• Genes and Genomics
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• 제40권12호
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• pp.1339-1349
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• 2018

Cerebral palsy (CP) is a non-progressive neurological disease, of which susceptibility is linked to genetic and environmental risk factors. More and more studies have shown that CP might be caused by multiple genetic factors, similar to other neurodevelopmental disorders. Due to the high genetic heterogeneity of CP, we focused on investigating related molecular pathways. Ten children with CP were collected for whole-exome sequencing by next-generation sequencing (NGS) technology. Customized processes were used to identify potential pathogenic pathways and variants. Three pathways (axon guidance, transmission across chemical synapses, protein-protein interactions at synapses) with twenty-three genes were identified to be highly correlated with CP. This study showed that the three pathways associated with CP might be the molecular mechanism of pathogenesis. These findings could provide useful clues for developing pathway-based pharmacotherapies. Further studies are required to confirm potential roles for these pathways in the pathogenesis of CP.

• 디지털융복합연구
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• 제10권9호
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• pp.397-407
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• 2012

본 연구에서는 대전지역 일개 건강검진센터의 디지털화된 국민건강보험 건강검진 수검 자료를 이용하여 국민건강보험 검진환자를 효율적으로 관리할 수 있는 방안을 제시하고자 하였다. 이를 위해 대전지역 일개 건강검진센터의 2002년부터 2011년까지 10년간의 국민건강보험 건강검진 수검 자료를 수집하였으며, 수집된 자료를 이용하여 국민건강보험 검진환자의 재검진 예측모형, 민간검진 예측모형, 위암검진 예측모형을 개발하였다. 예측모형 개발 결과 연령, 거주지, 단체 또는 개인 검진 여부, 이전 국민건강보험 건강검진 횟수 등이 국민건강보험 재검진, 민간검진, 위암검진에 유의한 영향을 미치는 것으로 나타났다. 개발된 예측모형을 토대로 재검진, 민간검진, 위암검진 확률 로직을 산출하여 대전지역 일개 건강검진센터의 시스템에 적용할 수 있는 방안을 마련하였다. 국민건강보험 건강검진 환자관리 시스템을 토대로 맞춤형 서비스를 제공한다면 건강검진센터 운영의 효율화에 크게 이바지 할 수 있을 것이다.

• 부모자녀건강학회지
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• 제11권1호
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• pp.49-60
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• 2008

This is an underlying study for expanding child growth and developmental screening program, which had been implemented as a part of maternal child health service in a certain public health center located in P City. This study attempted to develop system model to discover, consult and follow-up developmental disabilities in children in early stage. For the purpose of providing groundwork for further development of screening program, the system model was analyzed and evaluated. One of the focuses of this study was developing practical tool that can aid small number staffs of public health center to handle large number of patients. 9 types of developmental checklist by key month was developed to support understaffed public health center. These checklists were also supplied to other public health centers, greatly improving qualitative and quantitative development of screening project. Also, the 4-step program of operating and managing child growth and developmental screening was proved to be quite effective. Total 632 children were evaluated and 21 of them were suspected to have developmental problem. Among these children, 8 children were determined to receive regular supervision of public health center. Other 13 children were recommended to visit professional institution, but only 7 of them actually visited institution. Four of these children who visited professional institution are currently receiving treatment, while the other 3 children were determined to require close observation. Five times of screening education were provided to the staffs in public health center and personnel in charge of children in every district public center in P City. The purpose of this training was to improve individuals' capability to implement project and to establish basis for expanding child growth and developmental screening program. The participants were guided to have continuous attention for the project, and their knowledge, skill and recognition were greatly improved through educational training. Also, professional child consulting and education, including lecture for baby food and baby food menu exhibition, were given to parents. Through this opportunity, parents acquired higher understanding about baby food while the local residents' recognition for maternal child health service was greatly improved.

• Journal of Preventive Medicine and Public Health
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• 제44권3호
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• pp.101-110
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• 2011

Objectives: Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention. Methods: A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping. Results: The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy. Conclusions: The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and costeffectiveness of interventions to increase colorectal cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.609-614
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• 2016

Background: Although breast cancer is the most common cancer in women, economic evaluation of breast cancer screening is not fully addressed in developing countries. The main objective of the present study was to analyze the cost-effectiveness of breast cancer screening using mammography in 35-69 year old women in an Iranian setting. Materials and Methods: This was an economic evaluation study assessing the cost-effectiveness of a population-based screening program in 35-69 year old women residing in rural areas of South east Iran. The study was conducted from the perspective of policy-makers of insurance. The study population consisted of 35- to 69-year old women in rural areas of Kerman with a population of about 19,651 in 2013. The decision tree modeling and economic evaluation software were used for cost-effectiveness and sensitivity analyses of the interventions. Results: The total cost of the screening program was 7,067.69 US$ and the total effectiveness for screening and no-screening interventions was 0.06171 and 0.00864 disability adjusted life years averted, respectively. The average cost-effectiveness ratio DALY averted US$ for screening intervention was 7,7082.5 US$ per DALY averted and 589,027 US $ for no-screening intervention. The incremental cost-effectiveness ratio DALY averted was 6,264 US$ per DALY averted for screening intervention compared with no-screening intervention. Conclusions: Although the screening intervention is more cost-effective than the alternative (noscreening) strategy, it seems that including breast cancer screening program in health insurance package may not be recommended as long as the target group has a low participation rate.

• 한국학교보건학회지
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• 제22권1호
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• pp.33-48
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• 2009

Purpose: The purpose of the study was to find the strategies of mental health screening in school. Based on the literature review, we discuss the importance of screening students in schools for mental health problems. Methods: Data from the 2008 Korean Mental Health Screening in Schools(2008-KMHSS) are used to estimate the outline of this screening. We administered the questionnaire for satisfaction of 2008-KMHSS for students(N=1,280), parents(N=2,672), school nurses(N=75), teachers(N=685), district personnels(N=6), and mental health center staffs(N=37). Also we interviewed a part of them by telephone and e-mail. And we reviewed the tools and methods for screening students for emotional/behavioral problems. Results: Mental health screening in schools is a very important, yet worrisome, agenda that is in its very early stages. From the 2008 Korean Mental Health Screening in Schools, 9,588 students(12.9%) needed more evaluation in the first stage. Of these, 6,910(72.1%) completed the second stage screening. In this sample, 1,975(28.6%) utilized the mental health services in school or community. 38.3% of students and 43.7% of their parents notified the 2008-KMHSS. But only 12.1% of students and 10.9% of their parents dissatisfied with the screening. 9.9% of teachers and 22.7% of school nurses dissatisfied with the screening. Among them the school nurses were mostly dissatisfied, and they complained work burden from KMHSS. Mental health center staffs complained similar issues. The Children's Problem-behavior Screening Questionnaire(CPSQ) and Adolescents' Mental-health & Problem-behavior Screening Questionnaire(AMPQ) were compatible to screen students in schools for mental health problems in first stage. Conclusion: Mental health screening in schools needs careful planning and implementation. For successful mental health screening in schools, several elements need to be considered: careful planning, collaboration, staff training, and integrative mental health programs and services in community or schools.

• 보건행정학회지
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• 제16권1호
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• pp.54-72
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• 2006

This study was conducted as the primary work to develop a customer relationship management (CRM) system to improve the performance of health screening programs. The specific aims of the study was to identify and classify the characteristics of the people who did not receive their health screening using decision trees and to propose management strategies according to their characteristics identified. The data on a total of 5,102,761 subjects of health screening provided by the National Health Insurance Program in the year of 2002 were used. The target variable was whether they underwent their health screening. The input variables included a total of 27. The SAS 9.1 version was used for data preprocessing and statistical analyses. SAS Enterprise Miner was used to develop the decision trees model. The decision trees identified the factors greatly affecting the health screening. In the non-disease group, the highest rate of non-examinees was characterized by: no experience of receiving a health screen, household's age, non-insured episode for the last one year, and patients' age. In the disease group, the one showing the highest rate of non-examinees was characterized by: no experience of receiving a health screening, no experience of going to public health center or midwife clinic for the last one year, and examinees' age. Developing CRM systems for health screening management taking into account the individual characteristics would be considerably helpful to increase the rate of receiving health screening.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3729-3734
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• 2015

Background: Although cervical cancer is preventable and early screening might decrease the associated mortality, challenges faced by the women and health care providers can postpone early detection. This qualitative study aimed to establish patient and provider perceptions about personal and socio-cultural barriers for cervical cancer screening in Mashhad, Iran. Materials and Methods: In the present study, which was conducted in 2012, eighteen participants, who were selected purposefully, participated in individual in-depth, semi-structured interviews, which were recorded, transcribed verbatim, and analyzed using conventional content analysis and Atlas-Ti software. Results: One theme and two categories were derived from data including: cognitive/behavioral factors (lack of a community-based approach to cervical cancer, lack of awareness, wrong attitude and lack of health seeking behaviors) and socio/cultural issues (socio-cultural invasion, mismatch between tradition, modernity and religious, extra marital relationships and cultural taboos). Conclusions: Providing community based approach education programs and employing social policy are needed for preventing of cervical cancer in Iran.

• Journal of Preventive Medicine and Public Health
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• 제41권2호
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• pp.100-106
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• 2008

Objectives : We measured behavioral factors associated with Koreans receiving gastric cancer screening based on a socio-ecological model, in part to develop strategies to improve cancer screening rates. Methods : A telephone survey was conducted with 2,576 people chosen through stratified random sampling from April 1 - May 31, 2004. Collected information included gastric cancer screening, socio-demographic factors, and socio-ecological factors at intrapersonal, interpersonal, community, and public policy levels. Results : Among 985 survey respondents(380 men and 605 women), 402 had received gastric cancer screening. Logistic analysis was performed to compare those screened and unscreened. 'Age' was the only demographic factor that showed a statistically significant association with getting screening. People in their fifties (OR=1.731, 95% CI=1.190-2.520) and sixties (OR=2.098, 95% CI=1.301-3.385) showed a higher likelihood of getting screened, compared to those in the forties. 'Accessibility to a medical institution' was a significant factor related to having gastric cancer screening at the intrapersonal level. At the interpersonal level, recommendations by family members to be screened and a family practice of routine cancer screening were significantly related. People with frequent education about cancer screening or with stronger social feelings that cancer screening is necessary also demonstrated significantly higher tendencies to be screened. Conclusions : In conclusion, a socio-ecological model seems appropriate for explaining gastric cancer screening behavior and associated factors. Health planners should develop integrated strategies to improve cancer screening rates based on socio-ecological factors, especially at the interpersonal and community levels.

• Journal of Preventive Medicine and Public Health
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• 제38권4호
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• pp.473-481
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• 2005

Objectives : We wanted to identify those factors associated with stomach, colon, breast and cervix cancer screening. Methods : A population-based telephone survey was conducted for 2 weeks (the 9th-23th of July, 2004) by trained interviewers with using a questionnaire. 2,598 respondents (females aged 30 years or over, and the males aged 40 years or over) were selected by random-digit dialing that was based on the 2000 Population and Housing Census. The data on socio-demographic, health behavior and enabling factors were collected. 2,571 respondents were included in analysis. The cancer screening rate was classified into 2 categories : the life time screening rate and the screening rate with recommendations. Results : For the 2,571 respondent s, the life time screening rate was as follows: 52.0% (Stomach), 25.3% (Colon), 55.9% (Breast) and 76.8% (Cervix). The screening rate with recommendation was as follows : 3 9.2% (Stomach), 20.6% (Colon), 42.5% (Breast) and 58.3% (Cervix). On a multiple logistic regression analysis of the life time screening, statistically significant relationships were observed for the screening intention, the health exam, the disease history, the age of the patients and the cancer screening rates. On a multiple logistic regression analysis of the screening with recommendation, statistically significant relationships were observed for the screening intention, the health exam, the age of the patients, the concern about the risk of cancer, the voluntary health insurance for cancer and the cancer screening rates. Conclusions : The results of this study suggest that the cancer screening intention, the health exam and the age of the patients are the most important factors to participate in life time cancer screening and also screening with recommendations. A positive association was also observed for the concern about the risk of cancer, the voluntary health insurance for cancer. It is hoped that this study will be a base line data for suggesting the representative cancer screening rate in Korea.