• Gut and Liver
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• v.12 no.6
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• pp.615-622
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• 2018

Despite the well-proven, safe and effective therapies for hepatitis B infection, delivery of treatment remains a significant challenge in resource-poor settings. Geopolitical and economic restrictions present additional difficulties in providing care in North Korea. However, treatment of patients with chronic hepatitis B remains a top priority for both the North Korean Ministry of Public Health and international agencies working in North Korean hepatitis healthcare facilities. Working in partnership, a path was created to institute this much-needed program. A consortium of United States and Australian humanitarian non-governmental organizations along with generous individual and corporate donors working in concert with local and national health authorities have succeeded in establishing the first hepatitis B treatment program in North Korea. The essential elements of this program include renovation of existing hepatitis hospitals, access to antiviral medications, establishment of laboratory facilities, creation of medical documentation and record-keeping, training of local health care professionals, and quarterly visits by international volunteer physicians and laboratory experts. Management and treatment decisions are made bilaterally. To date, nearly 1,500 patients have been evaluated, and over 800 have been started on long-term antiviral therapy. It is envisioned that this program will eventually be managed and funded by the Democratic People's Republic of Korea Ministry of Public Health. This program's success demonstrates a potential model for delivery of antiviral therapy for patients suffering from hepatitis B in other developing countries.

• Journal of Preventive Medicine and Public Health
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• v.47 no.1
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• pp.1-6
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• 2014

A set of exposure factors that reflects the characteristics of individual behavior capable of influencing exposure is essential for risk and exposure assessment. In 2007, the Korean Exposure Factors Handbook was, therefore, issued, driven by the need to develop reliable exposure factors representing the Korean population. The purpose of this study was to overview the development process of the Korean Exposure Factors Handbook and major recommended exposure values for the Korean population to allow information exchanges and comparison of recommended values among nations. The researchers reviewed the domestic data that could be used in the development of exposure factors, confirmed a knowledge gap, and set a priority of development by phases. A methodology to measure exposure factors was established to develop measuring techniques and test their validity. Data were processed or a survey was conducted according to the availability of data. The study thus produced recommended values for 24 exposure factors grouped by general exposure factors, food ingestion factors, and activity factors by setting up a database of exposure factors and carrying out statistical analysis. The study has significantly contributed to reducing the potential uncertainty of the risk and exposure assessment derived by the application of foreign data or research findings lacking representativeness or grounds by developing a set of exposure factors reflecting the characteristics of the Korean people. It will be necessary to conduct revisions in light of the changing statistical values of national data and the exposure factors based on Korean characteristics.

• Korean Journal of Health Education and Promotion
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• v.29 no.4
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• pp.15-28
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• 2012

Objective: This paper aims to describe health promotion (HP) research according to HP activities, strategies, target population, and settings, and to explore challenges for HP to reflect principles and values. Methods: A content analysis was employed for all research reports funded by the Korea Health Promotion Foundation from 2005 to 2011. Content analysis was conducted according to the HP activities and strategies as mentioned in the Ottawa Charter, and by target population and setting. Challenges for HP research were explored by priority actions suggested by the International Union for Health Promotion and Education. Results: The total number of research was 384. The most popular topic was on HP actions for reorienting health services, followed by developing personal skills, creating supportive environments, building healthy public policy, and strengthening community actions. Research focusing on enabling strategies was most dominant among the HP strategies, while both advocating and mediating strategies were unlikely to be studied. An even distribution was found across target populations. The most popular setting was communities, followed by workplaces and schools. Conclusion: HP research tends to be anchored on bio-medical, individualized, and behavioral perspectives. A discussion was made to overcome this tendency by employing HP in social sciences theory and methods.

• Health Policy and Management
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• v.32 no.1
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• pp.45-52
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• 2022

Background: There are regional variations in the incidence of coronavirus disease 2019 (COVID-19), which means that some regions are more exposed to the risk of COVID-19 than others. Therefore, this study aims to investigate regional variations in the incidence of COVID-19 in Korea and identify risk factors associated with the incidence of COVID-19 using community-level data. Methods: This study was conducted at the districts (si·gun·gu) level in Korea. Data of COVID-19 incidence by districts were collected from the official website of each province. Data was also obtained from the Korean Statistical Information Service and the Community Health Survey; socio-demographic factor, transmission pathway, healthcare resource, and factor in response to COVID-19. Community risk factors that drive the incidence of COVID-19 were selected using a least absolute shrinkage and selection operator regression. Results: As of June 2021, the incidence of COVID-19 differed by more than 80 times between districts. Among the candidate factors, sex ratio, population aged 20-29, local financial independence, population density, diabetes prevalence, and failure to comply with the quarantine rules were significantly associated with COVID-19 incidence. Conclusion: This study suggests setting COVID-19 quarantine policy and allocating resources, considering the community risk factors. Protecting vulnerable groups should be a high priority for these policies.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7651-7656
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• 2013

Background: Breast cancer is the most common malignancy among women in both developed and developing countries. The burden is increasing in low-income and middle-income countries (LMCs) and threatens the public health of such societies. Introduction of expensive monoclonal antibodies to cancer treatment regimens poses a real challenge in the health systems of LMCs. Despite controversy of cost-effectiveness of bevacizumab in breast cancer, some studies indicate gain of patients from this drug. The present study aimed to propose a priority setting model for administration of anti-angiogenic agents in breast cancer via assessment of tumor angiogenesis by the microvessel density (MVD) method and associations with clinicopathological characteristics (including simultaneous mutations of TP53 and HER-2 genes). Materials and Methods: Age, axillary lymph nodes status, tumor size, stage and grade, estrogen and progesterone receptors status, HER-2/neu status (by immunohistochemistry and FISH test), TP53 mutation, Ki-67 (for proliferation assay) and CD34 (for angiogenesis assay) were assessed in 111 breast cancer patients. The molecular subtype of each tumor was also determined and correlations of simultaneous mutations of HER-2 and p53 genes with angiogenesis and other clinicopathological characteristics were evaluated. Results: There were significant associations between simultaneous mutations of HER-2 and p53 genes and all other parameters except tumor size. The degree of angiogenesis in the ERBB2 subtype was greater than the others. Younger patients showed a higher angiogenesis rate rather those older than 50 years. Conclusions: Our results demonstrated that patients with simultaneous mutations of HER-2 and p53 genes, those with ERBB2 molecular subtype and also younger women (often triple negative) seem more eligible for obtaining anti-angiogenic agents. These results suggest a model for priority setting of patients with breast cancer for treatment with anti-angiogenic drugs in LMCs.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.433-439
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• 2014

We attempted to develop an indicator combining incidence with mortality rates (single measure of cancer burden, SMCB) and to compare the magnitudes of cancer burden by world region. The SMCB was used to measure the size of cancer burden summarizing the incidence and mortality. The incidence and mortality were divided in equivalent forms and were split. The criteria dividing the size of cancer burden were used as the maximum incidence and mortality by men and women according to the world database, and the value corresponding to 10% of each maximum was set as the cut-off value. In SMCB, the size of cancer burden was highest for men with lung cancer (SMCB=18) and for women with breast cancer (SMCB=14) in MDR (more developed regions) compared to the size of burden in LDR (lower developed regions) (lung, SMCB=11, breast, SMCB=8). For men, the size of cancer burden by region was highest in EURO (SMCB=18, lung), followed by WPRO (SMCB=16, lung), PAHO (SMCB=14, prostate), AFRO (SMCB=8, prostate) and SEARO (SMCB=7, lung). Moreover, for women, the size of cancer burden was greatest in EURO (SMCB=14, breast), followed by PAHO (SMCB=13, breast), AFRO (SMCB=11, cervix uteri), EMRO (SMCB=9, breast) or SEARO (SMCB=8, cervix uteri) and WPRO (SMCB=7, lung). The summary indicator will help to provide a priority setting for reducing cancer burden in health policy.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.175-181
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• 2005

Objectives: This study estimated the burden of disease due to high alcohol consumption using DALY, a composite indicator recently developed by the Global Burden of Disease study group. The results were analyzed by age and sex. Methods: Firstly, high alcohol consumption-related diseases, and their relative risk (RR), were selected. Secondly, population attributable fractions (PAFs) were computed using formulae, including the relative risk (RR) and prevalence of exposure (Pe). Thirdly, the DALYs of high alcohol consumption-related diseases were estimated. Lastly, the attributable burdens of diseases due to high alcohol consumption wereconcluded as being the sum of the products that multiplied the DALYs of high alcohol consumption-related diseases by their population attributable fraction (PAF). Results : The burden of high alcohol consumption in Korea was 2992.3 person years (PYs) per 100,000 persons in men, and 1426.6 in women. For men, the high alcohol consumption-induced diseases with the five biggest burdens were liver cirrhosis, hypertensive disease, liver cancer, cerebral infarction and intracerebral hemorrhage. For women, these were cerebral infarction, intracerebral hemorrhage, hypertensive disease, liver cirrhosis and liver cancer. Conclusion: This study highlighted the attributable fraction of diseases due to exposure to high alcohol consumption, by quantifying the results of exposure to risk factors. Therefore, it is now possible to assess interventions for risk factors in quantifiable terms in each population. Finally, measuring the risk factor burdens was expected to contribute to priority setting and effective resource allocation in public health policy.

• Women's Health Nursing
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• v.5 no.1
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• pp.146-165
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• 1999

The purpose of this paper was to identify the performance of health promoting lifestyles and health perception over 18 years old women living Wonju city so that the results will be based for setting up women's health nursing center. The subjects were 1080 women selected by stratified and purposive sampling. The data were collected by self reporting questionnaire and interview from May to June, 1998. Data were analyzed by SPSS win program. The results were as follows : 1. The range of age was 18-84 years, The proportion according to women's lifecycle was premarital group 20.0%, delivery and rearing group 49.9%, over middle aged-elderly group 29.8%. 2. The mean menarchial age was 15.2 and menopausal age was 48. Mean frequenices of pregnancy is 2.4 and artificical abortion rate is 36.4%. Primary cause of abortion was unwanted babies 42.8%. The practice rate of family planning was 79.4% and permanent sterilization rate was 37.6%. 3. Fatigue was predominated problem in target population. Depression and headache was predominated in premarital group, headache and nervous felling in delivery and rearing group, arthritis and loss of memory in over middle aged-elderly group. 4. Only 13.7% of the target population make some efforts for their health in compare to 85.9% have attention for their health. Perception of unhealthy rate was 9.1% in premarital group, 24.8% in delivery and rearing group, 30.1% in middle aged-elderly group. 5. The average score of the HPLP(Health Promoting Lifestyle Profile) was 2.41. The variable with the highest degree of performance was interpersonal relationship, whereas the one with the lowest degree was the professional health maintenance. The significant difference was found in HPLP according to age, residential area, marital status, educational level, income level. 6. Majority(95.1%) of the target population agreed on necessity for women's health nursing center. Proper location area was presented to women's center and public health center. The priority for health education program was proper diet, family health, stress management, and exercise. In conclusion, we should prepare the education program for women's health according to women's lifecycle, because health perception, HPLP, and education program needed was differentiated in women's lifecycle. Also we suggest that women's health nursing center based community was needed for proper management of women's health.

• Journal of agricultural medicine and community health
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• v.34 no.1
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• pp.87-100
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• 2009

Objectives: This study was conducted to suggest the way to improve the tobacco control program of public health centers in Korea. Methods: A survey with a self-administered questionnaire was conducted among 246 persons in charge of tobacco control work in public health centers nationwide in December, 2006. Frequency analysis was performed with a final sample of 212 respondents with SPSS 12.0 for Windows. Results: The duration of engagement in tobacco control work was less than 3 years among 86.7% of respondents, and 87.3% of respondents had other duties besides tobacco control. Almost all public health centers conducted a campaign with posters or leaflets, and smoking prevention education among adolescents. The actual priority for programs was based on the community diagnosis in only 33.5% of the cases. Only 1.9% of respondents complained lack of budget, on the other hand, 44.7% of respondents appealed insufficient number of personnel. The route of knowledge and skill was largely dependent on self-learning or information from colleague. Collaboration with other related department was done well in 39.5% of the cases. The majority of respondents was satisfied with the general support from central government. Conclusions: To improve the tobacco control program of public health centers, it is needed the reinforcement of capacity and specialty among personnel, priority setting and performance of programs based on the scientific evidence, induction of community participation, utilization of community human resources, development of education and training course for practical skill, effective networking among departments.

• Quality Improvement in Health Care
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• v.8 no.2
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• pp.146-159
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• 2001

Background : To propose effective strategies for successful implementation of QI in health care institutions, by identifying facilitating factors and barriers to conducting QI programs. Methods : In order to examine empirical evidence on the success factors or barriers to QI implementation in hospitals, a literature study was performed on the basis of MEDLINE search. Among the identified literature. 13 provided reliable findings and basis comprehensive discussion on this issue and thus were selected for in-depth analysis. A mailed questionnaire survey was conducted for hospital CEOs and QI directors of hospitals with 400 beds or greater to investigate what attributes of their organizations they perceived as success factors or obstacles to QI implementation. Result : The analysis of selected literature and survey results presented that the primary factors considered to be most important as successful implementation of QI were: strong support from hospital CEOs, setting higher priority for QI activities, continuous and persistent efforts in QI activities, and active participation of clinical staffs. The barriers identified in this study were : the lack of orientation and understanding of QI concepts, low level of interest and participation of physician in QI programs, the lack of evaluation and rewarding system for QI activities. Conclusion : By identifying factors that affect facilitation of QI, the study results will be of great use for either institutions being in the early stage of evolving QI or those looking for better strategies to achieve more active and persistent QI implementation in their institutions.