• The Journal of Korean Medicine
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• v.34 no.2
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• pp.41-50
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• 2013

Objectives: As a newcomer to the medical tourism industry, Korea needs to differentiate itself from the leading competing countries to vitalize its early-stage medical tourism industry. This study aims to introduce a strategic plan to vitalize the Korean integrated medical tourism so that Korea can differentiate itself from competing countries and create high added value. Methods: The concept and actual conditions of medical tourism and Oriental medical tourism were examined. A plan to differentiate Korea from the competing countries in the medical tourism industry was studied to create high added-value through strategic vitalization of its medical tourism industry. Results: Korean integrated medical tourism must be developed differently from those of other South-East Asian countries in order to strategically promote the cash-cow medical tourism industry. In order to develop such medical tourism, Korean medical practice, which integrates Western and Oriental medicine, is to be developed through mutual understanding and fusion of other disciplines among medical doctors and Oriental medical doctors who are working in local healthcare for health promotion of local residents and disease prevention and control. This will play a key role in developing a unique medical tourism product of Korea by means of strategic alliances as an integrated medicine. Manpower specialized for integrated medicine is to be specially supplied for Oriental medicine-related business lines at city, county and borough levels, among local governments, that are enthusiastically carrying forward Oriental medical tourism with an interest to promoting more active and strategic business development and raise the effectiveness and efficiency of public health centers handling related medical tourism. Manpower specialized for Korean integrated medical tourism is to be specially supplied for the Ministry of Culture, Health and Tourism, a policy control tower to develop and vitalize high value-added fusion (theme) tourism products such as the Korean integrated medical tourism, in order to discover, promote and support Korean integrated medical tourism's differences from existing medical tourism. Conclusions: The differentiated integrated medical tourism that only Korea can offer in a variety of forms, in order to create a key area of high value-added medical tourism, should be strategically vitalized through a liaison between integrated medicine and tourism and the realization of patient-centered health care services with medical technology developed based on mutual understanding of Western and Oriental medicine.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.349-366
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• 2016

Objectives: We conducted a systematic review and meta-analysis to summarize current evidence regarding the association of parity and duration of breastfeeding with the risk of epithelial ovarian cancer (EOC). Methods: A systematic search of relevant studies published by December 31, 2015 was performed in PubMed and EMBASE. A random-effect model was used to obtain the summary relative risks (RRs) and 95% confidence intervals (CIs). Results: Thirty-two studies had parity categories of 1, 2, and ${\geq}3$. The summary RRs for EOC were 0.72 (95% CI, 0.65 to 0.79), 0.57 (95% CI, 0.49 to 0.65), and 0.46 (95% CI, 0.41 to 0.52), respectively. Small to moderate heterogeneity was observed for one birth (p<0.01; Q = 59.46; $I^2=47.9%$). Fifteen studies had breastfeeding categories of <6 months, 6-12 months, and >13 months. The summary RRs were 0.79 (95% CI, 0.72 to 0.87), 0.72 (95% CI, 0.64 to 0.81), and 0.67 (95% CI, 0.56 to 0.79), respectively. Only small heterogeneity was observed for <6 months of breastfeeding (p = 0.17; Q = 18.79, $I^2=25.5%$). Compared to nulliparous women with no history of breastfeeding, the joint effects of two births and <6 months of breastfeeding resulted in a 0.5-fold reduced risk for EOC. Conclusions: The first birth and breastfeeding for <6 months were associated with significant reductions in EOC risk.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7967-7973
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• 2015

Background: The abrupt rise of colorectal cancer in developing countries is raising concern in healthcare settings. Studies on assessing relationships with modifiable and non-modifiable risk factors in the Pakistani population have been limited. The present investigation was designed to examine associations of dietary practices, addictive behavior and bowel habits in developing colorectal cancer (CRC) among patients in a low-resource setup. Materials and Methods: An age-gender matched case control study was conducted from October 2011 to July 2015 in Karachi, Pakistan. Cases were from the surgical oncology department of a public sector tertiary care hospital, while their two pair-matched controls were recruited from the general population. A structured questionnaire was used which included questions related to demographic characteristics, family history, dietary patterns, addictive behavior and bowel habits. Results: A family history of cancer was associated with a 2.2 fold higher chance of developing CRC. Weight loss reduced the likelihood 7.6 times. Refraining from a high fat diet and consuming more vegetables showed protective effects for CRC. The risk of CRC was more than twice among smokers and those who consumed Asian specific addictive products as compared to those who avoid using these addictions (ORsmoking: 2.12, 95% CI: 1.08 - 4.17, ORpan: 2.92, 95% CI: 1.6 - 5.33, ORgutka: 2.13, 95% CI: 1.14 - 3.97). Use of NSAID attenuated risk of CRC up to 86% (OR: 0.14, 95% CI: 0.07 - 0.31). Conclusions: Most of the findings showed concordance with the literature elucidating protective effects of consuming vegetables and low fat diet while documenting adverse associations with family history, weight loss, constipation and hematochezia. Moreover, this study highlighted Asian specific indigenous addictive products as important factors. Further studies are needed to validate the findings produced by this research.

• Journal of dental hygiene science
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• v.7 no.2
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• pp.73-79
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• 2007

The purpose of this survey research was to investigate the relationship between the health promotion and the Oral Health knowledge of 230 adults which lived in Kyunggi-do using SPSSWIN 12.0. The following conclusions were obtained. 1. Objects who take the periodic health examination was 38.2% and the opposite case was 61.8%. And the reseach subjects who take the periodic dental examination was 30.7% and the opposite case was 69.3%. 2. The research subjects who take the Oral Health education was 11.8% and the opposite case was 88.2%. 3. The relationship between the general characteristic and health promotion status of the research subjects taking periodic examination showed statistically significant difference at items of ages, occupation and the reason of training (p < 0.05). 4. In case of the relationship of the Oral Health knowledge according to sex distinction, 68.4% of all research subjects thought that the appropriate toothbrushing time was around 3 minutes, but it did not show significant difference statistically. 5. In case of the Oral Health knowledge according to age, it showed significant difference statistically at item of 'the toothbrushing time is after each meal and before retiring (p = .032)', item of 'if you use the fluorine, you can prevent the dental caries (p = .011)', and item of 'foods causing the dental caries are a chocholate and a biscuit, etc. (p-.044). 6. In case of the Oral Health knowledge according to the occupation, 68.4% of all reasearch subjects thought that the appropriate toothbrushing time was around 3 minutes (p = .043), and it showed significant difference statistically. 7. In case of he relationship between reseach subjects taking the periodic examination and the Oral Health knowledge, it did not show significant difference statistically.

• Parasites, Hosts and Diseases
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• v.55 no.5
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• pp.523-532
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• 2017

A field survey studying intestinal parasites in humans and microbial pathogen contamination at environment was performed in a Laotian rural village to identify potential risks for disease outbreaks. A parasitological investigation was conducted in Ban Lak Sip village, Luang Prabang, Lao PDR involving fecal samples from 305 inhabitants as well as water samples taken from 3 sites of the local stream. Water analysis indicated the presence of several enteric pathogens, i.e., Aeromonas spp., Vibrio spp., E. coli H7, E. coli O157: H7, verocytotoxin-producing E. coli (VTEC), Shigella spp., and enteric adenovirus. The level of microbial pathogens contamination was associated with human activity, with greater levels of contamination found at the downstream site compared to the site at the village and upstream, respectively. Regarding intestinal parasites, the prevalence of helminth and protozoan infections were 68.9% and 27.2%, respectively. Eight helminth taxa were identified in fecal samples, i.e., 2 tapeworm species (Taenia sp. and Hymenolepis diminuta), 1 trematode (Opisthorchis sp.), and 5 nematodes (Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, trichostrongylids, and hookworms). Six species of intestinal protists were identified, i.e., Blastocystis hominis, Cyclospora spp., Endolimax nana, Entamoeba histolytica/E. dispar, Entamoeba coli, and Giardia lamblia. Questionnaires and interviews were also conducted to determine risk factors of infection. These analyses together with a prevailing infection level suggested that most of villagers were exposed to parasites in a similar degree due to limited socio-economic differences and sharing of similar practices. Limited access to effective public health facilities is also a significant contributing factor.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.508-516
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• 2016

This study was conducted to investigate the fitness of major courses according to the development and application of new curricula based on the NCS (National Competency Standards) of health-related departments at junior colleges. To accomplish this, 300 students of the health-related departments at junior colleges were surveyed from March 11 to March 30, 2016. The overall findings showed that their awareness of NCS, intent of integration and understanding of curriculum contents had a significant effect on the fitness for linkage and combination with existing education. Competency unit elements based on the newly developed NCS (job, work, qualification and training standardization of major courses) were linked with existing education. And students - who accept this - are rapidly assimilated into the new curriculum contents. In particular, they have a high understanding of the integrated development of standardized curricula between three major departments, unlike existing textbooks. In conclusion, the high perception and understanding of knowledge integration education are expected to have a positive effect on healthcare education, establishing an early health-related NCS system in the future, and improving site fitness for development of the contents of NCS.

• Journal of Preventive Medicine and Public Health
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• v.42 no.3
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• pp.190-198
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• 2009

Objectives : The objective of this study is to estimate the economic costs of cancer on society. Methods : We estimated the economic burden of people with cancer in South Korea. To perform the analysis, we reviewed the records of people who were cancer patients and those who were newly diagnosed with cancer. The data was compiled from the National Health Insurance Corporation, which included the insurance claims database, a list of cancer patients, a database that records the cancer rates, the Korea Central Cancer Registry Center s cancer patient registry database and the Korea National Statistical Office s causes of death database. We classified the costs as related to cancer into direct costs and indirect costs, and we estimated each cost. Direct costs included both medical and non-medical care expenses and the indirect costs consisted of morbidity, mortality and the caregiver's time costs. Results : The total economic costs of cancer in South Korea stood at 14.1 trillion won in 2005. The largest amount of the cost 7.4 trillion won, was the mortality costs. Following this were the morbidity costs (3.2 trillion won), the medical care costs (2.2 trillion won), the non-medical care costs (1.1 trillion won) and the costs related to the caregiver's time (100 billion won). As a result, the economic cost of cancer to South Korea is estimated to be between 11.6 trillion won to 14.1 trillion won for the year 2005. Conclusions : We need to reduce the cancer burden through encouraging people to undergo early screening for cancer and curing it in the early stage of cancer, as well as implementing policies to actively prevent cancer.

• Journal of Hospice and Palliative Care
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• v.20 no.1
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• pp.8-17
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• 2017

Globally, efforts are being made to develop and strengthen a palliative care policy to support a comprehensive healthcare system. Korea has implemented a hospice and palliative care (HPC) policy as part of a cancer policy under the 10 year plan to conquer cancer and a comprehensive measure for national cancer management. A legal ground for the HPC policy was laid by the Cancer Control Act passed in 2003. Currently in the process is legislation of a law on the decision for life-sustaining treatment for HPC and terminally-ill patients. The relevant law has expanded the policy-affected disease group from terminal cancer to cancer, human immunodeficiency virus/acquired immune deficiency syndrome, chronic obstructive pulmonary disease and chronic liver disease/liver cirrhosis. Since 2015, the National Health Insurance (NHI) scheme reimburses for HPC with a combination of the daily fixed sum and the fee for service systems. By the provision type, the HPC is classified into hospitalization, consultation, and home-based treatment. Also in place is the system that designates, evaluates and supports facilities specializing in HPC, and such facilities are funded by the NHI fund and government subsidy. Also needed along with the legal system are consensus reached by people affected by the policy and more realistic fee levels for HPC. The public and private domains should also cooperate to set HPC standards, train professional caregivers, control quality and establish an evaluation system. A stable funding system should be prepared by utilizing the long-term care insurance fund and hospice care fund.

• Journal of Preventive Medicine and Public Health
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• v.36 no.2
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• pp.117-124
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• 2003

Objectives : This study was performed to examine the relationship between maternal exposure to environmental tobacco smoke (ETS) and pregnancy outcomes (low birth weight or preform baby) in a prospective cohort study. Methods : We made a pregnant women's cohort, and followed the pregnancy outcomes, between May 1st 2001 and August 31st 2002. We surveyed 2,250 women who visited our hospital during their 35th gestational week, with a self-administered questionnaire. The final total of mother-infant pairs analyzed in this study was 1,712. We used a multiple logistic regression analysis to analyze the effect of maternal ETS on the incidence of preform or low birth weight, and a linear regression analysis for the birth weight and gestational age. Results : Higher exposure to ETS (>=1 hours/day) during pregnancy was more negatively associated with the gestational age and birth weight, than no exposure to ETS (no or less than 1 hour). Maternal exposure to ETS was associated with preform baby(adjusted odds ratio (AOR) 1.7; 95% confidence interval (CI) 0.9, 3.3) and low birth weight (AOR 2.3; 95% CI 0.9, 5.5). In addition, we found that maternal ETS may reduce the birth weight by 70g after adjusting for potential confounding factors. Conclusions : This study suggests that maternal exposure to ETS during pregnancy may increase the frequency of low birth weights and preform births.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.349-355
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• 2015

Background: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. Methods: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. Results: The mean duration of follow-up was $3.9{\pm}0.9years$. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ ${\geq}$ 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Conclusion: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.