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Objectives@#The purposes of this study were to compare the degree of sodium reduction practice and estimate sodium intake by salty food preference. @*Methods@#Sodium reduction practices, salty food preferences and estimated sodium intake were surveyed for restaurant owners (n = 80), employees (n = 82) and customers (n = 727) at the restaurants participating in the sodium reduction project in Daegu, Korea. Estimated sodium intake was performed by examining sex, age, body mass index (BMI), salty eating habit and dietary behaviors. @*Results@#The degree of sodium reduction practice was significantly higher in salinity meter use (P < 0.001), low salt seasonings (P < 0.001) and efforts to make the foods as bland as possible overall (P < 0.001) in the restaurants participating in sodium reduction project than in homes (P < 0.001). The degree of sodium reduction practice appeared lower in the high salty food preference group than in the low-preference group in such items as efforts to make the foods as bland as possible overall (P < 0.05) and washing the salty taste and then cooking (P < 0.05). The high-preference group showed high-salt dietary behavior, including eating all the soup until nothing was left (P < 0.05) more than the low-preference group, but low-salt dietary behavior included checking the sodium content in processed foods (P < 0 .0 5) less than the low-preference group. The high-preference group was higher in the soup and stew intake frequency than the low-preference group (P < 0.05) and much lower in nuts (P < 0.05) and fruits (P < 0.05) intake frequency. The high-preference group had a higher salty eating habit (P < 0.05), salty taste assessment (P < 0.05) and estimated sodium intake (P < 0.05) than the low-preference group. @*Conclusions@#The present study showed that the salty food preference was strongly associated with lower sodium reduction practice and higher estimated sodium intake.
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Purpose@#To analyze the change in the weekly incidence of epidemic keratoconjunctivitis (EKC) per 1,000 outpatients during the coronavirus disease 2019 (COVID-19) pandemic by comparing the mean weekly proportion of EKC of 2020 with that from 2016 to 2019. @*Methods@#Using data from the Korea Disease Control and Prevention Agency for 2016-2020, we analyzed the weekly proportion of EKC per 1,000 outpatients. The data were also analyzed according to age, semester and vacation periods, region, and social distancing stages. For the Daegu data, we also analyzed the effects of social distancing in an area. @*Results@#The mean weekly proportion of EKC per 1,000 outpatients in 2020 was lower than in previous years for all ages (2016-2019 19.77 ± 7.17‰, 2020 7.28 ± 2.97‰; p < 0.001). During the semester, the mean difference between 2016-2019 and 2020 was significant, particularly for preschool children. In Daegu, the weekly proportion of EKC per 1,000 outpatients during the extra 12-18 weeks of social distancing was significantly lower (2016-2019, 18.78 ± 6.61‰; 2020, 8.94 ± 2.92‰; p < 0.001). @*Conclusions@#The public health interventions implemented during the COVID-19 outbreak not only reduced the prevalence of COVID-19 but also reduced the prevalence of EKC. Therefore, maintaining hygiene principles and standard precautions may help prevent EKC.
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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.
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Objectives@#The purpose of this manuscript was to propose the policy and perspectives of prevention and management for hypertension and diabetes in Korea. @*Methods@#Authors reviewed the chronic disease prevention and management projects and models were executed in Korea until now, and analyzed and evaluated their performances. @*Results@#In the circumstances of Korea, the following several requisites should be improved ; Specific Korean strategy for development and pursuing of national level policy agenda for chronic disease management must be established. There are a need to establish several means of supplementing the weaknesses of the current chronic disease management policies and programs. Firstly, development and distribution of contents of guidelines on the systematic project execution regime (regarding systematization of local community, subjects and contents of the projects) with guarantee for the quality of chronic disease prevention and management are necessary. Secondly, there is a need for development of information system that can lead the chronic disease management programs currently being implemented. Thirdly, there is urgent need to develop resources such as cultivation of manpower and facilities for provision of education and consultation for the patients and holders of risk factors of chronic disease. Fourthly, there is a need for means of securing management system and financial resources for operation of policies and programs. @*Conclusions@#The results can be able to use as a road map, models, and direction and strategies of policies for chronic disease prevention and management of Korea.
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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 questionnairewas 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 analysiswas 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 (p = .001 and p < .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. CONCLUSIONS: 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.
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Humanos , Doenças Transmissíveis , Doenças Transmissíveis Emergentes , Coronavirus , Infecções por Coronavirus , Surtos de Doenças , Emergências , Hospitais Públicos , Intenção , Coreia (Geográfico) , Cuidados de Enfermagem , Enfermagem , Profissionalismo , Estresse PsicológicoRESUMO
Unhealthy lifestyle behaviors such as smoking, alcohol consumption, and physical inactivity (multiple risks) often lead to serious health consequence and impaired health status. The purpose of this study was to investigate the trend in health-related behavioral factors over time among adults in South Korea (hereafter Korea). The data of 1,595,842 Koreans older than 19 years who participated in the 2008-2014 Korea Community Health Survey were analyzed to assess the trend in the prevalence of behavioral risk factors. Individual or clustering health-related behaviors were assessed according to sex, age, and region among 228,712 adults who participated in the 2014 survey. From 2008 to 2014, the age-adjusted prevalence of obesity and high-risk alcohol use increased the prevalence of male current smoking and marginally decreased walking ability. Over 7 years, the percentage of adults who reported having all three healthy behaviors (i.e., currently not smoking, not consuming alcohol or having high-risk alcohol use, and engaging in walking) decreased from 35.2% in 2008 to 29.6% in 2014. Increased efforts to emphasize multiple health-related behavioral risk factors, including reducing alcohol use and smoking, and to encourage walking are needed in the thirties and forties age groups in Korea.
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Adulto , Humanos , Masculino , Consumo de Bebidas Alcoólicas , Inquéritos Epidemiológicos , Coreia (Geográfico) , Estilo de Vida , Obesidade , Prevalência , Fatores de Risco , Fumaça , Fumar , CaminhadaRESUMO
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.
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Adolescente , Humanos , Masculino , Comportamento do Adolescente , Psicologia do Adolescente , Consumo de Bebidas Alcoólicas , Depressão , Internet , Modelos Logísticos , Razão de Chances , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , População Rural , Fumar/epidemiologia , Poluição por Fumaça de TabacoRESUMO
This study attempted to calculate and investigate the incidence of hospitalized acute myocardial infarction (AMI) and stroke in Korea. Using the National Health Insurance claim data, we investigated patients whose main diagnostic codes included AMI or stroke during 2006 to 2010. As a result, we found out that the number of AMI hospitalized patients had decreased since 2006 and amounted to 15,893 in 2010; and that the number of those with stroke had decreased since 2006 and amounted to 73,501 in 2010. The age-standardized incidence rate of hospitalized AMI, after adjustment for readmission, was 41.6 cases per 100,000-population in 2006, and had decreased to 29.4 cases in 2010 (for trend P < 0.001). In the case of stroke was estimated at 172.8 cases per 100,000-population in 2006, and had decreased to 135.1 cases in 2010 (for trend P < 0.001). In conclusion, the age-standardized incidence rates of both hospitalized AMI and stroke in Korea had decreased continuously during 2006 to 2010. We consider this decreasing trend due to the active use of pharmaceuticals, early vascular intervention, and the national cardio-cerebrovascular disease care project as the primary and secondary prevention efforts.
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Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Doença Aguda , Fatores Etários , Hospitalização/tendências , Incidência , Infarto do Miocárdio/epidemiologia , Readmissão do Paciente , República da Coreia/epidemiologia , Fatores Sexuais , Acidente Vascular Cerebral/epidemiologiaRESUMO
OBJECTIVES: This study was conducted to observe recent changes in adolescents' dietary behavior and indirectly evaluate the effects of the government's nutritional policies in Korea. METHODS: We analyzed the secular trends in seven dietary behaviors using the Korea Youth Risk Behavior Web-based Survey data from 2005 to 2009. Through literature review, we included the policies implemented for the improvement of adolescents'dietary behaviors during the same periods. RESULTS: The significant linear trends were observed in all dietary behaviors (p<0.05). Overall, all behaviors except the fruit intake rate were desirably changed during five years but undesirable changes were observed between 2008 and 2009 in all behaviors. Within those periods, several policies were implemented including 'Ban on carbonated-beverages in school', 'Green Food Zone', etc. Despite confirmed evidence of their effects, the policies on individual behavior such as nutrition education didn't influence the prevalence of dietary behaviors because they were conducted to too limited persons. Polices on the school environmental improvement, such as ban on carbonated beverage in school, were more effective because they decreased the exposure of undesirable food environment. However, for effect of Green Food Zone improving community environment we couldn't come to a conclusion because of too short period after full implementation. CONCLUSIONS: Among government nutrition policies conducted from 2005 to 2009, those on environmental improvement, especially in school, were more effective than those on individual behavior. Therefore, the development and implement of policies on school environmental improvement are needed in Korea.
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Adolescente , Feminino , Humanos , Masculino , Comportamento do Adolescente , Política Ambiental , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Coreia (Geográfico) , Modelos Lineares , Política NutricionalRESUMO
OBJECTIVES: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. METHODS: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. RESULTS: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. CONCLUSIONS: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.
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Idoso , Criança , Humanos , Cuidadores , Características da Família , Imunização , Programas de Imunização , Coreia (Geográfico) , Modelos Logísticos , Sarampo , Mycobacterium bovis , Pais , Poliomielite , Atenção Primária à Saúde , Tétano , Vacinação , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To survey the awareness of patient to scrub typhus to provide data for education and communication concerning scrub typhus. METHODS: Patients with scrub typhus (case group, n=299) and people without scrub typhus within the previous 2 years (control group, n=598) were matched for age (within 5 years), gender, and occupation (farmer or non-farmer). The participants were recruited from 15 study areas between October and December 2006. RESULTS: The awareness rate of scrub typhus was 75.1%, and was significantly higher than in the case group (79.4% vs. 66.6%, respectively; p<0.01). The major routes of awareness were from 'past history of scrub typhus in family members or neighbors' (54.9%), 'television' (28.3%), and their past history of scrub typhus (5.5%). The average correct rate of scrub typhus was 48.4%, and the correct response rate of cases was significantly higher than controls (p<0.01). Especially, the correct rate of etiology, incubation period, route of transmission, and acquired immunity was <40%. Through conditional logistic regression test, the factor significantly associated with awareness in case group was age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94-0.98). And the factors associated with awareness in control group were female (OR, 1.56; 95% CI, 1.03-2.36) age (OR, 0.98; 95% CI, 0.96-0.99), family history of scrub typhus (OR, 10.18; 95% CI, 1.37-75.99), history of receiving prevention education (OR, 8.47; 95% CI, 1.14-63.00). CONCLUSIONS: The rate of awareness was relatively low in study population. Thus, effective working guidelines and educational program to prevent scrub typhus must be developed, and publicity activities about the prevention of scrub typhus are needed for high-risk groups.
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Feminino , Humanos , Imunidade Adaptativa , Coreia (Geográfico) , Modelos Logísticos , Ocupações , Tifo por ÁcarosRESUMO
OBJECTIVES: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. METHODS: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. RESULTS: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. CONCLUSIONS: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.
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Criança , Pré-Escolar , Feminino , Humanos , Política de Saúde , Imunização/estatística & dados numéricos , Programas de Imunização/normas , Coreia (Geográfico)RESUMO
OBJECTIVES: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. METHODS: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. RESULTS: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. CONCLUSIONS: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.
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Feminino , Humanos , Encéfalo , Comorbidade , Pessoas com Deficiência , Emprego , Hospitais Gerais , Habitação , Seguro Saúde , Modelos Logísticos , Estado Civil , Medicina Tradicional do Leste Asiático , Saúde Pública , Centros de Reabilitação , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea. METHODS: The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender. RESULTS: Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly. CONCLUSIONS: Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.
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Adolescente , Feminino , Humanos , Masculino , Comportamento do Adolescente/psicologia , Prevalência , Inquéritos e Questionários , República da Coreia , População Rural , Fumar/epidemiologia , População UrbanaRESUMO
No abstract available.
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Imunização , Programas de Imunização , Coreia (Geográfico) , VacinaçãoRESUMO
Stroke is the most common cause of death as single-diseases in South Korea. And it generates additional medical cost through high incidence of related disabilities and complications, which would become more important with the rapid aging process in Korean society. This study was preformed to identify stroke patients' mortality and its associated factors. Patients diagnosed as stroke (ICD-10 code I60-I63) in 2003 were identified. Their follow-up mortality rate in 5 years and related factors (stroke type, sex, age, type of first admission hospital, comorbidity score) were analyzed using national health insurance claim data and national cause of death statistics. The mortality rate peaked in early days after attack, and decreased subsequently as the survive time gets longer. The mortality rate was higher in hemorrhagic stroke than ischemic stroke, in female than male, with the older age, and with the higher comorbidity score. It is recommended that the early intervention at general hospital or tertiary referral hospital should be promoted to decrease the mortality rate in stroke patients, and related quality assurance programs have to be enforced.
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Feminino , Humanos , Masculino , Envelhecimento , Causas de Morte , Comorbidade , Intervenção Educacional Precoce , Seguimentos , Hospitais Gerais , Incidência , Programas Nacionais de Saúde , República da Coreia , Acidente Vascular Cerebral , Centros de Atenção TerciáriaRESUMO
BACKGROUND: Depression is a common comorbid condition in patients with coronary artery disease and a well-documented risk factor for recurrent cardiac events and mortality. We examined the impact of percutaneous coronary intervention (PCI) on depressive mood in elderly patients with chronic stable angina. METHODS: Consecutive patients with chronic stable angina (n=171) who had undergone elective PCI from January 2010 to May 2010 were included in this study. Patients were divided into elderly (> or =65 years) and non-elderly groups (<65 years) and then completed the 21-item Beck Depression Inventory I (BDI-I) at baseline and prior to discharge to assess for depressive symptoms. RESULTS: Seventy-three (43%) patients were assigned to the elderly group and 98 (57%) to the non-elderly group. Using multivariate regression analysis, we found that the elderly group had a higher prevalence of joint, lung, and gastrointestinal diseases; were less religious and less likely to be employed; had lower rates of private health insurance; and were, less frequently, users of regular alcohol, current smokers, and regular exercisers compared to the non-elderly patients. The mean difference in BDI-I scores at baseline and pre-discharge was higher in elderly patients. CONCLUSION: Our study showed a correlation between the extent of depression and elective PCI, especially in elderly patients. This population should be assessed routinely for depressive symptoms and managed accordingly.
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Idoso , Humanos , Angina Estável , Angioplastia , Doença da Artéria Coronariana , Depressão , Articulações , Pulmão , Intervenção Coronária Percutânea , Prevalência , Fatores de RiscoRESUMO
The healthy cities approach emphasizes the role of the leadership of local governments in promoting the health of the population in city settings. The concept emerged from public health strategies declared in the Ottawa Charter for Health Promotion, and reflects the characteristics of the third public health revolution. The Korean healthy cities movement, characterized by voluntary participation of local governments in the Alliance for Healthy Cities, has grown rapidly in recent years. A strong push of the healthy cities movement by a local government without a profound commitment to the vision may hinder the effective and sustainable development of the movement. By reviewing the historical background and significance of the healthy cities movement and its underlying concepts, and illustrating the main strategies and goals of the movement, that is, the development of partnerships, community participation and empowerment, and working in networks for stimulating change, this article argues that the healthy cities movement is a potent vehicle for implementing the new paradigm of public health introduced to local governments. We also argue that the Korean healthy cities movement needs more active participants and more support of the central government and other related stakeholders.
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Participação da Comunidade , Promoção da Saúde , Coreia (Geográfico) , Governo Local , Recursos Naturais , Poder Psicológico , Saúde Pública , Visão OcularRESUMO
BACKGROUND: This study was conducted to evaluate the factors affecting medication adherence in geriatric diabetic patients treated at private clinics and tertiary hospitals. We compared the factors affecting medication adherence between these two patient groups. METHODS: We included 108 diabetic patients older than 65 years treated at one tertiary hospital and 157 patients older than 65 years treated at two private clinics. We conducted an interview survey based on the Health Belief Model, and used a questionnaire that included the self-efficacy variable. For the medication adherence, Morisky's self-report was used. RESULTS: The medication adherence based on Morisky's self-report was significantly higher in tertiary hospital patients (61.1%) compared to private clinic patients (43.2%) (P < 0.01). The results showed that drug storage and self-efficacy were factors affecting adherence to medication in tertiary hospital patients (P < 0.05). The adherence was high in cases of proper drug storage (odds ratio [OR], 5.401) and in cases with high self-efficacy (OR, 13.114). In private clinic patients, financial level (P < 0.05), recognition of the seriousness of diabetes complications (P < 0.05) and self-efficacy (P < 0.01) were associated with medication adherence. The medication adherence was significantly lower in patients whose financial state were moderate than those with lower (OR, 0.410), and medication adherence was significantly higher in patients who had higher perceived severity (OR, 2.936) and in patients with higher self-efficacy (OR, 4.040). CONCLUSION: Different strategies should be used to increase medication adherence in geriatric diabetic patients, depending on institutions whether they are treated.
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Idoso , Humanos , Complicações do Diabetes , Diabetes Mellitus , Armazenamento de Medicamentos , Adesão à Medicação , Centros de Atenção Terciária , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: The purpose of this research was to evaluate the ability of completing death certificates among medical students. METHODS: The self-administered questionnaires were completed, during May to August 2007, by 380 medical students in senior. The questionnaire was composed of 10 cases to write the death certificate. The cause-of-deaths written by students were compared with the gold standards and their errors in the certificates also evaluated. RESULTS: Mean agreement score for 10 underlying cause-of-deaths completed on the lowest line of part I in the death certificate (UC1) was 4.8+/-1.7, and for underlying cause-of-death selected by a coder of the death certificates (UC2) was 5.6+/-1.5. The UC1 and UC2 were significantly higher among the students having the case-oriented education for death certificate than others. For the major errors in the certificates completed by students, the students having the error with no antecedent cause were highest, the error with two or more conditions secondly highest. Mean number of errors was significantly lower in the case-oriented education group than others. CONCLUSIONS: Errors are common in the death certificates completed by medical students in senior. The accuracy of death certification may be more improved with the case-oriented education than the traditional method.