• Journal of Genetic Medicine
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• v.2 no.1
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• pp.35-39
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• 1998

Duchenne/Becker muscular dystrophy are the major neuromuscular disorders with X-linked recessive inheritance. Preimplantation diagnosis of sex determination has been generally used to avoid male pregnancies with these diseases. However, in order to determine if the embryo is normal, carrier or affected regardless of the sex, there is a need for a combined analysis of specific exon on dystrophin gene as well as sex determination of embryo using the same biopsied blastomere. If the exon deletion is not determinable, further diagnosis of carrier or patient can be performed by haplotype analysis. In this study, we applied the primer extension preamplification (PEP) method, which amplifies the whole genome, in 40 cases of single amniocyte and 40 cases of chorionic villus cell. We analysed haplotypes using two (CA)n dinucleotide polymorphic markers located at the end of 5' and 3' region of the dystrophin gene. Exon 46 of dystrophin gene and DYZ3 on chromosome Y were chosen as a target sequence for coamplification PCR. Upon optimizing the conditions, the amplification rates were 91.25% (73/80) for haplotypes (92.5% in amniocyte, 90% in chorionic villus cell) and 88.75% (71/80) for coamplification (85% in amniocyte, 92.5% in chorionic villus cell). The result of the study indicates that haplotypes analysis and coamplification of dystrophin and Y-specific gene using PEP can be applied to prenatal and preimplantation diagnosis in Duchenne/Becker muscular dystrophy making it possible to determine if the fetus is a carrier or an affected one.

• Safety and Health at Work
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• v.6 no.3
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• pp.240-248
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• 2015

Background: Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work. Methods: Sixty-one male offshore employees-20 night workers, 16 swing shift workers, and 25 day workers-rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1-11) for 14 days after an offshore tour. After the two night-work schedules, differences on the $1^{st}$ day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis. Results: After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05-1.89) and swing shift workers (1.42, 95% confidence interval 1.03-1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found. Conclusion: After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the $1^{st}$ day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.

• Journal of Trauma and Injury
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• v.18 no.1
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• pp.1-16
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• 2005

An ideal trauma care system would include all the components identified with optimal trauma care, such as prevention, access, acute hospital care, rehabilitation, and research activities. Central to an ideal system is a large resource-rich trauma center. The need for resources is primarily based on the concept of being able to provide immediate medical care for unlimited numbers of injured patients at any time. Optimal resources at such a trauma center would include inhouse board-certified emergency medicine physicians, general surgeons, anesthesiologists, neurosurgeons, and orthopedic surgeons. Other board-certified specialists would be available, within a short time frame, to all patients who require their expertise. This center would require a certain volume of injured patients to be admitted each year, and these patients would include the most severely injured patients within the system. Additionally, certain injuries that are infrequently seen would be concentrated in this special center to ensure that these patients could be properly treated and studied, providing the opportunity to improve the care of these patients. These research activities are necessary to enhance our knowledge of the care of the injured. Basic science research in areas such as shock, brain edema, organ failure, and rehabilitation would also be present in the ideal center. This trauma center would have an integrated concurrent performance improvement program to ensure optimal care and continuous improvement in care. This center would not only be responsible for assessing care delivered within its trauma program, but for helping to organize the assessment of care within the entire trauma system. This ideal trauma center would serve as a total resource for all organizations dealing with the injured patient in the regional area.

• Journal of the Korean Dietetic Association
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• v.16 no.2
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• pp.122-132
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• 2010

Elderly people comprise an increasing proportion of the population, and nutritional impairments may contribute to health problems among this group. This study was conducted to evaluate the nutritional status by Mini-Nutritional Assessment (MNA) and to identify relationships among anthropometric measurements, biochemical indicators, bone Mineral Density (BMD) and MNA results among older adults (${\geq}$65 yrs, n=98, 66.7${\pm}$2.5 yrs; M=52, F=46, BMI 24.5${\pm}$2.8 $kg/m^2$) at a Health Care Center. A dietitian administered MNA and collected anthropometric measurements (weight, height, waist circumference), biochemical indicators (albumin, hemoglobin, hematocrit, TLC, glucose, lipids) and the BMD (spine, femur, F=46). Subjects were grouped into a normal nutrition group (0~2 risk factors of malnutrition) and a high risk of malnutrition group (>=3 risk factors of malnutrition) based on their risk factor status for malnutrition. The risk factors for malnutrition include age ${\geq}$65 years, PIBW <90%, albumin <3.5 g/dl, TLC <1,500%, Hgb <14 g/dl (men), Hgb <10 g/dl (women), loss of appetite and weight loss 1~3 kg/last 3 months. In addition, subjects were grouped into a normal, osteopenia and osteoporosis group by BMD. We found that 12% of the subjects were at risk of malnutrition (MNA score, 21.4${\pm}$2.1) and that 88% were well nourished (27.3${\pm}$1.5) according to the MNA. Full-MNA scores were positively and significantly (p<0.05) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), albumin and hemoglobin, respectively. The full-MNA score of the high risk of malnutrition group (23.0${\pm}$3.8) was lower than that of the normal nutrition group (27.0${\pm}$2.1) (p<0.05). In addition, the Full-MNA score was negatively associated with the risk factor of malnutrition (r=－0.35, p=0.0004). We found that 39.1% of the subjects had osteoporosis, 45.7% had osteopenia and 15.2% were normal according to their BMD. The MNA score of osteoporosis group (24.58${\pm}$3.3) was lower than that of the normal (27.4${\pm}$1.1) and osteopenia group (26.9${\pm}$1.5) (p<0.05). These results suggested that MNA can be useful as a nutritional screening tool of older adults in Health Care Centers.

• Journal of Korean Public Health Nursing
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• v.11 no.1
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• pp.138-162
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• 1997

This study was conducted to, develop the social workers role participating health and welfare services production of health centers The sharp increase rate on the elderly population in Korea lead the social issues as that health and social services are not developed enough to cope with the increase on the elderly's hearth care needs. The priority in the elderly's care service development should be put on public sectors. so that could prevent financial catastrophy of the elderly's care. The pulbic sector was concerned with health center services : as health center in Korea provide :mainly medical-oriented services. this study focused on to combine the existing health center's services into social services. The study method was based on needs survey with 322 patients aged over than 55 in rural area. "The needs survey include general health and disease care needs and daily life caring needs. The latter was applied with ADL and IADL with modificiation for the use of Korea environment. The findings were as follows : Social workers should be able to care diseases of muscular and skeletal. circulatory, digestive and general chronic disease in social service needs. aspect. Mostly the chronic pateints quit their care services because of shortage of finanical support$(18.3\%)$ and transportation problem$(19.5\%)$, but still prefer to be cured and cared from general hospitals. and at least clinic and health centers in community. The univisible dramatic effect. of health. care services also should be concerned and cared by xocial workers. The ADL and! IADL shown the most needs on transportation needs and problems caused by weaken legs. Mostly daily activities were supported by family members $(53.3\%\;spousers\;and\;35.0\%\;children)$, and the most demands were shown on helps for transportation visiting hospitals$(37\%)$ and getting similar care services for health care needs $(31.2\%)$ and daily hygeieal needs$(11.2\%)$ Social workers' role should include health care participation with social and health promotion approach as well as socio-economic supports: during health care receiving. Social workers also should provide social services for the elderly's daily needs solving for these are not in available family supporters.

• Journal of Home Health Care Nursing
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• v.16 no.2
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• pp.115-122
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• 2009

Purpose: This study was to examine patient satisfaction related to an increase in nursing personnel staffing. Methods: The subjects of this study were 317 hospitalized patients in the general wards of a medical center in Kyungki Do. Data were collected at 2 and 8 months following an increase in nursing personnel in the hospital. Patient Satisfaction Scale developed by Lee(1986) and revised by Seo(2000) was used. The data were analyzed by descriptive analysis, t-test, ${\chi}2$ test, and one way ANOVA. Results: Although the patient satisfaction scores at 8 months were higher than the scores at 2 months, there were no significant differences in patient satisfaction between the two periods Among the patient satisfaction subscales, the scores of the education subscale at 8 months were marginally higher than at 2 months (t=-1.97, p=.050). Conclusions: Adequate nursing staffing is important in patient satisfaction and patient outcome. The results provide data that suggests a positive direction for nursing intervention and development of nursing professionals.

• Quality Improvement in Health Care
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• v.25 no.2
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• pp.44-55
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• 2019

Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE). Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status ('MA to MA,' 'MA to MA Exit,' 'MA Exit to MA,' and 'MA Exit to MA Exit') on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals. Results: In 1,164 Medical Aid type I individuals, compared to the 'MA to MA' group, the 'MA to MA Exit' group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The 'MA Exit to MA Exit' group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the 'MA to MA Exit' group had higher likelihoods of CHE at the 10% standard. Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I 'MA Exit to MA Exit' beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.

• Journal of the Korean Society of School Health
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• v.21 no.2
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• pp.107-117
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• 2008

Purpose: To investigate the utilization of medical care benefits of school personnel on duty in Seoul. Method: The subjects were 551 workers under Seoul Metropolitan Office of Education(male 301, female 250) who got medical care benefits from March 2000 to February 2005. To analyze the data, frequency, chi-square test, and t-test by SAS package 9.12 were used. Result: The results show that elementary school personnel got the highest ranking, 314(57.0%). Among subjects, 57.2% personnel got accident when they were working on their own duty, 21% during school events and 13.5% were during commutes. They got medical care from orthopedics 75.9%, neurosurgery 7.6%, dental 4%, and 8 male and 2 female died during these days. The most frequent diseases of males and female were fracture and joints related disease. The reason of most health problem was due to injury(92.3%). Conclusion: The results of this study suggest that the continuous health care services like regular health check for school personnel, or social safety network to prevent injury are needed.

• Health Policy and Management
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• v.18 no.1
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• pp.85-107
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• 2008

This study aims to describe levels and distribution of the continuity of primary care among children and adolescent patients who are 2-19 years old, and analyze the effects of it on the risk of hospitalization. Study population was 2-19 year old child and adolescent patients as of 2002, who had more than three ambulatory care visits in the years of 2002-3 and whose most frequent provider was the primary care practices (189,660 persons). Association of levels of primary care with the risk of hospitalization was evaluated using multiple event survival analysis. Outcome variables were whether the patient had hospitalized or not, and whether the patient had hospitalized due to ambulatory care-sensitive conditions or not. Multiple event survival analysis revealed statistically significant association of the levels of primary care with the risk of hospitalization. Hazard ratio was 1.34 [1.27-1.41] at the medium level of continuity and 1.47 [1.39-1.55] at the lower level where outcome variable was whether the patient had been hospitalized or not. Hazard ratios were 1.35 [1.21-1.50] at the medium level of continuity and 1.60 [1.44-1.78] at the lower level, where outcome variable was whether the patient been had hospitalized due to ambulatory care-sensitive conditions or not. This study produced some evidences on the benefits of continuity of care, which will in turn support the introduction of personal doctor registration program in the future.

• Journal of Korean Critical Care Nursing
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• v.9 no.2
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• pp.61-70
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• 2016

Purpose: The purpose of this study was to identify the influences of death perception, terminal care attitude on clinical nurses' terminal care performance for cancer patients. Methods: Data were collected through self-reported questionnaires filled by 526 nurses at a General Hospital in Seoul. Data were analyzed using a multiple regression analysis. Results: Death perception showed a positive correlation with terminal care attitude (r = .45, p < .001), while there was no correlation with terminal care performance. Additionally, terminal care attitude had a positive correlation with terminal care performance (r = .18, p < .001). The explanatory power of nurses' death perception and terminal care attitude toward terminal care performance was 14%. Conclusions: The study results imply that nurses' death perception and terminal care attitude are significant variables affecting terminal care performance.