• Health Policy and Management
• /
• v.34 no.1
• /
• pp.38-47
• /
• 2024

Background: Korea's population of children and adolescents has decreased by 2.88 million over the past decade and is expected to decline further due to the unprecedented low birth rate. In the fee-for-service compensation system, the decline in the pediatric population relates directly to the profit decrease in the pediatric clinics. This study analyzed whether the worsening profits of pediatric clinics impacted their closure. Methods: We built annual data for pediatric and other department clinics (internal medicine, otolaryngology, and family medicine) using the status of medical institute and health insurance claims data from 2012 to 2022. Then, we analyzed whether institutional variables such as annual profit and regional variables (Herfindahl-Hirschman index, the number of clinics per 100,000, etc.) affected the closure of clinics. The methods used in this study are descriptive statistics and chi-square analysis. Odds ratios for each variable were estimated by generalized estimating equations (GEE). Results: The closure rate of pediatric clinics was 2.66%-7.04% in 2012-2022, which was consistently higher than those of internal medicine, otolaryngology, and family medicine clinics. The profit gap per institution between the pediatric and the other clinics grew from 126 million won in 2012 to 245 million won in 2019. In the GEE analysis, profit decrease compared to the previous year with lower profit was the main factor that increased the closure of pediatric and other department clinics. After adjusting profit-related variables, the decrease in the pediatric population itself did not relate to the closure of pediatric clinics. The number of pediatric clinics or monopolies also did not affect the closure of pediatric clinics. Conclusion: The worsening profit is the crucial factor for the closure of pediatric clinics, while the pediatric population is decreasing. For this reason, it is necessary to actively seek ways to maintain a stable treatment system for children and adolescents.

• Health Policy and Management
• /
• v.34 no.2
• /
• pp.185-195
• /
• 2024

Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
• /
• v.12 no.1
• /
• pp.9-23
• /
• 2007

To investigate the degree of pollution using the species composition of benthic community and environments, the present study was conducted in Jinhae Bay, May of 1998. In Jinhae Bay, benthic macrofaunal community was investigated on the base of the samples from 67 stations. The main facies of the surface sediment was silty clay and clay. The total species number and the mean density of macrobenthic animals were 255 species and 984 $ind./m^2$, respectively. There were 90 species and 773 $ind./m^2$ of polychaetes as the most major faunal group in Jinhae Bay. At the region between the eastern mouth of Jinhae Bay and Gadeok Is., the species number and density were higher, while lower at the western area of Jinhae Bay. The most dominant benthic macrofauna in Jinhae Bay was the polychaetes, Lumbrineris longifolia(16.9%), and followed by polychaetes Tharyx sp.(6.7%), Clone teres(4.7%), Glycinde sp.(4.2%), bivalves Theora fragilis(4.0%), crustaceans Corophium sp.(4.0%) and so on. The most of the predominant species appeared mainly on the region between the eastern mouth of Jinhae Bay and Gadeok Is. Cluster analysis based on the macrobenthic faunal composition showed that Jinhae Bay could be divided into three station groups: The western Jinhae Bay(Station group A), the mouth of Jinhae Bay(Station groupe B), and offshore area between Gadeok Is. and Geoje Is.(Station group C). The mouth of Jinhae Bay had the highest mean species number and the mean density, and its important species was Lumbrineris longifolia. The offshore area between Gadeok Is. and Geoje Is. had medium mean species number and the mean density. The western Jinhae Bay had the lowest mean species number and the mean density. The distribution of BPI and BC values, used to assess benthic pollution, showed similar patterns. According to the classification proposed by Borja et al.(2000), the stations of the western inner-bay were heavily polluted sites, the stations between mouth of the bay and the offshore area were slightly polluted sites, and the stations of the other area were meanly polluted sites. Benthic community healthiness of the western Jinhae Bay was classified to 'Transitional to pollution' by BC values. The degree of pollution in Jinhae Bay may have extended gradually from the western Jinhae Bay to the mouth of the bay.

• Land and Housing Review
• /
• v.15 no.1
• /
• pp.1-22
• /
• 2024

This research explores the household and housing characteristics of young renters aged between 19 and 34 living independently in rental housing of non-Seoul Metropolitan Area (non-SMA) and to determine the factors of their housing affordability and residential environment qualities in two districts of non-SMA - metropolises and non-metropolises. Using the 2020 Korean Housing Survey (KHS), this study identified 1,191 unmarried young renters, and most were single adults in mid-twenties who were salaried workers with a bachelor's degree or higher. Also, many lived in single-room occupancy of non-APT housing for less than 2 years and rarely relied on social services. The findings showed that the distinction of local housing market between metropolises and non-metropolises forced the former to spend more housing expense (tenancy deposit and rental fees) than the latter. With regard to housing affordability indices (Schwabe index, housing expense ratio and rent to income ratio), most were housing cost-burdened and nearly one quarter were severely rent-burdened. The regression analysis indicated that housing affordability in both districts was positively affected by income increase and social services, and housing satisfaction in non-metropolises was added to its determinants. Further, residential environment qualities were largely divided into two groups of livelihood and urban infrastructure, and the two factors influenced residential assessment in both districts. Since young renters interdependently living had suffered with housing affordability, both income growth and housing assistance are critically required to enable them not just to reduce the burden but to ensure livability.

• Korean Circulation Journal
• /
• v.53 no.4
• /
• pp.254-267
• /
• 2023

Background and Objectives: Although the shortage of donor is a common problem worldwide, a significant portion of unutilized hearts are classified as marginal donor (MD) hearts. However, research on the correlation between the MD and the prognosis of heart transplantation (HTx) is lacking. This study was conducted to investigate the clinical impact of MD in HTx. Methods: Consecutive 73 HTxs during 2014 and 2021 in a tertiary hospital were analyzed. MD was defined as follows; a donor age >55 years, left ventricular ejection fraction <50%, cold ischemic time >240 minutes, or significant cardiac structural problems. Preoperative characteristics and postoperative hemodynamic data, primary graft dysfunction (PGD), and the survival rate were analyzed. Risk stratification by Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was performed to examine the outcomes according to the recipient state. Each group was sub-divided into 2 risk groups according to the IMPACT score (low <10 vs. high ≥10). Results: A total of 32 (43.8%) patients received an organ from MDs. Extracorporeal membrane oxygenation was more frequent in the non-MD group (34.4% vs. 70.7, p=0.007) There was no significant difference in PGD, 30-day mortality and long-term survival between groups. In the subgroup analysis, early outcomes did not differ between low- and high-risk groups. However, the long-term survival was better in the low-risk group (p=0.01). Conclusions: The outcomes of MD group were not significantly different from non-MD group. Particularly, in low-risk recipient, the MD group showed excellent early and long-term outcomes. These results suggest the usability of selected MD hearts without increasing adverse events.

• Journal of the Korean Society of Radiology
• /
• v.81 no.4
• /
• pp.886-898
• /
• 2020

Purpose The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. Materials and Methods This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. Results Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. Conclusion Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.

• Journal of the Korean Society of Radiology
• /
• v.81 no.2
• /
• pp.395-408
• /
• 2020

Purpose To evaluate the value of clinicopathologic factors and imaging features of primary breast cancer in predicting early recurrence after the primary treatment. Materials and Methods We enrolled 480 patients who had been followed-up after breast-conserving surgery and adjuvant therapy from January 2010 to December 2014 at our hospital. Early recurrence was defined as recurrence within 3 years after completion of primary treatment, and univariate and multivariate logistic regression analyses were performed to determine the clinicopathologic and imaging predictive factors of early recurrence. Results In the univariate analysis, among the clinicopathologic factors, advanced stage (p = 0.021), high histologic grade (p < 0.001), estrogen receptor negative (p = 0.002), high Ki-67 proliferation index (p = 0.017), and triple-negative breast cancer (p = 0.019), and among the imaging features, multifocality (p < 0.001), vessels in the rim on Doppler ultrasonography (US) (p = 0.012), and rim enhancement (p < 0.001) on magnetic resonance imaging of the breast were significantly associated with early recurrence. In the multivariate analysis, advanced stage [odds ratio (OR) = 3.47; 95% confidence interval (CI) 1.12-10.73; p = 0.031] and vessels in the rim on Doppler US (OR = 3.32; 95% CI 1.38-8.02; p = 0.008) were the independent predictive factors of early recurrence. Conclusion Vascular findings in the rim of the primary breast cancer on Doppler US before treatment is a radiologic independent predictive factor of early recurrence after the primary treatment.

• Journal of Nutrition and Health
• /
• v.57 no.3
• /
• pp.336-348
• /
• 2024

Purpose: The use of food delivery services is increasing continuously in Korea, which may lead to nutritional problems and obesity. Despite this, the research on the association between delivered food consumption and obesity has been insufficient. This study examined the relationship between delivered food consumption and dietary behaviors and obesity among young adults in Jeju. Methods: An online survey was conducted from March 15 to April 5, 2023; 312 participants aged 19-39 years were included in the final analysis. The frequency, types, and time of delivered food consumption were measured using a questionnaire. The dietary behaviors included the following: eating out, breakfast consumption, recognition of nutrition labels, and eating salty foods, vegetables, and fruit. Obesity was defined using the body mass index based on self-reported body weight and height. Results: Approximately 59.3% of the participants ordered delivery foods more than one time/week. The frequency of delivered food consumption was higher in people who consumed breakfast < 5 times/week than those who consumed ≥ 5 times/week (p = 0.0088). People who usually eat salty foods tended to consume delivered food more frequently than those who did not (p = 0.0377). On the other hand, people who consumed fruits ≥ 1 time/day had a higher frequency of delivered food consumption than those who consumed fruits < 1 time/day (p = 0.0110). After adjusting for the confounding variables, the group who consumed delivered foods more than three times/week had an increased odds ratio (OR) of obesity compared to those who consumed less one time/week (OR, 2.38; 95% confidence intervals, 1.12-5.06). Conclusion: Young adults in Jeju who frequently consume delivered foods tended to have poor dietary habits including skipping breakfast and eating salty, and they had an increased odds of obesity. The overall dietary patterns can be improved by providing nutrition education and developing policies to promote or support healthy food choices when ordering delivered foods or eating out.

• KOREAN JOURNAL OF CROP SCIENCE
• /
• v.69 no.1
• /
• pp.25-33
• /
• 2024

This experiment was conducted at the affiliated farm of the Suncheon University from 2022 to 2023 to investigate the growth, yield, and quality characteristics of soybeans based on the treatment method of Methyl Sulfony Methane (MSM) for the establishment of stable production practices. In the initial investigation of growth characteristics in 2022, an increasing trend in characteristics such as plant height, stem thickness, and branching index was observed as the treatment concentration increased from 50% to 200%. Yield components also followed the same trend, with the basal fertilization + top dressing 3 times at 200% treatment showing the highest yield at 355 kg·10a^-1, with the highest number of pods. In the subsequent study to determine the optimal concentration exceeding 200% in 2023, growth characteristics showed a trend of 400% > 200% > 800%. The basal fertilization + top dressing 3 times at 400% treatment exhibited the longest plant height (106.7 cm) and the most branches (6). In terms of seed quality, this treatment also had the highest proportion (66.9%) of seeds with a diameter over 6.7 mm. Additionally, in yield components such as pods, seeds per pod, and 100-seed weight, the basal fertilization + top dressing 3 times at 400% treatment showed the highest values, resulting in a maximum yield of 374 kg·10a^-1, representing a 23.4% increase compared to the control. Therefore, for the optimal production of high-quality soybeans, it is recommended to apply the treatment of basal fertilization + top dressing 3 times at 400% concentration, with top dressing occurring at 30-day intervals before harvest.

• Journal of the Korean Applied Science and Technology
• /
• v.40 no.6
• /
• pp.1309-1321
• /
• 2023

This study was conducted by dividing L-arginine intake group (n=14) and placebo group (n=14) to investigate the effect of L-arginine intake on athletic performance, lactate, lactate dehydrogenase, and ammonia of men's college Taekwondo Kyorugi players during 8-week of intensive winter training. The L-arginine intake group consumed a total of 3 g, including 1 g for breakfast, 1 g for lunch, and 1 g for dinner, and the placebo group consumed maltodextrin in the same way. The 8-week winter training program was conducted at 70-90%HRR (heart rate reserve). Two-way repeated measures ANOVA was used for the interaction between the L-arginine intake group and the placebo group of the measured data, paired t-test was used for the difference between the periods within the group, and the difference between groups was analyzed using independent t-test. As a result, there was an interaction between groups in the average number of kicks among the performance ability through the TAAA (Taekwondo-specific aerobic anaerobic agility) test , and the main effect between groups was shown (p<.05). In addition, there was an interaction between groups and time in the kick fatigue index (p<.05). In lactate, the time-interaction were shown (p<.05) and interaction effects and inter-time main effects were observed in lactate dehydrogenase (LDH)(p<.05). In the case of ammonia, the interaction effect between the group and time was shown (p<.05). These results show that L-arginine intake can play a positive role in quickly synthesizing nitric oxide in blood vessels and expanding blood vessels to quickly remove fatigue-causing substances in the body for athletes who are easily exposed to fatigue after high-intensity training for male college Taekwondo Kyorugi players. Therefore, it is recommended to take L-arginine as a way to improve the performance of high-intensity elite Taekwondo Kyorugi players and recover from fatigue.