This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview survey performed by the korean Institute of Health & social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions; There were more elderly people over the age of 65; unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionally, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.
Aged ; Causality ; Education ; Health Resources ; Humans ; Inpatients ; Korea* ; Length of Stay ; Marital Status ; Models, Statistical ; Primary Health Care ; Public Health ; Sample Size

The widespread pursuit for the thin physique may have detrimental impact on the wellbeing of the young generation, especially females. This study aimed to determine the effect of wanting very low body weight on dietary habits and psychological factors of female adolescents. Participants were 619 girls from 5 high schools in Kyeonggi, Korea. Information on dietary behaviors, psychological factors as well as current heights and weights and the desired weight for current height were obtained by questionnaire. Of total subjects, 38.1%, 35.5%, and 26.5% desired weights corresponding to normal (10~85 percentile), low (3~10 percentile) and very low BMI (< 3 percentile), respectively. The subjects who wanted to be very low weight had the average BMI of 18.57 kg/m2, which was significantly lower than 21.21 kg/m2 of those who wanted to be normal weight (p < 0.001). The subjects who desired very low weight had significantly higher scores for depression symptoms (p < 0.05), while there were no differences in obsession to lose weight and obesity stress. Moreover, more subjects in this group had undesirable dietary habits such as eating fast foods more than weekly (p < 0.05). These findings suggest that the desire for extreme thinness may lead female adolescents to have not only unreasonably similar obesity stress and obsession to lose weight but also higher depression symptoms, along with undesirable dietary habits. The findings suggest the potential harm from excessive weight concerns of female adolescents; thus efforts to teach this group about healthy weights are urgently needed.
Adolescent ; Body Mass Index ; Body Weight ; Depression ; Eating ; Fast Foods ; Female ; Food Habits ; Humans ; Korea ; Obesity ; Obsessive Behavior ; Overweight ; Surveys and Questionnaires ; Thinness ; Weights and Measures

BACKGROUND: As Korea advances into the ageing society, the number of elderly person receiving dialysis has increased. Two-year survival rate of the patients who received hemodialysis was 84.2% in 1996. But there is no estimate on the survival rate of the patients over age 65. Elderly persons are more prone to have dialysis complications and have more problems in cardiovascular system. The following is a 5-year-study on the elderly ESRD patients who underwent hemodialysis. METHODS: In this retrospective study, 825 patients had received hemodialysis at Seoul Paik Hospital from Jan. 1997 to Dec. 2002. The elderly group was consisted of 35 patients over age 65 and the non-elderly group was consisted of 43 patients below age 65 who received hemodialysis. And they had been traced for more than six months. The patient`s age, sex, occupation and whether the patient was married or not, had been compiled. Also taken into consideration was etiology, complications, initial laboratory data, electrocardiography, abdominal sonography, echocardiography, ftmndus examination, cause of death. RESULTS: Average age of the elderly and the non-elderly group was 70.1 and 47.4 years(p<0.00). nd parathyroid hormone were different between the two groups(p<0.05), other laboratory data were not. Prevalence of diabetes mellitus and hypertensive nephrosclerosis were not either. The overall 1, 2, 5 year survival rate was 97.3%, 93.4%, 73.7%. And the 5-year survival rate was 88.6% in the non-elderly group and it was 54.1% in the elderly group(Kaplan-Meier method). Causes of death were sepsis(n=3), cerebrovas cular accident(n=2), myocardial infarction, pneumonia and gastrointestinal bleeding, malignancy, withdrawal of treatment(1 patient respectively) in the elderly group and were myocardial infarction, withdrawal of treatment in the non-elderly group(n=2). CONCLUSION: The 5-year survival rate of the elderly patients was lower than the non-elderly(p<0.001). The contributing factor of death was not etiology but cormobid condition according to ageing process and socioeconomic circumstance. In other words, it was cardiovascular disease, infection due to impaired immune system and withdrawal of treatment due to economic problems. So it would be necessary to monitor carefully these factors for the elderly hemodialysis patients to improve survival..
Aged* ; Cardiovascular Diseases ; Cardiovascular System ; Cause of Death ; Diabetes Mellitus ; Dialysis ; Echocardiography ; Electrocardiography ; Hemorrhage ; Humans ; Immune System ; Kidney Failure, Chronic ; Korea ; Myocardial Infarction ; Nephrosclerosis ; Occupations ; Parathyroid Hormone ; Pneumonia ; Prevalence ; Renal Dialysis* ; Retrospective Studies ; Seoul ; Survival Rate

Strange attractor can be constructed from time series data such as heart sound. In the areas of the recognition and diagnosis of abnormal heart sounds, signal presentation method is very useful because good features can be detected from good presentation. This paper examines efficiency in diagnosing abnormal heart sounds of the two different methods for constructing attractor. Nine different heart sounds from typical clinical conditions were used for this study. The first method was constructing attractors using original heart sounds, and the second was modifying the original sounds by autocorrelation and they were then applied to the orignal sounds as to cross correlation checks. Attractors could be constructed using signals generated by these methods, and values of fractal dimensions would then be calculated which has been a well known method to measure characteristics of attractors. The results showed that the second method appeared to provide more efficient way to correctly classify abnormal heart sounds.
Diagnosis ; Fractals* ; Heart Sounds* ; Heart*

Purpose: The purpose of this study was to investigate interpersonal competence and social support and their mediating effects on the relationship between caring efficacy and empathy in nursing students. Methods: This study used a cross-sectional design. Data collection was conducted from February 5 to February 12, 2019, from 254 students enrolled in the Department of Nursing in Jeollabuk-do and Chungcheongbuk-do. Data analysis was conducted using the SPSS/WIN 21.0 program. Results: As a result of verifying the mediating effects of social support and interpersonal competence on the relationship between the empathy ability and caring efficacy of nursing college students, it was found that social support and interpersonal competence partially mediated the relationship between the two variables (Z=1.68, p=.046). Conclusion Through this study, a theoretical basis was provided that when applied to an educational program could improve nursing students' caring efficacy. Content that can improve not only empathy but also social support and interpersonal competence should be included.

Purpose: The purpose of this study was to investigate interpersonal competence and social support and their mediating effects on the relationship between caring efficacy and empathy in nursing students. Methods: This study used a cross-sectional design. Data collection was conducted from February 5 to February 12, 2019, from 254 students enrolled in the Department of Nursing in Jeollabuk-do and Chungcheongbuk-do. Data analysis was conducted using the SPSS/WIN 21.0 program. Results: As a result of verifying the mediating effects of social support and interpersonal competence on the relationship between the empathy ability and caring efficacy of nursing college students, it was found that social support and interpersonal competence partially mediated the relationship between the two variables (Z=1.68, p=.046). Conclusion Through this study, a theoretical basis was provided that when applied to an educational program could improve nursing students' caring efficacy. Content that can improve not only empathy but also social support and interpersonal competence should be included.

Background: Th17 cytokines such as interleukin-17 and interleukin-22 are expressed in atopic dermatitis lesions. Previous studies have reported increased levels of interleukin-17A, -17E, and -17F in patients with atopic dermatitis.As interleukin-17A, -17E and -17F act through a common receptor composed of interleukin-17RA, it is speculated that interleukin-17RA gene (IL17RA) mutation could affect the clinical characteristics of atopic dermatitis. Objective: This study aimed to characterize the clinical features of atopic dermatitis according to the presence of an IL17RA mutation in patients with atopic dermatitis. Methods: We performed reverse blot hybridization assay to detect IL17RA mutations in Korean patients with atopic dermatitis. The clinical features of atopic dermatitis were compared between atopic dermatitis patients with and without IL17RA mutation. Results: Of 332 patients with atopic dermatitis, 27 (8.1%) were found to have IL17RA mutation compared to 8 of 245 controls without atopic diseases (3.27%), which was statistically significant. Furthermore, 272 of atopic dermatitis patients (81.9%) had extrinsic type atopic dermatitis and 60 (18.1%) had intrinsic type. All patients with IL17RA mutations had extrinsic type. In addition, atopic dermatitis with IL17RA mutation was associated with longer disease duration, more frequent keratosis pilaris, higher blood eosinophil count, higher serum total immunoglobulin E level, higher house dust mite allergen-specific immunoglobulin E levels, and more need for systemic treatment than that in patients without IL17RA mutation. Conclusion IL17RA mutation is associated with the more severe extrinsic type atopic dermatitis. So, it may predict the progress to severe atopic dermatitis.

Background: Th17 cytokines such as interleukin-17 and interleukin-22 are expressed in atopic dermatitis lesions. Previous studies have reported increased levels of interleukin-17A, -17E, and -17F in patients with atopic dermatitis.As interleukin-17A, -17E and -17F act through a common receptor composed of interleukin-17RA, it is speculated that interleukin-17RA gene (IL17RA) mutation could affect the clinical characteristics of atopic dermatitis. Objective: This study aimed to characterize the clinical features of atopic dermatitis according to the presence of an IL17RA mutation in patients with atopic dermatitis. Methods: We performed reverse blot hybridization assay to detect IL17RA mutations in Korean patients with atopic dermatitis. The clinical features of atopic dermatitis were compared between atopic dermatitis patients with and without IL17RA mutation. Results: Of 332 patients with atopic dermatitis, 27 (8.1%) were found to have IL17RA mutation compared to 8 of 245 controls without atopic diseases (3.27%), which was statistically significant. Furthermore, 272 of atopic dermatitis patients (81.9%) had extrinsic type atopic dermatitis and 60 (18.1%) had intrinsic type. All patients with IL17RA mutations had extrinsic type. In addition, atopic dermatitis with IL17RA mutation was associated with longer disease duration, more frequent keratosis pilaris, higher blood eosinophil count, higher serum total immunoglobulin E level, higher house dust mite allergen-specific immunoglobulin E levels, and more need for systemic treatment than that in patients without IL17RA mutation. Conclusion IL17RA mutation is associated with the more severe extrinsic type atopic dermatitis. So, it may predict the progress to severe atopic dermatitis.

BACKGROUND: The genetic and environmental factors involved in the development of obesity and several candidate genes have been suggested to have an influence on energy and fuel metabolism. However, the specific genetic defects responsible for human obesity have not been identified yet. It is likely that a combination of polymorphisms in one or more candidate genes may affect energy metabolism and the development of obesity. We performed this study to determine the role of 45 bp insertion in the uncoupling protein (UCP)2 exon 8 and Trp64Arg polymorphism of beta3-adrenergic receptor ( 3-AR) gene in the regulation of body weight and the pattern of fat distribution. METHODS: In 114 subjects (male: 40, female: 74, mean body mass index: 24.1+/-2.7 kg/m2, 80 subjects with normal glucose tolerance, 34 subjects with impaired glucose tolerance), body fat distribution patterns were assessed by anthropometric measurement, bioelectric impedance analysis and computed tomogram. The genotypes of UCP genes were determined by polymerase chain reaction (PCR), and mutation in 3-AR gene by PCR followed by enzymatic digestion. RESULTS: In UCP2 genes, the frequency of deletion homozygote (DD) was 59.4%, heterozygote (DI) was 3.5% and insertion homozygote (II) was 3.1% Meanwhile, in 3-AR, the frequency of TrpTrp was 67.9%, TrpArg was 29.5% and ArgArg was 2.7%. In the lean group (subjects with a BMI less than 25 kg/m2), the frequencies of insertion allele and Arg64 allele were not significantly different than those among the overweight subjects (BMI > or = 25 kg/m2). There was not significant difference in clinical, biochemical or body fat distribution patterns between the groups according to UCP2 polymorphism. In the case of the polymorphism in 3-AR gene, the subjects with ArgArg homozygotes had lower HDL-cholesterol level (p<0.05). For the individuals over 40 years of age, BMI was greater among those with the deletion homozygotes and Arg64 allele, as compared to other groups according to the combination of UCP2 and 3-AR genotypes (p<0.05). CONCLUSION: These results suggest that genetic variations in UCP2 and 3-AR can synergistically affect metabolic rate and susceptibility to weight gain, thereby and contribute to the change in body weight in later life.
Adult* ; Alleles ; Body Fat Distribution ; Body Mass Index ; Body Weight ; Digestion ; Electric Impedance ; Energy Metabolism ; Exons ; Female ; Genetic Variation ; Genotype ; Glucose ; Heterozygote ; Homozygote ; Humans ; Metabolism ; Obesity* ; Overweight ; Polymerase Chain Reaction ; Weight Gain