• Health Policy and Management
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• v.29 no.3
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• pp.342-356
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• 2019

Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.161-172
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• 2008

Purpose: This study was to classify patient severity score for hemodialysis patients. Method: The subject of this study was 1,575 patients. To study the severity of the patients, we used t-test and ANOVA. The congruity was measured by Kappa coefficient and the severity in each medical facility was analyzed by ANOVA. Result: The results showed that there was a significant difference according to the levels of medical center (F=171.187, p<.0001). Categorizing the severity of the patients in each medical facility, group II and III of the secondary medical institution had higher ratio than the primary medical institution. There was not a single patient coming under group IV in both of the primary or secondary medical institutions. However, the tertiary medical institutions had more subjects in group II and III than the primary and secondary medical institutions. The group IV with the highest severity had 11 patients(1.5%), demonstrating that the tertiary medical institution had higher severity patients than the primary or secondary medical institutions. Conclusion: The results of this study appropriately reflects the repayment system of medical expenses by the government. Also, it provides the fundamental information to develop nursing fee system taken into account of the systemic differences among the primary, secondary and tertiary medical institutions.

• Research in Community and Public Health Nursing
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• v.33 no.4
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• pp.385-395
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• 2022

Purpose: To support implementation of comprehensive, person-centered healthcare, this study aimed to explore immigrant women's public health center (PHC) service experiences and needs while considering Photovoice's feasibility for this purpose. Methods: This qualitative study included 15 marriage-based immigrant women. Participants were recruited from churches and multicultural family support centers using purposive and snowball sampling. Data were collected through four focus group interviews and were subjected to inductive content analysis. Results: Five categories of experiences were identified: language barriers, hectic environment, affordable and practical primary healthcare, feeling ignored and discriminated against, and feeling frustrated. In addition, five categories of needs were identified: language assistance services, ease of access, healthcare across the lifespan, expansion of affordable healthcare, and being accepted as they are. This study provides preliminary evidence that the Photovoice approach can facilitate the interview process in a qualitative inquiry involving participants with limited ability to express their perspectives in the researchers' language. Conclusion: Study findings highlight the need to implement institutional policy and procedural changes within PHCs and to provide culturally competent, personcentered care for South Korea's marriage-based immigrant women and other ethnic minority populations. The findings also provide evidence-based direction for PHC service planning.

• The Korean Journal of Emergency Medical Services
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• v.21 no.3
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• pp.97-107
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• 2017

Purpose: The purpose of the study was to investigate and compare the usual source of healthcare and frequent visits to emergency departments. Methods: The study subjects were 7,252 individuals with chronic diseases who filled out the questionnaire of the 2013 Korea Health Panel Survey. Data were analyzed using chi-square test and logistic regression. Results: Compared to having a public health center or clinic as a usual source of healthcare, it is 1.341 times more likely for a chronic disease patient to visit an emergency department if the hospital is her/his usual source of healthcare, while it is 1.656 times more likely for the patient to visit a general/tertiary hospital. Conclusion: It is important to investigate visits at the emergency department requiring primary care for diseases.

• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.46-52
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• 2019

Objective : The aim of this nationwide study was to analyze the current state of patients with newly diagnosed metastatic spine tumors according to surgical methods. Methods : Data was extracted from the Korean Health Insurance Review and Assessment Service database. Surgery was categorized into three methods : fusion, decompression, and vertebroplasty. Data included patient age, sex, health insurance type, and co-morbidities. Survival rates of metastatic spine tumor patients according to each surgical method were evaluated. Results : Among 1677 patients who had an operation, 823 patients were treated by fusion, 141 patients underwent decompression, and 713 patients were treated by vertebroplasty. The three most prevalent primary tumor sites were the lung, breast, and liver & biliary. On the other hand, the three most prevalent primary tumor sites of patients who underwent surgery were the lung, liver & biliary, and the prostate. The median survival periods for each surgical method in the metastatic spine tumor patients were 228 days for those who underwent surgery, 249 days for decompression, and 154 days for vertebroplasty. Age, sex, and comorbidities significantly affected survival rate. Conclusion : For every primary tumor site, decompression was the least common surgical method during the study period. Although the three surgical methods did not significantly affect the survival period, patients with a poor prognosis tended to undergo vertebroplasty.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.3
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• pp.134-142
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• 2012

Objectives : Childhood depressive disorder one of the most prevalent chronic health conditions affecting school aged children. The objective of this study was to examine the prevalence and epidemiological characteristics of childhood depressive disorder in Korea. Methods : In this study, a survey was conducted of elementary school children in the Cheonan area from September 2009 to August 2010. A total of 12,084 children were included in the analyses. The primary measure of depression was the 27-item Kovacs' Children's Depression Inventory (CDI), the Korean Dupaul attention-deficit hyperactivity disorder Rating Scales (K-ARS), Autism Spectrum Screening Questionnaire (ASSQ) and Restless Legs Syndrome Questionnaire (RLSQ) were also administered. Results : The prevalence rate of childhood depressive disorder was 3.07%. The mean age was $9.21{\pm}1.81$ years for the control group (5,969 male, 6,054 female) and $9.91{\pm}1.83$ years for the depression group (CDI score${\geq}$22 ; 159 male, 210 female). Age, height, weight, and economic status were similar for the two groups. However, there were statistically significant differences in the distribution of sex. The distribution of school grade also differed between the two groups. Scores for CDI, K-ARS, and ASSQ in the depressive group were higher than those of the control group. Conclusions : This is the first large-scale population-based study to report on the prevalence of childhood depressive disorder in South Korea. Increased rates of childhood depressive disorder, as reported by primary caretakers, might reflect the increasing negative impact of environmental risk factors on neurobehavioral health. Longitudinal study of the prevalence of childhood depressive disorder should be considered for further evaluation.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.215-225
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• 1996

Decentralization to local governments and amending of Health Center Law are to promote the efforts of health planning at the level of local agencies. In the health facility planning, it is important to take into account that what to be built, where to be located, how far should be service area and so forth, because health facilities are immovable, and require capital as well as personnel and consumable supplies. The aim of our study, answering to the question of 'where to be located?', is to determine the best location of urban health sub-center. At the local level, planning is the matter of finding the best location of specific facilitiy, in relation to population needs. We confine the accessibility, which is basic to location planning, to geographic one. Location-Allocation Model is used to solve the problem where the location is to maximize geographic accessibility. To minimize the weighted travel distance, objective function, $R_k=\sum{\sum}a_{ij}w_{i}d_{ij}$ is used. Distances are measured indirectly by map measure-meter with 1:25,000 Suwon map, and each potential sites, 10 administrative Dongs in Kwonson Gu, Suwon, are weighted by each number of households, total population, maternal age group, child age group, old age group, Relief for the livelihood, and population/primary health clinics. We find that Kuwoon-Dong, Seodun-Dong, Seryu3-Dong, according the descending orders, are best sites which can minimize the weighted distance, and conclude that it is reasonable to determine the location of urban health sub-center among those sites.

• BMB Reports
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• v.43 no.5
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• pp.311-318
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• 2010

This review explored the mechanism of breast carcinoma progression by focusing on integrins and receptor tyrosine kinases (or growth factor receptors). While the primary role of integrins was previously thought to be solely as mediators of adhesive interactions between cells and extracellular matrices, it is now believed that integrins also regulate signaling pathways that control cancer cell growth, survival, and invasion. A large body of evidence suggests that the cooperation between integrin and receptor tyrosine kinase signaling regulates certain signaling functions that are important for cancer progression. Recent developments on the crosstalk between integrins and receptor tyrosine kinases, and its implication in mammary tumor progression, are discussed.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.250-257
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• 2017

Vitamin D is a cofactor responsible for autoimmune disorders. There is no agreement in the studies investigating the association between vitamin D and fibromyalgia. This study aims to combine the conflicting results of the primary studies which compared these patients with control groups regarding the serum concentration of vitamin D. This meta-analysis has been designed based on PRISMA guidelines. Relevant keywords were searched in PubMed, Science direct, Scopus, Cochrane, and Google scholar and primary studies were selected. After screening the eligible studies according to inclusion/exclusion criteria, we investigated the risk of bias in the selected studies and also the heterogeneity between the primary results using Cochrane (Q) and I-squared ($I^2$) indices. The primary results were combined using inverse variance method and Cohen statistics as well as a random effects model. Publication bias was assessed using Egger test. Sensitivity analysis was applied to investigate the influence of each primary study on the final result of the meta-analysis. Suspected factors in the heterogeneity were assessed using meta-regression models. We entered 12 eligible studies in the meta-analysis including 851 cases compared with 862 controls. The standardized mean difference of Vitamin D between the two groups was -0.56 (95% confidence interval: -1.05, -0.08). Our meta-analysis showed that vitamin D serum levels of patients with fibromyalgia was significantly lower than that of control group.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.421-424
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• 2023

This case report presents the case of a 49-year-old man who presented to our level I trauma center after sustaining injuries in an altercation with local law enforcement in which he was shot with a less lethal bean bag and tased. In a primary survey, a penetrating left supraclavicular wound was noted in addition to a taser dart lodged in his flank. No other traumatic findings were noted in a secondary survey. Given hemodynamic stability, completion imaging was obtained, revealing a foreign body in the left lung, a left open clavicle fracture, a C5 tubercle fracture, a possible grade I left vertebral injury, and a left first rib fracture. Soft tissue gas was seen around the left subclavian and axillary arteries, although no definitive arterial injury was identified. The bean bag projectile was embedded in the parenchyma of the left lung on cross-sectional imaging. The patient underwent thoracotomy for removal of the projectile and hemostasis. A thoracotomy was chosen as the operative approach due to concerns about significant bleeding upon foreign body removal. A chest tube was placed and subsequently removed on postoperative day 5. The patient was discharged on postoperative day 7. At a 2-week outpatient follow-up visit, the patient was doing well. This case report is the first to describe this outcome for a drag-stabilized bean bag. Although law enforcement officers utilize bean bag projectiles as a "less lethal" means of crowd control and protection, these ballistics pose significant risk and can result in serious injury.