• Journal of health informatics and statistics
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• 제42권2호
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• pp.192-198
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• 2017

Objectives: This study was designed to construct and test the structural equation model for the alcohol-related problem of alcohol use disorders. Methods: Data were collected by structured self-questionnaires from 229 male subjects who received > 8 (greater than 8) score on Alcohol Use Disorder Identification Test (AUDIT). The Data were analyzed by SPSS 21.0 and AMOS 21.0. Results: The model fit indices for the modified hypothetical model showed Q = 2.50, GFI = 0.90, and CFI = 0.94. As a result, Life position, parent's drinking problem, and alcohol expectancy had significantly direct effect on alcohol-related problem. Alcohol expectancy also had mediator effect between life position and alcohol-related problem. Conclusions: Consequently, the more positive life position, the less alcohol-related problem occurred. It is necessary to change their life position, which is individual factor, to prevent or reduce the alcohol related problem of alcohol use disorders.

• Journal of Hospice and Palliative Care
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• 제24권4호
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• pp.254-260
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• 2021

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

• 한국축산식품학회지
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• 제38권1호
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• pp.43-51
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• 2018

This study was conducted to analyze the microbiological contamination status of raw beef distributed in Korea, and evaluate the suitability of current aerobic plate count (APC) guidelines. We analyzed five years (2010-2014) of microbiological monitoring data obtained from the Ministry of Food and Drug Safety and investigated the microbiological status of raw beef collected from meat packing centers and meat shops in the Seoul/Gyeonggi, Gangwon, and Chungcheong regions in August 2015. From 2010-2014, most raw beef (>94%) displayed APC levels of < $1.0{\times}10^6CFU/g$. However, raw beef samples collected from all three regions in August 2015 had comparatively higher APC levels than those reported in previous years. To evaluate the relationship between the APC level and quality, changes in beef loin were evaluated during cold storage for 15 days at $4^{\circ}C$. On day 11, the mean APC level ($4.7{\times}10^6CFU/g$) conformed to current guidelines in Korea ($1.0{\times}10^7CFU/g$) and the pH value was 5.82. However, the sensory evaluation score for color and overall acceptability was under 3.0, meaning that the beef loin was not acceptable for eating. These results suggest that current APC guideline for raw beef should be lowered to $1.0{\times}10^6CFU/g$ to improve both the microbiological safety and palatability of raw beef.

• Journal of Preventive Medicine and Public Health
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• 제56권2호
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• pp.145-153
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• 2023

Objectives: Although it is difficult to define the quality of stroke care, acute ischemic stroke (AIS) patients with moderate-to-severe neurological deficits may benefit from thrombectomy-capable hospitals (TCHs) that have a stroke unit, stroke specialists, and a substantial endovascular thrombectomy (EVT) case volume. Methods: From national audit data collected between 2013 and 2016, potential EVT candidates arriving within 24 hours with a baseline National Institutes of Health Stroke Scale score ≥6 were identified. Hospitals were classified as TCHs (≥15 EVT case/y, stroke unit, and stroke specialists), primary stroke hospitals (PSHs) without EVT (PSHs-without-EVT, 0 case/y), and PSHs-with-EVT. Thirty-day and 1-year case-fatality rates (CFRs) were analyzed using random intercept multilevel logistic regression. Results: Out of 35 004 AIS patients, 7954 (22.7%) EVT candidates were included in this study. The average 30-day CFR was 16.3% in PSHs-without-EVT, 14.8% in PSHs-with-EVT, and 11.0% in TCHs. The average 1-year CFR was 37.5% in PSHs-without-EVT, 31.3% in PSHs-with-EVT, and 26.2% in TCHs. In TCHs, a significant reduction was not found in the 30-day CFR (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.76 to 1.12), but was found in the 1-year CFR (OR, 0.84; 95% CI, 0.73 to 0.96). Conclusions: The 1-year CFR was significantly reduced when EVT candidates were treated at TCHs. TCHs are not defined based solely on the number of EVTs, but also based on the presence of a stroke unit and stroke specialists. This supports the need for TCH certification in Korea and suggests that annual EVT case volume could be used to qualify TCHs.

• 한국간담췌외과학회지
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• 제27권4호
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• pp.394-402
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• 2023

Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.

• 한국사회복지학
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• 제56권3호
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• pp.37-59
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• 2004

Short Michigan Alcoholism Screening Test for Fathers(F-SMAST) and Mothers(MSMAST)는 알코올중독자 자녀를 선별하기 위해서 사회복지사가 일선 현장에서 유용하게 활용할 수 있는 도구이다. 본 연구의 목적은 한국어판 F-SMAST와 M-SMAST의 신뢰도와 타당도를 다양하고 객관적인 방법을 통해서 분석하는 것이다. 본 연구에 참여한 조사대상자는 서울과 지방에 위치한 3개 대학교에 재학 중인 대학생이며 총 241 사례가 분석에 활용되었다. 한국어판 F-SMAST와 M-SMAST의 내적일관성 신뢰도(Cronbach's alpha)는 모두 0.82로 매우 높았으며 개별문항과 총점간의 상관 관계계수의 범위도 대체로 양호하여 선별도구의 문항들이 모두 동일한 개념을 측정하고 있는 것으로 분석되었다. 선별도구의 측정의 표준오차도 매우 낮은 수준이었다. F-SMAST의 경우 절단점수를 3점으로 했을 때 아버지가 음주문제가 있는 조사대상자들의 91%를 정확하게 판별하였고(민감도) 아버지가 음주문제가 없는 조사대상자의 81%를 판별하여(특이도) 매우 양호하였다. 그러나 M-SMAST의 민감도와 특이도는 F-SMAST에 비해서 낮은 수준이었다. 마지막으로 F-SMAST와 M-SMAST는 알코올중독자 자녀를 선별하는 타 선별도구들(CAST와 F-CAGE)과 통계적으로 유의미한 정적 상관관계를 보였으며 이론적으로 관계가 있는 변인들과의 관계가 거의 대부분 통계적으로 유의미하였다. 또한, F-SMAST와 M-SMAST는 이론적으로 관계가 없는 변인들과는 관계가 없는 것으로 분석되어 한국어판 F-SMAST와 M-SMAST의 수렴타당도와 판별타당도는 매우 양호하였다.

• 대한지역사회영양학회지
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• 제21권4호
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• pp.378-385
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• 2016

Objectives: This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women. Methods: We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass. Results: The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher ($3.82{\pm}0.22%$) than the normal group ($2.73{\pm}0.09%$) and sarcopenia group ($3.17{\pm}0.22%$) (p < 0.000). The odd ratios (ORs) for the ${\geq}7.5%$ 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy). Conclusions: Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

• 대한영양사협회학술지
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• 제19권4호
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• pp.343-355
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• 2013

This study analyzed the dietary habits and nutrient intake status of adult drinkers in Korea. Alcohol drinking patterns were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). Among 4,968 persons, 91.5% were drinkers. Classification of their drinking patterns by the Alcohol Use Disorders Identification Test (AUDIT) score showed 64.5% of the drinkers were normal drinkers, 22.4% problem drinkers and 13.2% alcohol-dependent drinkers. Overall, 47% of the drinkers were considered alcohol-dependent in the Rapid Alcohol Problems Screen (RAPS4). Significant differences were found between those who abstained from alcohol (86.8%) and alcohol-dependent drinkers (68.9%); when asked about breakfast habits 73.4% of non-drinkers often had family meals, while only 55.4% of the alcohol-dependent drinkers had family meals. Dietary energy, alcohol energy, and total energy intake significantly increased for the alcohol-dependents (P<0.001). In addition, the intake of eight nutrients (protein, vitamin A, vitamin $B_1$, vitamin $B_2$, niacin, calcium, phosphorous and iron), significantly increased in the following order (least to highest): abstainers, normal drinkers, drinkers with a moderate addiction to alcohol and alcohol-dependent drinkers (P <0.05). Nutrient Adequacy Ratios (NAR) of all nutrients, except vitamin C, and the Mean nutrient Adequacy Ratio (MAR) significantly increased in the following order (least to highest): abstainers, normal drinkers, drinkers with a moderate addiction to alcohol and alcohol-dependent drinkers (P<0.05). The intake of vitamin $B_1$, vitamin $B_2$, and niacin per 1,000 kcal, according to drinking pattern, decreased in the order of abstainers, normal drinkers, drinkers with a moderate addiction to alcohol, and alcohol-dependent drinkers (P<0.001). The above results show that the nutrient intake of normal drinkers, drinkers with a moderate addiction to alcohol, and alcohol-dependent drinkers are higher than abstainers. However, overall intake of vitamin $B_1$, vitamin $B_2$, and niacin per 1,000 kcal was low. Therefore it is necessary to increase vitamin $B_1$, vitamin $B_2$, and niacin intake for drinkers.

• 한국건설관리학회논문집
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• 제25권2호
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• pp.45-55
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• 2024

본 연구는 DEA 모형과 Tobit 모형을 이용하여 전문건설기업의 업종별 효율성과 효율성 결정요인을 분석하였다. 분석대상은 2022년도를 기준으로 한 394개 전문건설기업이다. 먼저 효율성 분석결과, 지반조성‧포장공사업의 효율성이 주요 7개 업종 중 가장 낮게 나타나 효율성 향상을 위한 전략 마련이 가장 시급한 상황이다. 또한 철근‧콘크리트공사업과 지반조성‧포장공사업, 구조물해체‧비계공사업은 매출액 효율성 대비 영업이익 효율성이 낮아 투입요소의 관리전략이 우선적으로 마련되어야 한다. 다음으로 12개 기업특성을 독립변수로 한 효율성 결정요인의 분석결과, 전문건설기업은 전반적으로 인건비 상승에 따른 효율성 감소가 가장 큰 문제였다. 또한 건설기업의 대출규제가 심각한 상황에서 부채비율이 효율성에 긍정적 효과를 가지는 것으로 나타났다. 마지막으로 업종별 효율성 결정요인을 비교한 결과, 업종별 결정요인과 미치는 영향의 차이가 발생하였다. 기업규모는 업종별로 다른 영향을 미쳤고, 보유업종수나 신용점수, 총자본회전율은 일부 업종에만 영향을 미쳤다. 본 연구는 전문건설기업의 효율성 향상을 위한 요인을 정량적으로 분석하였다는 점에서 기존 연구의 진일보한 결과를 제시하였다. 그러나 외부감사 대상인 전문건설기업만을 분석대상으로 한정한 점과 업종별 분석대상 기업수가 부족한 점, 업종별로 동일한 범주에서 상대적 효율성을 분석했다는 점 등의 한계점을 갖는다.