• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.137-147
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• 2012

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.

• Journal of Preventive Medicine and Public Health
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• v.22 no.4 s.28
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• pp.518-527
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• 1989

The relationship between copper content in scalp hair and mental retardation was investigated. Samples of scalp hair were collected from 297 mentally retarded children who were students in one of two schools providing special educational services, one, consisted of children living in an orphan home, the other, children living with parents. For comparison, 117 scalp hair samples were collected from the children who had got average or above average academic achivement in a regular elementary school. Hair samples were taken from the nape of the neck and the copper content was determined by an atomic absorption spectrophotometer (IL 551). There was no statistically significant difference in scalp copper levels across different age groups except female orphan group, but no trend or correlation between copper conents and age was found. The hair copper contents of the mentally retarded children groups were significantly lower than that of control groups. But there was no dose-response relationship between degree of mental retardation and hair copper level. The hair copper contents of the group accompanied by Down's syndrome and unknown group were significantly lower than that of control group in both sex, and in the case of accompanied by epilepsy or autism, lower than control group in male. Although the results of this study show no evidence that mental retardation has owed to copper deficiency, the possibility of copper deficiciency in their fetal or infant age could not be ruled out. Thus further study is needed to determine whether mental retardation could be attributed to copper deficiency, through the examinations about their living environments, dietary pattern, eating habit and the impact of copper deficiency on brain development.

• Journal of Preventive Medicine and Public Health
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• v.51 no.6
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• pp.281-288
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• 2018

Objectives: We investigated the association between cholecystectomy or appendectomy and the subsequent risk of colorectal cancer (CRC) in the Korean population. Methods: A retrospective cohort study was conducted with the National Health Insurance Service-National Sample Cohort of Korea; this sample was followed up from January 1, 2002, until the date of CRC incidence, loss to follow-up, or December 31, 2015. The exposure status of cholecystectomy and appendectomy was treated as a time-varying covariate. The calculated risk of CRC was stratified by follow-up period, and the association between these surgical procedures and CRC was investigated by a Cox regression model applying appropriate lag periods. Results: A total of 707 663 individuals were identified for analysis. The study population was followed up for an average of 13.66 years, and 4324 CRC cases were identified. The hazard ratio (HR) of CRC was elevated in the first year after cholecystectomy (HR, 1.71; 95% confidence interval [CI], 1.01 to 2.89) and in the first year and 2-3 years after appendectomy (HR, 4.22; 95% CI, 2.87 to 6.20; HR, 2.34; 95% CI, 1.36 to 4.03, respectively). The HRs of CRC after applying 1 year of lag after cholecystectomy and 3 years of lag after appendectomy were 0.80 (95% CI, 0.57 to 1.13) and 0.77 (95% CI, 0.51 to 1.16), respectively. Conclusions: The risk of CRC increased in the first year after cholecystectomy and appendectomy, implying the possibility of bias. When appropriate lag periods after surgery were applied, no association was found between cholecystectomy or appendectomy and CRC.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.7-26
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• 2020

Purpose: This study aimed to identify the factors affecting the survival outcomes of out-of-hospital cardiac arrest based on the Sudden Cardiac Arrest Survey by the Korean Centers for Disease Control and Prevention from 2012 to 2016. Methods: Out of 84,776 cases, 57,104 cases of cardiac arrest were analyzed. To identify the factors that affect survival outcomes after a sudden cardiac arrest (SCA), we performed a logistic regression using SPSS. We also performed a multilevel analysis using SAS to determine whether the survival outcomes were affected by the socioeconomic level and health index of the communities. Results: When SCA was witnessed by someone, the possibility of discharge with survival outcomes increased by a factor of 4.54. If CPR was administered immediately in emergency situations, this possibility further increased. When defibrillation was performed before hospitalization, the possibility was increased by a factor of 10.31. The multilevel analysis reflected the personal and regional factors that had an impact on the survival outcomes. Conclusion: Because the initial response in SCA is crucial, a community response system is essential before hospitalization. It is necessary to actively publicize and educate the people because the their understanding, sympathy, and cooperation in emergency situations play a role in determining the survival outcomes of the patients.

• 대한예방의학회:학술대회논문집
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• 1994.02a
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• pp.412-415
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• 1994

The fundamental assumption that thresholds exist for noncarcinogenic toxic effects of chemicals is reviewed; this assumption forms the basis for the no-observed-effect level/ safety-factor (NOEL/SF) approach to risk assessment for such effects. The origin and evolution of the NOEL/SF approach are traced, and its limitations are discussed. The recently proposed use of dose-response modeling to estimate a benchmark dose as a replacement for the NOEL is explained. The possibility of expanding dose-response modeling of non carcinogenic effects to include the estimation of assumed thresholds is discussed. A new method for conversion of quantitative toxic responses to a probability scale for risk assessment via dose-response modeling is outlined.

• The Journal of the Korea Contents Association
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• v.18 no.4
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• pp.653-663
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• 2018

This study is a descriptive survey to examine the dementia related attitudes and dementia preventive behaviors in middle aged and to determine the relationships between the both sides. In this study, between October 1st and 9th, 2017, data were collected from the middle aged people in their 40s~60s in Korea through online questionnaires. Finally, 220 questionnaires were analyzed by t-test One way ANOVA, Pearson's correlation coefficient, and etc. The results of the study are as follows. First, 52.7% of the subjects were interested in prevention of dementia, but only 5.9% of them had experience of receiving education related to dementia. Second, fear of dementia was higher than cancer, cerebrovascular disease, and cardiovascular disease, but confidence in coping with the disease, expectation of the possibility of maintaining the daily life, expectation of the help of the family and the surrounding people, expectation of the national medical and economic support were significantly lower. Third, as the dementia preventive behaviors were implemented, the confidence in overcoming the disease, the expectation of the possibility of maintaining the daily life, the expectation of the help of the family and the surrounding people, the expectation of the medical and economic support of the country increased and the burden of the treatment cost was lowered. As a result, it is thought that this personal and social effort will improve the quality of life of the people by reducing physical, psychological, social and economic problems caused by dementia.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.77-84
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• 1988

The principal mode of the transmission of Legionnaires disease is a inthalation of the cooling tower water droplets in which Legionellae exist. As a central cooling system is popularized in many public buildings and large buildings nowadays, the number of cooling towers is rapidly increasing. Therefore the possibility of an outbreak of Legionnaires disease is likely increased. To determine the presence of Legionella in cooling tower water as the first step for the prevention of Legionnaires disease, 48 samples of cooling tower water were taken from 24 buildings in Taegu city in july and september 1987. Three samples out of 24 water samples In September yielded Legionella but it was not isolated in the samples of July. Isolated 3 Legionellas were identified as Legionella peumophila. It seems that Legionella from the cooling tower will be isolated more frequently in late summer than early because central cooling system is stopped operation during winter season which is cool. As based on our survey, Legionnaires disease can occur in Taegu city and if it happens it is most likely due to L. pneumophila.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.156-163
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• 2012

Objectives: It is necessary to examine groups carrying out sexually risky behavior because the prevalence of sexually transmitted diseases (STDs) is high among them. In this study, the prevalence of STDs among homosexuals and sexbuying men in South Korea was investigated, along with their sexual risk factors. Methods: Men who have sex with men (MSMs, n=108) were recruited in Seoul and Busan by applying the time location sampling method, while sex-buying men (n=118) were recruited from a john school in Gyeonggi province, the suburbs of Seoul. Dependent variables included past or present infection with syphilis, Chlamydia, gonorrhea, and human immunodeficiency virus. Independent variables included health behavior, social support, sexual behavior, and safe sex. Results: It was found that when the MSMs were non-drunk while having sexual intercourse (odds ratio [OR], 0.132), they showed a higher STD infection rate when they had a higher number of anal sex partners (OR, 5.872), rarely used condoms (OR, 1.980), had lower self-efficacy (OR, 0.229), and were more anxious about becoming infected with an STD (OR, 3.723). However, the men who paid for sex showed high STD infections when they had more sex partners (OR, 2.286) and lower education levels (OR, 3.028). Conclusions: STD infections among the two groups were high when they were engaged with many sex partners and not having protected sex. In other words, there was a gap in risky sex behavior within such groups, which was significantly related to the possibility of developing an STD. Therefore, the preventive intervention against STDs for these groups needs to be expanded to include management of sex behaviors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5143-5147
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• 2014

Cervical cancer screening in Malaysia is by opportunistic Pap smear which contributes to the low uptake rate. To overcome this, a pilot project called the SIPPS program (translated as information system of Pap smear program) had been introduced whereby women aged 20-65 years old are invited for Pap smear and receive recall to repeat the test. This study aimed at determining which recall method is most cost-effective in getting women to repeat Pap smear. A randomised control trial was conducted where one thousand women were recalled for repeat smear either by registered letter, phone messages, phone call or the usual postal letter. The total cost applied for cost-effectiveness analysis includes the cost of sending letter for first invitation, cost of the recall method and cost of two Pap smears. Cost-effective analysis (CEA) of Pap smear uptake by each recall method was then performed. The uptake of Pap smear by postal letter, registered letters, SMS and phone calls were 18.8%, 20.0%, 21.6% and 34.4%, respectively (p<0.05). The CER for the recall method was lowest by phone call compared to other interventions; RM 69.18 (SD RM 0.14) compared to RM 106.53 (SD RM 0.13), RM 134.02 (SD RM 0.15) and RM 136.38 (SD RM 0.11) for SMS, registered letter and letter, respectively. ICER showed that it is most cost saving if the usual method of recall by postal letter be changed to recall by phone call. The possibility of letter as a recall for repeat Pap smear to reach the women is higher compared to sending SMS or making phone call. However, getting women to do repeat Pap smear is better with phone call which allows direct communication. Despite the high cost of the phone call as a recall method for repeat Pap smear, it is the most cost-effective method compared to others.

• Journal of Preventive Medicine and Public Health
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• v.45 no.6
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• pp.353-363
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• 2012

Methylmercury is a hazardous substance that is of interest with regard to environmental health, as inorganic mercury circulating in the general environment is dissolved into freshwater and seawater, condensed through the food chain, ingested by humans, and consequently affects human health. Recently, there has been much interest and discussion regarding the toxicity of methylmercury, the correlation with fish and shellfish intake, and methods of long-term management of the human health effects of methylmercury. What effects chronic exposure to a low concentration of methylmercury has on human health remains controversial. Although the possibility of methylmercury poisoning the heart and blood vessel system, the reproductive system, and the immune system is continuously raised and discussed, and the carcinogenicity of methylmercury is also under discussion, a clear conclusion regarding the human health effects according to exposure level has not yet been drawn. The Joint FAO/WHO Expert Committee on Food Additives proposed to prepare additional fish and shellfish intake recommendations for consumers based on the quantified evaluation of the hazardousness of methylmercury contained in fish and shellfish, methylmercury management in the Korea has not yet caught up with this international trend. Currently, the methylmercury exposure level of Koreans is known to be very high. The starting point of methylmercury exposure management is inorganic mercury in the general environment, but food intake through methylation is the main exposure source. Along with efforts to reduce mercury in the general environment, food intake management should be undertaken to reduce the human exposure to methylmercury in Korea.