• Journal of Preventive Medicine and Public Health
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• 제44권6호
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• pp.242-248
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• 2011

Objectives: Busan is reported to have the highest mortality rate among 16 provinces in Korea, as well as considerable health inequality across its districts. This study sought to examine overall and cause-specific mortality and deprivation at the town level in Busan, thereby identifying towns and causes of deaths to be targeted for improving overall health and alleviating health inequality. Methods: Standardized mortality ratios (SMRs) for all-cause and four specific leading causes of death were calculated at the town level in Busan for the years 2005 through 2008. To construct a deprivation index, principal components and factor analysis were adopted, using 10% sample data from the 2005 census. Geographic information system (GIS) mapping techniques were applied to compare spatial distributions between the deprivation index and SMRs. We fitted the Gaussian conditional autoregressive model (CAR) to estimate the relative risks of mortality by deprivation level, controlling for both the heterogeneity effect and spatial autocorrelation. Results: The SMRs of towns in Busan averaged 100.3, ranging from 70.7 to 139.8. In old inner cities and towns reclaimed for replaced households, the deprivation index and SMRs were relatively high. CAR modeling showed that gaps in SMRs for heart disease, cerebrovascular disease, and physical injury were particularly high. Conclusions: Our findings indicate that more deprived towns are likely to have higher mortality, in particular from cardiovascular disease and physical injury. To improve overall health status and address health inequality, such deprived towns should be targeted.

• 보건행정학회지
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• 제32권3호
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• pp.304-316
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• 2022

Background: As prevention of coronavirus disease 2019 (COVID-19) transmission in healthcare settings has become a critical component in its effective management, COVID-19 specific infection prevention and control (IPC) guidelines were developed and implemented by numerous countries. Although largely based on the current evidence-base, guidelines show much heterogeneity, as they are influenced by respective health system capacities, epidemiological risk, and socioeconomic status. This study aims to analyze the variations and concurrences of these guidelines to draw policy implications for COVID-19 response and future guidelines development. Methods: The contents of the COVID-19 IPC guidelines were analyzed using the categories and codes developed based on "World Health Organization guidelines on core components." Data analysis involved reviewing, appraising and synthesizing data from guidelines, which were then arranged into categories and codes. Selection of countries was based on the country income level, availability of COVID-19 specific IPC guideline developed at a national or district level. Results: The guidelines particularly agreed on IPC measures regarding application of standard precautions and providing information to patients and visitors, monitoring and audit of IPC activities and staff illnesses, and management of built environment/equipments. The guidelines showed considerable differences in certain components, such as workplace safety measures and criteria for discontinuation of precautions. Several guidelines also contained unique features which enabled a more systematic response to COVID-19. Conclusion: The guidelines generally complied with the current evidence-based COVID-19 management but also revealed variances stemming from differences in local health system capacity. Several unique features should be considered for benchmark in future guidelines development.

• Journal of Preventive Medicine and Public Health
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• 제55권6호
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• pp.520-528
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• 2022

Objectives: Thiamine is thought to modify sleeping patterns, while alcohol use diminishes internal thiamine levels. We investigated the association between thiamine intake and sleep duration and explored possible heterogeneity in the effect according to alcohol use. Methods: In total, 15 384 participants aged 19-64 were obtained from the Korea National Health and Nutrition Examination Survey 2012-2016. Nutrient intake, including thiamine, was measured using a food frequency questionnaire. Sleep duration was measured by a self-reported questionnaire. The highest thiamine intake quartile was set as the reference group. Participants were divided into 3 groups, with 7-8 hours of daily sleep as a reference group and those who slept more or less than that as "oversleeping" and "insufficient sleeping," respectively. Multivariate logistic regression was used, adjusting for socioeconomic, medical, and nutritional factors. Additionally, participants were stratified according to high-risk alcohol use defined by the World Health Organization standards on alcohol use. Results: Low thiamine intake was associated with oversleeping (Q3: odds ratio [OR], 1.06; 95% confidence interval [CI], 0.86 to 1.32; Q2: OR, 1.24; 95% CI, 0.99 to 1.55; Q1: OR, 1.49; 95% CI, 1.16 to 1.91) and showed a significant trend for higher ORs at lower intake levels (p-trend<0.001). The effect was stronger in the high-risk alcohol use group (Q1: OR, 1.78; 95% CI, 1.28 to 2.49). Conclusions: Low thiamine intake was associated with oversleeping, and alcohol use intensified that association. These results were found in a context where overt clinical symptoms due to thiamine deficiency are considered rare. More awareness of the potential relationship of thiamine intake with oversleeping and its related risks should be considered.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.7-24
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• 2024

Post-tuberculosis lung disease (PTLD) is emerging as a significant area of global interest. As the number of patients surviving tuberculosis (TB) increases, the subsequent long-term repercussions have drawn increased attention due to their profound clinical and socioeconomic impacts. A primary obstacle to its comprehensive study has been its marked heterogeneity. The disease presents a spectrum of clinical manifestations which encompass tracheobronchial stenosis, bronchiectasis, granulomas with fibrosis, cavitation with associated aspergillosis, chronic pleural diseases, and small airway diseases-all persistent consequences of PTLD. The spectrum of symptoms a patient may experience varies based on the severity of the initial infection and the efficacy of the treatment received. As a result, the long-term management of PTLD necessitates a detailed and specific approach, addressing each manifestation individually-a tailored strategy. In the immediate aftermath (0-12 months after anti-TB chemotherapy), there should be an emphasis on monitoring for relapse, tracheobronchial stenosis, and smoking cessation. Subsequent management should focus on addressing hemoptysis, managing infection including aspergillosis, and TB-associated chronic obstructive pulmonary disease or restrictive lung function. There remains a vast expanse of knowledge to be discovered in PTLD. This review emphasizes the pressing need for comprehensive, consolidated guidelines for management of patients with PTLD.

• 한국지리정보학회지
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• 제8권2호
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• pp.81-94
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• 2005

본 연구의 목적은 각종 환경적 교란이 야기되고 있는 금호강 유역의 경관구조를 정량화, 모니터링하기 위한 경관메트릭스의 적용가능성을 평가하는데 있다. 경관메트릭스는 토지피복지도(1985년, 1999년)의 산림패취만을 대상으로 계산하였다. 최초 사용된 12개 메트릭스는 인자분석을 통해서 전체 변량의 91% 이상 설명하는 3개의 공통인자로 축소되었다. 또한, 다중회귀분석을 사용하여 토지개발이 산림경관구조의 변화에 미치는 영향을 규명하였다. 산림패치에서 도시지역과 농경지로의 전환은 파편화의 증가를 초래한 것으로 나타났다. 특히, 도시지역으로의 전환은 패치면적과 패치크기를 감소시키고, 패치밀도는 증가시켰다($R^2=0.696$, p<0.01). 패치크기의 이질성과 패치모양의 복잡성은 농경지로의 전환에 의해서 감소하였다($R^2=0.405$, p<0.01). 핵심구역과 가장자리의 밀도는 증가하는 경향을 보였으나, 산림의 도시지역과 농경지로의 전환과는 뚜렷한 상호관계를 가지지 않았다. 향후에는 경관구조와 특정한 환경적, 사회경제적 경관기능 사이의 상호관계성을 분석하는 연구가 필요할 것이다.

• 대한토목학회논문집
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• 제29권4D호
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• pp.433-441
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• 2009

유비쿼터스 사회가 도래함에 따라 기존 첨단 대중교통체계를 이용자들의 개별선호에 대응하고 일상생활에 보다 활용될 수 있도록 신규 서비스의 제시 필요성이 높아지고 있다. 본 연구는 기존 첨단 대중교통체계를 한 단계 발전시키기 위한 기초 연구로서 대중교통 차내 무료 인터넷 서비스와 실시간 교통정보 제공 서비스를 제안하고 이용자들의 선호도를 계량적으로 분석하는 것을 목적으로 한다. 먼저 선호의식조사를 이용하여 신규 서비스에 대한 응답자들의 선호도와 지불의사액을 조사 분석하였다. 특히 응답자들의 사회 경제적 특성에 따른 이질성을 고려한 모형을 구축하고 차내 이동시간별 지불의사액의 변화를 계량적으로 분석하였다. 사례분석결과 신규 서비스에 대한 선호도는 차내 이동시간별, 계층별 유의한 차이가 있었다. 먼저 장거리 통행일수록 지불의사액이 증가했다. 계층별로는 주부-자영업의 경우 차내 실시간 교통정보 서비스에 대한 지불 의사액이 높은 반면, 회사원-학생의 경우에는 무료 인터넷 서비스와 실시간 교통정보 제공 서비스에 대한 지불의사액이 비슷하였고 비교적 장거리인 경우에 유효한 것으로 분석되었다.