• Toxicological Research
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• 제28권2호
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• pp.81-91
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• 2012

Many risk factors exist for chemotherapy-induced nausea and vomiting (CINV). This study utilized a multivariate projection technique to identify which risk factors were predictive of CINV in clinical practice. A single-centre, prospective, observational study was conducted from January 2007~July 2010 in Singapore. Patients were on highly (HECs) and moderately emetogenic chemotherapies with/without radiotherapy. Patient demographics and CINV risk factors were documented. Daily recording of CINV events was done using a standardized diary. Principal component (PC) analysis was performed to identify which risk factors could differentiate patients with and without CINV. A total of 710 patients were recruited. Majority were females (67%) and Chinese (84%). Five risk factors were potential CINV predictors: histories of alcohol drinking, chemotherapy-induced nausea, chemotherapy-induced vomiting, fatigue and gender. Period (ex-/current drinkers) and frequency of drinking (social/chronic drinkers) differentiated the CINV endpoints in patients on HECs and anthracycline-based, and XELOX regimens, respectively. Fatigue interference and severity were predictive of CINV in anthracycline-based populations, while the former was predictive in HEC and XELOX populations. PC analysis is a potential technique in analyzing clinical population data, and can provide clinicians with an insight as to what predictors to look out for in the clinical assessment of CINV. We hope that our results will increase the awareness among clinician-scientists regarding the usefulness of this technique in the analysis of clinical data, so that appropriate preventive measures can be taken to improve patients' quality of life.

• 한국환경보건학회지
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• 제37권6호
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• pp.418-428
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• 2011

Objectives: The purpose of this study was to examine the cross-sectional relationship between low blood lead levels and increasing blood pressure among Korean adults using a nationally representative sample of the Korean population: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. Methods: A total of 918 subjects aged 40 and older and not currently being treated for hypertension participated in this study. Information about age, gender, smoking status, alcohol consumption, education level, and the use of anti-hypertensive medication was collected. The blood pressure was defined as the mean of the second and the third measurements after three time measurements. Lead levels were determined by an analysis of blood samples. Multiple linear and logistic regression analyses were implemented after adjusting for covariates including age, gender, educational level, smoking status, alcohol consumption, and BMI. Results: This study showed that the average differences in systolic and diastolic blood pressure comparing the lowest to highest quintile of blood lead were 4.33 mmHg (95% CI, 0.66-8.00; p for trend = 0.027) and 2.66 mmHg (95% CI, 0.26-5.06; p for trend = 0.021), respectively. After multivariate adjustment for covariates, the prevalence odds ratio (POR) of subjects in the highest quintile was associated with a 1.70-fold increase in the risks of hypertension (95% CI, 0.83-3.49; p for trend test = 0.112) over those in the lowest quintile of blood lead concentration, However, it was not statistically significant. Conclusions: This study provided evidence for an association between low- levels of blood lead and elevations in blood pressure and risk for hypertension in the general population of Korea.

• Nutrition Research and Practice
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• 제11권3호
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• pp.240-246
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• 2017

BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to significantly reduce the risk of having a baby with neural tube defects (NTDs). Therefore, it is important for women to be aware of the effects of folic acid supplementation before pregnancy. The purpose of this study was to investigate the awareness and preconceptional use of folic acid and to assess the current knowledge about folic acid among low-income pregnant women in Korea. SUBJECTS/METHODS: A questionnaire survey was conducted in 2012. Five hundred pregnant women were selected from the waiting list for the Nutriplus program implemented in public health centers using a multistage clustered probability sampling design. Data from 439 women were analyzed after excluding ones with incomplete answers. RESULTS: Among women who responded to the questionnaire, 65.6% had heard of folic acid before pregnancy, and 26.4% reported on the preconceptional use of folic acid. Women with a university degree or higher education were more likely to be aware of folic acid and to take folic acid in the preconception period. In a multivariate logistic regression, when age, education level, household income, employment status, gravidity, parity, and folic acid awareness were included in the model, folic acid awareness was a strong predictor of preconceptional folic acid use. As of interview, 85.4% and 77.7% of women were aware of the NTD-preventive role of folic acid and the appropriate time to take folic acid, respectively. The main sources of information on folic acid were healthcare professionals (41.2%), friends and family members (31.2%), and the media (26.5%). CONCLUSIONS: Our results suggest that public health strategies are needed to increase the preconceptional use of folic acid among Korean women.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6669-6671
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• 2014

Background: We here examined the awareness of female health employees (doctors, nurses, midwives) working in primary health care service about cervical cancer and its risk factors. Additionally attitude and behavior for gynecologic examination and pap smear screening wwere researched. Materials and Methods: This cross-sectional, descriptive study con cerned female health employees working at primary health care services in two southern cities of Turkey, over a four month period in 2013. Participants were recently or previously sexually active research was explained and verbal informed consent was obtained face to face. The questionnaire consisted of two parts; socio-demographic characteristics and level of knowledge about cervical cancer and its risk factors. Results: The average age of the participants (midwives 43.7%, n=143; nurses 40.4%, n=132; doctors 6.4%, n=21; emergency medical technicians and others, 9.5%, n=31; total, n=327) was $30.9{\pm}6.41$ years. 64.2% (n=210) were working in Diyarbakir and 35.8% (n=117) in Batman. A large proportion reported low knowledge and inadequate screening practice Conclusions: Health employees should be better informed about the importance of screening for cancers, given their preventive roles for the general population.

• Journal of Periodontal and Implant Science
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• 제44권2호
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• pp.85-93
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• 2014

Purpose: Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies. Methods: A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ${\geq}2,500g$. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth. Results: LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2). Conclusions: Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.

• 한국병원경영학회지
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• 제16권3호
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• pp.1-18
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• 2011

In this study, population census(2005 & 2008) from Statistics Korea and the statistical data of the number of hospital beds by healthcare facilities classification from Ministry of Health and Welfare were used. For analyzing distribution of hospital beds, hospital beds were classified as acute care beds, long-term care beds and all hospital beds, which is including acute and long-term care beds. Regional areas, which are city(si), county(goon) for the study and district(gu) were reclassified as metropolitan city, city(si) and county(goon). Because there were 165 regional areas in 2005 and 2008, 84 and 81 areas were classified as metropolitan city and/or city and county, respectively. Gini index were calculated for hospital beds from each year, and Lorenz curves were drawn. The following summary presents the findings of this study. Compared to the year 2005 and 2008, the Gini index was 0.24472, and hospital bed numbers increased slightly by 0.80% than in 2005. In case of acute care beds, the Gini index was 0.23797(0.13%), and there was no big difference; however, the Gini index for long-term care beds was 0.41091, and there was a 30.25% decrease, which shows improvement to reduce disparities. It might result from an increase in long-term care beds up to 476.2%. For geographical equality of hospital beds, the Gini index and Lorenz curve, which can be compared the degree of inequality in the distribution of hospital beds reasonably and possibly show statistical data, should be used. Through this study, the distribution policy of hospital beds should be established.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6285-6288
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• 2012

Background: The aim of this study was to outline the trend in the incidence of colorectal cancer (CRC) in the city of Jeddah, Kingdom of Saudi Arabia (KSA), for comparison with previously published national CRC data. Materials and Methods: A retrospective data analysis was performed on all cases of CRC diagnosed between January 2000 and December 2006 amongst Saudi patients in Jeddah using data retrieved from the Saudi Cancer Registry (SCR). Descriptive analysis was performed and results were compared to national CRC data from the SCR. Results: In Jeddah, 644 cases of CRC were diagnosed during the time period, accounting for 15% of all CRC cases in KSA. Males were more commonly affected than females (58% versus 42%). The male preponderance of CRC was similar to that observed at a national level. In Jeddah, the incidence was higher among those >45 years (77.0%), and the mean age at diagnosis was 57 years. At diagnosis, 10% of patients presented with localized disease; 25% presented with distant metastasis and the remaining patients had various stages of regional extension. Adenocarcinomas accounted for 72% of cases. Statistical analysis did not reveal any clinically significant differences between cases diagnosed in Jeddah and those diagnosed throughout KSA. Conclusions: The increased trend in the incidence of CRC in Jeddah between 2000 and 2006 mirrors the recent trend in KSA. This highlights the magnitude of this healthcare hazard, not only in Jeddah, but also across the country and supports the need for preventive measures and early detection of the disease.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3949-3953
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• 2012

Head and neck cancers are amongst the commonest malignancies, accounting for approximately 20% of the cancer burden in India. The major risk factors are tobacco chewing, smoking and alcohol consumption, which are all preventable. This retrospective study presents data from the histopathology register for a five year period from 2002-2006 at Patna Medical College and Hospital, a tertiary care hospital drawing patients from the entire Bihar state, the 3rd most populous state of India with the majority of the population residing in rural areas. Incidence rates based on sex, age, site of lesion, including age standardized incidence rates for males and females, with mean age of presentation, distribution of histological variants and year wise trend were calculated. Out of 455 head and neck neoplasias, 241 were benign while 214 were malignant. The most common age group for all malignant biopsies was 7th decade for males and the 5th decade for females. Malignant cases were commoner in males than females with the male:female ratio of 3.1:1, which was found to be statistically significant by the chi-square (${\chi}^2$) test. The crude rate and age standardized incidence rate was 0.05 and 0.06 per 100,000 population respectively. Squamous cell carcinoma (SCC) contributed about 96% of all cases, with grade I being the most common. Larynx was the most common site for malignancy, the supraglottic region being its most commonly affected sub-site. This observed incidence patterns in the region are a reminder of widespread unawareness, low healthcare utilization with virtually non-existent cancer programs. It also underlines the need to advocate for reliable cost-effective programs to create awareness, for early detection and plan appropriate management strategies. There is a compelling demand for a cancer registry in this region as well as proper implementation of preventive measures to combat this growing threat of cancer, many of whose risk factors are preventable.

• 보건행정학회지
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• 제26권2호
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• pp.107-114
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• 2016

Background: Over the last few decades, because hospitals in South Korea also have undergone dramatic changes, Korean hospitals traditionally have provided specialized health care services in the health care market. Inner Herfindahl-Hirschman Index (IHI) measures hospital caseloads based on patient proportions, independent of patient volumes. However, IHI that rely solely on patient proportions might be problematic for larger hospitals that provide a high number of diagnosis categories, as the patient proportions in each category are naturally relatively smaller in such hospitals. Therefore, recently developed novel measure, category medical specialization (CMS) is based on patient volumes as well as patient proportions. Methods: We examine the distribution of hospital specialization score by hospital size and investigate association between each hospital specialization and length of stay per case and hospital cost per case using Korean National Health Insurance Service-cohort sample data from 2002 to 2013. Results: Our results show that IHI show a decreasing trend according to the number of beds and hospital type but CMS show an increasing trend according to the number of beds and hospital type. Further, inpatients admitted at hospitals with higher IHI and CMS had a shorter length of stay per case (IHI: B=-0.104, p<0.0001; CMS: B=-0.044, p=0.001) and inpatients admitted at hospitals with higher IHI and CMS had a shorter hospital cost per case (IHI: B=-0.110, p=0.002; CMS: B=-0.118, p=<0.0001). Conclusion: This study may help hospital policymakers and hospital administrators to understand the effects of hospital specialization strategy on hospital performance under recent changes in the Korean health care environment.

• 보건행정학회지
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• 제20권2호
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• pp.69-88
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• 2010

The effective administration of hospital with innovation and human resource practices is a matter of grave concern because hospitals are becoming bigger and more specialized. Biomedical engineers who manage medical machineries and tools used to deliver healthcare services in a hospital setting play an important role in providing customers good quality services. Maintaining job satisfaction of biomedical engineers is, thus, important in the delivery of quality care. This is a descriptive cross-sectional study aiming to determine factors affecting job satisfaction of biomedical engineers working in general hospitals. The study population consisted of biomedical engineers at 79 general hospitals of 26 regions based on the registry of the Korea Medical Engineering Association (KMEA). The data were collected using a self-administerd questionnaire between May and July of 2009. Job satisfaction was assessed with 19 items covering 3 dimensions of work-external, work-internal, and organizational aspects (Cronbach's ${\alpha}=0.884$), resulting in an average summary score. Statistical analysis was conducted with SPSS for Windows version 15.0. The mean score of job satisfaction was 3.50 (${\pm}0.04$). There were statistically significant differences in job satisfaction according to age, health status, job position, duration of work as a biomedical engineer, years in the current workplace, difficulty at work, intent to change job, and the amount of support from superiors and colleagues. In multiple regression analysis, the factors affecting job satisfaction of biomedical engineers were salary, health status, and support of superiors and colleagues ($r^2=0.512$). Effective motivation-plans, taking into account organizational characteristics and the working environment of the hospital, may help to improve the job satisfaction of biomedical engineers.