Factors affecting screening for diabetic complications in the community: a multilevel analysis / 한국역학회지

OBJECTIVES: The objective of the present study was to identify the factors that affect screening for diabetic complications by sex in the community. METHODS: This study used individual-level data from the 2013 Community Health Survey (CHS) for 20,806 (male, 9,958; female, 10,848) adults aged 30 years or older who were diagnosed with diabetes. Community-level data for 253 communities were derived from either CHS or national statistics. A chi-square test and multilevel logistic regression analysis was performed. RESULTS: There were significant differences in the rate of screening for diabetic complications according to individual-level and community-level variables. In the multilevel analysis, the community-level variance ratio of the null model was 7.4% and 9.2% for males and females, respectively. With regard to community-level variables, males were affected by the city type, number of physicians, and their living environment, while females were affected by number of physicians, natural and living environments, and public transportation. CONCLUSIONS: The factors that influenced individual willingness to undergo screening for diabetic complications differed slightly by sex; however, both males and females were more likely to undergo screening when they recognized their health status as poor or when they actively sought to manage their health conditions. Moreover, in terms of community-level variables, both males and females were affected by the number of physicians. It is essential to provide sufficient and ongoing opportunities for education on diabetes and its management through collaboration with local communities and primary care medical centers.

Test-retest reliability of health behavior items in the Community Health Survey in South Korea / 한국역학회지

OBJECTIVES: Responses to health-related items on the Community Health Survey (CHS) provide evidence that is used to develop community-based health policy. This study aimed to assess the test-retest reliability of selected health behavioral items on the CHS according to item category, response period, and response scale. METHODS: A sample of 159 men and women 20 to 69 years of age participated in a test-retest with an interval of 14 to 21 days. A total of 28 items relating to smoking, alcohol consumption, diet and weight control, and mental health were selected. We evaluated the test-retest reliability of the items using kappa statistics. RESULTS: Kappa values ranged from 0.44 to 0.93. Items concerning habits had higher kappa values (mean, 0.7; standard error, 0.05) than items concerning awareness or attitudes (p=0.012). The kappa value of items with two- to four-point scales was 0.63, which was higher than the value of 0.59 for items with scales involving five or more points, although this difference was not statistically significant. Different kappa values were observed for each reference period, but no statistically significant differences were noted. CONCLUSIONS: The test-retest reliability of the CHS items that we studied was associated with item category. Further study of the relationship between item category and reliability in domains other than health behaviors is required.

Hematological Effect of Water Extracts of Cham-Dang-Gui on Cyclophosphamide Induced Anemic Rat

Anemia, the condition of the diminished concentration of hemoglobin per erythrocyte is common in patients with cancer and is a frequent complication of myelosuppressive chemotherapy. Cham-Dang-Gui (Angelicae Gigantis Radix) has been used in traditional Korean medicine to treat hematologic deficiencies. In this study, Cyclophosphamide (CYP), an alkylating agent that has a broad spectrum of anti-cancer activities, was intraperitoneally injected into the experimental animals to suppress the bone marrow thereafter, causing anemia. The hemopoietic effects of Cham-Dang-Gui were examined using anemic rat model. Rats were divided into five groups: CON (control group), ANS (CYP-injected + normal diet), AND (CYP-injected + normal diet + Cham-Dang-Gui), ALS (CYP-injected + low iron diet), and ALD (CYP-injected + low iron diet + Cham- Dang-Gui) groups. CYP (30 mg/kg) was intraperitoneally injected to rats for 3 days to induce anemic condition. Saline or Cham-Dang-Gui was administrated orally during the entire experimental period. CYP injection decreased body weight gain and food consumption in comparison with CON group. Oral administration of Cham-Dang-Gui extract with normal iron diet significantly prevented the lower body weight gain. The blood level of hemoglobin, iron status (serum iron, transferrin, ferritin and TIBC) and blood level of vitamin B-12 in Cham-Dang-Gui treated groups were significantly higher than those of Cham-Dang-Gui untreated groups regardless of amount of iron in the diet. Taken together, it could be concluded that the Cham-Dang-Gui extract could improve anemic condition induced by CYP injection by improving hematological value, iron status and vitamin B12 status in rats.