PURPOSE: The purpose of this study is to identify levels of quality of health-related life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas. METHODS: The subjects of this study were vulnerable elders aged 65 or higher receiving visiting health care benefits by a public health center in a county. RESULTS: Levels of health-related EQ-5D were high when the subjects were males, their ADL and IADL were high. The EQ-5D of the vulnerable elders and social supports had a positive correlation, while their IADL and depression had a negative correlation with the EQ-5D. We can see that the EQ-5D related factors are variables that have significance influence on gender, subjective health status, BMI, IADL, depression levels, and social support. CONCLUSION: To improve the EQ-5D of the vulnerable elderly, it needs maintenance of independent IADL levels, social supporting systems using small meeting of the elderly in community. It is necessary to maintain independent IADL levels, enhance social supporting systems including small group gatherings for elders living alone by means of places like community halls, and develop specific intervention programs for the prevention and management of depressive elders.
Activities of Daily Living ; Aged ; Delivery of Health Care ; Depression ; Health Services ; House Calls ; Humans ; Male ; Public Health ; Quality of Life

OBJECTIVES: To estimate the demand and demand-supply balances of occupational and environmental medical specialties (OEMS) in the target year of 2020. METHODS: We adopted a new OEMS demand model based on the situations of periodic workers' health examination (PHE) agencies, health management agencies (HMA), and legal enforcement for health and safety systems in Korea. The model uses data selected primarily from the database of the Korean Society of Occupational and Environmental Medicine (KSOEM), a survey for certified members of KSOEM, statistics and internal documents from the Ministry of Employment and Labor (MOEL). RESULTS: From the data and assumptions, newly demanded OEMS were 193 for workers who had received PHE, and 205 based on total workers for PHE in 2020 for PHE. But no OEMS for HMA area is demanded. Comparing with the calculated numbers of supply estimates, the demand was slightly higher, but could be balanced if MOEL kept consistent and unchanging policies. CONCLUSIONS: The study results suggest that the demand-supply balance of OEMS is mainly influenced by the policy of MOEL. Further studies are needed examining more detailed data and statistics about PHE agencies, HMA and considering MOEL policies are needed to configuring more sophisticated and need-included estimation.
Employment ; Environmental Medicine ; Health Manpower ; Health Services Needs and Demand ; Korea ; Occupational Medicine ; Public Policy

OBJECTIVES: To estimate the supply of occupational and environmental medicine specialties in the target year of 2020. METHODS: We adopted alternative projection models combined with a demographic method as a supply forecasting method. The model uses data selected primarily from the database of the Korean Society of Occupational and Environmental Medicine (KSOEM), a survey for certified members of KSOEM, audit data from the Ministry of Employment and Labor (MOEL) and Hospital Accreditation. We assumed five viable alternatives in supply forecasting. RESULTS: Depending on the assumptions, the total occupational and environmental medicine specialties supply ranged from 706 by low-level supply estimates to 754 by high-level supply estimates in 2020. Among them, approximately 81% were estimated to engage themselves in agency for health management and periodic health examinations for workers exposed to hazards. CONCLUSIONS: The study results suggest that the supply of occupational and environmental medicine specialties is related to the policy of MOEL. Further studies are needed concerning overall policy about health and safety and for the newly demanded market.
Accreditation ; Employment ; Environmental Medicine ; Forecasting ; Korea

PURPOSE: The purpose of this study was to investigate the influence of ego-resilience and self-efficacy on satisfaction in major of nursing student. METHOD: Data were collected from 275 nursing students by means of self reported questionnaires about ego-resilience, self-efficacy and satisfaction in major from December 3 to 20, 2012. RESULTS: There were positive correlations between ego-resilience, self-efficacy and satisfaction in major. The optimistic attitude in ego-resilience (beta=.56, p<.001), an associate's degree (beta=.38, p<.001), suitable to aptitude (beta=.17, p<.001), social self-efficacy (beta=.14, p=.039) and high employment rate (beta=.12, p=.033) were significant predictors of satisfaction in major. CONCLUSION: It is necessary to develop an effective intervention program to improve nursing student's ego-resilience, self-efficacy and satisfaction in major of nursing student.
Aptitude ; Employment ; Humans ; Nursing ; Personal Satisfaction ; Surveys and Questionnaires ; Self Efficacy ; Self Report ; Students, Nursing*

In medicine and public health areas, it is essential for researchers and clinicians to investigate causal relationships dealing with the terms of cause, causation and causality. In treating a patient, the treatment will be given based on the assumption that that treatment will cause an improvement or cure of the patient. For diagnosis, we need a causation concept to associate diseases with etiologic factors such as genetic, environmental, occupational and other components. The prevention and intervention of a disease involve the selecting process of probable causal factors too. The causal problem is one of main issues in philosophy since ancient Greek. Aristotle theorized material, formal, efficient, and formal causes. Francis Bacon and Descartes mainly used induction and deduction, respectively. Hume denied the capacity of inductive methodologies to find truth. Among philosophers of science, the debates whether we can find objective truth or not will be continued. This causation can be two subsets, ontological and epistemological (or methodological). Traditional philosophical approaches mainly focus on ontological problems, such as what is causation?; are there causal laws? In general, scientific or epidemiological approaches are dealing with the epistemological dimension, i.e, causation criteria; test for a causal hypothesis. For clinicians and researchers in medical and public health, it would be a good chance to review and re-think the notions of cause, causation and causality. Also there will be helpful understanding of more detail informations about the methodology such as causal inference, Hill's criteria and Rothman's causal pie model.
Diagnosis ; Epidemiology* ; Humans ; Jurisprudence ; Philosophy ; Public Health

The context of specific criteria for the recognition of occupational diseases (ODs) due to physical agents in the Enforcement Decree of the Industrial Accident Compensation Insurance Act (ED-IACIA) and the Labor Standard Act (LSA) does not describe definite disease along with the agents but listed symptoms or obscure clinical conditions. Moreover, the needs for an amendment of these Acts have recently attracted renewed interest. To establish agreed criteria for compensable ODs due to physical agents, we reviewed the criteria for recognizing ODs on the basis of International Labor Organization (ILO) documents and European Union (EU) guideline. After providing a brief review of the history of OD outbreaks due to physical exposure in South Korea and the responses to them, we describe the basis for the recent amendments to the IACI Act and LSA and assess their appropriateness. On the basis of these findings, this study could be helpful for determining and compensating process of ODs. However, further work is required to ascertain the scientific relationship between diseases caused by physical agents and the exposure criteria.
Accidents, Occupational ; Humans ; Male ; Noise/*adverse effects ; Occupational Diseases/*economics ; Occupational Exposure/adverse effects ; Radiation Injuries/*economics ; Republic of Korea ; Vibration/*adverse effects ; Workers' Compensation/*economics

OBJECTIVES: Cancer has attracted worldwide attention. The incidence and prevalence are increasing, and it is the main cause of death. The purpose of this study was to identify the characteristics of hospitalized cancer patients. METHODS: This study is a secondary data study using the Korean National Hospital Discharge In-depth Injury Survey Data conducted annually by the Korea Centers for Disease Control and Prevention. Using these data, we extracted inpatients who principal diagnosis is cancer for nine years from 2005 to 2013. RESULTS: According to the analysis, the annual trend of cancer inpatients is steadily increasing. In 2025, it is expected to increase to about 670,000 inpatients. A cancer diagnosis created a change in medical utilization depending on the characteristics of patients and hospital. Men are more at risk of cancer than women. The number of hospital beds and hospital days were inversely proportional to cancer inpatients. There was also a difference in the equity of medical utilization by region. Other cancer management policies should be based on sex. CONCLUSION: Populations between the ages of 45 and 64 years should be a priority in cancer policy. Because of the long-term hospitalization of patients with death as the outcome, a terminal cancer patient care facility is needed. These conclusions can provide a basis for various health policies.
Cause of Death ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Female ; Health Policy ; Hospitalization ; Humans ; Incidence ; Inpatients* ; Korea* ; Length of Stay ; Male ; Mortality ; Patient Care ; Prevalence

BACKGROUND: An in-training examination is given annually to the all laboratory medicine residents of in Korea. The purpose of this study was to evaluate the results of the in-training examinations according to the examinees' postgraduate years, a number of teaching faculty members and hospital beds, and the score of the board examination. METHODS: A total number of examinees during the 5-year period from 2001 to 2005 were 311. All residents took the same in-training examinations given each year irrespective of the postgraduate year (PGY). RESULTS: The scores of in-training examinations increased with advance in the examinees' PGY (P<0.01). The scores were not different according to the size of teaching faculty or hospital beds (P>0.05). The correlation coefficients of each PGY scores were from 0.474 to 0.755 (P<0.01). The scores of the 4th PGY were correlated with those of the board examinations (r=0.627, P<0.001). CONCLUSIONS: These results suggest that the scores of the in-training examinations may be a valid measure of knowledge acquired by residents during their training years and provide a useful information for improving the laboratory medicine residency training program.
Education ; Internship and Residency* ; Korea

BACKGROUND: The KCl hypotonic treatment is important for swelling the cells and adequate spreading of chromosomes on the slide. Cytogenetic laboratory usually use 0.075M KCl solution. Sometimes, it is difficult to obtain enough and good quality of metaphase cells, because of inadequate hypotonic treatment. The purpose of this study was to evaluate the mitotic index and band resolution according to the different KCl concentration. METHODS: The group I included blood specimens obtained from 14 newborns (median age 1 day, range 1-8 days) and 4 cord blood. The group II included 16 persons whose median age was 28 years (1-37 years). The blood was cultured in RPMI 1640 medium with fetal calf serum and phytohemagglutinin for 72 hours. Mitosis was arrested by adding colcemid (100 ng/mL). The hypotonic treatment was done by adding different KCl concentration such as 0.075M, 0.068M and 0.057M for 30 minutes at 37 degrees C. The mitotic index was calculated as the number of metaphase cells per total 1,000 cells. The band resolution was evaluated by 2 persons independently. RESULTS: For group I, the mitotic index was not different according to the KCl concentration; 0.075M, 18.8 (5.5~31.5); 0.068M, 22.3 (11~32.5); 0.057M, 20.5 (2.5~29), (P=0.137). The proportion of cells with 400 or more band resolution was significantly higher in specimens treated with 0.068M KCl than those treated with 0.075M KCl; 0.075M, 67.8% (56~92.5); 0.068M, 73.6% (46.1~84.6); 0.057M, 71.6% (63~89.2), (P=0.027). For group II, the results were similar to those of group I. The mitotic index was as follows; 0.075M, 22.3 (5~28); 0.068M, 26 (4~34.5); 0.057M, 21.5 (2.5~36.5), (P=0.568). The proportion of cells with 400 or more band resolution was as follows; 0.075M, 66.6% (42.8~83.3); 0.068M, 69.7% (54.3~87.5); 0.057M, 68.2% (50~78.6) (P=0.04). CONCLUSIONS: For 0.068M or 0.057M KCl treatment, band resolution was improved, while the mitotic index was similar to that of 0.075M KCl. We suggest use of 0.068M or 0.057M KCl hypotonic treatment in addition to 0.075M KCl for chromosome preparation of peripheral blood.
Cytogenetics ; Demecolcine ; Fetal Blood ; Humans ; Infant, Newborn ; Metaphase ; Mitosis ; Mitotic Index*

Background: Mental illness is known to be caused by genetic, biological, and environmental risk factors. Although previous studies have established the link between mental illness and job stress, most of them are limited to major depression disorder. Therefore, this study examined the relationship between job stress and bipolar spectrum disorder (BSD). Methods: This is a cross-sectional study based on a survey conducted in April 2017 at an electronic parts manufacturing company in Busan. In a total of 441 workers, the degree of BSD was identified using the Korean version of the Mood Disorder Questionnaire, and the degree of job stress was identified using the Korean Occupational Stress Scale Short Form.This study also identified general characteristics of workers and job-related factors. The χ2 test and Fisher's exact test was conducted to determine the differences among the variables, based on BSD. Multiple logistic regression analysis was conducted to determine the influence of independent variables on BSD. Results: Cross-analysis showed significant differences between the BSD high-risk and lowrisk groups regarding age, sex, occupation, smoking, problem drinking, job stress total score, occupational climate, and major depression disorder symptom. In addition, the significant differences between the BSD high-risk and low-risk groups about job stress were observed in terms of job demand, job insecurity, and occupational climate. A multiple logistic regression analysis revealed that the high-risk group in the job stress group had a higher effect on BSD than the low-risk group (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.10–4.88). Among the categories of job stress, high-risk groups in 3 areas—job demand (OR: 2.56, 95% CI: 1.27–5.17), job insecurity (OR: 4.42, 95% CI: 1.19–16.42), and occupational climate (OR:2.55, 95% CI: 1.29–5.05)—were more likely to have an impact on BSD than the low-risk groups. Conclusions This study demonstrated that the high-risk groups of job stress total score, job demand, job insecurity, and occupational climate had a more significant effect on BSD than the low-risk groups. As workers with BSD may have difficulties in their work and personal lives, there is a need to manage job stress to prevention of BSD.