• The Journal of Korean Medicine
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• v.40 no.1
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• pp.12-23
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• 2019

Objectives: The purpose of this study was to analyze the aspects of the Korean medicine (KM) treatment among children with cerebral palsy (CP) according to the disease characteristics. Methods: In a prospective observational multicenter study for children with CP, we analyzed 78 baseline questionnaires of children having experience of KM treatments such as acupuncture and Korean herbal medicine and 43 follow-up data of children who have received KM during the one observation year. Results: Of all the 182 participants, 38 children were currently getting KM treatment and 40 children have discontinued KM treatment. Children with non-spastic CP and more health problems tended to use KM. The most frequent reason for quitting acupuncture therapy was 'suffering of children' and the highest reason of stopping herbal medicine was 'rejection of children'. Among the 133 participants finished one year follow-up, 43 children have received at least one KM treatment. The average number of acupuncture therapy was twice a week and the average monthly cost of acupuncture therapy and herbal medicine were 65,922 won and 476,003 won, respectively. Children under 32 month old have received significantly more acupuncture and children with non-spastic CP have taken significantly more herbal medicine. Conclusions: Further study will be required to confirm the effectiveness of KM and increase the utilization of KM among the children with CP. More efforts should be made to increase the convenience of acupuncture therapy and herbal medicine and to expand the insurance coverage of KM for children with CP.

• Women's Health Nursing
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• v.27 no.2
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• pp.128-140
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• 2021

Purpose: The purpose of this study was to develop a self-transcendence enhancement program and examine its effect on self-transcendence, spiritual well-being, and psychological well-being in elderly women who live alone. Methods: A self-transcendence enhancement program was developed through theory, literature review, and in-depth interviews. The theoretical framework came from the Psychoeducational Approach to Transcendence and Health intervention model based on Reed's middle-range theory of self-transcendence. The program consisted of multiple modalities in a structured, theory-based program lasting for eight weekly sessions. Using a single-group pretest-posttest design, the program was tested on a group of 40 elderly women aged 75 to 84 years living alone in Daejeon, Korea. Participants completed self-reported study questionnaires before and after the program at the elderly welfare center. Data were analyzed using SPSS version 24.0, with significance level set at .05. Paired t-test was used to compare mean differences before and after the program. Results: The mean age of the study participants was 79.1 years. After completing the program, the participants showed higher levels of self-transcendence (t=8.78, p<.001), overall spiritual well-being (t=8.30, p=.002), religious spiritual well-being (t=1.79, p=.040), existential spiritual well-being (t=6.75, p=.002), and positive affect (t=3.77, p=.001) than they did before the program. They also reported lower levels of depression (t=-7.59, p<.001) and negative affect (t=-6.15, p<.001). Conclusion: The self-transcendence enhancement program developed in this study may be effective for improving the level of self-transcendence in elderly women living alone and helping them to attain spiritual and psychological well-being.

• Journal of Preventive Medicine and Public Health
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• v.35 no.1
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• pp.1-12
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• 2002

Objective : To estimate the socioeconomic costs of obesity in Korea,1998. Methods : The 1998 National Health and Nutrition Examination Survey(1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM(non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF(Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. Results : The direct costs of obesity were 2,126 billion${\sim}965$ billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion${\sim}1,086$ billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4.225 billion${\sim}2,050$ billion Won, which corresponded to about $0.094%{\sim}0.046%$ of GDP and $1.88%{\sim}0.91$ of total health care costs in Korea. Conclusions : Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. further studies are needed to caculate socioeconomic costs of obesity more exactly.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.15 no.2
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• pp.175-190
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• 2011

Objectives: Even though there has been no consensus on the concept of viscera organ between the oriental and western medicine, we tried to investigate the correlation between clinical biomarkers of five Jang and chronological age and develop the models for predicting five Jang biological ages by statistical analysis. Methods: We obtained data from about 120,000 subjects who visited health promotion centers for health promotion and disease prevention from January 2004 to June 2009. Participants were included if they were over 20 years old, and excluded if reported to have cardiovascular disease or other serious medical illness such as cancer, malignant hypertension, uncontrolled diabetes, cardiopulmonary insufficiency, liver disease, pancreatic disease or renal disease. Among the clinical biomarkers obtained, we selected the biomarkers which were associated with the function of 5 Jang in previous studies, or showed statistically significant correlation with age. Multiple regression models were used for building prediction models of biological age after adjusting for potential confounders for men and women, respectively. Pearson correlation coefficient was calculated to examine the linear relationship between age and various biomarkers, and multiple regression analysis was used for building the prediction models of five Jang biological ages for men and women, respectively. All statistical data analysis was performed by using SPSS Version 12.0 software and statistical significance was obtained if p<0.05. Results: For males, the best models were developed using 12, 2, 8, 3, and 4 biomarkers for predicting biological ages of heart, lung, liver, pancreas, and kidney, respectively (R2 = 0.57, 0.43, 0.11, 0.24, and 0.93, respectively). Similar to males, for the females, 10, 2, 8, 3, and 4 biomarkers were selected as the models respectively (R2 = 0.76, 0.44, 0.14, 0.38, and 0.89, respectively). Conclusions: As we have developed for the first time the models for predicting five Jang biological ages with common clinical biomarkers, it is expected that these models may be used as clinical supplementary tools in the evaluation of aging status and functional decline of five Jang according to age in health promotion centers and private clinics. At the same time, it is considered that the use as objective tools to evaluate aging status and functional decline of each Jang.

• Journal of Digital Convergence
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• v.14 no.1
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• pp.327-338
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• 2016

The purpose of the present study is to determine the occurrence of dyslipidemia and the effects of health life practices among Korean males and females. The study subjects were 4,036 persons aged at least 19 years, as selected from the health questionnaire data out of the third year data(2012) Korea National Health and Nutrition Examination Survey. They were divided into a dyslipidemia group of 2,092 subjects (male 1,042, female 1,050) and a normal group of 1,944 subjects (male 740, female 1,204) by applying the dyslipidemia treatment guidelines of the Korean Society of Lipidology and Atherosclerosis. In the present study, the SPSS 18.0 program was used to conduct t-tests, a ${\chi}^2-test$, and a logistic regression analysis of descriptive statistics. Therefore, dyslipidemia-related healthy life practice programs should apply the characteristics of Korean males and females that show differences in serum lipid concentrations and to this end, continued studies, and national-level customized education applying the effects of healthy life practices is considered necessary.

• Journal of Korean Neurosurgical Society
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• v.62 no.5
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• pp.502-518
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• 2019

Objective : Since less invasive endovascular treatment was introduced to South Korea in 1994, a considerable proportion of endovascular treatments have been performed by neuroradiology doctors, and endovascular treatments by vascular neurosurgeons have recently increased. However, few specific statistics are known regarding how many endovascular treatments are performed by neurosurgeons. Thus, authors compared endovascular treatments collaboratively performed by vascular neurosurgeons with all cases throughout South Korea from 2013 to 2017 to elucidate the role of neurosurgeons in the field of endovascular treatment in South Korea. Methods : The Society of Korean Endovascular Neurosurgeons (SKEN) has issued annual reports every year since 2014. These reports cover statistics on endovascular treatments collaboratively or individually performed by SKEN members from 2013 to 2017. The data was requested and collected from vascular neurosurgeons in various hospitals. The study involved 77 hospitals in its first year, and 100 in its last. National statistics on endovascular treatment from all over South Korea were obtained from the Healthcare Bigdata Hub website of the Health Insurance Review & Assessment Service based on the Electronic Data Interchange (EDI) codes (in the case of intra-arterial (IA) thrombolysis, however, statistics were based on a combination of the EDI and I63 codes, a cerebral infarction disease code) from 2013 to 2017. These two data sets were directly compared and the ratios were obtained. Results : Regionally, during the entire study period, endovascular treatments by SKEN members were most common in Gyeonggido, followed by Seoul and Busan. Among the endovascular treatments, conventional cerebral angiography was the most common, followed by cerebral aneurysmal coiling, endovascular treatments for ischemic stroke, and finally endovascular treatments for vascular malformation and tumor embolization. The number of endovascular treatments performed by SKEN members increased every year. Conclusion : The SKEN members have been responsible for the major role of endovascular treatments in South Korea for the recent 5 years. This was achieved through the perseverance of senior members who started out in the midst of hardship, the establishment of standards for the training/certification of endovascular neurosurgery, and the enthusiasm of current SKEN members who followed. To provide better treatment to patients, we will have to make further progress in SKEN.

• Journal of Digital Convergence
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• v.13 no.2
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• pp.215-225
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• 2015

This study was conducted to develop a severity-adjusted LOS(Length of Stay) model for knee replacement patients and identify factors that can influence the LOS by using the Korean National Hospital Discharge in-depth Injury Survey data. The comorbidity scoring systems and data-mining methods were used to design a severity-adjusted LOS model which covered 4,102 knee replacement patients. In this study, a decision tree model using CCS comorbidity scoring index was chosen for the final model that produced superior results. Factors such as presence of arthritis, patient sex and admission route etc. influenced patient length of stay. And there was a statistically significant difference between real LOS and adjusted LOS resulted from health-insurance type, bed size, and hospital location. Therefore the policy alternative on excessive medical utilization is needed to reduce variation in length of hospital stay in patients who undergo knee replacement.

• Journal of Preventive Medicine and Public Health
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• v.42 no.5
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• pp.331-336
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• 2009

Objectives : The objectives of this study were to determine the relationship between lifestyle-implementation and metabolic syndrome in an electronics research and development company, and to provide a foundation for health providers of health management programs for setting priorities. Methods : From July 1 to July 16, 2008 we carried out a descriptive cross-sectional survey. Consecutive workers of one R & D company in Seoul, Korea (N=2,079) were enrolled in study. A checklist for lifestyle (from the National Health Insurance Corporation) consisted of questions regarding diet, drinking, smoking and exercise. After the survey, researchers obtained data from health profiles for metabolic syndrome(waist-circumference, triglycerides, HDL cholesterol, blood pressure and fasting blood sugar level). Lifestyle was recorded as good or not good. Statistical analysis of metabolic syndrome and the lifestyle of subjects was done using multiple logistic regression analysis. Results : The prevalence of metabolic syndrome in our study gropu was 13.3% (N=277). After adjustment for age, the adjusted odds ratios (odds ratio, 95% confidence intervals) for metabolic syndrome increased in proportion to the number of bad habits: two (1.72, 1.23-2.44), three (2.47, 1.73-3.56), and four (3.63, 2.03-6.34). Relative to subjects eating both vegetables and meat', the OR for 'meat' eaters was 1.66 (1.18-2.31). Compared with 'nonsmokers and ever-smoker', the OR for 'current-smoker' was 1.62 (1.25-2.10). Compared with 'Healthy drinker', the OR for 'unhealthy drinker' was 1.38 (1.05-1.83). Conclusions : Poor lifestyle was associated with an increased likelihood of metabolic syndrome. These findings suggest that lifestyle-based occupational health interventions for young employees should include a specific diet, smoking cessation, and healthy-drinking programs.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.4
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• pp.183-194
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• 2021

In this study, the conversion factor for 2020 is estimated based on an outpatient and inpatient conversion factor separation model developed from SGR and AR by using actual medical expense data. In addition, a policy plan is proposed to calculate the values of single and multiple conversion factors for each type of medical expense, and to effectively use the conversion factor separation model as one of the means to establish a medical delivery system. The major results are as follows. First, at r=0.1, the rate of adjustment in the hospital single conversion index in 2020 was 2.0%, and the outpatient and hospitalization conversion rates for hospitals were 2.2% and 2.3%, respectively. In addition, a combination of outpatient and inpatient conversion factors can be used for the adjustment. Second, as a measure to establish a medical delivery system, instead of adjusting the addition rate, a method of interlocking the addition rate and the conversion factor is proposed. Third, it is necessary to develop a model that enables target management of volumes, in addition to the outpatient conversion factor, the inpatient conversion factor, and the adjustment coefficient.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.398-406
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• 2018

Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.