• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3153-3157
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• 2015

Background: Incidence and mortality rates for cancer have increased dramatically in the recent 30 years in Taiwan. However, not all patients receive treatment. Treatment refusal might impair patient survival and life quality. In order to improve this situation, we proposed this study to evaluate factors that are related to refusal of treatment in cancer patients via a cancer case manager system. Materials and Methods: This study analysed data from a case management system during the period from 2010 to 2012 at a medical center in Northern Taiwan. We enrolled a total of 14,974 patients who were diagnosed with cancer. Using the PRECEDE Model as a framework, we conducted logistic regression analysis to identify independent variables that are significantly associated with refusal of therapy in cancer patients. A multivariate logistic regression model was also applied to estimate adjusted the odds ratios (ORs) with 95% confidence intervals (95%CI). Results: A total of 253 patients (1.69%) refused treatment. The multivariate logistic regression result showed that the high risk factors for refusal of treatment in cancer patient included: concerns about adverse effects (p<0.001), poor performance(p<0.001), changes in medical condition (p<0.001), timing of case manager contact (p=.026), the methods by which case manager contact patients (p<0.001) and the frequency that case managers contact patients (${\geq}10times$) (p=0.016). Conclusions: Cancer patients who refuse treatment have poor survival. The present study provides evidence of factors that are related to refusal of therapy and might be helpful for further application and improvement of cancer care.

• 척추신경추나의학회지
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• 제16권2호
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• pp.97-105
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• 2021

Objectives This study is aimed to evaluate cost-effectiveness of treatment of Korean Medicine for whiplash associated disorders (WAD) and to suggest the direction of future research. Methods We searched papers in Pubmed database to use some keywords indicating whiplash injury syndrome, treatment of Korean Medicine and cost-effectiveness. After searching, appropriate papers were selected depending on the exclusion criteria. The selected papers were analyzed in the sections of author, publication year, intervention and control groups, outcome measurement, the list including in the cost, cost-effectiveness, cost-utility and study design. Results Four studies about effect of Korean medicine and 3 studies about economic evaluation were finally included. Acupuncture was effective for balance disorder and neck pain. Economic evaluation studies used analytical decision model or cost-consequence analysis. Cost-effectiveness analysis using visual analog scale and cost-utility analysis using quality adjusted life years were performed. Initiating timing of proper management affected the consequence of treatments. Direct and indirect medical costs including supportive devices, and non-medical costs such as litigation were considered. Conclusions We conclude that studies haven't been conducted so far to evaluate the cost-effectiveness of Korean Medicine in whiplash injury syndrome. Thus, future studies are needed in this section.

• 대한영양사협회학술지
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• 제28권2호
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• pp.114-126
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• 2022

The relationship between mortality and the Korean Healthy Eating Index ("KHEI") is well established. This study was to investigate the associations between health habits, mental health, and nutritional status and KHEI in older Koreans (aged≥65 years). A total of 4,247 subjects (1,842 men and 2,405 women) that participated in the 2016~2018 Korean National Health and Nutrition Examination Survey were included in the analysis. The lowest scoring KHEI item was milk and milk products. KHEI tertile groups were classified by total KHEI score. Tertile group percentages were related to general characteristics such as gender, residential area, educational level, income level, number of family members, and age. Logistic regression analysis adjusted for general characteristics, showed that ex-smokers (OR: male 1.53 female 2.29), smokers (OR: male 2.90), low hand grip strength (OR: male 1.42 female 1.90), poor self-rated health status (OR: female 1.83), stressful mental status (OR: female 1.51), poor health-related quality of life (OR: female 1.64), poor nutritional status (OR: male 2.88~37.20 female 1.98~16.12), and food insecurity (OR: male 6.87 female 2.03) were significantly related to a lower KHEI. This study suggests that gender-specific associations exist between mental health status and KHEI.

• 한국융합학회논문지
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• 제12권11호
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• pp.501-510
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• 2021

본 연구는 노인의 배우자 유무에 따라 신체와 정신건강에 미치는 영향 요인을 확인하기 위해 제8기 1차(2019년)의 국민건강영양조사의 복합표본을 이용한 2차 자료 분석연구이다. 1,510명을 대상으로 𝜒²검정, 로지스틱 회귀분석과 선형회귀분석을 실시하였다. 연구결과 배우자 유무에 따라 일반적 특성(성별, 연령, 교육수준, 가구소득)과 건강관련 특성(흡연, 음주, 신체활동)을 보정한 결과 무배우자 집단과 비교하여 유배우자 집단의 경우, 관절염 진단 가능성은 약 0.673배 수준으로 낮았고(p=.010), 우울감 경험 가능성은 약 0.535배 수준으로 낮았으며(p=.003), 삶의 질은 약 0.023배 만큼 유의하게 높은 것으로 검증되었다(B=0.023, p=.040). 따라서 본 연구 결과는 노인의 배우자 유무가 건강상태 미치는 영향 요인을 확인하기 위한 기초자료로 활용할 수 있을 것이다.

• 대한간호학회지
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• 제26권4호
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• pp.833-852
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• 1996

Regular long term dance movement could be one of ways to induce improvement of psychophysiological variables, resulting in improvement of quality of life. However, there have been few studies to evaluate the effect of dance movement training on both physiological and psychological variables in the elderly. This study was focused to determine the effect of Korean traditional dance movement training on psychophysiological variables-body weight, body fat, lean body mass, muscle strength, muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satisfaction-in Korean elderly women. Thirty four subjects, aged between 65 and 75years who have normal cognition, sensory function, cerebellum function, cardiovascular function, participated in this study. Seventeen experimental group subjects were selected from E-elderly university in Kyung Gi province, and Seventeen control group subjects were selected from N-welfare facility in Seoul City. Seventeen experimental group subjects participated for 12weeks dance movement program. Korean traditional dance movement program was developed on the basis of Korean traditional dance and music by the author. The program consisted of approximately 50minutes of dance, 3times a week for 12weeks. During 50minutes workout, there were 15minutes of warm-up dancing, 25minutes of conditioning dance and 10minutes of cool-down dancing. The intensity for the conditioning phase was at between 60% and 65% of age-adjusted maximum heart rates. The body weight, body fat, lean body mass, muscle strength(grip strength, leg strength), muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satis-faction were measured prior to and following the experimental treatment. The participants in dance movement were interviewed focusing on subjective feeling following 12 week's regular dance movement. Data were analyzed with mean, standard deviation, percentage of change, X²-test, t-test, and ANCOVA test using SPSS PC/sup +/ program. Subjective feeling was categorized into cognitopsy-chological and physiological responses. Results were obtained as follows : 1) The body weight (F=15.52, p=.000), body fat (F=18.33, p=.000) and lean body mass (F=7.28, p=.011) of the experimental group were significantly lower than those of the control group following the dance movement training. 2) The leg strength (F=30.96, p=.000), muscle endurance (F=9.06, p=.005), agility(F=44.92, 000), flexibility(F=6.84, p=.014) of the experimental group were significantly higher than those of the control group following the dance movement training. There was no significant difference of grip strength(F=.43, p=.515) between experimental and control groups. 3) The heart rate(F=26.96, p=.000), systolic (F=10.40, p=.000) and diastolic(F=3.99, p=.005) blood pressure at rest of the experimental group were significantly lower than those of the control group following the dance movement training. 4) No significant difference of score of depression (F=3.49, p=.071) was observed between experimental and control groups. 5) Score of life satisfaction of experimental group was remarkably higher than that of control group following 12weeks of dance movement training (p<0.05). 6) Thematic responses about the dance movement following the training were positive. "I feel good" was the most frequent among cognitopsychological responses and "I feel lightness of body" was the most frequent among physiological responses. The results suggest that Korean traditional dance movement training can improve psychophysiological variables of Korean elderly.

• Korean Journal of Radiology
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• 제24권12호
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• pp.1249-1259
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• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

• 치위생과학회지
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• 제10권2호
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• pp.109-116
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• 2010

본 연구는 2006년과 2007년 경상북도 성주군과 영양군 내에 거주하는 만 65세 이상 노인들을 대상으로 노인들의 인구사회학적 특성에 구강건강과 관련된 삶의 질 증진에 관여하는 요인들을 분석하고자 하였다. 이를 위하여 경상북도 지역 내 2개군 지역을 선정하여 지역 내 만 65세 이상 노인들을 대상으로 구강건강영향지수(Oral Health Impact Profile: OHIP-14)를 활용하여 구강건강과 관련된 삶의 질을 설문조사하였다. 최종 수합된 546명의 자료를 분석한 결과 다음과 같은 결론을 얻었다. 1. 조사대상자의 구강건강과 관련된 삶의 질의 각 세부요인 중 사회적 능력저하는 평균 4.61점, 정신적 능력저하는 평균 4.53점, 신체적 능력저하는 평균 3.99점, 정신적 불편감은 평균 3.98점, 사회적 불리는 평균 3.82점, 신체적 동통은 평균 3.77점, 그리고 기능적 제한은 평균 3.44점으로 조사되었다. 2. 구강건강과 관련된 삶의 질 중 기능적 제한은 조사된 특성 중 성별, 교육수준 및 직업유무에 따라 통계적으로 유의한 차이가 있었고 신체적 동통은 조사된 특성 중 성별, 교육수준, 동거가족에 따라 통계적으로 유의하였으며, 정신적 불편감은 조사된 특성 중 성별, 교육수준, 직업유무 따라 통계적으로 유의한 차이가 있었고, 신체적 능력저하는 조사된 특성 중 성별, 교육수준, 월수입에 따른 차이가 통계적으로 유의하였다. 또한 정신적 능력저하는 조사된 특성 중 성별, 교육수준에 따라 통계적으로 유의한 차이가 있었고, 사회적 능력저하는 조사된 특성 중 교육수준, 직업유무, 월수입에 따른 차이가 통계적으로 유의하였으며, 사회적 불리는 조사된 특성 중 연령, 직업유무, 월수입에 따라 통계적으로 유의한 차이가 있었다. 3. 조사대상자의 구강건강과 관련된 삶의 질 총합은 조사된 특성 중 성별, 교육수준, 직업유무에 따른 차이가 통계적으로 유의하였다. 따라서 본 연구에서는 우리나라 일부 농촌노인들의 구강건강 영향지수를 측정하고 각 세부항목에 영향을 주는 요인들을 조사하였다. 구강건강 영향지수에 대한 세부요인 별 관련성을 볼 때, 구강건강과 삶의 질은 밀접한 관련이 있는 것으로 나타났다. 이에 노인들의 구강건강관련 삶의 질 향상을 위해서는 다양한 측면에서 노인들의 복지정책과 효과적인 노인건강 관리가 이루어져야한다고 본다. 또한 구강건강 영향지수와 관련된 다양한 연구가 지속적으로 필요하리라 사료된다.

• 원예과학기술지
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• 제33권3호
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• pp.375-382
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• 2015

곰취의 수확 후 품질 유지와 출하시기 연장을 위한 MAP 저장의 기초 연구로서 3년에 걸쳐 CA 환경 최적화 연구를 수행하였다. 4월과 5월에 수확한 곰취는 차압통풍 예냉 방식으로 $4^{\circ}C$까지 품온을 낮춘 후 펀치 홀 MAP(일반 공기 조성과 같은 대조구) 및 CA 환경을 조성하였다. 대조구로서 MA 포장은 펀치 홀 천공 처리한 PP 필름 봉지를 활용하였다. CA 환경은 1년차에는 $O_2$ 1, 3% 2개 농도에 각각 $CO_2$ 5, 10%를 조합한 $2{\times}2$ 요인 처리, 2년차에는 $O_2$ 3% 고정에 $CO_2$ 0, 2.5, 5% 3개 처리, 3년차에는 $O_2$ 3%와 $CO_2$ 2.5, 5% 2개 처리를 설정하여 단계적인 최적화 과정을 거쳤다. 1년차 실험 결과, $O_2$ 1, 3%와 무관하게 $CO_2$ 10% 조합 CA 조건에서는 호흡속도의 감소와 함께 흑변 증상이 심하게 발생하였다. 2, 3년차에는 CA 저장에서도 장해 발생률이 뚜렷하게 나타나지 않았으나 4주 이상 저장 + 유통 후에는 대조구에 비해 다소 높은 경향이었다. 저장 4주 + 유통 5일 후에 조사한 조직감과 외관 상품성은 $O_2$ 3% + $CO_2$ 2.5% CA 저장에서 우수하였으나 CA 조성에 따른 저장기간 연장 효과는 크지 않았다. 연구 결과를 종합해 보면, 곰취는 이산화탄소 장해에 민감한 작물로서 상품성 유지를 위한 안전하고 효과적인 MAP 또는 CA 저장을 위한 $CO_2$ 농도 조성은 2.5% 수준이 적합한 것으로 판단되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7309-7314
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• 2013

Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and Methods: We recruited 702 consecutive patients (${\geq}18$ years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.

• The Korean Journal of Pain
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• 제29권4호
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• pp.239-248
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• 2016

Background: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. Methods: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included. Patients were excluded if had other causes of pain, cognitive dysfunction or chronic neurological disorders. Statistical analysis of pool data was done using SPSS version-17. For various scales like GPE, PDQ, NPSI, the visual analogue scale (VAS), global perceived effect (GPE), the pain DETECT questionnaire (PDQ), and neuropathic pain symptoms inventory (NPSI), one factor repaeted measure ANOVA applied with simple contrast with baseline as on post-operative day 1 (considered as reference and compared with subsequent time-interval), and the P values were adjusted according to "Bonferroni adjustments". In patients with CPPP, the ${\Delta}ct$ values of mRNA expressions of genes at the end of postoperative day 90 were compared with the baseline control values by one factor repeated ANOVA. P value < 0.005 significant. Results: The present study demonstrates 38.1% (8 out of 21 patients) incidence of CPPP. The functional status and quality of life as were observed to be significantly diminished in all patients with chronic pain. An up-regulation in the mRNA expression of signal transduction and a positive correlation was noted between the mRNA expression of signal transduction genes and VAS score in all patients with CPPP at the end of postoperative day 90. Conclusions: The reported incidence of CPPP in patients with carcinoma ovary was 38.1%. An up-regulation and positive correlation between mRNA expression of signal transduction genes and VAS score depicts its potential role in the pathogenesis of CPPP.