RESUMO
OBJECTIVES: This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model. METHODS: After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu's responses were organized into 4 phases and evaluated by applying the response model. RESULTS: In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation-based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing. CONCLUSIONS: This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.
Assuntos
COVID-19 , Pandemias , Humanos , Pandemias/prevenção & controle , Saúde Pública , Quarentena , República da Coreia/epidemiologiaRESUMO
Falling is one of the leading causes of injury among elderly populations. As the population over 65 years old increases, medical costs due to falling will also increase. Urban and rural areas have different fall characteristics, and research into these differences is lacking.A survey was conducted on 2012 people over 60 years old between September 1, 2015, to October 12, 2015. Guro-gu (Seoul), Yeongdeungpo-gu (Seoul), and Jung-gu (Daegu) were classified as urban areas and included 1205 of the study participants. Dalseong-gun (Daegu) and Yangpyeong-gun (Gyeonggi-do) were categorized as rural areas and included 807 participants. The survey included questions about fall history, cause, season and time of recent falls, and external conditions associated with recent falls, like floor or ground materials and shoe types.Rural respondents were older than urban respondents (Pâ<â.001) but did not differ significantly in gender proportion (Pâ=â.082). Fall history over the past year was not different between the 2 regions (Pâ=â.693), but lifetime fall history was greater among rural respondents (Pâ<â.001). Only 5.1% of all respondents had undergone fall-prevention education. A slippery floor was the most common cause of falls in both regions, but there was a significant difference in pattern of fall causes (Pâ<â.001). Falls were more frequent in the summer, spring, and the afternoon in urban areas, and in the summer, autumn, and the morning in rural areas. Cement and asphalt were the most common ground materials at the time of falls in both regions, but rural respondents had higher fall rates when walking on soil and when wearing slippers.A fall-prevention program that reflects the characteristics and differences of falls in urban and rural areas should be developed and used to effectively prevent falling among elderly people.
Assuntos
Acidentes por Quedas , Saúde Pública/métodos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Feminino , Humanos , Masculino , República da Coreia/epidemiologia , Fatores de Risco , Estações do Ano , Inquéritos e QuestionáriosRESUMO
PURPOSE: To determine the long-term prevalence and characteristics of acute hydrofluoric acid (HF) exposure in 2223 patients during the first 30 months after a mass-casualty exposure, and to confirm the antidotal effect of nebulized calcium on inhalation burns caused by HF. METHODS: This observational cohort study included patients after an HF spill in the Republic of Korea on September 27, 2012; registered patients were followed until April 2015. We assessed toxic effects, distance from spill, degree of acute poisoning, and the effect of nebulized calcium in HF-exposed individuals. RESULTS: Overall, 2223 patients received emergency management or antidote therapy for 20 days. Seventy-four of 134 patients with dermal toxicity received calcium-lidocaine gel, and 368 individuals with bronchial irritation signs received calcium gluconate via nebulizer nCG. A total 377 ampoules 786 g of calcium gluconate were used in the nCG formulation. Calcium administration did not cause adverse reactions during the observation period. Long-term cohort observation showed that 120 patients (120/2233, 5.4%) returned to medical facilities for management of HF-related symptoms within 1 month; 18 persons (18/1660, 1.1%) returned 1-3 months later with chronic cough and respiratory symptoms; and 3 patients (3/1660, 0.2%) underwent medical treatment due to upper-airway toxic symptoms more than 2 years after HF exposure. CONCLUSION: Respiratory toxicity after mass exposure to an HF spill was successfully treated by calcium nebulizer. Based on our experience, detoxification processes and the amounts of antidote stocked are important when planning for future chemical disasters at the community level.
Assuntos
Antídotos/uso terapêutico , Queimaduras Químicas/tratamento farmacológico , Queimaduras por Inalação/tratamento farmacológico , Gluconato de Cálcio/uso terapêutico , Vazamento de Resíduos Químicos , Ácido Fluorídrico/intoxicação , Administração Cutânea , Administração por Inalação , Adolescente , Adulto , Idoso , Anestésicos Locais/uso terapêutico , Queimaduras Químicas/etiologia , Queimaduras por Inalação/etiologia , Cálcio/uso terapêutico , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Géis , Humanos , Lactente , Recém-Nascido , Exposição por Inalação , Lidocaína/uso terapêutico , Masculino , Incidentes com Feridos em Massa , Pessoa de Meia-Idade , Nebulizadores e Vaporizadores , República da Coreia , Adulto JovemRESUMO
OBJECTIVE: To explore the incidence, characteristics, complications and socioeconomic impacts associated with falls in community-dwelling elderly. METHODS: From September 1, 2015 to October 12, 2015, a questionnaire-based survey was conducted involving a total of 2,012 elderly who lived in Guro-gu (Seoul), Yeongdeungpo-gu (Seoul), Yangpyeong-gu (Gyeonggi-do), Dalseong-gu (Daegu), and Jung-gu (Daegu). The subjects were interviewed using a structured questionnaire to obtain demographic characteristics and comprehensive falling histories. The socioeconomic cost related to falls was estimated using the statistical data provided by the Health Insurance Review and Assessment Service. RESULTS: Falls were recorded in 666 out of the 2,012 subjects (33.1%) during the past year. Frequent falls occurred during December, in the afternoons, when the floor was slippery. The most common injuries included the low back and the most common injury type was sprain. The total direct costs related to falls involving the 2,012 subjects were 303,061,019 KRW (Korean won). The average medical cost related to falls in the 2,012 subjects was 150,627 KRW and the average medical cost of 666 subjects who experienced falls was 455,047 KRW. Estimates of the total population over the age of 60 years showed that the annual direct costs associated with falls in Korea over the age of 60 years were about 1.378 trillion KRW. CONCLUSION: This study was conducted to explore the incidence, characteristics, complications, and socioeconomic impacts of falls in community-dwelling elderly. This study is expected to be used as a source of basic data for the establishment of medical policy for the elderly and the development of a fall prevention program for the elderly in Korea.
RESUMO
PURPOSE: This study aimed to examine levels of stress and professionalism of nurses who provided nursing care during the 2015 Middle East respiratory syndrome outbreak based on their experience, to investigate the nurses' intention to respond to possible future outbreaks in relation to their experience during the outbreak, and to determine the relationship between the outbreak experience and nursing intention considering stress and professionalism. METHODS: A self-administered questionnaire was designed based on modifications of related questionnaires, and used to assess levels of stress, professionalism, and nursing intention according to participants' experiences during the outbreak. Multiple regression analysis was used to examine the relationship between the outbreak nursing experience and nursing intention considering stress and nursing professionalism. RESULTS: The overall stress, professionalism, and nursing intention scores for the firsthand experience group were 33.72, 103.00, and 16.92, respectively, whereas those of the secondhand experience group were 32.25, 98.99, and 15.60, respectively. There were significant differences in professionalism and nursing intention scores between the groups (pâ¯=â¯.001 and pâ¯<â¯.001, respectively). The regression analysis revealed that the regression estimate between stress and nursing intention was B(SE) = -0.08(0.02), beta = -0.21, p < .001 and the regression estimate between professionalism in nursing and nursing intention was B(SE) = 0.05(0.01), beta = 0.23, p < .001. CONCLUSION: Prior outbreak nursing experience was importantly associated with intention to provide care for patients with a newly emerging infectious disease in the future considering stress and professionalism. Gathering information about nurses' experience of epidemics and regular assessment of job stress and professionalism are required.
Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Emergências , Hospitais Públicos , Intenção , Recursos Humanos de Enfermagem Hospitalar/psicologia , Humanos , República da Coreia/epidemiologia , Inquéritos e Questionários , Recursos HumanosRESUMO
OBJECTIVES: The objective of the present study was to compare prognosis of patients with gastric or colorectal cancer according to places where they received surgeries. METHODS: The cancer patients underwent surgeries in sampled hospitals located in Daegu were matched 1:1 to the patients who visited sampled hospitals in Seoul using propensity score method. After the occurrences of death were examined, Kaplan-Meier method was used for survival analysis and the log-rank test was performed to compare the survival curves. RESULTS: A total of six out of 291 gastric cancer patients who had surgeries in Daegu died (2.1%) and ten deaths (3.4%) occurred from patients went Seoul hospitals. Out of 84 gastric cancer patients who had chemotherapy after surgeries in Daegu, 13 (15.5%) patients died while 18 (21.4%) deaths occurred among patients underwent surgeries in Seoul. Six deaths (6.9%) out of 87 colorectal cancer patients who had surgeries in Daegu were reported. Five patients (5.7%) died among the patients underwent surgeries in Seoul. Among the colorectal cancer patients with chemotherapy after surgeries, 13 patients (12.4%) who visited hospitals in Daegu and 14 (13.3%) patients who used medical centers in Seoul died. There were no significant differences according to places where patients used medical services. CONCLUSIONS: The result of this study is expected to be used as basic data for policy making to resolve centralization problem of cancer patients and to help patients to make rational choices in selection of medical centers.
Assuntos
Neoplasias Colorretais/mortalidade , Neoplasias Gástricas/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Cidades , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia , Análise de SobrevidaRESUMO
PURPOSE: We assessed medication nonadherence, categorized as intentional or unintentional, and related factors in elderly patients with hypertension, correlating the data with measurement of blood pressure as the final target of medication adherence and other possible influencing factors, such as lifestyle. PATIENTS AND METHODS: Subjects were aged ≥65 years, resided in a rural area, and were taking antihypertensive drugs. The survey was conducted in July 2014. Participants were divided into the following three groups: "Adherence", "Unintentional nonadherence", and "Intentional nonadherence". Individual cognitive components, such as necessity and concern as well as self-efficacy and other related factors, were compared according to adherence groups. The interrelationships between those factors and nonadherence were tested using structural equation modeling analysis. RESULTS: Of the 401 subjects, 182 (45.6%) were in the adherence group, 107 (26.7%) in the unintentional nonadherence group, and 112 (27.9%) in the intentional nonadherence group. Necessity and self-efficacy were found to have a significant direct influence on unintentional nonadherence behaviors (necessity ß=-0.171, P=0.019; self-efficacy ß=-0.433, P<0.001); concern was not statistically significant (ß=-0.009, P=0.909). Necessity was found to have significant direct and indirect impact on intentional nonadherence (direct ß=-0.275, P=0.002; indirect ß=-0.113, P=0.036). Self-efficacy had no significant direct effect on intentional nonadherence though it had the only significant indirect effect on intentional nonadherence (direct ß=-0.055, P=0.515; indirect ß=-0.286, P<0.001). Concern had no significant influence on intentional or on unintentional nonadherence (direct ß=0.132 0.132, P=0.151; indirect ß=-0.006, P=0.909). CONCLUSION: Unintentional nonadherence should be regularly monitored and managed because of its potential prognostic significance. Interventions addressing cognitive factors, such as beliefs about medicine or self-efficacy, are relatively difficult to implement, but are essential to improve medication adherence.
RESUMO
BACKGROUND & AIMS: This study sought to identify discrepancies between the expectations of patients with cancer and oncologists regarding the efficacy of complementary and alternative medicines (CAMs), and to determine how patients evaluate CAM efficacy after its use. METHODS: Data from the Cancer Patient Experience Study, a nationwide survey, were used. Seven subdivided efficacy domains were included in the survey. An oncologist-patient matching analysis was done to assess the concordance of CAM efficacies between oncologists and patients with cancer. In addition, the patients' expectations of CAM efficacies were compared before and after use. RESULTS: Out of 719 participants, 201 patients with cancer (28.0%) reported using CAMs. The patients with cancer generally tended to be more positive about CAM efficacies than the oncologists. The largest discrepancy in efficacy perception was found in the efficacy domain of survival benefit, which included complete disease remission and prolonged survival. Many patients reported that they did not experience the positive efficacy they had anticipated before use. However, a substantial proportion of patients indicated that CAMs were as effective as they had expected, even though there is little evidence supporting the CAM efficacies. CONCLUSIONS: There was a marked discrepancy and a lack of concordance in expectations of CAM efficacy between patients with cancer and oncologists. Better communication between the patients and oncologists regarding CAM efficacy would be needed to make the patients to have shared expectations, and to reduce unnecessary CAM use.
Assuntos
Terapias Complementares/métodos , Neoplasias/psicologia , Neoplasias/terapia , Oncologistas/psicologia , Atitude do Pessoal de Saúde , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção/fisiologia , Relações Médico-PacienteRESUMO
Acinetobacter baumannii, a strictly aerobic, non-fermentative, Gram-negative coccobacillary rod-shaped bacterium, is an opportunistic pathogen in humans. We recently isolated a multidrug-resistant A. baumannii strain KBN10P02143 from the pus sample drawn from a surgical patient in South Korea. We report the complete genome of this strain, which consists of 4,139,396 bp (G + C content, 39.08%) with 3,868 protein-coding genes, 73 tRNAs and six rRNA operons. Identification of the genes related to multidrug resistance from this genome and the discovery of a novel conjugative plasmid will increase our understanding of the pathogenicity associated with this species.
Assuntos
Acinetobacter baumannii/genética , Farmacorresistência Bacteriana Múltipla/genética , Genoma Bacteriano/genética , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/isolamento & purificação , DNA Bacteriano/genética , Humanos , República da Coreia , Análise de Sequência de DNARESUMO
Acinetobacter baumannii, a strictly aerobic, non-fermentative, Gram-negative coccobacillary rod-shaped bacterium, is an opportunistic pathogen in humans. We recently isolated a multidrug-resistant A. baumannii strain KBN10P02143 from the pus sample drawn from a surgical patient in South Korea. We report the complete genome of this strain, which consists of 4,139,396 bp (G + C content, 39.08%) with 3,868 protein-coding genes, 73 tRNAs and six rRNA operons. Identification of the genes related to multidrug resistance from this genome and the discovery of a novel conjugative plasmid will increase our understanding of the pathogenicity associated with this species.
Assuntos
Humanos , Acinetobacter baumannii/genética , Farmacorresistência Bacteriana Múltipla/genética , Genoma Bacteriano/genética , Acinetobacter baumannii/isolamento & purificação , Infecções por Acinetobacter/microbiologia , DNA Bacteriano/genética , República da Coreia , Análise de Sequência de DNARESUMO
OBJECTIVES: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. METHODS: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. RESULTS: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only ('I'-only) and of fixed amount+indemnity-type ('F+I') increased, whereas the proportion of holders with fixed amount-type only ('F'-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with 'F'-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with 'I'-only PMI or 'F+I' PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for 'I'-only: 1.39, 1.63, and 1.38, respectively; ORs for 'F+I': 1.67, 2.09, and 1.37, respectively). CONCLUSIONS: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.
Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Renda , Lactente , Recém-Nascido , Seguro Saúde/economia , Masculino , Pessoas sem Cobertura de Seguro de Saúde , Razão de Chances , República da CoreiaRESUMO
BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) may be obesogens. However, the role of PAHs independent of environmental tobacco smoke (ETS) is unclear, and the interaction between PAHs and ETS remains unknown. METHODS: We performed cross-sectional analyses of urinary concentrations of PAH metabolites, body mass index (BMI), and waist circumference (WC) in 1985 people aged 6-18 years using data from the 2003-2008 U.S. National Health and Nutrition Examination Survey. ETS exposure level was measured as serum cotinine level. RESULTS: PAH metabolites were positively associated with BMI and WC in both the ETS-unexposed and ETS-exposed groups. The adjusted odds ratios for general obesity defined by age- and sex-specific BMI≥95th percentile across the quartiles of total PAH metabolites were 1, 4.51, 2.57, and 8.09 (Ptrend=0.003) in the ETS-unexposed group and 1, 2.02, 1.83, and 3.86 (Ptrend<0.001) in the ETS-exposed group. However, the association of PAH metabolites with obesity became stronger as serum cotinine levels increased (Pinteraction<0.05). Among those with high ETS exposure, the adjusted odds ratios for general obesity across quartiles of total PAH metabolites were 1, 2.89, 5.26, and 16.29 (Ptrend<0.001). Compared to the low PAH-exposure group without exposure to ETS, the high ETS- and high PAH-exposure group had 33.85- and 17.64-fold greater risks of general and central obesity, respectively. CONCLUSION: Environmental exposure to PAHs may be associated with childhood obesity irrespective of ETS. In particular, simultaneous exposure to PAHs and ETS may substantially increase the risk of obesity.
Assuntos
Obesidade/epidemiologia , Hidrocarbonetos Policíclicos Aromáticos/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Adolescente , Índice de Massa Corporal , Criança , Cotinina/sangue , Estudos Transversais , Humanos , Análise Multivariada , Inquéritos Nutricionais , Razão de Chances , Hidrocarbonetos Policíclicos Aromáticos/urina , Fatores de Risco , Estados Unidos/epidemiologia , Circunferência da CinturaRESUMO
Public health centers in Korea play an important role at the community level in encouraging residents to participate in cancer screening, usually by sending reminders in the mail and by making phone calls. However, there have not been any studies on the effectiveness of these interventions by public health centers in Korea. The purpose of this study was to evaluate this question. The study was limited to male subjects aged 50-59 years living in one district of Daegu, Korea. A total of 923 subjects were selected for the study among the target population for gastric and colorectal cancer screening as part of the National Cancer Screening Program in 2012. The subjects were randomly assigned to one of four groups: control, postal intervention, telephone intervention, and telephone and postal intervention. Three months after the interventions, the results were confirmed by the National Health Insurance Corporation. Logistic regression analyses were performed to find differences in participation rates in cancer screening for each group. Men who received telephone and postal intervention were most likely (40.5%) to undergo gastric cancer screening, in comparison to the men who received telephone intervention only (31.7%), postal intervention only (22.2%) and those in the control group (17.9%). Also, men who received telephone and postal intervention were most likely (27.8%) to participate in colorectal cancer screening, followed by the men who received telephone intervention only (24.3%), postal intervention only (16.5%), and men in the control group (13.5%). Combined telephone and postal intervention and telephone only intervention as well produced significantly increased rates of participation in cancer screening in comparison to the control group. There was no significant difference, however, between the postal intervention only and control groups for either colorectal or gastric cancer screening.
Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias Gástricas/diagnóstico , Estudos de Casos e Controles , Neoplasias Colorretais/prevenção & controle , Comunicação , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Aceitação pelo Paciente de Cuidados de Saúde , Serviços Postais , Prognóstico , Sistemas de Alerta , República da Coreia , Neoplasias Gástricas/prevenção & controle , TelefoneRESUMO
OBJECTIVES: This community-based cohort study was performed to investigate the incidence of and factors related to self-reported fragility fractures among middle-aged and elderly women living in rural Korea. METHODS: The osteoporosis cohort recruited 430 women 40 to 69 years old in 1999, and 396 of these women were followed over 11 years. In 1999, questionnaires from all participants assessed general characteristics, medical history, lifestyle, menstrual and reproductive characteristics, and bone mineral density. In 2010, self-reported fractures and the date, site, and cause of these fractures were recorded. Cox proportional hazards models were used to calculate hazard ratios (HRs). RESULTS: Seventy-six participants among 3949.7 person-years experienced fragility fractures during the 11-year follow-up. The incidence of fragility fractures was 1924.2 per 100 000 person-years (95% confidence interval [CI], 1491.6 to 2356.8). In the multivariate model, low body mass index (HR, 2.66; 95% CI, 1.13 to 6.24), a parental history of osteoporosis (HR, 2.03; 95% CI, 1.18 to 3.49), and postmenopausal status (HR, 3.50; 95% CI, 1.05 to 11.67) were significantly related to fragility fracture. CONCLUSIONS: Fracture prevention programs are needed among postmenopausal, rural, Korean women with a low body mass index and parental history of osteoporosis Korea.
Assuntos
Fraturas Ósseas/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Densidade Óssea , Estudos de Coortes , Feminino , Seguimentos , Fraturas Ósseas/etiologia , Humanos , Incidência , Estilo de Vida , Pessoa de Meia-Idade , Osteoporose/complicações , Pós-Menopausa , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , População Rural , Autorrelato , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Despite the consistent relationship between serum γ-glutamyltransferase (GGT) and type 2 diabetes (T2D), one unsolved issue is the role of serum GGT in the well-known association between obesity and T2D. This study was performed to investigate whether the association between body mass index (BMI) and impaired fasting glucose (IFG) differed depending on serum GGT levels within the normal range. METHODS: Study subjects were 2,424 men and 3,652 women aged ≥ 40, participating in the Fifth Korean National Health and Nutrition Examination Survey. Serum GGT levels within the normal range were classified into gender-specific tertiles. RESULTS: Among men and women belonging to the lowest tertile of serum GGT, BMI showed statistically non-significant weak associations with the risk of IFG. However, among persons in the highest tertile of serum GGT, the risk of IFG was 3 - 4 times higher among persons with BMI ≥ 25 kg/m2 than those with BMI < 23 kg/m2 (Pinteraction = 0.032 in men and 0.059 in women). CONCLUSIONS: The well-known strong association between BMI and IFG was observed mainly among persons with elevation of serum GGT to certain physiological levels, suggesting a critical role of serum GGT in the pathogenesis of IFG. This finding has an important clinical implication because serum GGT can be used to detect high-risk obese persons.
Assuntos
Diabetes Mellitus Tipo 2/sangue , Intolerância à Glucose/sangue , Obesidade/complicações , gama-Glutamiltransferase/sangue , Glicemia/análise , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/etiologia , Feminino , Seguimentos , Intolerância à Glucose/diagnóstico , Intolerância à Glucose/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade/fisiopatologia , Prognóstico , Valores de Referência , Fatores de RiscoRESUMO
The aim of this study was to describe the incidence of metabolic syndrome and to identify five components as metabolic syndrome predictors. The final study included 1,095 subjects enrolled in a rural part of Daegu Metropolitan City, Korea for a cohort study in 2003. Of these, 762 (69.6%) subjects had participated in the repeat survey. During the five-year follow-up, incidence density was significantly higher for women than for men (men, 30.0/1,000 person-years; women, 46.4/1,000 person-years). In both men and women, incidence of metabolic syndrome showed a significant increase with increasing number of metabolic syndrome components at baseline. Compared with individuals presenting none of components at baseline, relative risks were increased 1.22 (men; 95% CI, 0.43-3.51), 2.21 (women; 95% CI, 0.98-4.97) times more for individuals with one component of metabolic syndrome and 5.30 (men; 95% CI, 2.31-12.13), 5.53 (women; 95% CI, 2.78-11.01) times more for those who had two components. In multivariate analysis, the most powerful risk factor for metabolic syndrome was abdominal obesity in men and low HDL-cholesterol in women (adjusted relative risk, 3.28, 2.53, respectively). Consequently, finding a high risk group for metabolic syndrome according to gender and prevention of metabolic syndrome through lifestyle modification are essential.
Assuntos
Síndrome Metabólica/epidemiologia , Adulto , Idoso , HDL-Colesterol/sangue , Estudos de Coortes , Diabetes Mellitus Tipo 2/complicações , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Hipertrigliceridemia/complicações , Incidência , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Análise Multivariada , Obesidade Abdominal/complicações , República da Coreia/epidemiologia , Fatores de RiscoRESUMO
OBJECTIVES: Cigarette smoking prevalence among adolescent males in rural areas of Korea has increased in recent years. The aim of this study was to explore the factors related to increasing trends in cigarette smoking among adolescent males living in rural areas. METHODS: The raw data from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Multiple logistic regression models were used to explore the factors affecting cigarette smoking. We evaluated the linear time trends in the prevalence of factors that were related to current smoking status and the linear time trends in cigarette smoking in groups stratified by the exposure to each factor using logistic regression models. Finally, we examined the contributions of the factors to the time trends in cigarette smoking by adjusting for each of those factors in the baseline regression models and changes in the adjusted odds ratio by survey year. RESULTS: A statistically significant increasing trend in smoking was observed after adjusting for the factors affecting cigarette smoking. Significant factors related to cigarette use were perceived stress, experience with depression, current alcohol drinking, exposure to secondhand smoke, and academic performance. The factor related to increasing trends in cigarette smoking was academic performance. CONCLUSIONS: Stress about academic performance is an important factor affecting the increase in cigarette smoking among adolescent males in a rural area of Korea.
Assuntos
Fumar/epidemiologia , Adolescente , Comportamento do Adolescente , Consumo de Bebidas Alcoólicas , Depressão , Humanos , Internet , Modelos Logísticos , Masculino , Razão de Chances , Prevalência , Psicologia do Adolescente , República da Coreia/epidemiologia , Fatores de Risco , População Rural , Fumar/tendências , Poluição por Fumaça de TabacoRESUMO
OBJECTIVE: With the increased survival rate of cancer patients, positive changes in health behaviors, including smoking cessation, are becoming progressively more important. While studies in the general population have demonstrated the beneficial effects of high perceived support of smoking cessation and continuing abstinence, few studies have addressed such issues in cancer survivors. We examined the factors related to continued smoking among cancer survivors with specific attention given to the role of perceived social support. METHODS: A nationwide, multicenter survey was conducted with 1956 cancer patients. Smoking status at the time of diagnosis and at the time of survey, and perceived social support, as measured by the Duke-UNC Functional Social Support Questionnaire, were collected by self-reported questionnaire. RESULTS: Among 493 participants who were smoking at the time of cancer diagnosis, 131 (26.6%) were continued smokers at the time of survey. In a multivariate logistic regression analysis, current alcohol consumption (odds ratio, 3.29; 95% confidence interval, 1.91-5.65), early cancer stage (P(for trend)< 0.01), lung cancer diagnosis (odds ratio, 0.41; 95% confidence interval, 0.19-0.88), and high perceived social support (odds ratio, 0.59; 95% confidence interval, 0.37-0.96) showed significant associations with continued smoking. CONCLUSIONS: Cancer survivors with low perceived social support were more likely to continue smoking. Our study suggests that perceived social support may be an important factor for smoking cessation and maintenance of smoking cessation in this population.
Assuntos
Comportamentos Relacionados com a Saúde , Neoplasias/psicologia , Fumar/psicologia , Apoio Social , Sobreviventes/psicologia , Atitude Frente a Saúde , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Percepção , Prognóstico , Abandono do Hábito de Fumar , Inquéritos e QuestionáriosRESUMO
This study aims to examine the functional status of Korean centenarians, who have crossed the relatively rare but increasingly common life transition of living for a century. As functional health is one of the essential components of healthy aging, our primary objective is to identify the correlates of two aspects of functioning, activities of daily living (ADL) and instrumental activities of daily living (IADL). Using a census survey conducted by the Korean National Statistical Office (KNSO) in 2005, we documented ADL and IADL limitations and analyzed their relationship to sociodemographic factors, health behaviors, social connectedness, and presence of diseases. The study participants were 796 adults aged 100 years or older. The mean age was 101.5 +/- 1.8, and females were 89.9% of the sample. Both ADL and IADL dependences were more common among females, those who did less physical activity, those who had more diseases, and those who did not participate in social activities. Intervention programs designed to address life-stage issues such as focusing on initiating healthy behaviors from youth, managing chronic diseases in mid-life, and fostering social participation in later life are recommended ways to improve functional independence and promote healthy aging among current and future generations of Korean centenarians.
Assuntos
Atividades Cotidianas , Idoso de 80 Anos ou mais , Envelhecimento , Pessoas com Deficiência/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Nível de Saúde , Humanos , Relações InterpessoaisRESUMO
BACKGROUND AND OBJECTIVES: This study was conducted to investigate the impact of polymorphisms in the AKT1 gene on the survival of early stage non-small cell lung cancer (NSCLC) patients. METHODS: Three hundred and ten patients with surgically resected NSCLC were enrolled. The rs3803300, rs1130214, rs3730358, rs1130233, and rs2494732 single nucleotide polymorphisms (SNPs) in the AKT1 gene were investigated. The genotype and haplotype associations with overall survival (OS) and disease free survival (DFS) were analyzed. RESULTS: The three SNPs (rs3803300, rs1130214, and rs2494732) were significantly associated with survival outcomes on multivariate analysis. When the three SNPs were combined, OS and DFS were decreased in a dose-dependent manner as the number of bad genotypes increased (P(trend) = <1.0 × 10(-4) and 0.001, respectively). Patients with 2 bad genotypes had a significantly worse OS and DFS compared with those with 0 bad genotypes (adjusted hazard ratio (HR) = 3.08, 95% confidence interval (CI) = 1.61-5.89, P = 0.001; and adjusted HR = 2.04, 95% CI = 1.22-3.43, P = 0.01). CONCLUSIONS: These results suggest that the AKT1 polymorphisms could be used as prognostic markers for the patients with early-stage NSCLC.