Professional Job Perception, Job Stress and Job Satisfaction of Westerm Doctors and Oriental Doctors Practicing at Local Clinic / 예방의학회지

OBJECTIVE: This study was conducted in order to investigate the professionalism, job stress and job satisfaction in western and oriental doctors in Korea. METHODS: The authors conducted a survey using a selfadministered questionnaire, conducted between August and September, 2001. The study subjects were 457 western doctors and 161 oriental doctors practicing at local clinics in Daegu City. RESULTS: For the professionalism scale, the score for 'belief in service to the public' of western doctors was significantly higher than that of oriental doctors (p< 0.05) whereas the scores for 'sense of calling to the field' and 'feeling of autonomy' were higher in oriental doctors (p< 0.01). For the job stress scale, the scores for 'work factor', and 'clinical responsibility/decision factor' of western doctors were significantly higher than those of oriental doctors (p< 0.01). Of the western doctors, 59.7% expressed satisfaction with their job as a doctor, 69.5% responded that the role of a doctor was appropriate to their aptitude, and 61.8% answered that they wouldn't consider other kinds of job even if offered. In case of oriental doctors, these responses were83.1%, 82.5%, and 82.3%, espectively. CONCLUSION: The job stress scores of western doctors were higher than those of oriental doctors, but the job satisfaction was lower. The reasons for the above results are not clear. Further studies are required to understand the characteristics of job stress and job satisfaction in doctors.

Professional Job Perception, Job Stress and Job Satisfaction of Doctors Practicing in Local Clinic in Daegu City / 예방의학회지

OBJECTIVE: This study was conducted in order to investigate professional job perception, job stress and job satisfaction in doctors. METHOD: The authors conducted a survey using a self-administered questionnaire, conducted between August and September, 2001. The study subjects were 457 doctors practicing at local clinics in Daegu City. RESULTS: For the professionalism scale, the score for 'sense of calling to field' and 'feeling of autonomy' were relatively high. Age, working hours per day, and perception of socioeconomic status significantly influenced the professionalism scale scores (p 2.0). The working hours per day and status perception also influenced their job satisfaction (T> 2.0). CONCLUSION: To promote the job satisfaction of doctors, the development of coping tools and other intervention methods are needed to increase doctor's professional job perception and reduce their job stress. Further studies are required to understand the characteristics of job satisfaction and for its promotion with doctors.

Therapeutic Compliance and Its Related Factors of Lung Cancer Patients / 예방의학회지

OBJECTIVES: To investigate the therapeutic compliance and its related factors in lung cancer patients. METHODS: The subjects of this study comprised 277 patients first diagnosed with lung cancer at Kyungpook National University Hospital between Jan 1999 and Sept 1999. Of these, 141 (50.9%) participated in the study by properly replying to structured questionnaires. The data was analyzed using a simplified Health Decision Model. This model includes categories of variables covering therapeutic compliance, health beliefs, patient preferences, knowledge and experience, social interaction, sociodemographic and clinical characteristics. RESULTS: The therapeutic compliance rate of the 141 study subjects was 78.0%. An analysis of health beliefs and patient preferences revealed health concern (p<0.05), dependency on medicine (p<0.05), perceived susceptibility and severity (p<0.05) as well as preferred treatment (p<0.01) as factors related to therapeutic compliance. Factors from the sociodemographic characteristics and clinical factors that were related to therapeutic compliance were age (p<0.01), monthly income (p<0.05), histological type (p<0.05) and clinical stage (p<0.05) of cancer. CONCLUSIONS: In order to improve therapeutic compliance in lung cancer patients it is necessary to educate the aged, low-income patients, or patients who have small cell lung cancer or lung cancer of an advanced stage for which surgery is not indicated. Additionally, it is essential for medical personnel to have a deep concern about patients who have poor lifestyles, a low dependency on medicine, or a high perceived susceptibility and severity. Practically, early diagnosis of lung cancer and thoughtful considerations of low-income patients are important. By means of population-based education in a community, we may promote attention to health and enhance the early diagnosis of lung cancer.

Bone Mineral Density and Related Factors of Postmenopausal Women / 한국역학회지

PURPOSE: This study was conducted to estimate the prevalence of osteoporosis and to identify the related factors of bone mineral density (BMD) in rural postmenopausal women. METHODS: Three hundred ninety postmenopausal women in a rural area were examined in 1999 Their BMDs of the lumbar spine (L1-L3) were measured by a quantitative computerized tomography (QCT) and their height and weight were measured. A questionnaires interviewing method was used to collect risk factor data. PESULTS: The prevalence of osteoporosis in postmenopausal women of 40-69 years old was 89.2% by reference value of UCSF(University of California, Sanfrancisco), however, changed to 63.1% by that of Korean. From simple analyses, age(p<0.01), duration after menopause (p<0.01), menstrual regularity(p<0.05), delivery frequencies (p<0.01), breast feeding years (p<0.01), alcohol intake(p<0.01), and smoking(p<0.05) were significant risk factors relating to BMD. In multiple linear regression analysis, duration after menopause(p<0.01), menstrual regularity(p<0.05), and breast feeding years (p<0.05) proved to be significant risk factors. However dietary factors and life style were not significantly associated with BMD. CONCLUSIONS: The significant risk factors of postmenopausal women in a rural area relating to BMD were duration after menopause, menstrual regularity, and breast feeding duration.

Job Stress and Its Related Factors in South Korean Doctors / 예방의학회지

OBJECTIVE: To investigate the sources, extent and related factors in South Korean doctors. METHODS: The study subjects were 934 doctors in Taegu, Kyungpook Province, Korea(540 independent practitioners, 105 employed at hospitals and 289 residents in training). Information concerning job stress was obtained using a 9-item questionnaire. Information regarding related factors such as demographic characteristics(age, sex, marital status), perceptions on the socioeconomic status of doctors and working conditions(work time, on-call days per week) was also obtained by self-administered questionnaire during April and May, 2000. RESULTS: Major sources of job stress included clnical responsibility/judgement factor, patient factor and work loading factor. The job stress score of residents was the highest among three groups. The score was lower in older doctors. The score was low among those who thought doctors socioeconomic status was not good. The longer the work time, the higher the job stress score was. Multiple regression analysis was conducted to control for the mutual influence of independent variables. In regression analysis, the score of residents was higher than practitioners. Work time and socioeconomic status perception had negative effects on job stress score. CONCLUSION: The average job stress score of the doctors was high. Age, work type, working conditions and perceptions of socioeconomic status were found to besignificantly related to job stress score. Although the job stress of doctors is somewhat inevitable due to the nature of the doctor's job, control of work time, development of coping tools and other intervention methods are needed to reduce job stress of doctors. Further studies are required to understand the characteristics of job stress and reduce the job stress of doctors.

Effect of smoking on pulmonary function in ex\smokers and current smokers

BACKGROUND: Smoking is closely related to pulmonary diseases, especially pulmonary function. Past studies were defective in that pulmonary function was not included for ex-smokers and the study population being too small. This study attempted to show the change of pulmonary function parameters according to post-smoking years of ex-smokers and pack-years of current smokers. METHODS: We analyzed the results of parameters derived from the forced expiratory spirogram in 3,713 adults who visited Kyungpook National University Hospital Health Screening Center between May 1997 and March 1998. Independent variables used were age, sex, height, weight and smoking status. Dependent variables were pulmonary function parameters. Multiple regression analysis was used. RESULTS: 1.Overall, there was a significant change in pulmonary function parameters among the subjects studied. Significant variables shown were age, sex, height and pack-years. Weight and post-smoking years turned out to be relatively less significant variables. 2. Positive correlation was seen in both FEV1/FVC and FEF25-75% in ex-smokers with longer post-smoking years. 3. There was negative correlation in all the parameters of current smokers with longer pack-years. CONCLUSION: The results of this test show that smoking slowly reduce pulmonary function and even those smokers who quit smoking can not be expected to have normal pulmonary function as healthy nonsmokers. However, ex-smokers can expect some improvement in certain pulmonary function parameters as the post-smoking years become longer.

The Risk Factors for the Development of Hypertension in a Rural Area - An 1-Year Prospective Cohort Study / 예방의학회지

OBJECTIVES: This study was performed to identify the risk factors related to the development of hypertension in a rural area. METHOD: Total of 3,573 subjects in Chung-Song County were interviewed and examined in 1996. The study cohort comprised 2,580 hypertension-free subjects aged above 20. One-year follow up was completed for 1,781 subjects(69.0%) in 1997. General characteristics(age, gender, education level, economic status, marital status), the family history of hypertension, diet, alcohol, smoking, coffee, stress, past history of oral contraceptive and menopausal status in female, height, weight, waist and hip circumference, baseline blood pressure, and serum total cholesterol were considered as risk factors. RESULTS: Multivariate analysis using logistic regression model indicated that age(RR=1.50, 95% CI; 1.15-1.96), the family history of hypertension(RR=2.11, 95% CI; 1.04-4.26), waist-hip ratio(WHR) (RR=2.09, 95% CI; 1.15-3.79), and baseline systolic blood pressure(130-139/ yes/no-->no) (RR=3.32, 95% CI; 1.01-10.87), baseline systolic blood pressure(120-129/<120mmHg: RR=2.00, 95% CI; 1.02-3.90)(130-139/<120mmHg: RR=2.64, 95% CI; 1.34-5.20) and baseline diastolic blood pressure(85-89/<80mmHg)(RR=4.09, 95% CI; 1.86-8.96) were identified as risk factors. CONCLUSIONS: Age and high normal blood pressure were significant risk factors for the development of hypertension above the borderline level. In addition, the family history of hypertension and WHR in men, and the change of menopausal status in women might be significant risk factors in Korea.

Therapeutic Compliance and Its Related Factors of Patients with Hypertension in Rural Area / 예방의학회지

OBJECTIVE: The purpose of this study was to examine the therapeutic compliance and its related factors in the rural hypertensives. METHOD: A questionnaire survey and blood pressure measurement were performed to 3,876 residents of a rural area, and 660 hypertensives were selected as subjects of study. The study employed a hypothetical model which was composed of constructs from the health belief model and KAP model. The analysis techniques employed included contingency table analysis and structural equation modeling. RESULT: The proportion of those who were compliant to the treatment of hypertension was 44.2% of subjects. As the result of structural equation modeling, when patients had more favorable attitude toward treatment, higher perceived benefit, or lower perceived barriers to treatment, the therapeutic compliance was significantly higher(T>2.0). When patients had more knowledge about hypertension, or higher perceived severity of hypertension, the attitude toward the treatment of hypertension was more favorable significantly(T>2.0). And when patients had the support for treatment from family or neighbor, the attitude toward treatment was more favorable(T>2.0). When patients had experience of health education, they had more knowledge, higher perceived susceptibility of complication, perceived severity for hypertension, and perceived benefit of treatment, compare to patients without health education(T>2.0). CONCLUSION: In consideration of above findings, in order to improve the therapeutic compliance in the rural hypertensives, it would be necessary to change attitude, perception, knowledge about hypertension and its treatment, by various methods such as effective health education and programs for maintaining the supportive environment for hypertension treatment.

Structural Relationships among Health Concern, Health Practice and Health Status of the Disabled / 예방의학회지

OBJECTIVES: This study was performed to determine the relationships among Health concern, health practice and health status of the disabled. METHODS: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. RESULTS: Health concern had a significant and positive relationship with health practice(p2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect on health status(T>2.0). In men and women, health practice was significantly increased with increasing Health concern and the more health practice, the higher health status(T>2.0). CONCLUSIONS: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.

Factors Related to the Intention of Participation in a Worksite Smoking Cessation Program / 예방의학회지

OBJECTIVES: This study was conducted to evaluate factors related to the intention of participation in a worksite smoking cessation program. METHODS: To explain the health behavior of participating intention in a worksite smoking cessation program, the health belief model(HBM) was used as study model, and 144 self-administered questionnaires were completed by electronic company workers. Variables of the health belief model were composed of perceived susceptibility to smokinginduced disease, perceived severity of smoking-induced disease, economical gain as perceived benefit of smoking cessation, and nicotine dependency as perceived barrier of smoking cessation. Variables of sociodemographics, smoking status, knowledge about adverse health effects of smoking, and cues to smoking cessation were used as modifying factors. RESULTS: Perceived severity(POR=1.99, 95%CI: 1.03-3.83), perceived benefit(POR=2.11, 95%CI: 1.07-4.17), and perceived barrier(POR=0.29, 95%CI: 0.11-0.76) were significant variables to the intention of participation in a worksite smoking cessation program in the logistic regression analysis. The perceived severity was significantly affected by knowledge about adverse health effects of smoking(POR=2.17, 95%CI: 1.23-3.84). The perceived barrier was significantly affected by education level(POR=3.66, 95%CI: 1.17-11.44), age to first cigarette (POR=0.32, 95%CI: 0.10-0.98), pack-years(POR=5.47, 95%CI: 2.37-12.61). To the perceived benefit, the model was not fitted. CONCLUSIONS: Our results found that counterplans improving the knowledge about adverse health effects of smoking, preventing early smoking, and decreasing smoking amount should be considered for an effective smoking ban policy.

Determinanats of Health Care Utilization of the Physically Disabled / 예방의학회지

To investigate determinants of health care utilization of the physically, disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization rate was 81.9%(69.l% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically, significant relationship with health care utilization(p<0.05). By, path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.l%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health Concern toward physically disabled should be implemented to increase health care utilization rate.

A Study on Urinary Cadmium Concentration and Renal Indices of Inhabitant in an Abandoned Mine Area / 예방의학회지

Urinary cadmium is used as a sensitive indicator for internal Cd dose, and increased excretion of N-acetyl-beta-D-glucosaminidase(NAG), beta(2)microglobulin(MG) and total protein are useful indices for renal dysfunction by chronic exposure to Cd. The target group was 184 inhabitant(82 men and 102 women) in an abandoned mine area known as exposure to low level Cd. The control group was took 160 individuals(64 men and 96 women) in Cd not-exposed area. Urinary Cd concentration was significantly higher in the target group than the control. The geometric mean of urinary Cd for male was 2.56ng/l, 2.80ng/g creatinine and 2.50ng/S.G. in the target group and 1.19ng/l, 1.36ng/g creatinine and 1.17ng/S.G. in the control. For female 2.69ng/l, 3.94ng/g creatinine and 2.63ng/S.G. in the target group and 1.27ng/l, 1.97ng/g creatinine and 1.25ng/S.G. in the control, respectively. In addition, urinary Cd of the target group had affected by the period of residence and dietary habit for the rice and the vegetables from the target area. These findings suggest the chronic exposure to Cd of the target population. Mean excretion of urinary NAG, beta(2)MG and total protein were not significant between two groups. In the target group, urinary NAG activity and total protein were significantly correlated with urinary Cd, but beta(2)MG was not related. Urinary excretion of NAG, beta(2)MG and total protein were significantly increased in 10 than in <2 of urinary Cd level. In 2~10 group of urinary Cd level, the excretion of NAG significantly increased while not showed for beta(2)MG. In present study, urinary excretion of NAG was relatively sensitive than beta(2)MG in chronic exposure population to low level Cd.

Effect of cigareet smoking on air-conduction hearing threshold level in adult men / 예방의학회지

To investigate the effect of smoking on the hearing threshold, l,887 adult male workers who visited health care center during the period l January 1996 - 31 July 1997 were selected. Air-conduction hearing threshold level, diastolic blood pressure(DBP), total cholesterol, fasting blood sugar(FBS), hematocrit and obesity, were measured. The data on age, occupation, and smoking were collected. Air-conduction hearing threshold in smoker was significantly higher than non-smoker in categories of 250, 500, 1000 and 4000 Hz(p<0.05). Mean values of PTA-low, PTA-mid, and PTA-high in smoker were also significantly higher than non-smoker(p<0.05). In multiple regression analysis, smoking is likely to play a significant role after controlling age, occupation, DBP, FBS, total cholesterol, hematocrit, and obesity,(p<0.05). The hearing threshold was significantly increased with increasing age(p<0.05), the manufacturing worker may have higher hearing threshold(p<0.05). The higher hematocrit and the more obese, the higher hearing threshold(p<0.05). However, DBP, total cholesterol and FBS were not significantly related with hearing threshold level. In conclusion, smoking was significantly related with the hearing threshold level in adult men.

Interns' Resident's Professional Job Perception and Its Effect to Their Job Satisfaction / 예방의학회지

In order to investigate the professional job perception and job satisfaction of interns and residents and its related factors, the author conducted survey using self administered questionnaire for 2 months(August and September, 1996). The study subjects were 562 interns and residents who worked at one university hospital(tertiary hospital) and two general hospitals(secondary hospital) in Taegu, Korea. Among them, 297(52.8%) responded completely. The results were as follows ; Respondents thought that people component was most important, science and status components were next among professional value scales which meant the desirable attitudes required to conduct professional works. But, the score of professional value scales was generally high and not affected by other variables in multiple linear regression analysis. They seemed to have very normative and ideal perceptions about professional values. The score of professionalism scales, which were attitudinal and behavioral traits about professional job, of high grade residents was significantly higher than that of interns and lower grade residents. The score of reference to professional organization and autonomy factor were increasing significantly as the grade increased. Working conditions and perception for socioeconomic status of doctors influenced the score of professionalism scale significantly. It seemed that professional socialization was made during the training periods of interns and residents. Most of respondents answered that current socioeconomic status of doctors were middle and high strata but they responded that the socioeconomic status of doctors would fall in the future. They seemed to have a pessimistic thought about doctor's status. Generally the respondents thought that they were satisfied with doctor job and fit to the job, but 51.9% answered that if possible they would get other jobs. It seemed to reflect their critical thinking on doctors' status. Perceptions about socioeconomic status of doctors, professional value and professionalism influenced job satisfaction significantly. The interns and residents had high sense of calling to doctors and thought that doctors were socially important job. Generally they were satisfied with their job. Interns and residents had normative thoughts about the trait which competent doctors must have. During the training period, they seemed to have attitude and perception as a professional and to make professional socializations.

Factors Affecting Blood Donation in University Students / 대한수혈학회지

BACKGROUND: Investigation of the factors affecting blood donation practice is essential to develop the ways of making blood donation campaign, as well as efficient and facilitating blood donation practice. A few studies has been made concerning the factors affecting blood donation in Korea. METHODS: 637 participants were examined using self-administered questionnaires including demographic variables, experience, knowledge and attitude for blood donation and others. RESULTS: 51.5% of participants had experienced the blood donation. Students who donated blood in high school days showed tendency to donate blood more than those who didn t donate blood in high school days. Students who had more knowledge and desirable attitude about blood donation experienced more blood donations. CONCLUSION: It is necessary for adolescents to take the opportunity of blood donation. It is important to clarify factors affecting blood donation practice and to encourage the public education and campaign which enable public has accurate knowledge and positive attitude about blood donation.

Incidence and Risk Factors of Needle Stick Injury and the Association with HBV Infection in Hospital Personnels / 한국역학회지

To investigate the incidence and risk factors of needle stick injury(NSI) and the association between NSI and hepatitis B infection in hospital personnel, a prospective cohort study was conducted at a university hospital in Pusan city from April 1, 1994 to September 30, 1994. Of five hundred and thirty hospital personnel, 38.7 percent reported one NSI or more. The annual person incidence rate of NSI was 81.3 per 100 person and annual spell incidence rate was 144.3 per 100 persons. The annual incidence rate in registered nurses(192.8 cases per 100) was the highest, followed by physicians(115.4 cases per 100), nurse aids(75.5 cases per 100) and laboratory technicals(51.8 cases per 100) (p<0.05). Risk factors significantly associated with needle stick injuries were being interns higher than residents(p<0.05) for physicians, the incidence rate decreased as length of employment increased (p<0.05) for registered nurses and working in operating room and central supply room higher than working in surgical department(p<0.05) for nurses aids. The most common device related to needle stick injuries was disposable needles(49.7%), the most frequent activity related to needle stick injuries was recapping needle(35.7%), and most of the needle stick injuries occurred in nurse station(40.9%) and patient room (34.1%). The vaccination rate for hepatitis B virus was 40.2 percent. Of the non-vacciness, 4.5 percent were positive for hepatitis B surface antigen and 69.2 percent were serologically positive for hepatitis B viral markers at the beginning of this study. Of 80 negative personnel for for all hepatitis B viral markers, 27 persons experienced needle stick injuries during study period. Three out of 27persons were positive for hepatitis B markers at the end of follow-up. However, all of 53 persons who had no experience of needle stick injuries were negative. Therefore, NSI was significantly associated with HBV infection and the annual incidence for hepatitis B virus infection was as 8.0 per 100 in hospital personnel. These findings suggest that hospital personnels are at a high risk group for needle stick injuries. Particulary interns, novice registered nures (length of employment less than 1 year), and nurse aids who are working at operating room and central supply room are the highest risk group. It is recommended that NSI prevention program for hospital personnel should be developed to minimize the risk of needle stick injuries in the hospital.

The Relationship between Change in Obesity Indices and Change in Serum Lipids in Adult Male Workers / 예방의학회지

This study was conducted to evaluate the relationship between change in obesity indices and change in serum lipids in adult male workers. Two-hundred-eight adult male workers of an industry in Taegu city were followed-up from 1991 to 1995. Height, weight, circumferences of hip and waist, blood pressure were measured and serum lipids were analysed. Data on life style were obtained using self-administered questionnaires. Mean differences of anthropometric measurements between 1991 and 1995 were as follows; 1.63kg in weight, 3.61cm in waist circumferences, 4.23cm in hip circumferences, 0.52kg/m2 in BMI and -0.021 in WHR. Those of lipids were as follows; 15.09mg/dl in total cholesterol, 20.43mg/dl in triglyceride, 9.40mg/dl in HDL-cholesterol, 2.87 in MI-index(p<0.01) and 350mg/dl in LDL-cholesterol. The changed value of BMI and Katsura index were strongly correlated with that of total cholesterol(r=0.174, p<0.05), the changed value of BMI correlated with that of triglyceride(r=0.374, p<0.01) and the changed value of weight correlated with that of MI index(r=-0.173, p<0.05). The changed value of WHR was significantly correlated with that of total cholesterol(r=0.162, p<0.05), however, was not significantly correlated with HDL-cholesterol, LDL-cholesterol, triglyceride and MI index. The changed value of weight, BMI and Katsura index were correlated with that of triglyceride(r=0.262, p<0.01; r=0.267, p<0.01; r=0.258, p<0.01) and the changed value of MI index(r=-0.143, p<0.05; r=-0.158; r=-0.144, p<0.01), adjusting the pattern of change in life style. The changed values of HDL-cholesterol and MI index between 1991 and 1995 in low WHR group were significantly higher than those in high WHR group(p<0.05, p<0.01), adjusting the baseline value of them. Similar pattern was observed when considering Katsura index. When stratifying by BMI value of 1991, in low BMI group, the changed value of HDL-cholesterol and MI index showed the same pattern as above, however the of triglyceride was statistically higher in obese group than in non obese group(p<0.05). In conclusion BMI might be a better indicator to predict serum lipids change than other obesity indices.

Impact of the Discontinuance of Regular Exercise on Serum Lipids / 한국역학회지

To estimate the impact the discontinuance of regular exercise on serum lipids, we selected 90 healthy young adults who were recruited and completed their training course as scheduled(5-week basic physical training and 4-week indoor education) during the period February 1995 to April 1995. Serum lipids, height, and weight were measured three times(Time I: before training, Time II: after 5-week training, Time III: after 4-week detraining). Ninety study subjects were classified as underweight, normal and overweight based on the criteria of Katsura equation. Of 17 underweight subjects, two were weight maintainers and 15 were weight gainers. There was no significant change in serum lipids after detraining among 15 weight gainers. Of 64 normal weight subjects, three were weight losers, 12 weight maintainers and 49 were weight gainers. There was significant increase in total cholesterol after detraining among 12 weight maintainers(P<0.01). In addition to this, there was also significant increase in total cholesterol(P<0. 01), LDL- cholesterol(P<0. 01) and HDL-cholesterol(P<0.05) after detraining among 49 weight gainers. This might be due to the harmful effect of detraining except HDL-cholesterol change. Of nine overweight subjects, only one was weight loser and eight were weight maintainers. There was significant increase in HDL-cholesterol after detraining among 7 weight maintainers (P<0.05). However, there were no significant changes in total cholesterol, triglyceride, LDL-cholesterol and MI index. The harmful effect of detraining was not observed in overweight subjects. In conclusion, the harmful effect of detraining was observed in weight maintainers and weight gainers among normal weight subjects after regular exercise.

Determinant Factors for Expenditure of the Medical Insurance Program for Self-Employeds / 예방의학회지

This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 "The Medical Insurance program for self-Employeds Statical Yearbook", and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows: We have divided benefits into these four components such as the utilization rate for out-patients. expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings: in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are: first, the determinant factor for administrative expenses was the number of households. The more the number of household, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second. in urban areas. the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas. a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Since the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.

Relationship of Body Fat Distribution and Serum Lipids in Men / 한국역학회지

This study was conducted to investigate the relationship of body fatness indicators and serum lipids (total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein(LDL) cholesterol, triglycerides, myocardial infarction(MI) index) to find anthropometric indicators of body fat distribution that are strongly associated with serum lipids. 347 adult male workers of an industry in Kyungpook province were selected and data on the general characteristics were obtained using questionnaire from June 26 to June 29, 1991. Serum lipids were tested with 5 ml fasting blood and height, weight, circumferences of waist, hip and mid-thigh, five subcutaneous fat thickeness(biceps, triceps, supscapular, suprailiac, thigh) were mea sured using Ultrasound type A TATT. Waist circumference, waist/hip circumference ratio and subcutaneous fat thickness of suprailiac area are significantly increased with increasing age, but thigh circumference is significantly decreased (P< 0.05). These results suggest that central obesity is closely related to age and waist circumference may be the best indicator of body fatness or body fat distribution in men. In younger age group(below 40 year old), the result of canonical correlations analysis suggests that circumferences(0.501) was slightly closely related to serum lipids than subcutaneous fat thickness(0.493), however, in older age group (above 40 year old), subcutaneous fat thickness(0.528) were more strongly associated with serum lipids than circumferences(0.419). Weighted canonical analyses suggest that biceps and suprailiac areas in younger age group and sub scapular area in older age group are stronger indicators of serum lipids among .subcutaneous fatness measurements. Of the circumferences, waist is the most strongest indicator of serum lipids in both age groups. Therefore, it is recommended that circumference of waist and subcutaneous fat thickness of subscapular area should be measured to estimate the degree of central obesity for preventing cardiovascular disease in men.