• Health Policy and Management
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• v.16 no.4
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• pp.48-67
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• 2006

The aim of the study was to examine levels of satisfaction with health care in North Korea and to identify factors associated with it using a convenience sample of North Korean refugees in China. Data from the 2004 Survey of Health Seeking Behavior of North Korean Households conducted by the Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health were used. The study subjects were 273 North Korean refugees whose length of stay in China was less than 3 months. Factor analysis was used to extract factor dimensions from the 12 satisfaction items. Bivariate (t test and ANOVA) and multiple regression analyses were used in examining factors associated with satisfaction with health care use in North Korea Overall, satisfaction level was low ($2.36{\pm}0.36$, score range: 1-5). Of the three-factor dimensions, physician skills scored the highest $(2.93{\pm}0.36)$, followed by drug availability $(2.51{\pm}0.07)$ and general cleanliness $(1.66{\pm}0.55)$. In the multiple regression analysis, having a usual source of care was significantly associated with patient satisfaction. Respondents who identified primary care (section) doctors as their usual source of care tended to be less satisfied than those with the city or county hospital as their usual source of care. County residents tended to report a lower degree of satisfaction with general cleanliness than city residents. Among socioeconomic characteristics, the number of household assets positively predicted satisfaction with drug availability. North Korean residents appear to be dissatisfied with their medical care. It may reflect some inadequacies in the North's universal health care system to meet the healthcare needs of its people.

• Journal of agricultural medicine and community health
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• v.40 no.2
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• pp.72-79
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• 2015

Objectives: To identify the importance of preventing tuberculosis for HIV (Human Immunodeficiency Virus) infectees and to monitor their management of health, we investigated the proportion of HIV-TB (Tuberculosis) deaths among the HIV deaths and its related factors. Methods: Data for HIV deaths from 2002 to 2010 was acquired from Statistics Korea, after which the HIV deaths were reclassified into HIV-TB deaths or other deaths according to the KCD (Korean Classification of Diseases). We analyzed the proportion of HIV-TB deaths among HIV disease deaths and the relationship between HIV-TB deaths and related variables such as sex, age, educational level, marital status, etc. Results: There were 774 HIV deaths in South Korea between 2002 and 2010. TB was the main cause of death in 10.1% of all HIV deaths. The total proportion of HIV-TB deaths was 10.1% but its proportion reached 16.3% between 2005-2007 and then decreased to 4% in 2010. Also, the proportion of HIV-TB deaths was significantly high in the young age groups, but its proportion was significantly low in married groups and well educated groups (p<0.05). Conclusions: The result implies that the policy that takes care of HIV infectee regarding TB prevention has been getting systemized on a national scale. Also, HIV-TB deaths have been affected by social factors such as education and marriage status.

• Journal of the Korean Data and Information Science Society
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• v.24 no.1
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• pp.117-124
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• 2013

Association rule of data mining techniques is the method to quantify the relationship between a set of items in a huge database, andhas been applied in various fields like internet shopping mall, healthcare, insurance, and education. There are three primary interestingness measures for association rule, support and confidence and lift. Confidence is the most important measure of these measures, and we generate some association rules using confidence. But it is an asymmetric measure and has only positive value. So we can face with difficult problems in generation of association rules. In this paper we apply the similarity measures by probabilistic interestingness measure (PIM) with all marginal proportions (AMP) to solve this problem. The comparative studies with support, confidences, lift, chi-square statistics, and some similarity measures by PIM with AMPare shown by numerical example. As the result, we knew that the similarity measures by PIM with AMP could be seen the degree of association same as confidence. And we could confirm the direction of association because they had the sign of their values, and select the best similarity measure by PIM with AMP.

• Korea Journal of Hospital Management
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• v.20 no.2
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• pp.15-27
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• 2015

As patient satisfaction is a crucial component of improved health care outcomes, there is a need to evaluate the relationship between physicians' attitude and patients' satisfaction. The objective of this study is to examine the relationship between patients' satisfaction and physicians' friendly and caring attitudes by using recent physician ratings by patients. Data from a cross-sectional survey using a convenience sampling was utilized to examine the relationship between physicians' attitudes and patients' satisfaction. The independent variable was the physician's attitude, and the dependent variables were patients' satisfaction with the physician and the office setting. A total of 273,994 patients it the US were included. The patients' average (standard deviation, SD) satisfaction with the physician was 78.08 (0.14), and the average (SD) satisfaction with the office setting was 78.62 (0.12) out of 100. Physicians' attitude was a significant predicting factor impacting the patients' satisfaction with the physician and the office setting (p < 0.001). To facilitate patients' satisfaction with healthcare, a continuous effort to develop physicians' ability to communicate in an empathetic manner should be undertaken so that patients perceive their physicians as empathetic.

• Journal of the Korean Dietetic Association
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• v.20 no.3
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• pp.183-198
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• 2014

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.82-86
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• 2016

Lowe syndrome is X-linked gene disorder, characterized by cataracts, renal dysfunction and brain abnormalities. Oral healthcare of young patients with Lowe syndrome could be easily neglected due to the uncooperative behavior or other systemic condition of the child. We are presenting a case of successful treatment under general anesthesia with uncooperative child with Lowe syndrome. A 3-year old boy with Lowe syndrome visited Seoul National University Dental Hospital for multiple caries. He had been suffering from congenital cataract, medullary nephrocalcinosis and hypotonia. Multiple caries were observed from clinical and radiographic examination. Concerning behavior management problem and possibility of aspiration due to hypotonia, dental treatment under general anesthesia was planned. Left upper primary first molar was extracted to prevent further infection. Other teeth were treated with Stainless steel crown or composite resin restoration based upon the extent and the severity of dental caries. Under general anesthesia, dental procedure was carried out successfully and safely. Considering uncooperative behavior and other medical conditions of the patient, general anesthesia could be effective. Home oral care and periodic visit to dental clinic should be emphasized to the caregiver of patient with Lowe syndrome, considering the susceptibility of dental caries and other oral manifestation.

• Clinical and Experimental Reproductive Medicine
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• v.45 no.3
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• pp.135-142
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• 2018

Objective: To prospectively evaluate the efficacy and safety of a fixed early gonadotropin-releasing hormone (GnRH) antagonist protocol compared to a conventional midfollicular GnRH antagonist protocol and a long GnRH agonist protocol for in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS). Methods: Randomized patients in all three groups (early antagonist, n = 14; conventional antagonist, n = 11; long agonist, n = 11) received 21 days of oral contraceptive pill treatment prior to stimulation. The GnRH antagonist was initiated on the 1st day of stimulation in the early antagonist group and on the 6th day in the conventional antagonist group. The GnRH agonist was initiated on the 18th day of the preceding cycle. The primary endpoint was the number of oocytes retrieved, and the secondary endpoints included the rate of moderate-to-severe ovarian hyperstimulation syndrome (OHSS) and the clinical pregnancy rate. Results: The median total number of oocytes was similar among the three groups (early, 16; conventional, 12; agonist, 19; p= 0.111). The early GnRH antagonist protocol showed statistically non-significant associations with a higher clinical pregnancy rate (early, 50.0%; conventional, 11.1%; agonist, 22.2%; p= 0.180) and lower incidence of moderate-to-severe OHSS (early, 7.7%; conventional, 18.2%; agonist, 27.3%; p= 0.463), especially among subjects at high risk for OHSS (early, 12.5%; conventional, 40.0%; agonist, 50.0%; p= 0.324). Conclusion: In PCOS patients undergoing IVF, early administration of a GnRH antagonist may possibly lead to benefits due to a reduced incidence of moderate-to-severe OHSS in high-risk subjects with a better clinical pregnancy rate per embryo transfer. Further studies with more subjects are required.

• Journal of Preventive Medicine and Public Health
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• v.55 no.1
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• pp.88-97
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• 2022

Objectives: This study investigated the determinants of depression in adolescents and young adults. Methods: The present study analyzed data from the 2018 Indonesia Basic Health Survey (Riset Kesehatan Dasar; RISKESDAS). The study subjects were adolescents (15-17 years old) and young adults (18-24 years old). In total, 64 179 subjects were included. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between youths' characteristics, risky behavior, chronic disease, parents' health, and youths' depression. Results: The prevalence of depression was 5.1% in adolescents and 5.6% in young adults. The risk factors for depression in adolescents were being women (adjusted odds ratio [aOR], 3.53; 95% confidence interval [CI], 2.89 to 4.30; p<0.001), an ex-smoker (aOR, 2.99; 95% CI, 2.10 to 4.25; p<0.001), or a current smoker (aOR, 2.60; 95% CI, 1.97 to 3.44; p<0.001); consuming alcohol (aOR, 2.00; 95% CI, 1.33 to 3.01; p=0.001), having a chronic disease (aOR, 2.64; 95% CI, 1.41 to 4.96; p=0.002); maternal depression (aOR, 2.47; 95% CI, 1.97 to 3.09; p<0.001); and paternal depression (aOR, 2.63; 95% CI, 1.98 to 3.50; p<0.001). In young adults, the risk factors were being women (aOR, 2.23; 95% CI, 1.82 to 2.75; p<0.001) or an ex-smoker (aOR, 2.47; 95% CI, 1.67 to 3.67; p<0.001), consuming alcohol (aOR, 2.42; 95% CI, 1.89 to 3.09; p<0.001), maternal depression (aOR, 3.12; 95% CI, 2.54 to 3.84; p<0.001), and paternal depression (aOR, 2.80; 95% CI, 2.17 to 3.63; p<0.001). Conclusions: Being women, smoking, drinking alcohol, having a chronic disease, and having a parent with depression were crucial factors associated with youth depression. Mental health screening, prevention, and treatment should involve collaboration among primary healthcare, schools, universities, professionals, and families.

• International journal of advanced smart convergence
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• v.12 no.3
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• pp.89-103
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• 2023

Obstructive sleep apnea (OSA) is one of the most prevalent sleep disorders that can lead to serious consequences, including hypertension and/or cardiovascular diseases, if not treated promptly. Continuous positive airway pressure (CPAP) is widely recognized as the most effective treatment for OSA, which needs the proper titration of airway pressure to achieve the most effective treatment results. However, the process of CPAP titration can be time-consuming and cumbersome. There is a growing importance in predicting personalized CPAP pressure before CPAP treatment. The primary objective of this study was to optimize the CPAP titration process for obstructive sleep apnea patients through EEG feature engineering with machine learning techniques. We aimed to identify and utilize the most critical EEG features to forecast key OSA predictive indicators, ultimately facilitating more precise and personalized CPAP treatment strategies. Here, we analyzed 126 OSA patients' PSG datasets before and after the CPAP treatment. We extracted 29 EEG features to predict the features that have high importance on the OSA prediction index which are AHI and SpO2 by applying the Shapley Additive exPlanation (SHAP) method. Through extracted EEG features, we confirmed the six EEG features that had high importance in predicting AHI and SpO2 using XGBoost, Support Vector Machine regression, and Random Forest Regression. By utilizing the predictive capabilities of EEG-derived features for AHI and SpO2, we can better understand and evaluate the condition of patients undergoing CPAP treatment. The ability to predict these key indicators accurately provides more immediate insight into the patient's sleep quality and potential disturbances. This not only ensures the efficiency of the diagnostic process but also provides more tailored and effective treatment approach. Consequently, the integration of EEG analysis into the sleep study protocol has the potential to revolutionize sleep diagnostics, offering a time-saving, and ultimately more effective evaluation for patients with sleep-related disorders.

• Journal of Hospice and Palliative Care
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• v.22 no.3
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• pp.105-116
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• 2019

Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.