Journal of Preventive Medicine and Public Health

Jung Ae Rhee

16 Articles

Management of Diabetic Mellitus in Low-income Rural Patients.: Hye Yeon Kim, Woo Jun Yun, Min Ho Shin, Sun Seong Kweon, Hye Ran Ahn, Seong Woo Choi, Young Hoon Lee, Dong Hyeok Cho, Jung Ae Rhee; J Prev Med Public Health. 2009;42(5):315-322.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.315

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OBJECTIVES
Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. METHODS: We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. ankle-brachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. RESULTS: The age of diabetic subjects was 68.7+/-8.7 years and the duration of diabetes was 8.9+/-8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. CONCLUSIONS: DM management in low income patients is very poor and requires further work to improve.

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Comparison of Health Status in Primary Care Underserved Area Residents and the General Population in Korea
Min So Kim, Kyae Hyung Kim, Sang Min Park, Jong-goo Lee, Yeon Seo Ko, A Ra Cho, Yoon Su Ku
Korean Journal of Family Medicine.2020; 41(2): 119. CrossRef
The Influence of Health Literacy and Diabetes Knowledge on Diabetes Self-care Activities in Korean Low-income Elders with Diabetes
Jihye Jeong, Namhee Park, So Young Shin
Journal of Korean Academy of Community Health Nursing.2014; 25(3): 217. CrossRef
Group Classification on Management Behavior of Diabetic Mellitus
Sung-Hong Kang, Soon-Ho Choi
Journal of the Korea Academia-Industrial cooperation Society.2011; 12(2): 765. CrossRef
Relationship between Glycemic Control and Diabetic Retinopathy
Woo-Jun Yun
Journal of the Korean Geriatrics Society.2010; 14(4): 234. CrossRef

Association of Blood Pressure Levels with Carotid Intima-Media Thickness and Plaques.: Young Hoon Lee, Sun Seog Kweon, Jin Su Choi, Jung Ae Rhee, Sung Woo Choi, So Yeon Ryu, Min Ho Shin; J Prev Med Public Health. 2009;42(5):298-304.; DOI: https://doi.org/10.3961/jpmph.2009.42.5.298

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OBJECTIVES
The aim of this study was to investigate the association of blood pressure levels with the common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. METHODS: Data were obtained from 2,635 subjects, aged 50 years and over, who participated in the Community Health Survey (a population-based, cross-sectional study) in Dong-gu, Gwangju city between 2007 and 2008. Participants were categorized into three groups according to blood pressure levels; normotensives (<120/80 mmHg), prehypertensives (120-139/80-89 mmHg), and hypertensives (> or =140/90 mmHg). Prehypertensives were further categorized as low prehypertensives (120-129/80-84 mmHg) and high prehypertensives (130-139/85-89 mmHg). Carotid intima-media thickness and plaques were evaluated with a high-resolution B-mode ultrasound. Statistical analyses were performed using chi-square test, ANOVA, and multiple logistic regression. RESULTS: Prehypertensives had significantly greater maximal CCA-IMT values than normotensives, with a multivariate adjusted odds ratio of 1.78 (95% CI=1.36-2.32) for abnormal CCA-IMT (maximal CCA-IMT > or =1.0 mm), and 1.45 (95% CI=1.19-1.77) for carotid plaques. The multivariate adjusted odds ratio of low prehypertensives was 1.64 (95% CI=1.21-2.21) for abnormal CCA-IMT, and 1.30 (95% CI=1.04-1.63) for carotid plaques compared with normotensives. Subject with hypertension had higher frequency of abnormal CCA-IMT (odds ratio, 2.18; 95% CI=1.49-3.18), and carotid plaques (odds ratio, 1.98; 95% CI=1.46-2.67) compared with normotensives after adjustment for other cardiovascular risk factors. CONCLUSIONS: Our results indicate that there is a significant increase in the prevalence of carotid atherosclerosis in subjects with prehypertension (even in low prehypertensives) compared with normotensive subjects. Further studies are required to confirm the benefits and role of carotid ultrasonography in persons with prehypertension.

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Association Between Serum Uric Acid and Carotid Intima-Media Thickness in Different Fasting Blood Glucose Patterns: A Case-Control Study
Yuanyuan Gao, Baofeng Xu, Yanyan Yang, Mei Zhang, Tian Yu, Qiujuan Zhang, Jianwei Sun, Rui Liu
Frontiers in Endocrinology.2022;[Epub] CrossRef
School children systolic and diastolic blood pressure values: YUSAD study
Zeljka Milincic, Dejan Nikolic, Slavko Simeunovic, Ivana Novakovic, Ivana Petronic, Dijana Risimic, Dejan Simeunovic
Open Medicine.2011; 6(5): 634. CrossRef

The Comparison of Health Behaviors Between Widowed Women and Married Women in Jeollanamdo Province, Korea.: Seong Woo Choi, Jung Ae Rhee, Jun Ho Shin, Min Ho Shin; J Prev Med Public Health. 2008;41(4):272-278.; DOI: https://doi.org/10.3961/jpmph.2008.41.4.272

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OBJECTIVES
To compare the health behaviors of widowed women with those of currently married women. METHODS: We randomly sampled the subjects from the Jeollanamdo Resident Registration Data and we then selected 2,331 widowed women and 4,775 married women. Well-trained examiners measured the height, weight, blood pressure and abdomen circumference, and the women were interviewed with using a questionnaire. Logistic regression analysis was used to estimate the odds ratios(OR) of the two groups. RESULTS: The smoking rate (OR=2.46; 95% confidence interval [CI]1.65, 3.66) was significantly higher for the widowed women. On the contrary, the awareness rate of a smoking cessation campaign (OR=0.80; 95% CI=0.70, 0.92), a quit tobacco telephone line (OR=0.73; 95% CI=0.61, 0.88) and a quit smoking clinic (OR=0.74; 95% CI=0.62, 0.89) were lower for the widowed women. The rate of receiving a health exam (OR=0.80; 95% CI=0.70, 0.91), the rate of undergoing gastric cancer screening (OR=0.77; 95% CI=0.68, 0.88), breast cancer screening (OR=0.79; 95% CI=0.69, 0.89), cervix cancer screening in the last 2 years (OR=0.81; 95% CI=0.71, 0.92), colon cancer screening in the last 5 years (OR=0.74; 95% CI=0.63, 0.87) were significantly lower for the widowed women. CONCLUSIONS: This study revealed that the health behaviors are significantly different between the widowed women and the married women. To improve the health behaviors of the widowed women, further study and research that will investigate the socioeconomic and environmental factors that affect the health behaviors of widowed women will be needed.

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Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis
Yi Zhang, Xiangfan Chen, Yimei Sun, Sujuan Feng, Fang Wang, Haiyan Gu, Hanyu Jia, Quanxing Zhang, Wenbin Ding, Hongjian Lu, Jidong Zhang
Frontiers in Public Health.2023;[Epub] CrossRef
Effect of Spousal Loss on Depression in Older Adults: Impacts of Time Passing, Living Arrangement, and Spouse’s Health Status before Death
Yu-Chan Hung, Yong-Hsin Chen, Meng-Chih Lee, Chih-Jung Yeh
International Journal of Environmental Research and Public Health.2021; 18(24): 13032. CrossRef
Socioeconomic differences among community-dwelling diabetic adults screened for diabetic retinopathy and nephropathy: The 2015 Korean Community Health Survey
Young-Hoon Lee, Antonio Palazón-Bru
PLOS ONE.2018; 13(1): e0191496. CrossRef
Marital Status and Health Behavior in Middle-aged Korean Adults
Hyun Ji Yim, Hyun Ah Park, Jae Heon Kang, Kyung-Woo Kim, Young Gyu Cho, Yang Im Hur, O Jin Ee Choi
Korean Journal of Family Medicine.2012; 33(6): 390. CrossRef

Prevalence and Related Factors of Dementia in an Urban Elderly Population Using a New Screening Method.: Hee Young Shin, Eun Kyung Chung, Jung Ae Rhee, Jin Sang Yoon, Jae Min Kim; J Prev Med Public Health. 2005;38(3):351-358.

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Abstract PDF: OBJECTIVE
Dementia has rapidly increased with the prolongation of life expectancy and aging in Korea. This study was conducted to estimate the prevalence of, and find related factors for, dementia in an urban elderly population, using a newly developed screening method. METHODS: Seven hundred and six people, aged over 65 years-old, in Dong district of Gwangju, Korea, were recruited using stratified cluster sampling, and completed Korean version of Geriatric Mental State Schedule B3 (GMS B3-K), the Korean version of the Community Screening Interview for Dementia (CSID-K) and modified 10 word list-learning from the Consortium to Establish a Registry of Alzheimer's Disease (CERAD). Dementia was diagnosed by an algorithm derived from all three of these measures. RESULTS: The crude and age adjusted prevalence rates of dementia were 13.0 and 11.5%, respectively. Age, education, marital status and a history of cerebrovascular disease were identified as factors related with dementia. CONCLUSIONS: The new instrument, using the GMS B3-K, CSID-K and modified 10 word list-learning from the CERAD, was considered effective as a community screening and diagnostic tool for dementia. The results of this study can also be used to develop a community-based prevention and management system for dementia in the future.; Summary

The Relation between Type of Insurance and Acute Appendicitis Rupture Rate.: Baeg Ju Na, Jee Young Hong, Keon Yeop Kim, Moo Sik Lee, Hae Sung Nam, Jeong Soo Im, Jung Ae Rhee; J Prev Med Public Health. 2004;37(3):267-273.

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Abstract PDF: OBJECTIVES
This study was aimed at investigating the medical service utilization pattern of patients who use public medical aid compared to those who have health insurance. METHODS: We selected every patient between the age of 18 and 69 who used public medical aid from January 1, 1999, to December 31, 2001, in Gwangju metropolitan city, South Korea. For comparison, a list of patients with health insurance was gathered for same period. Then the medical records of those who had been hospitalized for acute appendicitis were selected among both groups. Of those records, we compared the number of cases of ruptured appendicitis to cases of whole acute appendicitis in both groups. Regarding coding for ruptured appendicitis, International Classification of Diseases - 10 (ICD-10) was used. Multiple logistic regression was used as a statistical tool to determine the effectiveness of risk factors. RESULTS: Even after adjusting for risk factors, such as age and sex, the proportion of perforation of acute appendicitis among public medical aid patients was found to be significantly higher than among insured patients. CONCLUSIONS: This comparative study on ruptured appendicitis among public medical aid patients and insured patients, indicates that the proportion of perforation of acute appendicitis could be an index showing that these types of patients utilize medical services differently than insured patients. We know that when abdominal pain is not properly treated at the outset, it easily develops into ruptured appendicitis complicated with peritonitis. Considering this data analysis, we guess the public medical aid system to have significant problem with medical accessibility. So additional and systematic research on the pattern of utilization of medical services of public medical aid patients is needed.; Summary

Availability of the Time and Change Test in Screening for Dementia in the Elderly.: Jung Ae Rhee, Eun Kyung Chung, Min Ho Shin; Korean J Prev Med. 2003;36(2):101-107.

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Abstract PDF: OBJECTIVES
Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Time and Change (T and C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. METHODS: The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11: 10, and the change test the ability to make 1, 000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T and C ratings were validated against a reference standard based on the physician? diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T and C Test, the mean K-MMSE scores were compared with the results of the T and C Test in the elderly from a rural community. RESULTS: The T and C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T and C Test were significantly related in the elderly from a rural community (p< 0.01). The T and C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete. CONCLUSION: The T and C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T and C Test will be used for the widespread cognitive screening of aging populations.; Summary

Accuracy of the Registered Cause of Death in a County and its Related Factors.: Eun Kyung Chung, Hee Young Shin, Jun Ho Shin, Hae Sung Nam, So Yeon Ryu, Jeong Soo Im, Jung Ae Rhee; Korean J Prev Med. 2002;35(2):153-159.

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Abstract PDF: OBJECTIVES
To evaluate the accuracy of the registered cause of death in a county and its related factors. METHODS: The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. RESULTS: 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI= 0.12-0.78). CONCLUSIONS: The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration.; Summary

Quantitative Ultrasound for Osteoporosis Screening in Postmenopausal Women.: Min Ho Shin, Hee Young Shin, Eun Kyung Jung, Jung Ae Rhee, Jin Su Choi; Korean J Prev Med. 2001;34(4):408-416.

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Abstract PDF: OBJECTIVES
To evaluate the diagnostic value of quantitative ultrasound (QUS) in the prediction of osteoporosis as defined by dual energy x-ray absorptiometry (DEXA) in postmenopausal women. METHODS: Questionnaires and height and weight measurements were used in the investigation of 176 postmenopausal women. QUS measurements were taken on the right calcaneus while bone mineral density (BMD) measurements of the lumbar spine and femoral neck were made with DEXA. The areas under the curves (AUC) of the speed of sound (SOS) for osteoporosis in the lumbar spine and femoral neck were obtained through receiver operating characteristic (ROC) analysis and evaluated. A comparison was made, for osteoporosis in the lumbar spine and femoral neck, between the AUCs of the logistic model with clinical risk factors and SOS. RESULTS: Pearson's correlation coefficients of SOS and lumbar spine BMD, and of SOS and femoral neck BMD were 0.26 and 0.37. The AUC for the logistic model in its discrimination for lumbar spine osteoporosis was 0.764, and for SOS 0.605. The AUCs for the logistic model in its discrimination for femoral neck osteoporosis and for SOS were 0.890 and 0.892, respectively. CONCLUSIONS: These results suggest that the diagnostic value of QUS as a screening tool for osteoporosis is moderate for the femoral neck, but merely low for the lumbar spine and that the predictability provided by SOS is no better than that by the sole use of clinical risk factors in postmenopausal women.; Summary

Association between Snoring and Hypertension in a Rural Population.: Hee Young Shin, Jin Su Choi, Jung Ae Rhee; Korean J Prev Med. 2001;34(3):284-290.

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Abstract PDF: OBJECTIVES
To evaluate the association of snoring and hypertension in a rural population. METHODS: A population-based sample of 1,763 adults in Chonnam, Korea was investigated with questionnaires and height, weight, and blood pressure measurements. Information on the demographic characteristics, cigarette smoking, alcohol consumption, hypertension and snoring was collected through a person-to-person interview using a structured questionnaire. The level of obesity was measured by the body mass index (BMI). Hypertension was considered to be present if the average of two blood pressure measurements was greater than 140mmHg systolic or 90mmHg diastolic, or if they were currently on antihypertensive treatments. RESULTS: The prevalence of snoring was 42.7% in men and 39.8% in women. With regard to age, snoring prevalence was 44.3% in the middle-aged group (45 to 64 years), greater than 33.9% in the younger (<45 years) group or 38.7% in the elderly(> or =65 years) group. The snoring prevalence increased progressively with increasing BMI, but cigarette smoking and alcohol consumption was not associated with snoring. Hypertension occurred more frequently in snorers than in non-snorers (Odds ratio: 1.25, 95% confidence interval = 1.01-1.55). However after adjusting for sex, age, obesity, smoking, and alcohol use, an effect of snoring on hypertension was no longer present (Odds ratio: 1.13, 95% confidence interval = 0.90-1.41). CONCLUSION: These results suggest that snoring might not be associated with hypertension.; Summary

Trends of Preventive Medicine Research according to The Korean Journal of Preventive Medicine and Qualitative Meta-analysis on Articles of Lead Poisoning.: Chun Bae Kim, Jung Ae Rhee, Jong Ku Park, Seok Joon Sohn; Korean J Prev Med. 1999;32(2):113-122.

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Abstract PDF: OBJECTIVES
The purpose of this study was to describe the trends of original research in the Korean Journal of Preventive Medicine, and to evaluate the quality of original articles about lead poisoning. METHOD: The data for the analysis of trends in preventive medicine research was taken from a total of 829 original articles published in the Korean Journal of Preventive Medicine from 1968 to 1997. The qualitative meta-analysis was measured against a checklist of evaluation criteria, which were divided into 10 categories, with 46 articles on lead poisoning. The evaluation process was performed independently by two evaluators. RESULTS: The number of articles per 100 members over the study period increased by almost 4 pieces in the early 1980s, and by more than 9 pieces in the mid-1990s. In the major classifications of subjects, environmental and industrial health, epidemiology and health statistics, and health policy and management published 370 pieces (44.6%), 137 pieces (16.5%), 322 pieces (38.9%) respectively. In the order of the number of articles, five themes about health significance, including metal exposure (73 pieces), diseases associated with exposure to organic solvents (45 pieces), air pollution (36 pieces), maternal and child health (32 pieces), and occupational health (30 pieces) received consistent attention throughout the years 1968-1997. The overall mean score of article quality about lead poisoning was 37.8 out of 50. Of the articles any information on the purpose and hypothesis described well. Of those the originality of the subjects, the form of articles (including tables and figures), and the number of inappropriate words of abstracts showed very low score. For multiple regression analyses, the number of joint research institutes and the acceptance of research grants about the article quality were statistically significant. CONCLUSIONS: The number of original research reports in the Korean J Prev Med has recently increased and their subjects have diversified. Of the basis of this study, the articles need improvement in the areas of abstracts, tables and illustrations (figures), etc. The Korean Society for Preventive Medicine will revise contribution regulations for manuscripts submitted to the Korean J Prev Med. Future studies should address these issues and perform the quantitative mata-analysis about the specific subjects including the quality of articles.; Summary

The comparison of health-related quality of life between the institutional elderly and the community living elderly.: Kyeong Soo Park, Yong Gil Seo, Hae Sung Nam, Seok Joon Sohn, Jung Ae Rhee; Korean J Prev Med. 1998;31(2):293-309.

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Abstract PDF: The purpose of this study is to compare the level of health-related quality of life and relating factor between institutional elderly and community living elderly. The subjects were 390 from Sanatorium or Nursing home and 467 from the community, in Kwangju. The results are followed : l) A comparison of ADL between two groups, institutional elderly and community living elderly, resulted in that community elderly were more significantly independent in the areas of bathing and transfer than institutional elderly. 2) A comparison of IADL between two groups resulted in that ; Community elderly, were more independent in the areas of using telephone and transportation, food preparation, house keeping, and doing laundry. Institutional elderly were more independent in the area of handling finances. 3) In the case of poor health-related quality of life, institutional elderly showed 2.4 times in the dimension of physical fitness, l.8 times in daily activity, 2 times in social activity, 2 times in pain, 26.7 times in social support, and 0.4 times in subjective quality of life higher than community elderly. There was no significant differences in the rest of dimensions. 4) In institutional elderly, the analysis of variables related to the health-related quality, of life resulted in that; The relating factors were sex, education, and chronic illness in the dimension of physical function. Direct contact with family or significant others in the dimension of social activity. Chronic illness in the dimension of pain and perceived health status. Direct or indirect contact with family or significant others over the phone or through letters in the dimension of social support. 5) The analysis of variables relatd to the health-related quality of life showed that community elderly has more relating variables in each area than institutional elderly. The relating factors were age, sex, and chronic illness in the dimension of physical function. Education and chronic illness in the dimension of emotional status. Age and chronic illness in the dimension of daily activity and social activity. Education and chronic illness in the dimension of pain and perceived health status. Sex, education, family size in the dimension of social support. Education and chronic illness in the dimension of subjective quality-of-life. Throughout general daily activity, community elderly showed more satisfactory results than institutional elderly, but in the subjective area of health-related quality of life, such as subjective quality of life, institutional elderly, group showed more positive results. And community elderly had more relating factors than institutional elderly. For the health care of the elderly that focused on quality, of life, new approaches considering the characteristics of both group, institutional and community, living elderly, are needed.; Summary

The Relationship between the Cognitive Impairment and Mortality in the Rural Elderly.: Byung Hwan Sun, Kyeong Soo Park, Baeg Ju Na, Yo Seop Park, Hae Sung Nam, Jun Ho Shin, Seok Joon Sohn, Jung Ae Rhee; Korean J Prev Med. 1997;30(3):630-642.

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Abstract PDF: The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respondents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.; Summary

Community screening for stress by using General Health Questionnaire.: Soo Sung Oh, Kwang Seub Lee, Seok Joon Sohn, Jin Su Choi, Jung Ae Rhee; Korean J Prev Med. 1995;28(1):123-140.

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Abstract PDF: This study investigated the stress of community residents in Kwang-Ju and Chonnam areas by using the General Health Questionnaire(GHQ-60) as a instrument of stress measurement. The number of subject were 445 residents who lived in three areas (large city, middle city, and rural area) and they were individually interviewed in March, 1994. The result of study showed that the degrees of stress measured by GHQ-60 were statistically significant in the residents' area, age. sex variables: (a) the residents in middle city among three area had the highest level of stress: (b) the resident who were more than 60 in age had the highest level of stress: (c) the female resident had more stress than male residents: (d) particularly, the residents who were more than 60 years old in the middle city had the highest level of stress. Further, the results of factor analysis showed that there were three factors of social dysfunction, depression and anxiety, and psychosomatic symptom. The social dysfunction factor was statistically significant in both age and resident area variables. The depression and anxiety factor was statistically significant in the residents' area, age. sex variables. The psychosomatic symptom factor was statistically significant in both age and sex variables. The study suggested that they should give a special attention to solve the old people's stress because stress was closely related to residents age.; Summary

A study on the depression and cognitive impairment in the rural elderly.: Jung Ae Rhee, Hyang Gyun Jung; Korean J Prev Med. 1993;26(3):412-429.

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Abstract PDF: For the purpose of promotion of mental health in the rural elderly, the author surveyed 558 elderlies aged 60 years or more, and assessed the prevalence rates of depression and cognitive impairment by using self-rating depression scale of Zung(SDS) and the Korean version of mini-mental state examination(MMSEK). Also the association between depression or cognitive function and socio-environmental factors were investigated. The major findings were as follows; 1. The prevalence rates of severe depression and cognitive impairment were 20.9% and 14.9% in all the elderly of both sexes, respectively. 2. The rates of depression and cognitive impairment increased with increasing age in both sex groups. The mean scores of SDS increased and the mean scores of MMSEK decreased significantly among them(P<0.01). 3. Those being female, widows or widowers, and those having low levels of physical activity, showed significantly high the mean scores of depression and had significantly low the mean scores of cognitive impairment(P<0.01). 4. The depression scores relating to decreased libido, confusion, psychomotor retardation, hopelessness and indecisiveness were relatively high in both sexes. 5. All the items of mini-mental state examination were significantly correlated with depression. 6. In stepwise multiple regression analysis on depression, MMSEK, level of physical activity, chronic disease, marital status and family income were selected as highly correlated variables, and the R2-value for these variables was 33.7%. 7. In stepwise multiple regression analysis on cognitive function, level of physical activity, age, depression, sex and marital status were selected as highly correlated variables, and the R2-value for these variables was 62.6%. The depression and cognitive impairment of the elderly were positively correlated with nearly all sociodemographic variables.; Summary

Physician Utilization and its Determinants in Rural and Urban Slun Areas.: Jin Hee Lee, Kee Ho Ko, Yong Sik Kim, Jung Ae Rhee; Korean J Prev Med. 1988;21(2):404-418.

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Abstract PDF: The household survey was performed in a urban slum and a rural Chonnam areas to measure the level of illness and medical care utilization and to find the determinants of physician utilization. The data revealed that age-adjusted prevalence rates of acute and chronic diseases were much the same in both areas ranged between 10.0 to 11.3%. But medical care utilization was more frequent in urban slum than in rural area. The facility of the first medical contact was also different. Some personal and disease related variables including disease severity and activity restricted day were significantly, but somewhat differently by area, associated with physician utilization pattern. When applying Anderson model, the medical need factors explained 42.2 and 40.4% of physician utilization in urban slum and in rural areas respectively, while the enabling factors explained 18.0 and 12.2% and the predisposing factors explained 17.1 and 8.9% correspondingly.; Summary

Passive Smoking in Poorly Ventilated Room Space.: Jung Ae Rhee; Korean J Prev Med. 1981;14(1):23-31.

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Abstract PDF: This study was conducted to investigation the effects of passive inhalation of cigarette smoke and the correlation between change of flicker value and active or passive smoking in poorly ventilated room. Forty five male student were tested by divided into four experimental groups composed of active and passive smokers and three control groups. Each four experimental groups were exposed to smoke for Two hours in enclosed room. Vital capacities, flicker values, blood carboxy-hemoglobin levels and carbon monoxide concentration in room air were estimated before, during and after the exposure, and amounts of smoking or smoke exposure during two hours were also noted. The results obtained were as follows; 1. Concentration of carbon monxide in air and increase of blood carboxy-hemoglobin level(% COHb) were positively correlated with smoking amount. 2. Increase of blood carboxy-hemoglobin in passive smokers, in average, were about seventy six percent of that in smokers, as 2.2% vs. 2.9%. 3. Comparison with published data showed that Peterson's equation gave most similar result to this study in estimation of increase of blood carboxy-hemoglobin level. 4. During the exposure, flicker values fell steadily in both experimental groups and control groups as time passed. Flicker value were, however, elevated again in experimental groups after exposure, despite the fact that values still fell in control groups. 5. Blood carboxy-hemoglobin and flicker value were negatively correlated and this correlationship was stronger in passive smoker than in active smoker. 6. Multiple regression equation between flicker value and exposure time and blood carboxy-hemoglobin level was expressed as: Flicker value=41.6-0.2COHb%-0.9Hour, 7. In general, it is suggested that biological criteria would be more preferable than chemical criteria in establishment of statutory limitation of smoking in enclosed spaces.; Summary

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