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Suicide Mortality Across Broad Occupational Groups in Greece: A Descriptive Study

  • Alexopoulos, Evangelos C.;Kavalidou, Katerina;Messolora, Fani
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.1-5
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    • 2016
  • Background: Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000-2009. Methods: Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60-X84) was based on the international classification of diseases (ICD-10). Results: Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30-39 years in Greek male elementary workers and the 50-59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. Conclusion: Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations.

Developing CPG for Implementation of CDSS in Digital Hospitals (디지털 병원의 CDSS구현을 위한 CPG 개발)

  • Lee, Hyung-Lae;Won, Chang-Won;Lee, Sang-Chul;Park, Sang-Chan
    • Journal of Korean Society for Quality Management
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    • v.42 no.1
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    • pp.81-89
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    • 2014
  • Purpose: The purpose of this study is to propose Clinical Practice Guideline(CPG) model and Clinical Index(CI) for implementing CDSS in digital hospitals. Methods: This study uses EMR data at department of family practice in A hospital; 636 patients, 570 diseases (based on ICD 10-CM criteria), and 37,000 data related with labs and treatments. This study focuses on disease J342 which is the most high rate of incidence. Results: Using the suggested model, this study calculates frequency matrix and probability matrix to find out the correlation of diseases and labs. This study indicates the lab sets of Disease (J342) as CI for CPG. Conclusion: This study suggests CPG model including Lab-based, Disease-Based and Case-based modules. Through 6 level cased-based CPG model, especially, this study develops Clinical Index(CI) such as the Incidence Rate, Lab Rate, Disease Lab Rate, Disease confirmed by Lab.

An Analysis on Prescribing Patterns of Alzheimer's Dementia Treatment and Choline Alfoscerate using HIRA Claims Data (건강보험 청구자료를 이용한 알츠하이머 치매 치료제와 콜린알포세레이트의 처방 양상 분석)

  • Hwang, Sang Goo;Park, Hyekyung
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.1
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    • pp.1-8
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    • 2019
  • Background: Alzheimer's dementia is the most common dementia. However, recently, choline alfoscerate is prescribed for treating Alzheimer's dementia, although it is not a treatment for this disease. Purpose: To analyze the prescription patterns of choline alfoscerate as a dementia treatment for patients with Alzheimer's disease and to analyze, as well as the factors affecting choline alfoscerate prescription. Method: The 2016 HIRA-NPS data was used in this study. The code of Alzheimer's dementia is F00 in the ICD-10 disease classification code. We analyzed the demographic, clinical, and regional characteristics associated with donepezil, rivastigmine, galantamine, memantine, and choline alfoscerate prescriptions. All statistical and data analyse were conducted by SAS 9.4 and Excel. Results: For patients with Alzheimer's disease, choline alfoscerate was the second most prescribed after donepezil. Analysis results showed that choline alfoscerate was more likely to be prescribed to men than to women, and more likely to be prescribed by local health centers than by medical institutions. Moreover, choline alfoscerate was highly likely to be prescribed at neurosurgical departments, among medical departments. Conclusions: This study confirmed that choline alfoscerate was prescribed considerably for patients with Alzheimer's dementia. Further studies valuating its clinical validity should be performed to clarify whether choline alfoscerate prescription is appropriate for treating Alzheimer's dementia.

Avionics Software Data Modeling Method and Test For FACE Conformance (FACE 적합성을 위한 항공전자 소프트웨어 데이터 모델링 방안 및 검증)

  • Kyeong-Yeon, Cho;Doo-Hwan, Lee;Sang-Cheol, Cha;Jeong-Yeol, Kim
    • Journal of Aerospace System Engineering
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    • v.16 no.6
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    • pp.45-53
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    • 2022
  • The avionics industry has recently adopted an open architecture to increase software portability and reduce the development schedule and cost associated with changing hardware equipment. This paper presents a data modeling method compliant with FACE, a widely used open avionics architecture. A FACE data model is designed and implemented to output data from VOR/ILS avionics equipment. A FACE Conformance Test Suite (CTS) program is utilised to verify that the data model meets FACE standards. The proposed data modeling method is expected to improve the development schedule and cost associated with modifying communication methods and ICDs (Interface Control Documents).

Gaming Disorder and Addiction in Children and Adolescents (소아청소년의 게임장애와 중독)

  • Juyeop Lee
    • Journal of Convergence Korean Medicine
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    • v.5 no.1
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    • pp.25-44
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    • 2023
  • Objectives: Gaming disorder has been viewed as a disease in the DSM-5 and ICD-11. Its essential symptoms are loss of control over gaming, gaming becoming a markedly prioritized activity over other activities of daily living, and continued and excessive use of gaming despite negative problems occurring. Methods: Children and adolescents are especially vulnerable to gaming disorder because the striatal pathways related to reward develop earlier than the control regions of the prefrontal cortex. It is also associated with decreased dopamine D2 receptors. Addiction is related to 'want' and is explained by incentive-sensitization. In addition, allostasis, in which homeostasis is continuously achieved at a new target value, is also related to gaming disorder. In addition, personality causes, unchangeable factors, and external factors can influence on the onset of gaming disorder. Results: Prevention is the best solution for gaming disorder, and the role of parents is important. For gaming disorder, bupropion is used, cognitive-behavioral therapy and family-based therapy are also beneficial. Herbal medicine treatment such as Antler velvet and ginseng can be effective. Electroacupuncture and acupuncture using PC6, SP6, and LR3 has a correlation with relieving Internet craving. Ear-acupuncture was also effective in treating addiction. Conclusion: Psychologically, 'want' is an intense longing for reward and motivation, and is related to addiction. This 'want' may rather be related to avoidance, and game addiction in children and adolescents may be due to wanting to escape from academic stress or avoidance of comparison. Therefore, the importance of 'like', which gives pleasure in itself, increases. It can also be explained with Sasang Constitutional Medicine.

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Diagnostic Hierarchy of Tic Disorders in Real-World Clinical Practice

  • Yeeji Sung;Soon-Beom Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.4
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    • pp.236-241
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    • 2023
  • Objectives: According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice. Methods: Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette's syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette's syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student's t-tests, and chi-squared tests. Results: Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027). Conclusion: Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.

Continuity of Ambulatory Care among Adult Patients with Type 2 Diabetes and Its Associated Factors in Korea (우리나라 성인 2형 당뇨환자의 외래진료 지속성과 관련요인 분석)

  • Hong, Jae-Seok;Kim, Jai-Yong;Kang, Hee-Chung
    • Health Policy and Management
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    • v.19 no.2
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    • pp.51-70
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    • 2009
  • Background : Previous studies have reported that enhanced continuity of care prevented a sudden worsening in progress among chronic disease patients, and as a result was favorable for efficient spending of health care funds. This study aims to estimate the continuity of care of Korean with diabetes and to identify factors affecting the continuity of care. Methods : This study used the Korean National Health Insurance Claims Database which includes E11 (ICD-10) as a primary or secondary disease as of 2006. Study population is 1,160,725 type 2 diabetics (20-84 years). Continuity of Care Index (COC), Modified, Modified Continuity Index (MMCI), and Most Frequent Provider Continuity (MFPC) were used as indexes of continuity of care. Results : The continuity of care in the study population was $0.94{\pm}0.10$ as calculated by MMCI, $0.91{\pm}0.16$ as calculated by MFPC and $0.86{\pm}0.23$ as calculated by COC. The lower continuity of care was shown in the patients who were female, 65 and over years old, Medical Aid recipients, 13 times or more visitors, hospital users as main attending medical institution, patients experienced hospitalizations or comorbidities. Conclusion : The continuity of care for adult patients with type 2 diabetes was high in Korea, and showed variation according to patients' characteristics. This result provides empirical evidence for policymakers to develop or strengthen programs for managing patients showing low continuity of care.

Study on the Market Segmentation of inpatients (입원환자 시장세분화에 관한 연구)

  • Lee, Eun-Whan
    • Korea Journal of Hospital Management
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    • v.17 no.2
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    • pp.21-33
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    • 2012
  • Purpose : This study aims to suggest application of patients DB to hospital marketing by performing market segmentation and selecting target market. Consequently help to establish suited strategy of marketing. Method : 14,072 patients hospitalized in a University Medical Center were recruited into this study. In order to classify the customer groups, cluster analysis was used with RFM(Recency, Frequency, Monetary) model, and 1-way ANOVA verified the differences among groups. And then, sociodemographical status, healthcare utilization and diagnosis(ICD-10) of each group were compared to draw a marketing strategy. Results : Four groups were classified through clustering analysis, and'high use and high profit' and'low use and high profit' groups were selected as a target market. The features of target market were as follows, the female proportion was high; used a private room; hospitalized through the emergency room; had operation; length of stay was long; had many comorbidity and cooperative treatment. There was difference in each feature of target market: as for the'high use and high profit' group, many patients were diagnosed with 'certain infectious and parasitic diseases'; and as for the'low use and high profit'group, the proportion of patients who purchased'industrial accident compensation insurance'and'auto insurance'was relatively high; many patients were diagnosed with'Injury, poisoning and certain other consequences of external causes'. Conclusion : It is needed to establish'positioning' strategy by monitoring and communicating with'high use and high profit' group. And for the case of'low use and high profit' group, it is necessary to make a follow-up management and lead them to have a medical check-up.

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Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation (중풍환자에 대한 일차 한의임상진료 가이드라인)

  • Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.347-366
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    • 2012
  • The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

Prescribing Patterns of Codeine among Children under Aged 12 in Korea (건강보험자료를 이용한 12세 미만 소아에서 코데인 처방양상평가)

  • Park, Hyo-Ju;Shin, Han-Na;Shin, Ju-Young
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.4
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    • pp.273-279
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    • 2015
  • Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.