• Human Ecology Research
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• v.56 no.2
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• pp.175-193
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• 2018

This study identified the rate of income poverty and multidimensional poverty, correlation between income poverty and multidimensional poverty, and adjusted multidimensional poverty rate. We also analyzed the factors that affected the number of poverty dimension and the probability of belonging to the poor or not in 3,159 elderly households including 474 poor households and 2,685 middle class households. First, in poor households, the employment poverty rate was the highest and the housing poverty rate was the lowest. In middle class households, the relation poverty rate was the highest and the employment poverty rate was the lowest. Second, in poor households, correlation between asset poverty and relation poverty had the highest coefficient of .205 and asset poverty and housing poverty had the lowest coefficient of .149. In middle class households, the correlation between income poverty and relation poverty had highest coefficient of -.290 and employment poverty and relation poverty had the lowest coefficient of .038. Third, in poor households, the number of average poverty dimension was 4.30, but the number of average poverty dimensions of middle class households was 2.310. Fourth, the variable affecting the number of poverty dimensions in poor households were gender, age, level of education, marital status; however, the significant variables were gender, education level, marital status, income poverty in the middle class households. The variable that affected the probability of belonging to the poor or not in poor households was age. However, the significant variables were gender, education level, marital status, residence, and income poverty in middle class households.

• Journal of Preventive Medicine and Public Health
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• v.10 no.1
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• pp.142-149
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• 1977

To use basic data for health planning and evaluation of Kangwha community health project of Yonsei University, a study on death rates and causes of death were investigated in two townships (Naega and Sunwon Myuns) in Kangwha County from April 1, 1975 to March 31, 1977 All death was identified and reported by family health workers who are living in each village and 2 trained public health nurses confirmed the death. The causes of death were investigated by 2 public physicians. Total number of deaths for 2 years was 230 and the followings are brief summary of the study. 1. Age-adjusted crude death rates of study area were 8.69 per 1,000 population in 1975 and 7.18 per 1,000 population in 1976. Age-adjusted crude death rates for male were 9.18 in 1975 and 6.38 in 1976 and for female were 8.33 and 7.80 per 1,000 population 2. Age specific death rate curves by year and sex showed 'U' shapes. 3. Infant and neonatal death rates were 30.08 and 22.56 per 1,000 live births in 1975, and the rates in 1976 were 18.18 and 13.64. 4. The most common cause of death was cerebrovascular disease and average cause specific death rate for the disease was 215.5 per 100,000 population. 5. Four leading causes of death were non-infectious origin; cerebrovascular disease, malignant neoplasms, senility and suicide. Pulmonary tubeculosis and pneumonia occupied 5th and 9th causes of death. 6. Stomach cancer and hepatoma occupied 61.3% of total death due to malignant neoplasms. 7. Most frequent cause of neonatal death was birth injury. Two deaths due to tetanus were found in 1975, but no death due to this disease was found in 1976. 8. About half of deceased received care from physician before death.

• Health Policy and Management
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• v.32 no.2
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• pp.164-172
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• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7281-7285
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• 2014

Background: Gastric cancer is the second most common gastrointestinal cancer and is more common in the East, compared to the West. This study assesses the trend of gastric cancers in Brunei Darussalam, a developing nation with a predominantly Malay population. Materials and Methods: The cancer registry from 1986 to 2012 maintained by the Department of Pathology, the only State Laboratory at the RIPAS Hospital, Ministry of Health, was reviewed and data extracted for analyses. The age standardised rate (ASR) and age specific incidence rate were calculated based on the projected population. Cancers diagnosed below 45 years were categorised as young gastric cancer. Results: Over the study period, there were a total of 551 cases of gastric cancer diagnosed. The most common type was adenocarcinoma (87.9%), followed by lymphoma (6.1%) and gastrointestinal stromal tumour (2.8%). The overall mean age at diagnosis was 61.9 years old (range 15 to 98) with an increasing trend observed, but this was not significant (ANOVA). There were differences in the mean age at diagnosis for the different races (p=0.003 for trend), but not the gender (p=0.105). Young gastric cancer accounted for 14.9%, being more common in women, and in Expatriate and Malay populations compared to the Chinese. There was a decrease in the ASR, from 17.3/100,000 in 1986-1990 to 12.5/100,000 in 2006-2010. Chinese had a higher overall ASR (20.2/100,000) compared to the Malays (11.8/100,000). The age specific rates were comparable between men and women until the age group 55-59 years when the rates started to diverge, becoming higher in men. Chinese men had higher rates then Malay men whereas, the rates were higher or comparable between the women until the age group >70 when the rate for Chinese women overtook their Malay counterpart. Conclusions: Our study showed that there is a declining trend in the incidence of gastric cancer and higher rates were observed in men and Chinese.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.216-231
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• 2003

Objectives: To develop a model that predicts a death probability of acute myocardial infarction(AMI) patient, and to evaluate a performance of hospital services using the developed model. Methods: Medical records of 861 AMI patients in 7 general hospitals during 1996 and 1997 were reviewed by two trained nurses. Variables studied were risk factors which were measured in terms of severity measures. A risk model was developed by using the logistic regression, and its performance was evaluated using cross-validation and bootstrap techniques. The statistical prediction capability of the model was assessed by using c-statistic, $R^2$ as well as Hosmer-Lemeshow statistic. The model performance was also evaluated using severity-adjusted mortalities of hospitals. Results: Variables included in the model building are age, sex, ejection fraction, systolic BP, congestive heart failure at admission, cardiac arrest, EKG ischemia, arrhythmia, left anterior descending artery occlusion, verbal response within 48 hours after admission, acute neurological change within 48 hours after admission, and 3 interaction terms. The c statistics and $R^2$ were 0.887 and 0.2676. The Hosmer-Lemeshow statistic was 6.3355 (p-value=0.6067). Among 7 hospitals evaluated by the model, two hospitals showed significantly higher mortality rates, while other two hospitals had significantly lower mortality rates, than the average mortality rate of all hospitals. The remaining hospitals did not show any significant difference. Conclusion: The comparison of the qualities of hospital service using risk-adjusted mortality rates indicated significant difference among them. We therefore conclude that risk-adjusted mortality rate of AMI patients can be used as an indicator for evaluating hospital performance in Korea.

• Neonatal Medicine
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• v.28 no.3
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• pp.116-123
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• 2021

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU). Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed. Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004). Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.

• Journal of Korean Biological Nursing Science
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• v.4 no.1
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• pp.5-23
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• 2002

Purpose: To determine the effect of the Fall Prevention Program(EPP) on gait, balance and muscle strength in elderly women at a nursing home. Method: The subjects of this consisted of 38 elderly women between the ages of 70 to 89 years living at a nursing home located in Seoul. Each of the experimental group and control group was composed of 19 subjects. The subjects in experimental group have participated in FPP for the 8 weeks which consisted of exercise, education and foot care. They started to exercise for 40 minutes per session, 3 sessions a week during the 1st week at 40% of age adjusted maximum heart rate. From the 2nd week to the 4th week, they increased the duration of exercise to 50 minutes per session and the intensity to 60% of age-adjusted maximum heart rate. They participated in 50 minutes at 60% of age-adjusted maximum heart rate from the 5th week to the 8th week. Each exercise session consisted of 10 minutes of warming-up exercise, 30 minutes of conditioning exercise and 10 minutes of cooling-down exercise. They participated in education for 20 minutes per week from the 1st week to the 4th week. Then they participated in a 30-minute foot care program per week from the 5th week to the 8th week. Gait, balance and muscle strength for each subject were measured before and after FPP. Gait was evaluated by step length, step width, gait speed and walking distance. Balance was measured by the duration of standing on one leg with their eyes closed and open each, and a get-up and go test. Grip strength was measured by hand dynamometer. Hip extensor and flexor strength, knee extensor and flexor strength and ankle plantarflexor and dorsiflexor strength were measured by manual muscle tester. Data was analyzed using SPSS form Windows. t-test and Chi square test were utilized as a homogeneity test. Repeated measure ANOVA was used to test the effect of FPP. Result: 1) Step width significantly decreased, and step length, gait speed and walking distance significantly increased in the experimental group compared with the control group after FPP(p<0.005). 2) There was no significant change in standing time on one leg with their eyes closed after FPP. The standing time on leg with their eyes open and the time of "get-up and go" significantly decreased in the experimental group compared with the control group after FPP(p<0.005). 3) Muscle strength-grip strength, hip extensor and flexor strength-significantly increased in the experimental group compared with the control group after FPP(p<0.005). 4) There was no significant difference of frequency of fall between the experimental group and control group during the period of FPP. Conclusion: These results suggest that FPP can increase gait, balance and muscle strength of elderly women at a nursing home.

• Journal of Preventive Medicine and Public Health
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• v.32 no.4
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• pp.482-490
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• 1999

Objectives : This paper presents the information on the incidence of cancer from the population-based cancer resistry in Kangwha County. Material and methods : This investigation is based on Kangwha cancer registry. The data included cases of cancer diagnosed from 1986 through 1992. The diagnosis of cancer was confirmed by a team of physicians and nurses with the medical records kept in the clinics and hospitals based on the diagnostic criteria recommended by WHO. Home visitings were also made to cancer patients confirmed in every 6 months for the follow up and for the collection of relevant information directly from the patients. Results : A total of 992 cancer cases were registered during 1986-1992. The age-adjusted cancer incidence rate of all site is 201.7 in men and 110.7 in women. The most common cancer is the stomach cancer in both sexes. The age-adjusted incidence rate of the stomach cancer is 65.9 in men and 25.0 in women per 100,000 population. The lung cancer(33.8) and liver cancer(27.7) are next common cancers in men. The cervical cancer(21.8) and lung cancer(8.4) are next in women. Conclusion : The most common cancer is the stomach cancer in both sexes. The annual age-adjusted incidence rate of the stomach cancer is 65.9 in men and 25.0 in women per 100,000 population.

• Journal of Preventive Medicine and Public Health
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• v.36 no.1
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• pp.63-70
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• 2003

Objectives : To investigate the prevalence of cognitive impairment and dementia in elderly people, aged 65 or above, residing in Busan Metropolitan City. Methods : Total of 1,101 old people, aged 65 or above, living in Busan as of December 31, 2001 were selected using stratified three-stage cluster sampling. Cognitive impairment was determined from the MMSE-K score, and dementia confirmed from five psychometric measures and the Barthel index. The crude prevalence, sex-age adjusted for the Korean population, were obtained. Results : With the cut-off point for cognitive impairment was set at 24 points, or below, on the MMSE-K scale, the crude rate of cognitive impairment was 29.3% (15.7% for men and 37.5% for women), and the sex-age adjusted prevalence was 30.5% (17.5% for men and 37.0% for women). When the cut-off point for cognitive impairment was set at 20 points, or below, on the MMSE-K scale, the crude rate of cognitive impairments were 10.0% (4.1% for men and 13.5% for women), and 10.6% (4.7% for men and 13.1% for women), respectively. The crude dementia, and the sex-age adjusted rates were 7.4% (2.4% for men and 10.5% for women), and 8.0% (2.7% for men and 10.0% for women), respectively. Conclusions : The prevalence of dementia in this study was somewhat lower than that reported by other domestic and foreign studies. Our results related to the difference in time and space, diagnostic tools, response rates, and distribution of male and female subjects, etc.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7753-7756
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• 2014

Incidence trends of head and neck cancer (HNC) have implications for screening strategies, disease management, guiding health policy making, and are needed to further oral cancer research. This paper aims to describe trends in age-adjusted HNC incidence rates focusing on changes across calendar period between 2007 and 2010 in Australian Northern Territory. Age-adjusted incidence rates of HNC were calculated for 2007-2010 using Northern Territory population based data assembled by Department of Health, Northern Territory Government of Australia. Changes in the HNC rate ratio (RR) and Estimated Annual Percentage Change (EAPC) between 2007-2008, 2008-2009 and 2009-2010 were calculated. A total of 171 HNC patients were recorded by the Northern Territory Department of Health during the time period between 2007 and 2010, out of which, 135 were males (78.9% of male HNC patients) and 36 were females (21.1% of female HNC patients). In conclusion, HNC incidence rate has decreased in the Northern Territory Australian males but remains unchanged in Australian females. High incidences of HNC may be associated with the high smoking rate and high alcohol consumption in the Northern Territory. Continued monitoring of trends in HNC incidence rates is crucial to inform Northern Territory based cancer prevention strategies.