• 디지털융복합연구
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• 제12권4호
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• pp.93-102
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• 2014

이 연구에서는 공공부문 조직의 경영효율화 전략의 한 방안으로서 한국서부발전 사례를 통해 최근 전력산업의 해외진출 사례에 대한 현황분석을 시도하고, 이를 통해 경영효율화 전략을 도출해 봄으로써 향후 공공기관의 경영효율화에 대한 정책적 함의를 제시해 보는데 연구목적을 두었다. 이를 위해 본 연구에서는 선행연구의 경험을 토대로 (1) 기업환경 변화에 대한 대응 (2) 사용 전략(목표설정, 성과창출의 적시성, 리스크관리, 조직임무 및 역할) (3) 효율적인 인력관리 (4) 사업다각화 등의 4가지 분석국면을 토대로 분석을 하였다. 본 연구의 분석결과 공기업의 경쟁력 강화를 위한 주요 측면으로서 해외사업의 효율적 추진을 위해서는 첫째, 불확실한 경영환경에 대한 적극적인 대응 노력이 필요하고, 둘째, 민관 협력적 거버넌스 체계 구축을 통한 사업 추진, 셋째, 효율적인 글로벌 인적자원 관리, 넷째, 전략적 구성요소들의 고려가 필요함을 제시하였다.

• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.397-404
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• 2020

Objectives: The objective of this study was to demonstrate the effects of community-based social distancing interventions after the first coronavirus disease 2019 (COVID-19) case in Turkey on the course of the pandemic and to determine the number of prevented cases. Methods: In this ecological study, the interventions implemented in response to the first COVID-19 cases in Turkey were evaluated and the effect of the interventions was demonstrated by calculating the effective reproduction number (R_t) of severe acute respiratory syndrome coro navirus 2 (SARS-CoV-2) when people complied with community-based social distancing rules. Results: Google mobility scores decreased by an average of 36.33±22.41 points (range, 2.60 to 84.80) and a median of 43.80 points (interquartile range [IQR], 24.90 to 50.25). The interventions caused the calculated R_t to decrease to 1.88 (95% confidence interval, 1.87 to 1.89). The median growth rate was 19.90% (IQR, 10.90 to 53.90). A positive correlation was found between Google mobility data and R_t (r=0.783; p<0.001). The expected number of cases if the growth rate had not changed was predicted according to Google mobility categories, and it was estimated to be 1 381 922 in total. Thus, community-based interventions were estimated to have prevented 1 299 593 people from being infected. Conclusions: Community-based social distancing interventions significantly decreased the R_t of COVID-19 by reducing human mobility, and thereby prevented many people from becoming infected. Another important result of this study is that it shows health policymakers that data on human mobility in the community obtained via mobile phones can be a guide for measures to be taken.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8361-8366
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• 2014

This meta-analysis was performed to assess the implementation effects of clinical pathways in patients with gastrointestinal cancer. A comprehensive search was conducted in the Cochrane Library, PubMed, EMBASE, Web of Science and Chinese Biomedical Literature Database (from inception to May 2014). Selection of studies, assessing risk of bias and extracting data were performed by two reviewers independently. Outcomes were analyzed by fixed-effects and random-effects model meta-analysis and reported as mean difference (MD), standardized mean difference (SMD) and odds ratio (OR) with 95% confidence intervals (CI). The Jadad methodological approach was used to assess the quality of included studies and the meta-analysis was conducted with RevMan 5.1 software. Nine citations (eight trials) involving 642 patients were included. The aggregate results showed that a shorter average length of stay [MD = -4.0; 95% CI (-5.1, -2.8); P < 0.00001] was observed with the clinical pathways as compared with the usual care. A reduction in inpatient expenditure [SMD = -1.5; 95% CI (-2.3, -0.7); P = 0.0001] was also associated with clinical pathways, along with higher patient satisfaction [OR = 4.9; 95% CI (2.2, 10.6); P < 0.0001]. Clinical pathways could improve the quality of care in patients with gastrointestinal cancer, as evidenced by a significant reduction in average length of stay, a decrease in inpatient expenditure and an improvement in patient satisfaction. Therefore, indicators and mechanisms within clinical pathways should be a focus in the future.

• Journal of Preventive Medicine and Public Health
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• 제51권4호
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• pp.205-212
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• 2018

Objectives: The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. Methods: A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders. Results: Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome. Conclusions: Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.

• Parasites, Hosts and Diseases
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• 제56권1호
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• pp.33-39
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• 2018

Intestinal parasitic infections remain a major public health problem in many parts of Thailand, particularly in rural areas. This study aimed to determine the prevalence of intestinal parasitic infections and associated risk factors among the people living in Huai Sai sub-district, Bang Khla district, Chachoengsao Province, central Thailand. A cross-sectional survey was carried out from June 2017 to August 2017 which included a total of 224 participants. Stool samples were examined using a simple direct smear and formalin ethyl acetate concentration technique. Association between risk factors and intestinal parasitic infections was assessed using multivariate logistic regression analysis. The overall prevalence of intestinal parasitic infections was 16.1%. Soil-transmitted helminth infections (14.3%) were more common than protozoan infections (1.8%). The most common intestinal parasites were hookworms (6.7%) followed by Strongyloides stercoralis, (5.0%), Ascaris lumbricoides (1.3%) and Trichuris trichiura (1.3%). Entamoeba histolytica/dispar (1.0%), Giardia intestinalis (0.4%), and Blastocystis hominis (0.4%) were the protozoans identified. A high prevalence of infections was found in male participants of ${\geq}40years$ who raised dogs in the households and did not wear boots while working fields. Multivariate analysis showed a significant association of intestinal parasitic infections with gender with the adjusted odds ratio (OR) of 2.4 and 95% confidence interval (CI) of 1.1-5.2 (P=0.020). The results showed a high prevalence of soil-transmitted helminth infections among adults in rural communities which were particularly apparent regarding the skin-penetrating species of nematodes. A greater focus on intervention is required by improving sanitation and personal hygiene to prevent the spread of intestinal parasitic infections.

• Journal of Preventive Medicine and Public Health
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• 제37권2호
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• pp.127-132
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• 2004

Objectives : Cotinine, the major metabolite of nicotine, is a useful marker of exposure to tobacco smoke and self-reporting of smoking status is thought not to be reliable. This study aimed to evaluate the agreement between the smoking self-report among adolescents and the urinary cotinine test. Methods : The study subjects were 1226 middle and high school students in Hanam city, who were selected by stratified random sampling. The self-report about smoking behavior was compared with urine cotinine value measured with PBM $AccuSign^{\circledR}fi$ Nicotine(Princeton BioMeditech Corporation, USA). The percentage agreement, kappa and 95% confidence interval(CI) were calculated. Results : The overall percentage agreement was 88.6%, and those for boys, girls, middle school, general school and vocational school students were 87.3%, 90.1%, 93.7%, 85,5%, 90.7%, and 78.4%, respectively. The overall kappa index was 0.46(95% CI=0.39-0.54)for overall, .and those for boys, girls, middle school, general school and vocational school students were 0.56(95% CI=0.48-0.65), 0.20(95% CI=0.07-0.32), 0.21(95% CI=0.09-0.34), 0.55(95% CI=0.47-0.64), 0.42(95% CI=0.33-0.52), and 0.48(95% CI=0.36-0.60), respectively. Conclusion : The percentage agreement was relatively high but the kappa values very low for girls, and middle school students. Though the prevalence bias can be influenced by these results, the self-report was not a sufficient tool for the evaluation of adolescents' smoking status, especially in girls or middle school students.

• Journal of Preventive Medicine and Public Health
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• 제50권5호
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• pp.328-335
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• 2017

Objectives: The prevalence of underweight in children under 5 years of age is anomalously high in Konawe District, Southeast Sulawesi Province, Indonesia. This state of affairs may be related to poor housing conditions, such as limited access to clean water, the absence of a sanitary latrine, and the use of poor housing materials. Therefore, this study aimed to examine the effect of housing conditions on underweight in under-5 children in Konawe District. Methods: This study was conducted in 2013 in 5 health centres in Konawe District, Southeast Sulawesi Province, and used a case-control study design. The study recruited 400 under-5 children, including 100 of whom were cases and 300 of whom were age-matched controls (1:3). Cases were underweight children, while the controls were children with a normal nutritional status. The independent variables were the availability and types of water and latrine facilities and housing materials (roof, wall, and floor). The statistical analysis used Cox regression. Results: A lack of water availability (odds ratio [OR], 5.0; 95% confidence interval [CI], 2.7 to 9.5; p<0.001), a lack of latrine availability in the home (OR, 2.5; 95% CI, 1.5 to 4.0; p<0.001), and poor-quality roofing materials (OR, 1.7; 95% CI, 1.1 to 2.7; p<0.02) significantly contributed to underweight in children. In contrast, the walls and the floors did not contribute to under-5 year children being underweight (p=0.09 and p=0.71, respectively). Conclusions: Sanitation facilities and roofing were identified as important factors to address in order to improve children's nutritional status. Children's health status was directly impacted by food intake via their nutritional status.

• Journal of Preventive Medicine and Public Health
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• 제50권6호
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• pp.369-376
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• 2017

Objectives: Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI). Methods: The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI. Results: Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations. Conclusions: The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.4815-4821
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• 2014

Background: This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. Materials and Methods: A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. Results: The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). Conclusions: Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9725-9730
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• 2014

Background: Sister chromatid exchange (SCE) in human peripheral blood lymphocytes is one of the most extensively studied biomarkers employed to evaluate genetic damage subsequent to pesticide exposure. Objective: To estimate the pooled levels of SCE in human peripheral blood lymphocytes among population exposed to pesticide. Materials and Methods: Meta-analysis on the association between SCE frequency and pesticide exposure was performed with STATA 10.0 software package and Review Manager 5.0.24 in this study. Results: The overall means of SCE were 7.88 [95% confidence intervals (95%CI): 6.71-9.04] for exposure group and 6.05 (95%CI: 5.13-6.95) for controls, respectively. There was statistically significant difference in the SCE frequency in human peripheral blood lymphocytes between pesticide-exposed groups and control groups, and the summary estimate of weighted mean difference was 1.69 (95%CI: 1.01-2.38). We also observed that pesticide-exposed population had significantly higher SCE frequency than control groups among smokers, nonsmokers, pesticide applicator, pesticide producer, other exposure population and Asian population in stratified analyses. Conclusions: Data indicate that the SCE frequency in human peripheral blood lymphocytes might be an indicator of early genetic esffects for pesticide-exposed populations.