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JPMPH : Journal of Preventive Medicine and Public Health

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Volume 24(2); June 1991
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Original Articles
Tracking of blood pressure during childhood.
Soon Young Lee, Il Seo, Jeung Mo Nam
Korean J Prev Med. 1991;24(2):161-170.
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AbstractAbstract PDF
The purpose of this study is to find the tracking blood pressure in primary school-age children. A follow-up study was conducted from 1986 to 1990 on 330 first grade children attending primary schools in Kangwha County, Kyungki-Do. Basically we employed a linear regression model with random coefficients to figure out the relation between blood pressure changes and initial blood pressure. We obtained the following results; 1. The mean blood pressures were increased grade went up in both sexs and were generally higher in female than male except for the systolic blood pressure at first grade. The size of difference was about 0.8 mmHg in mean systolic blood pressure and 1.5 mmHg in mean diastolic blood pressure. 2. The average annual increasing rates of systolic blood pressure were 2.5 mmHg in male and 3.1 mmHg in female respectively. For the diastolic blood pressure IV the average annual increasing rates were observed to be 3.0 mmHg in male and 2.9 mmHg in female respectively. Increasing rate of systolic blood pressure was significantly higher in female than male. 3. The adjusted regression coefficient of systolic blood pressure change on initial value was -0.11 in male and -0.13 in female and that coefficient of diastolic blood pressure change on initial value was -0.01 in male and -0.11 in female. This result shows that children with higher initial blood pressure do not pick up their blood pressure faster than others with lower initial blood pressure. There is no evidence of tracking of blood pressure in children. It is essential to find the earliest age having the tracking of blood pressure and we leave it for the further study.
Summary
A study on the productivity of physicians operating clinic in Kyeongsangnamdo.
Jeong Ho Kim, Kwi Won Jeong, Jin Ho Chun, Chae Un Lee, Ki Taek Pae, Kong Hyun Kim, Hae Rim Shin, Hyung Jong Park
Korean J Prev Med. 1991;24(2):171-180.
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AbstractAbstract PDF
Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionnaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The major results were as follows. First, physicians were more prevalent 35~44 group (38.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization, city (78.0%) in geographical location. Age group of 35-54 and specialist were more prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatient load of all physician were 77.1 persons on average. Age group of 35~44 had the most outpatient load (90.3 persons) among all age group, 6~10 years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factorsnumber of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.
Summary
Relationship of between blood lead level and lead related symptoms in low level lead exposure.
Kyu Yoon Hwang, Jae Eog Ahn, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim
Korean J Prev Med. 1991;24(2):181-194.
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AbstractAbstract PDF
This study intended to obtain an useful information on the prevalence of subjective symptoms, and to clarify the interrelationships between blood lead and lead related symptoms in low level lead exposure. The 93 male workers exposed to lead and 56 male nonexposed workers were examined for their blood lead (PBB), Zinc-protoporphy (ZPP), hemoglobin (HB) and personal history, and completed 15 questionnaires related to symptoms of lead absorption; also measured lead concentration in air (PBA) in the workplace. The results obtained were as follow; 1. The means of blood lead (PBB), blood ZPP and hemoglobin (HB) among workers exposed to lead were 26.1+/-8.8 microgram/dl, 28.3+/-26.0 microgram/dl and 16.2+/-1.2g/dl; whereas those of nonexposed workers were 18.7+/-5.1 microgram/dl, 20.6+/-8.7 microgram/dl and 17.3+/-1.1g/dl. The means of above three indicies between two groups showed significant difference statistically (p<0.05). 2. The means of blood lead (PBB), blood ZPP and hemoglobin of workers exposed to different lead concentration in air were as follows; When it was below 25 microgram/m3 , the indices were 24.7+/-79, 26.1+/-26.8 microgram/dl and 16.4+/-1.1 g/dl respectively; These indices were 27.1+/-8.5, 23.9+/-10.92 /dl and 16.2+/-1.3 g/dl when the lead concentration in air was 25~50 microgram/m3; and they were 3.4+/-9.3, 42.3+/-31.3 microgram/dl and 15.5+/-1.2 g/dl when the concentration of lead was above 50 microgram/m3. Although there were statistical difference in blood lead and hemoglobin among three different lead concentration in air, there was no statistical difference of blood ZPP among the three groups with different exposure levels (p>0.05). 3. The most frequently by complained symptom was "Generalized weakness and fatigue", and fewest symptom was "Intermittent pains in abdomen". 4. Only two symptoms out of fifteen symptoms checked by themselves revealed significant difference between exposed and nonexposed groups. These were "Intermittent pains of abdomen" and "Joint pain or arthralgia" (p<0.05). No positive correlation was found between the levels of blood lead and symptom groups categorized as gastrointestinal, neuromuscular and constitutional symptoms. 5. Blood lead (r=0.3995) and ZPP (r=0.2837) showed statistically significant correlation with mean lead concentration in air, whereas correlations were not demonstrated between blood lead and lead related symptoms or blood ZPP and lead related symptoms. 6. Blood lead (PBB) and ZPP showed association (r=0.2466) and the equation PBB=23.75+0.0842 ZPP was derived. 7. On stepwise multiple regression, using blood lead level as a dependent variable and ZPP, hemoglobin (HB), age, work duration (WD) and symptom prevalence as a independent variables, only ZPP significantly contributed a lot to blood lead level. 8. While the ZPP measurement was found to be a good indicator in evaluating health effect of lead absorption in low level lead exposure, lead related symptoms were not sensitive enough to evaluate of lead absorption in low level exposure.
Summary
A cross-sectional study on prevalence rate and contributing factors of fatty liver diagnosed by ultrasonography.
Jae Eog Ahn, Jung Oh Ham, Kyu Yoon Hwang, Joo Ja Kim, Byung Kook Lee, Tack Sung Nam, Joung Soon Kim, Hun Kim
Korean J Prev Med. 1991;24(2):195-210.
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AbstractAbstract PDF
Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are 40~50's in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows; If the odds ratio of below 29 year of age is 1.0 then that of 30~39 is 1.74 (p=0.33), 40~49 is 2.47 (p=0.10), 50~59 is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of 0~9 is 5.08 (p<0.01), 10~19 is 12.37 (p<0.01), 20~29 is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of 100~120 is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below 29 micron/1 gamma-GT is 1.0 then that of 30~s59 is 2.11 (p<0.01), 60~90 is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then 150~199 is 1.49 (p=0.05), 200~250 is 1.09 (p=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and serum triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.
Summary
An analysis of contributing factors to financial status of regional health insurance.
Jong Kook Moon, Myeong Ho Park, Yong Joon Kim
Korean J Prev Med. 1991;24(2):211-220.
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AbstractAbstract PDF
Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women, premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.
Summary
A case-control study for risk factor related to hypertension.
Sin Kam, Min Hae Yeh, Sung Kook Lee, Byung Yeol Chun
Korean J Prev Med. 1991;24(2):221-231.
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AbstractAbstract PDF
A case-control study was conducted to investigate the risk factors (Part of job, Obesity, Alcohol, Smoking, Milk, Salt, and Family history) for hypertension. We selected 330 hypertension cases (male; 247, female; 83) and 1,336 controls (male; 887, female; 449) from employees in Taegu city from 1 May to 30 November, 1988. Data was analysed using a logistic regression model. Statistically Significant elevated odds ratio were noted for alcohol (odds ratio=3.23), obesity (odds ration=2.31), salt (odds ratio=1.75) in male (P<0.05) and those in female were noted for alcohol (odds ratio=16.49), family history (odds ratio=3.70), obesity (odds ratio=1.74) and salt (odds ratio=1.73) (P<0.05). Statistically significant reduced odds ratio was noted for milk in both sexes (odds ratio=0.69 for male and 0.65 for female) (P<0.05) and the dose-response relationship between milk intake and hypertension was confirmed (P<0.05). Therefore, milk seems to be preventive factor for hypertension. Smoking was not significantly associated with hypertension in both sexes. The part of job was significantly associated with hypertension in female by simple analysis (P<0.05) but the relationship was disappeared when multivariate analysis (logistic regression analysis) was done.
Summary
A survey on child battering among elementary school children and related factors in urban and rural areas.
Kae Soon Jeon, Jung Han Park
Korean J Prev Med. 1991;24(2):232-242.
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AbstractAbstract PDF
To determine the incidence rate of child battering and related factors, a questionnaire survey was conducted on 1,255 children in 4th and 5th grades of two elementary schools (one in the upper economic class area with 519 students and the other in the lower economic class area with 504 students) in Taegu and two schools in rural areas of Kyungpook province (120 and 112 students, respectively) from 1st May to 10th May 1990. Total number of children who were battered during one-month period (1-30 April 1990) prior to the survey was 918 (73.1%)> Among the battered children 87 (6.9%) were severely battered (twice or more in a month by kicking or more severe method) and 831 children (66.2%) were moderately battered (all other battering than severe battering). The percentage of battered children and degree of battering were not significantly different between two schools in Taegu and between urban and rural areas. Common reasons for battering were disobediance (61.9%), making troubles (34.9%), and poor school performance (33.3%). However, 16.1% of severely battered children responded that the perpetrators battered them to wreak their anger and 5.7% of them did not know the reason why they were battered. A majority of the battered children (65%) regretted their fault after being battered but 20.7% of the severely battered children wanted to run away and 9.2% of them had an urge to commit suicide. While most of the physical injuries due to battering were minor as bruise (52.7%) but some of them were severe, e.g., bone fracture (2.5%), skin laceration (1.5%), and loss of consciousness (0.2%). The common psycho-behavioral complaints of the severely battered children were unwillingness to study (31%), unwillingness to live (17.2%), and reluctance to go home (13.8%). The incidence rate of severe battering was significantly higher (p=0.018) among the children living in a quarter attached to a store (14.0%) than the children living in an apartment (6.6%) and individual louse (6.2%). The incidence rate of severe battering was higher among children living in a rental house (8.4%) than children living in their own house (6.3%) (p=0.005). The children of father only working (5.1%) and mother only working (4.5%) had a lower incidence rate of severe battering than the children of both parents working (9.1%) and both parents unemployed (20.7%) (p=0.006). More children were battered when there was a sick family member (80.8%) compared with the children without a sick family member (71.4%) (p=0.001). The incidence rates of severe and moderate battering increased as the frequency of quarreling between mother and father increased (P=0.000). The percentage of unbattered children was higher among children whose father's occupation was professional (39.4%) than that of the total study subjects (26.9%) (p<0.001).
Summary

JPMPH : Journal of Preventive Medicine and Public Health