• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4421-4426
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• 2016

Background: Smoking is recognized as a main leading preventable cause of mortality and morbidity worldwide. It is responsible for a considerable financial burden both on the health system and in society. This study aimed to examine the effect of smoking on cost of hospitalization and length of stay (LoS) among patients with lung cancer in Iran in 2014. Materials and Methods: A total of 415 patients were included in the study. Data on age, sex, insurance status, type of hospitals, type of insurance, geographic local, length of stay and cost of hospitalization was extracted by medical records and smoking status was obtained from a telephone survey. To compare cost of hospitalization and LoS for different smoking groups, current smokers, former smokers, and never smokers, a gamma regression model and zero-truncated poisson regression were used, respectively. Results: Compared with never smokers, current and former smokers showed a 48% and 35% increase in hospitalization costs, respectively. Also, hospital LoS for current and former smokers was 72% and 31% higher than for never smokers, respectively. Conclusions: Our study indicated that cigarette smoking imposes a significant financial burden on hospitals in Iran. It is, however, recommended that more research should be done to implement and evaluate hospital based smoking cessation interventions to better increase cessation rates in these settings.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup1호
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• pp.65-70
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• 2016

Background: In 2013, legislation in Vietnam regulated smoking in public areas. Included was a ban on indoor smoking at universities. Objective: Since awareness and attitude are moderators of the effectiveness of smoke-free policy, ou aim was to assess changes in students' knowledge and attitude tosecond hand smoke (SHS) and awareness and support of smoke-free legislation at four Vietnamese universities, one year after legislative changes. Methods: A two-phase cross sectional study of undergraduate students using self-administered questionnaires (based on the Global Adult Tobacco Survey and the Thrasher survey) was conducted at the introduction of the legislation and one year thereafter. Results: One-year post legislation there were significant increases in knowledge of smoke-free legislation and awareness of universities as smoke-free environments. There was a significant increase in knowledge of harmful effects of SHS on diseases such as examples in the heart and lung, including lung cancer, and miscarriage. Students expressed strong support of smoke-free environments in universities, hospitals, schools, workplaces, public transport, libraries, cinemas and theatres; support was also increased post legislation. Changes were seen in attitude to SHS, and rights of non-smokers and smokers. Conclusions: Positive changes have occurred in knowledge and attitude toward smoke-free environments and SHS in universities since enactment of Vietnamese tobacco control legislation.

• Journal of Preventive Medicine and Public Health
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• 제57권3호
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• pp.288-297
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• 2024

Objectives: This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS). Methods: We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05. Results: The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male sex (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p<0.001) and being in a lower academic year, specifically grade 7 (aOR, 4.08; 95% CI, 2.39 to 6.99; p<0.001) and grade 8 (aOR, 2.20; 95% CI, 1.30 to 3.72; p=0.003). Poor sleep quality was also a significant predictor (aOR, 1.77; 95% CI, 1.29 to 2.44; p<0.001), as was a history of attempted suicide (aOR, 5.31; 95% CI, 4.00 to 7.06; p<0.001). Physical inactivity was associated with lower odds of co-use (aOR, 0.45; 95% CI, 0.33 to 0.62; p<0.001). Additionally, non-attendance of physical education classes (aOR, 1.48; 95% CI, 1.06 to 2.05; p=0.021), infrequent unapproved parental checks (aOR, 1.37; 95% CI, 1.04 to 1.80; p=0.024), and lower parental awareness of free-time activities (aOR, 0.63; 95% CI, 0.45 to 0.87; p=0.005) were associated with higher odds of co-use. Factors not significantly linked to co-use included age group, being in grade 9, always feeling lonely, having no close friends, being bullied outside school, and whether a parent or guardian understood the adolescent's worries. Conclusions: The findings highlight the critical need for comprehensive interventions in the Philippines, addressing not only physical inactivity and parental monitoring but also focusing on sex, academic grade, participation in physical education classes, sleep quality, and suicide attempt history, to effectively reduce alcohol and cannabis co-use among adolescents.

• Korean Journal of Acupuncture
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• 제30권1호
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• pp.64-72
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• 2013

목적 : 본 연구는 퇴행성 슬관절염 환자의 통증을 줄이고 증상을 개선하는데 있어 현재 침구임상에서 활용되고 있는 온침이 침보다 더욱 유효한지를 알아보기 위하여 임상연구로 시행되었다. 방법 : 총 76명의 퇴행성 슬관절염 지원자가 연구에 참가하였으며, 이들 모두는 선정기준과 제외기준에 의하여 선발되었고 최종적으로 임상연구를 마친 지원자는 66명이었다. 지원자들은 무작위로 온침군과 침군 중에 할당이 되었다. 실험군(온침)에 속한 38명은 온침시술을, 대조군(침)에 속한 38명은 침시술을 받았으며, 8주 동안 총 16회의 시술을 환측의 무릎에 시행하였다. 주된 평가척도는 Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)이었고, 부수적 평가척도는 physical health score based on the 36-Item Short-Form Health Survey(SF-36), Patient Global Assessment이었다. 결과 : 실험군이 대조군에 비해서 WOMAC의 pain, function, total score와 Patient Global Assessment에서 월등한 감소를 나타내었으나 SF-36에서는 유의한 변화가 없었다. 결론 : 이번 연구의 결과를 통해 온침이 침에 비하여 퇴행성 슬관절염 환자의 통증 감소와 기능개선에 유의성있게 효과가 있음을 확인하였다.

• Perspectives in Nursing Science
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• 제15권2호
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• pp.49-69
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• 2018

Purpose: The purpose of this study was to derive contextual indicators of medical provider quality and assess their relative importance along with the individual utilization of antenatal care (ANC) and institutional births with a skilled birth attendant (SBA) in India using a multilevel framework. Methods: The 2015~2016 Demographic and Health Survey (DHS) from India was used to assess the outcomes of neonatal, infant, and under-five child mortality. The final analytic sample included 182,980 children across 28,283 communities, 640 districts, and 36 states and union territories. The contextual indicators of medical provider quality for districts and states were derived from the individual-level number of ANC visits (<4 or ${\geq}4$) and institutional delivery with SBA. A series of random effects logistic regression models were estimated with a stepwise addition of predictor variables. Results: About half of the mothers (47.3%) had attended ${\geq}4$ ANC visits and 75.8% delivered in institutional settings with SBAs. Based on ANC visits, 276~281 districts (43.1~43.9%) and 13~16 states (36.5~44.4%) were classified as "low" quality areas, whereas 268~285 districts (41.9~44.5%) and 8~9 states (22.2~25.0%) were classified as "low" quality areas based on institutional delivery with SBAs. Conditional on a comprehensive set of covariates, the individual use of both ANC and SBA were significantly associated with all mortality outcomes (OR: 1.17, 95% CI: 1.08, 1.26, and OR: 1.10, 95% CI: 1.02, 1.19, respectively, for under-five child mortality) and remained robust even after adjusting for contextual indicators of medical provider quality. Districts and states with low quality were associated with 57~61% and 27~43% higher odds of under-five child mortality, respectively. Conclusion: When simultaneously considered, district- and state-level provider quality mattered more than individual access to care for all mortality outcomes in India. Further investigations are needed to assess the importance of improving the quality of health service delivery at higher levels to prevent unnecessary child deaths in developing countries.

• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.419-428
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• 2020

Objectives: Adolescent suicide is a global problem. This study aimed to identify associations between parental marital status and suicidal behavior. Methods: This study analyzed 118 715 middle and high school students from the 13th and 14th Korea Youth Risk Behavior Web-based Survey. The odds ratios (ORs) of suicidal ideation, planning, and attempts were calculated based on parental marital status, living situation, and socioeconomic factors. The data were analyzed using multiple logistic regression. Results: When compared to those living with 2 married biological parents, the ORs of suicidal ideation among adolescents living with either remarried or no parents were 1.34 (95% confidence interval [CI], 1.17 to 1.53) and 1.36 (95% CI, 1.11 to 1.66), respectively. For suicidal planning, the OR of those living with 1 remarried biological parent was 1.24 (95% CI, 1.01 to 1.52), and that of those living without parents was 1.28 (95% CI, 0.95 to 1.73), when compared to adolescents living with 2 married biological parents. For suicide attempts, when compared to adolescents with 2 married biological parents, the OR of those living with 1 remarried biological parent was 1.48 (95% CI, 1.17 to 1.87) and that of those living without parents was 2.02 (95% CI, 1.44 to 2.83). For adolescents living with 1 remarried biological parent, suicidal behavior was strongly associated with having no siblings and were weakly associated with not living with grandparents. Conclusions: Suicidal behavior among adolescents was associated with the remarriage and loss of parents. Therefore, special attention and interventions are needed for adolescents in those situations.

• 디지털융복합연구
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• 제18권6호
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• pp.297-309
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• 2020

본 연구는 국내 공공 DB에 데이터마이닝 기법인 로지스틱 회귀분석과 의사결정나무 분석을 적용하여 국내 청소년의 삶의 만족도 증진에 관한 의미 있는 의사결정 규칙을 추출하는 과정을 분석한다. 분석을 위하여 한국아동·청소년패널조사(KYCPS) 중에서 중1 패널데이터의 4~6차연도 자료인 고등학생 학년별 자료를 활용하였다. 로지스틱 회귀분석으로 추출된 영향요인은 1학년은 전체 성적 만족도, 주의집중 문제, 우울, 자아 탄력성, 애정, 과잉간섭, 학습활동, 교사관계, 2학년은 가정의 경제 수준, 건강상태, 전체 성적 만족도, 신뢰, 소외, 학습활동, 학교규칙, 교우관계, 교사 관계, 3학년은 가정의 경제 수준, 전체 성적 만족도, 우울, 자아 탄력성, 애정, 학대, 학교규칙, 교사 관계로 나타났다. 의사결정나무 기법을 적용한 결과 국내 고등학생의 삶의 만족도는 개인의 정서 문제, 학교성적, 가정의 경제적 환경, 학교적응 등에 의하여 복합적으로 영향을 받는 것으로 파악되었다.

• Korean Journal of Acupuncture
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• 제26권4호
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• pp.53-66
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• 2009

Objective : Acupuncture has been widely used throughout the world for the treatment of knee osteoarthritis (knee OA). This study investigated whether acupuncture, particularly Sa-am acupuncture, could be effective in relieving pain and improving the symptoms of knee OA. Method : This study was conducted as a prospective, randomized, controlled, and patient- and investigator-blinded clinical trial. Forty volunteers with knee OA participated in the study. All participants were screened through an inclusion and exclusion criteria. Thirty four participants completed the clinical trial. In total, forty subjects were randomly selected to receive Sa-am acupuncture. Eight sessions of acupuncture were given at the contralateral side of the problematic knee for 4 weeks. Korean translation of Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC) scores were measured twice: at the beginning and end of the clinical trial period. Both the Patient Global Assessment and physical health scores based on the 36-Item Short-Form Health Survey were also used to measure the results. Results : Compared to the pre-trial scores, the Sa-am acupuncture group (n=34) showed a significant decrease in KWOMAC total scores according to a paired t-test. The Sa-am acupuncture group also showed significant improvement in the Patient Global Assessment when compared to the pre-trial. Conclusions : Sa-am acupuncture for knee OA resulted in an improved KWOMAC total score. This was mostly driven by the function component score that was greatly affected by acupuncture. However, further studies with expanded designs are needed to solidify this finding with scientific rigor.

• The Journal of Asian Finance, Economics and Business
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• 제9권1호
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• pp.93-103
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• 2022

The main purpose of this study was to gauge the patient satisfaction index and subsequently discuss the Importance-Performance (IP) matrix analysis of the inpatient services in the context of the private hospital setting. The Malaysian Customer Satisfaction Index Model was employed as the theoretical framework for the above purposes. This study involving 242 patients in Malaysian's private healthcare sector used a Web-based survey as the main method of data collection. Partial least square structural equation modeling (PLS-SEM) was utilized for data analysis. Using Fornell et al. (1996)'s formula, the resulting patient satisfaction index was slightly lower than the "very satisfied" category, the target level required for positioning as one of the world's premier medical tourism players. The IP matrix showed that medical quality is the main competitive advantage of the private hospitals that can propel their growth in the global healthcare marketplace. The results also indicate that outcome quality, patient rights, and privacy, and service quality are the three quality domains that need to be prioritized for further improvement. On the other hand, the servicescape quality domain needs to be strategized as the unique selling proposition as the performance of the private hospitals in this regard is already extremely good.

• Journal of Preventive Medicine and Public Health
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• 제46권4호
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• pp.192-200
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• 2013

Objectives: To measure the prevalence of behavioural risk factors for obesity among urban adolescent school children in Chennai, India. Methods: This study was performed as a cross-sectional study using a World Health Organization-designed Global School-based Student Health Survey questionnaire (modified for India) among adolescent school children studying in 30 randomly selected secondary and higher secondary schools in Chennai city. 1842 adolescents studying in the VIII to XII standards were randomly selected for the study. Results: In the present study, 40.7% of the students ate fruit one or more times per day and 74.5% of the students ate vegetables one or more times per day. Nearly 20% of the students ate fast food items on 4 to 7 days during the previous week. Among the students, 30.4% watched television for more than two hours per day. Nearly 68% of the girls and 22% of the boys did not participate in outdoor sports activities. When the pattern of physical activity of the students was assessed, it was observed that 15.6% were inactive, 43.4% were minimally active, and the remaining 41.0% belonged to the category of health enhancing physical activity. Among the students, 6.2% were overweight and 5.2% were obese. Conclusions: The prevalence of risk factors for obesity was quite high among the adolescents. This study also showed that a great proportion of overweight/obese adolescents had a correct perception of their body weight and they were making efforts to modify risk factors such as television viewing, computer use, a sedentary lifestyle, and unhealthy dietary habits.