neoplasias/psicología , Desempleo/psicología , Adulto , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Corea (Geográfico)/epidemiología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias/epidemiología , Neoplasias/etnología , Estudios Retrospectivos , Encuestas y Cuestionarios , Factores de Tiempo
18.
Cancer Epidemiol Biomarkers Prev ; 17(2): 359-64, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18268120

RESUMEN

There is increasing evidence that type 2 diabetes mellitus and glucose intolerance are a cause, not just a consequence, of pancreatic cancer. We examined whether other factors that characterize the insulin resistance syndrome are also risk factors for pancreatic cancer in a prospective cohort study of 631,172 men and women (ages 45+ years) who received health insurance from the Korean Medical Insurance Corporation. The biennial medical evaluations from 1992 to 1995 provided the baseline information for this study. Relative risks (RR) were estimated using proportional hazards models adjusted for age, sex, smoking, and fasting serum glucose (after excluding the first 2 years of follow-up). There were 2,194 incident cases of pancreatic cancer diagnosed in the cohort over a median follow-up of 12 years. There was no evidence that pancreatic cancer risk was associated with total cholesterol, systolic blood pressure, WBC count, or body mass index. Abnormal levels of aspartate aminotransferase and alanine aminotransferase were both associated with a moderately increased risk of developing the disease (40+ versus <20; RR, 1.33; 95% CI, 1.14-1.55; P(trend) = 0.05 and RR, 1.34; 95% CI, 1.16-1.56; P(trend) = 0.02, respectively). Excluding 6 years of follow-up reduced this RR (95% CI) for aspartate aminotransferase to 1.22 (1.01-1.49), but even after excluding 10 years follow-up the RR (95% CI) for alanine aminotransferase was unchanged [1.36 (1.01-1.83)]. Although fasting serum glucose has been found previously to be associated with pancreatic cancer risk in this cohort, most other factors that characterize insulin resistance syndrome were not associated with pancreatic cancer risk. The association with elevated liver enzyme levels is a novel finding that warrants further investigation.


Asunto(s)
Resistencia a la Insulina , Neoplasias Pancreáticas/etiología , Neoplasias Pancreáticas/prevención & control , Alanina Transaminasa/metabolismo , Aspartato Aminotransferasas/metabolismo , Índice de Masa Corporal , Femenino , Humanos , Corea (Geográfico)/epidemiología , Lípidos/sangre , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/epidemiología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Fumar/efectos adversos , Fumar/epidemiología
19.
J Prev Med Public Health ; 41(1): 45-50, 2008 Jan.
Artículo en Coreano | MEDLINE | ID: mdl-18250605

RESUMEN

OBJECTIVES: To determine the relationship between exercise and the incidence of type 2 diabetes in an impaired fasting glucose group. METHODS: This prospective cohort study was conducted in 19,440 men and 4,297 women, aged 30-69 years, with impaired fasting glucose at baseline who had undergone biennial medical evaluation through the National Health Insurance Corporation from 2000 to 2004. Impaired fasting glucose was defined as fasting glucose of 100 to 125 mg/dl and the subjects were divided into 3 groups depending on weekly exercise frequency. Multivariate logistic regression analysis was used to evaluate the association between the baseline exercise status and incidence of type 2 diabetes. RESULTS: During the 4-year follow-up, a total of 3,239 men and 283 women developed type 2 diabetes, a cumulative incidence of 16.6% for men, and 6.5% for women. Also, 1,688 men (21.2%) and 127 women (15.2%) developed type 2 diabetes in the obese group. The adjusted relative risk (RR) of developing type 2 diabetes in non-exercising men was significantly higher than exercising men regularly (RR= 1.375, 95% CI=1.236-1.529)(p<0.0001), and the RR for non-exercising women was higher than exercising women regularly (RR=1.124, 95% CI=0.711-1.778). The RR for non-exercise men/women in the obese group was 1.571 (95% CI=1.351-1.827)(p<0.0001)/1.869(95% CI=0.846-4.130). CONCLUSIONS: Regular exercise is effective in preventing type 2 diabetes in people with impaired fasting glucose, and particularly in obese people. People with risk factors for diabetes should participate in a regular exercise program.


Asunto(s)
Glucemia , Diabetes Mellitus Tipo 2/epidemiología , Ejercicio Físico , Adulto , Anciano , Diabetes Mellitus Tipo 2/prevención & control , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales
20.
Obesity (Silver Spring) ; 16(2): 396-401, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18239650

RESUMEN

OBJECTIVE: Obesity is known to be associated with diverse disease outcomes; however, the effect of body weight on the occurrence of stroke remains controversial and has not been studied sufficiently, particularly among Asian populations and among women. The purpose of this study was to investigate the effect of BMI on the risk of stroke among Korean women. METHODS AND PROCEDURES: The overall risk of stroke and the risk of different subtypes of stroke were evaluated in relation to BMI using Cox's proportional hazard models among 439,582 Korean women, aged 30-95 years, in a 13-year prospective cohort study with enrollment from 1992-1995. Stratified analyses were performed for age groups and cigarette smoking status. RESULTS: The average BMI was 23.2 kg/m(2) at baseline. The overall risk of stroke was the lowest in the group with a BMI <20.0 and increased with BMI in a dose-dependent manner. However, the direction and strength of association varied according to the type of stroke and age groups. The risk of ischemic stroke (IS) showed a strong and progressive linear relationship with an increase in the BMI, while the relationship was less linear for hemorrhagic stroke (HS). The association between the risk of stroke and BMI was modified by age, with a weaker association at higher ages. DISCUSSION: In Korean women, the BMI showed a progressive and linear relationship with the occurrence of stroke. The association of BMI with the risk of stroke was modified by age.


Asunto(s)
Índice de Masa Corporal , Obesidad/epidemiología , Accidente Cerebrovascular/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Humanos , Corea (Geográfico)/epidemiología , Estudios Longitudinales , Persona de Mediana Edad , Obesidad/etnología , Oportunidad Relativa , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Fumar/efectos adversos , Accidente Cerebrovascular/etnología
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