OBJECTIVES This study evaluated knowledge structure and its effect factor by analysis of co-author and keyword networks in Korea's preventive medicine sector. METHODS: The data was extracted from 873 papers listed in the Journal of Preventive Medicine and Public Health, and was transformed into a co-author and keyword matrix where the existence of a 'link' was judged by impact factors calculated by the weight value of the role and rate of author participation. Research achievement was dependent upon the author's status and networking index, as analyzed by neighborhood degree, multidimensional scaling, correspondence analysis, and multiple regression. RESULTS: Co-author networks developed as randomness network in the center of a few high-productivity researchers. In particular, closeness centrality was more developed than degree centrality. Also, power law distribution was discovered in impact factor and research productivity by college affiliation. In multiple regression, the effect of the author's role was significant in both the impact factor calculated by the participatory rate and the number of listed articles. However, the number of listed articles varied by sex. CONCLSIONS: This study shows that the small world phenomenon exists in co-author and keyword networks in a journal, as in citation networks. However, the differentiation of knowledge structure in the field of preventive medicine was relatively restricted by specialization.
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OBJECTIVES Korea faces a number of challenges to meet demands in the area of geriatric professional medicine in a country with a rapidly ageing population. We evaluated the satisfaction and feasibility of the current education certification for geriatric physicians. METHODS: Geriatric physicians who were deemed qualified by the Korean Geriatrics Society during the period of 2001 to 2005 (n=2,200) were asked to complete structured questionnaires sent to them by mail about their satisfaction of and need for certificates of education, as well as their opinions on their geriatric specialty training. A total of 419 physicians responded. Descriptive analysis and hierarchical regression were performed to rate the respondents.satisfaction, the characteristics of the need for clarity and utility in education certification, and the characteristics of their patients. RESULTS: Although most respondents were satisfied with their education certification, those who had more elderly patients, aged 65 or older, and those who had more cognitively impaired patients, rated their education as significantly lower than did other physicians. Both groups expressed the need for more the comprehensive care and assessment concerning of their education. Multiple regression analysis indicated that satisfaction with geriatric physician qualification was associated with a physician's age, specialty, and percentage of elderly patients. CONCLSIONS: This study suggests that the current system of education certification is limited in terms of feasibility and physician satisfaction.
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Is socioeconomic disparity in disability improving among Korean elders? Soong-Nang Jang, Sung-il Cho, Ichiro Kawachi Social Science & Medicine.2010; 71(2): 282. CrossRef
OBJECTIVES Period analysis estimates up-to-date survival rates of cancer patients. In this approach, analysis is restricted to recent time period by left-truncating all observations at the beginning of the period and rightcensoring at its end. Here, we applied period analysis to examine changes in 5-year relative survival (RS) by age group for 1997 and for 2002. METHODS: Using the National Cancer Incidence Database, 5-year RS was estimated for 1997 and 2002 in four age groups (15-54, 55-64, 65-74, and 75 years old and over) using period analysis. After excluding death certificate-only cases, patients with an unknown date of diagnosis or follow-up length, a total of 813,889 patients diagnosed with a first primary invasive cancer during 1992-2002 were included for analysis. Followup for vital status was included until 31 December 2002. RESULTS: Five-year RS increased from 41.7% for 1997 to 46.7% for 2002. Increases in survival occurred in all age groups except in the 75 and over group. CONCLSIONS: The age gradient in cancer prognosis seems to have widened between 1997 and 2002, a finding that requires further study of prognostic factors, including stage at diagnosis. Period analysis accurately estimates survival rates, especially for cancers with better prognosis.
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OBJECTIVES We examined the association between alcohol consumption and incidence of colorectal cancer in elderly Koreans. METHODS: The cohort members (n=14,304) consisted of 4,834 males and 9,470 females derived from the Korea Elderly Pharmacoepidemiologic Cohort (KEPEC), a population-based dynamic cohort. They were aged 65 years old or older and lived in Busan between 1993-1998; they were beneficiaries of the Korean Medical Insurance Corporation (KMIC). Baseline information was surveyed by a self-administered, mailed questionnaire. This study population was restricted to 14,304 participants who reported alcohol drinking habits on the questionnaire and had not been diagnosed with colorectal cancer at baseline. The adjusted hazard ratios (aHR) of status, type, frequency and daily average amount of alcohol consumption were computed with Cox's proportional hazard model, with the never-drinkers as a reference group and controlling for age and gender. RESULTS: After 4.82 person-years of mean follow-up 112 cases of colorectal cancer occurred. The incidence densities of colorectal cancer were 161 (95% CI=123-200) for never-drinkers, 219 (95% CI=125-339) for ex-drinkers, and 137 (95% CI=84-189) for current-drinkers per 100,000 person-year. The status, type, frequency, and daily average amount of alcohol consumption were not significantly related to the incidence of colorectal cancer after controlling for age and gender. CONCLSIONS: There was no significant association between alcohol consumption and colorectal cancer among elderly people after controlling for age and gender.
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OBJECTIVES The aim of this study was to determine the relationship between the core properties of professional socialization and social status satisfaction, economic reward satisfaction, and subjective class identification. METHODS: Medical knowledge and skill, autonomy, and professional value factors were used as essential properties of professional socialization to determine the association with job satisfaction and subjective class identification. The authors used a self-administered questionnaire survey and collected nationwide data between July and August 2003, with 211 responses used for final analysis. RESULTS: 'Age' and 'trust and respect' were positively associated with social status satisfaction, and 'occupation' was negatively associated. 'Income' and 'trust and respect' were positively related to economic reward satisfaction, and 'practicing for oneself', and 'a sense of duty and attendance' were negatively related. 'Practicing for oneself', 'not believing explanations', and 'a sense of duty and attendance' had a positive relationship with subjective class identification. 'Income', 'knowledge system', 'medical mistakes', 'treating like goods', 'meaning and joy', and 'trust and respect' had a negative relationship. CONCLSIONS: The core property variables of professional socialization had a different relationship with social status satisfaction, economic reward satisfaction and subjective class identification. In particular, many core property variables were associated with subjective class identification positively or negatively. The development of professional socialization would help promote job satisfaction and subjective class identification.
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OBJECTIVES This study was conducted to investigate the associations of non alcoholic fatty liver with metabolic syndrome and the serum carotenoids. METHODS: This study was conducted in a general hospital in South Korea from November, 2004 to August, 2005. The study subjects were 350 sampled persons who were aged from 40 years and older (males: 180, females: 170). They were grouped into the normal, mild and severe groups according to fat accumulation in their livers, as determined by ultrasonography. We analyzed the association between non alcoholic fatty liver and metabolic syndrome by multiple logistic regression analysis and we analyzed the association between non alcoholic fatty liver and the serum carotenoids by a general linear model(ANCOVA). RESULTS: After adjustment for the effect of potential covariates, the prevalence of metabolic syndrome was associated with fat accumulation in the liver (p trend <0.001). If the odds ratio of normal group is 1.00, then that of the mild group is 2.80 (95% C.I=1.17-6.71) and that of the severe group is 7.29 (95% C.I=2.76-19.30). The prevalence of metabolic alterations fitting the criteria of metabolic syndrome, according to the class of fat accumulation in the liver, was significantly increased, except for criteria of high blood pressure, a large waist circumference and low HDL (high density lipoprotein) cholesterol level (p trend <0.001). The level of serum beta-carotene was decreased according to the class of fat accumulation in the liver (p trend=0.036), but the levels of serum alpha-carotene, lycopene, bata-cryptoxanthin and lutein were not decreased. CONCLSIONS: This study shows that non alcoholic fatty liver was associated with metabolic syndrome and with the serum beta-carotene level.
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OBJECTIVES To determine the relationship between exercise and the incidence of type 2 diabetes in an impaired fasting glucose group. METHODS: This prospective cohort study was conducted in 19,440 men and 4,297 women, aged 30-69 years, with impaired fasting glucose at baseline who had undergone biennial medical evaluation through the National Health Insurance Corporation from 2000 to 2004. Impaired fasting glucose was defined as fasting glucose of 100 to 125 mg/dl and the subjects were divided into 3 groups depending on weekly exercise frequency. Multivariate logistic regression analysis was used to evaluate the association between the baseline exercise status and incidence of type 2 diabetes. RESULTS: During the 4-year follow-up, a total of 3,239 men and 283 women developed type 2 diabetes, a cumulative incidence of 16.6% for men, and 6.5% for women. Also, 1,688 men (21.2%) and 127 women (15.2%) developed type 2 diabetes in the obese group. The adjusted relative risk (RR) of developing type 2 diabetes in non-exercising men was significantly higher than exercising men regularly (RR= 1.375, 95% CI=1.236-1.529)(p<0.0001), and the RR for non-exercising women was higher than exercising women regularly (RR=1.124, 95% CI=0.711-1.778). The RR for non-exercise men/women in the obese group was 1.571 (95% CI=1.351-1.827)(p<0.0001)/1.869(95% CI=0.846-4.130). CONCLSIONS: Regular exercise is effective in preventing type 2 diabetes in people with impaired fasting glucose, and particularly in obese people. People with risk factors for diabetes should participate in a regular exercise program.
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OBJECTIVES We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. METHODS: The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. RESULTS: Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. CONCLSIONS: Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.
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OBJECTIVES Polycyclic aromatic hydrocarbons (PAH) and toluene have been reported to induce reactive oxygen species and oxidative stress. This study was performed to investigate the effects of low level exposure to PAHs or toluene on the lipid peroxidation level in elementary school children and the elderly in a rural area. METHODS: Forty seven elementary school children and 40 elderly people who were living in a rural area and not occupationally exposed to PAH or toluene were the subjects of this study. Information about active or passive smoking and diet was obtained using a self-administered questionnaire. The urinary 1-hydroxypyrene (1-OHP), 2-naphthol, hippuric acid and thiobarbituric acid reactive substance (TBARS) concentrations were measured, and these values were corrected with the urinary creatinine concentration. RESULTS: In school children, the geometric means of the urinary 1-OHP, 2-naphthol, hippuric acid and TBARS levels were 0.02 ymol/mol creatinine, 0.47 micron mol/mol creatinine, 0.14 g/g creatinine and 0.95 micron mol/g creatinine, respectively. Those values for the elderly were 0.07 micron mol/mol creatinine, 1.87 micron mol/mol creatinine, 0.11 g/g creatinine and 1.18 micron mol/g creatinine, respectively. The mean levels of urinary 1-OHP, 2-naphthol and TBARS were significantly higher in the elderly subjects than in the children. The urinary TBARS level was not correlated with the urinary 1-OHP, 2-naphthol and hippuric acid, but they were correlated with the age of the subjects. CONCLSIONS: These results suggest that low level inhalation exposure to PAH or toluene does not markedly increase lipid peroxidation, and age is a significant determinant of lipid peroxidation.
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