• Journal of the Korean association of regional geographers
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• v.13 no.1
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• pp.11-17
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• 2007

It was announced that 'making a better wellbeing city program' is a new core quality of life policy of Roh Mu-Hyun government. The policy is comprehended as a sign of regional policy changeover, that give empathize to human ware oriented governance from hard ware oriented physical elements input policies. To be effective, It is important to introduce a institutionalization of dynamic social relations in regional community such as participations of civil society. In the case study of Jinju city, a medium scale city located in southern part of Korean peninsular, Invitation of the innovation city, initiated by the alliance of city government and growth coalition, was making progress. Through alliance of labor unions and citizen associations, the public management of public bus companies were succeeded. But the restoration of historical places were suffered a setback by conflicts of interests with development profits. In these contexts, it is insisted that the core of 'making a better welling being city program is introducing of human ware oriented regional policies, such as institutionalization of citizen associations participation.

• Journal of Preventive Medicine and Public Health
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• v.51 no.1
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• pp.23-32
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• 2018

Objectives: To identify the associations of characteristics of the neighborhood environment with substance abuse among clients receiving treatment for drug abuse in Thailand. Methods: A cross-sectional study was conducted of 1128 drug addicts from 28 neighborhoods who were receiving treatment at all 7 compulsory drug detention centers in Thailand. A trained interviewer conducted structured interviews with the subjects about substance use and the perceived neighborhood environment in their community. A multilevel logistic regression model was applied to estimate the effects of the neighborhood environment on substance use. Results: The majority of participants, 53.8% only used methamphetamine pills, 31.3% used other illicit drugs as well as methamphetamine pills, and 14.9% used an illicit drug other than methamphetamine. Three neighborhood characteristics were associated with substance use. A 1-unit increase in the perceived neighborhood cohesion score was associated with a 15% reduction in methamphetamine pill use and an 11% reduction of the use of both methamphetamine pills and another illicit drug. Conversely, a 1-unit increase in perceived neighborhood crime predicted 19 and 14% increases in the use of methamphetamine pills and the use of both methamphetamine pills and another illicit drug, respectively. In addition, a 1-unit increase in the scores for stigma surrounding addiction corresponded to a 25% increase of the use of methamphetamine pills and a 12% increase in the use of both methamphetamine pills and another illicit drug. Conclusions: Substance use among drug addicts was influenced by characteristics of the neighborhood environment. Therefore, prevention and intervention strategies should be designed based on a consideration of the impact of neighborhood context on substance use behaviors.

• Health Policy and Management
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• v.27 no.3
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• Journal of Preventive Medicine and Public Health
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• v.45 no.6
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• pp.387-393
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• 2012

Objectives: Even though several epidemiological studies have observed positive associations between blood lead levels and homocysteine, no study has examined whether this association differs by the levels of micronutrients, such as folate, vitamin B6, and vitamin B12, which are involved in the metabolism of homocysteine. In this study, we examined the interactions between micronutrients and blood lead on homocysteine levels. Methods: This study was performed with 4089 adults aged ${\geq}20$ years old in the US general population using the National Health and Nutrition Examination Survey 2003-2004. Results: There were significant or marginally significant interactions between micronutrients and blood lead levels on mean homocysteine levels. Positive associations between blood lead and homocysteine were clearly observed among subjects with low levels of folate or low vitamin B6 (p-trend <0.01, respectively). However, in the case of vitamin B12, there was a stronger positive association between blood lead and homocysteine among subjects with high levels of vitamin B12, compared to those with low levels of vitamin B12. In fact, the levels of homocysteine were already high among subjects low in vitamin B12, irrespective of blood lead levels. When we used hyperhomocysteinemia (homocysteine>15 ${\mu}mol/L$) as the outcome, there were similar patterns of interaction, though p-values for each interaction failed to reach statistical significance. Conclusions: In the current study, the association between blood lead and homocysteine differed based on the levels of folate, vitamin B6, or vitamin B12 present in the blood. It may be important to keep sufficient levels of these micronutrients to prevent the possible harmful effects of lead exposure on homocysteine levels.

• Korean Journal of Health Education and Promotion
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• v.26 no.3
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• pp.35-48
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• 2009

Objectives: The community network is a foundation laid by the local community which has been formed historically and geographically to develop itself. This paper as a Korean way of healthy network survey for the community capacity building is an exploratory research to grasp the character of Korean society and then to organize an resident-governing partnership for that. Methods: Research objectives are CBOs(Community-Based Organizations) in S-district of Seoul. This region is a new town, however the solidarity and volunteerism of this resident is lively. The survey tool is Cho's CBOs Evaluation Questionnaire which was originated to measure the community capacity. The period of survey is from the January 2009 to the March 2009 and the study organizations which were collected by snowball sampling were 80. Results: The result shows two main networks: one is the civil society and craft union cluster, the other is welfare organization cluster. Groups of high centrality were organizations whose members are mainly women and craft organizations which were organized before 1990's. The group of high betweenness was the Association of Women's Organizations(0.188). Bi-components were six and they could be divided by organization's aim. In terms of the determinants of the participation to the health center enterprise, only the number of link(B=-0.60, p<0.04) was statistically significant. It means that when organization variables are controlled a tendency appears: the more the voluntary associations network, the less participation in the health enterprise. Conclusion: CBHOs(Community-Based Health Organizations) enhances residents' spontaneity and cohesion to increase the capability of the local community. If the surveyed healthy network, together the community health project, are used for various community development projects, the existing CBOs including CBHOs will be reorganized and furthered newly. For this it will be needed to construct an effective partnership of healthy network by restructuring the existing networks of voluntary associations.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.316-322
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• 2001

Objectives : To explore the possible effect of an interaction between summertime heat waves and ozone on cardiopulmonary mortality during the 1994 heat wave in Korea. Methods : The unusually hot summer of 1994 in Korea was defined as the heat wave in this study. We examined the associations of air pollutants with daily cardiopulmonary deaths between 1991-1995, considering the product term of the heat wave and each pollutant, weather and time trends. Results : During the heat wave, while temperatures were uniformly higher than those of other summers, the within-heat-wave difference in mortality paralleled that in the regional ozone levels. In terms of the influence of the heat wave, the results of ozone were different to those of total suspended particles (TSP) and sulfur dioxide $(SO_2)$. The ozone association (relative risk (RR) : 1.036; 95% confidence interval (CI) = 1.018-1.054) was observed only under heat wave conditions, while the TSP (RR : 1.006, 95% CI = 0.999-1.012) and the $SO_2$ (RR = 1.018, 95% CI : 1.011-1.024) associations were found under normal weather conditions (per interquartile increase of each pollutant; results of three pollutants model). The ozone association under heat wave was attributable to the statistical interaction between the heat wave and ozone. Conclusions : These results support the possibility of a biological synergy between the heat wave and ozone, one that is not evident between the heat wave and other major pollutants like particles or $SO_2$.

• Nutrition Research and Practice
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• v.15 no.6
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• pp.773-788
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• 2021

BACKGROUND/OBJECTIVES: Due to the rapid increase of global cancer incidence and mortality and a high level of interest in cancer prevention, a systematic review of garlic intake and cancer risk is needed. SUBJECTS/METHODS: We implemented a systematic review to examine the effects of varying levels of garlic intake on cancer. We conducted comprehensive literature searches in three electronic databases (MEDLINE, Embase, and Web of Science) for studies published between database inception and July or September of 2018. Two investigators independently screened abstracts and full-texts, extracted data, and assessed risk of bias (RoB). A total of one medium-quality randomized controlled trial (RCT) and 13 cohort studies graded as high RoB were included. RESULTS: The 1-year follow-up results from a RCT showed that a significant decrease in the number and size of colorectal adenomas among participants with colorectal adenomas who received high-dose aged garlic extract (AGE) compared with those who received low-dose AGE (P < 0.05). The results of prospective observational studies provided inconsistent associations of colorectal cancer risk with garlic supplements and garlic intake as food. CONCLUSIONS: In summary, the AGE was effective in reducing the number and magnitude of colorectal adenomas in one RCT, but there were inconsistent associations between garlic intake and colorectal cancer in cohort studies. Therefore, we could not draw a firm conclusion regarding the effects of garlic on cancer, because the current strength of evidence is inadequate due to a lack of number of high-quality RCTs.

• Journal of Preventive Medicine and Public Health
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• v.55 no.5
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• pp.475-484
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• 2022

Objectives: This study aimed to determine the association between metabolic syndrome (MetS) and the incidence of colorectal cancer (CRC) in Korean women with obesity. Methods: Cancer-free women (n=6 142 486) aged 40-79 years, who underwent National Health Insurance Service health examinations in 2009 and 2010 were included. The incidence of CRC was followed until 2018. The hazard ratio (HR) of MetS for the incidence of colon and rectal cancer was analyzed according to body mass index (BMI) categories, adjusting for confounders such as women's reproductive factors. In addition, the heterogeneity of associations across BMI categories was assessed. Results: Women with MetS were at increased risk of colon and rectal cancer compared to women without MetS (HR, 1.20; 95% confidence interval [CI], 1.16 to 1.23 and HR,1.15; 95% CI, 1.11 to 1.20), respectively. The HR of MetS for colon cancer across BMI categories was 1.12 (95% CI, 1.06 to 1.19), 1.14 (95% CI, 1.08 to 1.20), and 1.16 (95% CI, 1.12 to 1.21) in women with BMIs <23.0 kg/m², 23.0-24.9 kg/m², and ≥25.0 kg/m², respectively. The HR of MetS for rectal cancer across corresponding BMI categories was 1.16 (95% CI, 1.06 to 1.26), 1.14 (95% CI, 1.05 to 1.23), and 1.13 (95% CI, 1.06 to 1.20). The heterogeneity of associations across BMI categories was not significant in either colon or rectal cancer (p=0.587 for colon cancer and p=0.927 for rectal cancer). Conclusions: Women with MetS were at increased risk of colon and rectal cancer. Clinical and public health strategies should be considered for primary CRC prevention with an emphasis on improving women's metabolic health across all BMI groups.

• Journal of Preventive Medicine and Public Health
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• v.57 no.3
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• pp.260-268
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• 2024

Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

• Journal of Preventive Medicine and Public Health
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• v.53 no.6
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• pp.439-446
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• 2020

Objectives: This study analyzed the associations of hypertension (HTN) with symptoms and diagnosis of depression by income level among Korean adults. Methods: This study was based on the 2010-2017 Korea National Health and Nutrition Examination Survey data; a total of 29 425 adults (aged 20 years or older) were analyzed. HTN was defined as a systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of hypertensive medications. Depression symptoms were evaluated based on a questionnaire about depression-related symptoms. A depression diagnosis was defined based on questionnaire responses indicating that a participant had been diagnosed with depression. Household income was divided into higher or lower income ranges based on the median income of the participants. Multiple logistic regression analyses were performed to assess the associations between HTN and depression symptoms/diagnosis in the higher-income and lower-income groups. Results: In the higher-income group, the odds ratio (OR) for the association between HTN and depression symptoms was 1.15 (95% confidence interval [CI], 0.97 to 1.37), and the OR for the association between HTN and depression diagnosis was 1.41 (95% CI, 1.13 to 1.76). In the lower-income group, the OR for the association between HTN and depression symptoms was 1.18 (95% CI, 1.04 to 1.34), whereas the OR for the association between HTN and depression diagnosis was 0.82 (95% CI, 0.70 to 0.97). Conclusions: The associations of HTN with symptoms and diagnosis of depression differed by income level.