• Health Policy and Management
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• v.16 no.4
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• pp.48-67
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• 2006

The aim of the study was to examine levels of satisfaction with health care in North Korea and to identify factors associated with it using a convenience sample of North Korean refugees in China. Data from the 2004 Survey of Health Seeking Behavior of North Korean Households conducted by the Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health were used. The study subjects were 273 North Korean refugees whose length of stay in China was less than 3 months. Factor analysis was used to extract factor dimensions from the 12 satisfaction items. Bivariate (t test and ANOVA) and multiple regression analyses were used in examining factors associated with satisfaction with health care use in North Korea Overall, satisfaction level was low ($2.36{\pm}0.36$, score range: 1-5). Of the three-factor dimensions, physician skills scored the highest $(2.93{\pm}0.36)$, followed by drug availability $(2.51{\pm}0.07)$ and general cleanliness $(1.66{\pm}0.55)$. In the multiple regression analysis, having a usual source of care was significantly associated with patient satisfaction. Respondents who identified primary care (section) doctors as their usual source of care tended to be less satisfied than those with the city or county hospital as their usual source of care. County residents tended to report a lower degree of satisfaction with general cleanliness than city residents. Among socioeconomic characteristics, the number of household assets positively predicted satisfaction with drug availability. North Korean residents appear to be dissatisfied with their medical care. It may reflect some inadequacies in the North's universal health care system to meet the healthcare needs of its people.

• Health Policy and Management
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• v.29 no.4
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• pp.513-522
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• 2019

Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

• Analytical Science and Technology
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• v.26 no.5
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• pp.315-325
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• 2013

The possibility of acute hepatotoxicity caused by dimethylformamide (DMF) requires regular monitoring of the workers who are using DMF to prevent the occupational disease. The authors performed ambient and biological monitoring of workers involved in synthetic leather manufacturing processes using DMF to assess the correlation between the markers of ambient and biological monitoring of DMF. The authors monitored 142 workers occupationally exposed to DMF from 19 workshops in the synthetic leather and ink manufacturing industries located in northern region of Gyeonggi-do. The subjects answered questionnaire on work procedure and use of personal protective equipment to be classified by exposure type. DMF in air samples collected using personal air samplers, diffusive and active sampler, was analysed using gas chromatograph-flame ionization detector (GC-FID) with DB-FFAP column (length 30 m, i.d. 0.25 mm, film thickness 0.25 ${\mu}m$). Urinary N-methylformamide (NMF) was analysed using gas chromatograph-mass selective detector (GC-MSD) at selected ion monitoring (SIM) mode with DB-624 column (length 60 m, i.d. 0.25 mm, film thickness 1.40 ${\mu}m$). Geometric mean (GM) and geometric standard deviation (GSD) of the ambient DMF was $6.85{\pm}3.43$ ppm, and GM and GSD of urinary NMF was $42.3{\pm}2.7$ mg/L. The ratio of subjects with DMF level over 10 ppm was 44%, and those with urinary NMF over 15 mg/L was 87%. NMF in urine adjusted by DMF in air was $4.61{\pm}2.57$ mg/L/ppm and $9.50{\pm}2.41$ mg/L/ppm, respectively, with or without respirator. There was seasonal differences of NMF in urine adjusted by DMF in air, $7.63{\pm}2.74$ mg/L/ppm in summer and $4.53{\pm}2.29$ mg/L/ppm in winter. The urinary NMF concentration which corresponds to 10 ppm of ambient DMF was 52.7 mg/L (r=0.650, n=128). Considering the difference of the route of exposure which resulted from the compliance of wearing personal protective equipment, the estimated contribution of respiratory and dermal exposure route for DMF was 48.5% vs. 51.5%.

• The Journal of Korean Medicine
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• v.18 no.1
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• pp.72-81
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• 1997

The causes of stroke are presumed hypertension, atherosclerosis,. cardiac disease, diabetes mellitus and old age and risk factors of stroke are suggested hypertension, hyperlipidemia. obesity, smoking and drinking etc. Especilly, hypertension is one of the most important cause and risk factor of stroke, therfore without therapy hypertension leads to stroke. The frequence of hypertension is significantly higher in hemorrhage patients of intracranial hemorrhage and subarachnoid hemorrhage. Antihypertensive therapy has an impact not only on the primary prevention of stroke but also on stroke recurrence and the declining of stroke motality has been attributed to the widespread availability and use of antihypertensive therapy. The goals of antihypertensive therapy decrease the complications and motalitv of cardiovascular system and prevent the promoting arteriosclerosis. In this study, we observed the blood pressure change of cb-hemorrhagic patients with hypertension who were hospitalized from 1996. 3. 1 to 1997. 2 .26 in Wonkwang Oriental Hospital. These patients had no antihypertensive therapy and were supplied herb med(Jaum sikpoongtang, Chungrijagamtang, Gojinumja) in medication. Our results suggested as follows. 1. Systolic and diastolic average BP at admission is $150.71{\pm}15.61mmHg$ and $95.00{\pm}8.8mmHg$ and this is hypertension state defining WHO 2. During one week in admission, the blood pressure demostrated a marked declination by SBP 8.97mmHg and DBP 6.22mmHg. 3. During two week in admission, the declination of SBP was significant in paired t-test(p<0.05) but, the declination of DBP was non-significant in paired t-test. 4. The blood pressure during third and fourth weeks gradually declined but, non-significant in test. According to the above results, we suggested that the BP declination Was affected by $Jamyang{\cdot}Jaum$ prescriptions in acute stage of cerebral hemorrhage.

• Korean Journal of Acupuncture
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• v.28 no.4
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• pp.1-15
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• 2011

Objectives : The purpose of this study is to evaluate the feasibility of massive clinical research and to make a basic analysis on the effectiveness and safety of moxibustion treatment on knee osteoarthritis compared to usual care. Methods and Results : This study is a protocol for a pilot randomized controlled trial. Forty participants are assigned to the moxibustion group (n=20) and usual care group (n=20). Participants assigned to the moxibustion group receive moxibustion treatment on the affected knee(s) at six standard acupuncture points (ST36, ST35, ST34, SP9, Ex-LE04 and SP10) three times per week for four weeks (total of 12 sessions). Participants in the usual care group don't receive moxibustion treatment during the study period and follow-up are made on the 5th, 9th and 13th weeks after random allocation. Both groups are allowed to use any kind of treatment, including surgery, conventional medication, physical treatment, acupuncture, herbal medicine, over-the-counter drugs and other active treatments. Education material that explains knee osteoarthritis and current management options and self-exercise is provided for each group. The pain scale of the Korean Western Ontario and McMaster Universities Questionnaire (K-WOMAC) is the primary outcome measurement used in this study. Other subscales of the K-WOMAC, the Short-Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI), Physical Function test, Patient Global Assessment, and Pain Numeric Rating Scale (NRS) are used as outcome variables to evaluate the effectiveness of acupuncture. Safety is assessed at every visit. Conclusions : The result of this trial will provide a basis for the effectiveness and safety of acupuncture treatment for knee osteoarthritis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.2
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• pp.122-126
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• 2011

Introduction: In the lateral window approach for a maxillary sinus bone graft, there has been considerable controversy regarding the placement of a barrier membrane over the osteotomy site. In particular, when there is no damage to the Schneiderian membrane, clinicians should decide whether to use a barrier membrane or not, considering the benefits and costs. This study presents the clinical cases to demonstrate that only repositioning the detached window can lead to satisfactory bony healing of the grafted material without using a barrier membrane in the lateral approach for a maxillary sinus bone graft. Materials and Methods: Five consecutive patients were treated with the same surgical procedures. After performing the antrostomy on the lateral maxillary wall using a round carbide bur and diamond bur, the bony window was detached by a gentle levering action. After confirming no perforation of the Schneiderian membrane, the grafting procedure was carried out the detached window of the lateral maxillary wall was repositioned over the grafted material without using a barrier membrane. A gross examination was carried out at the postoperative 6 month re-entry, and the the preoperative and postoperative dental computed tomography (CT) at re-entry were compared. Results: All the procedures in the 5 patients went on to uneventful healing with no complications associated with the bone graft. Satisfactory bone regeneration without the interference of fibrous tissue on the gap between the repositioned window and lateral wall of the maxillary sinus was observed in the postoperative 6 month re-entry. The CT findings at re-entry revealed the, reconstruction of the external cortical plate including repositioned bony window. In addition, the loss of the discontinuity of the lateral maxillary wall was confirmed. Conclusion: This preliminary report showed that the detached window, which was just repositioned on the grafted material, could function as a barrier membrane in the lateral approach for a maxillary sinus bone graft. Therefore additional morphometric and histologic studies will be needed.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.673-682
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• 2006

Recent study shows that implant design has a great impact on initial stability in bone. The ITI $TE^{(R)}$ implant, designed originally for immediate placement has a tapered/ cylindrical form which fits the anatomical shape of the natural alvelous or tooth root. The increased diameter at the collar region coupled with more threads lead to more bone contact and enhanced stability. The aim of this retrospective study is to evaluate the clinical use and the efficacy of recently introduced ITI TE implant with a new macro-design. The following results are compiled from 139 patients who received ITl TE implant surgery at the periodontal department. of Yonsei University Hospital between July 2002 and September 2005. 1. 139 patients received 173 ITl $TE^{(R)}$ implants in their maxilla and mandible (Mx 82, Mn 91). Posterior area accounted for 84% of the whole implant surgery, 2. In the distribution of bone quality, type III(41,0%) was the most, followed by type IV(41,0%) and type II (27.7%). As for the bone quantity, type B(43.9%) was the most, followed by type C(42.2%), type D(12.2%) and type A(1.7%). 3. 125 implants(83.9%) were treated by single crown, which accounted for the majority. 4, The total implant survival rate was 100% after a mean follow-up period of 21.2 months. This preliminary data with ITl $TE^{(R)}$ implant showed excellent survival rate although the majority of implants evaluated in this study were placed in the posterior region of the jaw and compromised sites.

• Child Health Nursing Research
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• v.20 no.2
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• pp.96-104
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• 2014

Purpose: Nurse educators can use film effectively to promote nursing students' motivation and indirect experiences. The purpose of this study was to develop a teaching-learning design using films based on Kolb's experiential learning model for understanding of child growth and development, and to evaluate students' satisfaction with cinenurducation according to learning type and content. Methods: Participants were seventy-four first year nursing students in the spring semester of 2013 at a private university located in Busan. In each class, participants watched film, participated in peer-to-group discussion and an educator's lecture, and wrote a composition based on Kolb's four learning stages. After class, participants filled out a questionnaire developed by the researchers. Results: Results showed a high satisfaction with cinenurducation regardless of learning type and content concerning child growth and development. Advantages of cinenurducation included it being "fun and interesting," "helpful to understand the characteristics of children," and "develop critical thinking through discussions." Disadvantages included "length of time needed," and "burdensome." Conclusion: Films are advantageous in that they provide indirect experience for nursing students. Selection of appropriate films and evaluation of learning goal achievements are important to maximize the effectiveness of cinenurducation.

• Korean Journal of Occupational Health Nursing
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• v.10 no.1
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• pp.74-92
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• 2001

This study was carried out to investigate the types of health documents for nurses, the content of informations in the documents, and writing behaviors of occupational health nurses. Health documents were collected from 7 nurses who were working in 7 group occupational health agencies (GOHA) located at Seoul and Inchon area in Korea. The collected health documents written in January to June 1999 were analyzed, and revealed the following results. 1) The occupational health nurses were using 9 to 18 different types of health documents. The contents of the documents were considered quite similar to each other with slightly different headings and items to record. Among different types of health documents. Health Management Card for Workplace', Nursing performance sheet and Workplace environmental checklist were in common among nurses and were used for content analysis. 2) The 'Health Management Card for Workplace' was the only formal sheet of small-scale-enterprises (SSE) for health management, in which health and safety related information was recorded. The information on nursing services were recorded on the Nursing performance sheet, which has slightly different names on each type with similar contents. The Workplace environment checklist was for the information on general work environment management and mainly status of workplace hygiene. This checklist is to be used by or with nurses among the 3 types health professional team such as doctor, hygienist, and nurse, but it seemed not being used frequently by nurses. 3) Analysis on recording tendencies of nurses revealed that the writing styles of occupational health nurses were associated with 'memo' using a few number of words and short sentences. The amount of information by this kind of recording style was considered not enough for health management situation. The possible reasons for nurses to use this writing style might be insufficient time for recording and improper designed format of health documents. Because nurses working in SSE spend more time on the roads to visit workplaces, nurses may not found enough time for recording properly within their working time. In addition, the health records were designed to focus on the frequency of nurse's performance in certain types of work rather than on the method they used to deal with health problems. In conclusion, this study suggests that some steps are necessary to develop health documents and recording system which is appropriate to occupational health nurses. The educational need for nurses on appropriate recording behavior is also recommended.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.2
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• pp.196-211
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• 2000

The purpose of this study was to determine the effects of 5 weeks self-help management program on reducing depression, promoting Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings(IADLs), grasping power, hope and self-efficacy for post stroke patients visiting public health care centers in Seoul. This was pre-experimental study, and the subjects were 27 post stroke hemiplegic patients. The program was composed of five sessions and each session had health education on stroke, ROM exercise and recreation. Data were collected from May to November, 2000, and all subjects were asked to complete the Questionnaires, be measured vital signs and grasping power. Data were analyzed with frequency, percent, paired t-test, and Pearson's correlation coefficient using SAS(version 6.12) program. The results were as follows : 1) The scores of ADLs were increased from 27.04 to 28.22 after program, and that was statistically significant(p=.005). 2) The scores of IADLs were increased from 18.70 to 19.78 after program, and that was statistically significant(p=.004). 3) The grasping power of right hand were increased from 21.87kg to 26.93kg after program, and that was statistically significant(p=.002). But the grasping power of left hand were statistically insignificant(p=.919). 4) The scores of depression were decreased from 39.63 to 35.30 after program, and that was statistically significant(p=.030). 5) The scores of hope were increased from 30.89 to 34.15 after program, and that was statistically significant(p=.002). 6) The scores of self-efficacy were increased from 67.70 to 76.37 after program, and that was statistically significant(p=.000). According to the results of this study, the scores of Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings (IADLs), hope, and self-efficacy and the grasping power were improved and depression was reduced in post stroke patients participating in self-help management program. Therefore we recommend to use self-help management programs as a nursing intervention for the post stroke patient.