• 디지털융복합연구
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• 제17권6호
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• pp.315-326
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• 2019

본 연구는 프로바이오틱스의 특성과 관련 연구에 대한 종설이다. 프로바이오틱스는 면역질환 개선 효과, 유당불내증 완화 효과, 변비 및 설사 개선 효과, 항암 및 항종양 효과, 심혈관계 질환 예방 효과, 항당뇨 효과, 항산화 효과, 항균효과, 유용 대사산물의 생산 등의 기능성을 입증하였다. 구강 프로바이오틱스는 젖산을 생성하여 충치의 원인이 되는 뮤탄스균과 잇몸 질환을 일으키는 진지발리스균을 비롯한 유해균이 서식하기 어려운 환경을 만들어 구강 생태계 조성과 구취 제거에 효과적이라는 연구가 입증되었다. 그 결과 질환 완화는 물론 건강한 구강 밸런스를 관리하는 예방법으로 주목받고 있다. 일부 제한점에도 불구하고 현재 유용한 임상연구가 진행되고 있으며, 본 연구는 치아우식증과 치주염, 칸디다의 집락화 등 구강상태를 개선하기 위한 프로바이오틱스의 근거가 될 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.476-486
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• 2020

Objectives: The objective of this study was to estimate the risk of lung cancer in relation to angiotensin II receptor blocker (ARB) use among patients with hypertension from the Korean National Health Insurance Service-National Health Screening Cohort. Methods: We conducted a retrospective cohort study of patients with hypertension who started to take antihypertensive medications and had a treatment period of at least 6 months. We calculated the weighted hazard ratios (HRs) and their 95% confidence intervals (CIs) of lung cancer associated with ARB use compared with calcium channel blocker (CCB) use using inverse probability treatment weighting. Results: Among a total of 60 469 subjects with a median follow-up time of 7.8 years, 476 cases of lung cancer were identified. ARB use had a protective effect on lung cancer compared with CCB use (HR, 0.75; 95% CI, 0.59 to 0.96). Consistent findings were found in analyses considering patients who changed or discontinued their medication (HR, 0.50; 95% CI, 0.32 to 0.77), as well as for women (HR, 0.56; 95% CI, 0.34 to 0.93), patients without chronic obstructive pulmonary disease (HR, 0.75; 95% CI, 0.56 to 1.00), never-smokers (HR, 0.64; 95% CI, 0.42 to 0.99), and non-drinkers (HR, 0.69; 95% CI, 0.49 to 0.97). In analyses with different comparison antihypertensive medications, the overall protective effects of ARBs on lung cancer risk remained consistent. Conclusions: The results of the present study suggest that ARBs could decrease the risk of lung cancer. More evidence is needed to establish the causal effect of ARBs on the incidence of lung cancer.

• 한국방재안전학회논문집
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• 제5권1호
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• pp.1-6
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• 2012

본 연구는 국내 건설산업에 종사하는 근로자에 대하여 재해율이 가장 높은 추락재해에 대한 직접비용을 분석하였다. 첫째, 건설업에서 추락재해로 인한 1인 평균 보험급여 지급액은 18,971천원 정도이다. 10년 동안 평균 추락재해자 수가 5,863명 일 때 추락재해로 인한 전체 손실 비용은 1,113억6천만원 정도이다. 둘째, 추락재해 비구조적 예방대책으로 비용중심의 경제성을 분석하였다, 예방대책에 대한 비용과 효과를 화폐가치로 표현한 자료가 없기 때문에 추락재해로 인한 재해손실 비용 금액을 새롭게 도입한 예방대책이 얼마나 감소시킬 수 있는가에 초점을 두면서 경제성 분석을 시도하였다. 셋째, 재해손실 규모를 파악하고 아울러 추락재해 원인에 대한 예방대책을 발굴하여 철저하게 시행한다면 재해손실 비용을 줄일 수 있는 가를 파악할 수 있다. 향후 비용중심 접근방법에서 본 재해손실 비용의 감소를 편익으로 추정할 수 있는 연구가 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제49권5호
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• pp.260-274
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• 2016

Objectives: Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population. Methods: From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores. Results: A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ${\geq}8$ was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42). Conclusions: Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.

• Journal of Preventive Medicine and Public Health
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• 제50권6호
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• pp.369-376
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• 2017

Objectives: Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI). Methods: The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI. Results: Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations. Conclusions: The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2721-2728
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• 2012

Background: There are limited data evaluating the cost-effectiveness of gastric cancer screening using endoscopy or upper gastrointestinal x-ray in the general population. Objective: To evaluate the cost-effectiveness of population-based screening for gastric cancer in South Korea by decision analysis. Methods: A time-dependent Markov model for gastric cancer was constructed for healthy adults 30 years of age and older, and a deterministic sensitivity analysis was performed. Cost-utility analysis with multiple strategies was conducted to compare the costs and effects of 13 different screening alternatives with respect to the following eligibility criteria: age at the beginning of screening, screening interval, and screening method. The main outcome measurement was the incremental cost-effectiveness ratio. Results: The results revealed that annual endoscopic screening from ages 50-80 was the most cost-effective for the male population. In the females, biennial endoscopy screening from ages 50-80 was calculated as the most cost-effective strategy among the 12 screening alternatives. The most cost-effective screening strategy may be adjustable according to the screening costs and the distribution of cancer stage at screening. The limitation was that effectiveness data were obtained from published sources. Conclusions: Using the threshold of $19,162 per quality-adjusted life year on the basis of the Korean gross domestic product (2008), as suggested by the World Health Organization, endoscopic gastric cancer screening starting at the age of 50 years was highly cost-effective in the Korean population. The national recommendation for gastric cancer screening should consider the starting age of screening, the screening interval, and the screening modality.

• 한국의료질향상학회지
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• 제10권2호
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• pp.144-153
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• 2003

1) Background: The hospitals of modem society, like any other business entities, have to constantly strive to secure their survival from aggressive changes and competition outside. In this unstable environment, effective leadership is one of the most effective strategies for securing organization's growth as well as stability. This study investigated types of leadership (transformational or transactional) that is dominant in medical record departments and compared it's effects on organizational commitment and job satisfaction of their organizational members by types. 2) Method: A questionnaire was developed and mailed to all medical record administrators working at general hospitals throughout the country except department directors (N=450). Of these, 150 useable questionnaires were returned and analyzed by t-test, multiple regression analysis using SPSS. 3) Results: The organizational commitment and job satisfaction were a little bit higher than moderate level, and that of leadership perceived by medical record administrators was also in moderate level throughout types. Significant characteristics (positively) related to organizational commitment and job satisfaction by univariate analysis were marital status (married), position (middle management) and both type of leadership. However transformational leadership was the only significant factor in leadership styles after considering all the factors related to organizational commitment and job satisfaction together by multivariate analysis. 4) Conclusion: The average organizational commitment and job satisfaction of medical record administrators was just in moderate level. Efforts should be made to increase them by improving leadership capacity of medical record directors, primarily by using transformational leadership approach.

• 한국병원경영학회지
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• 제18권1호
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• pp.42-58
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• 2013

The purpose of this study was to investigate the awareness of long-term care hospitals on pay for performance(P4P) program in Korea. We conducted a cross-sectional, self-administered, the internet based survey from September to October in 2010. The questionnaire was consisted of the levels of awareness and agreement about the program, their preferred design and its possible effects and unintended consequences etc. Among 837 eligible long-term care hospitals in Korea, 114 hospitals(13.6%) were participated in the survey. About one-thirds of long-term care hospitals were not aware of P4P, namely it is important to heighten an awareness of P4P. There were pros and cons on introduction of P4P in Korea. The two major reasons of objections of P4P were the concerns of unintended consequences and the possibility of strengthening government control by implementing P4P. In conclusion, to successfully implement P4P to long-term care hospitals, the Health Insurance Review & Assessment Service(HIRA) in Korea should obtain the long-term care hospitals'opinion as to implementation of P4P.

• 대한예방한의학회지
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• 제21권1호
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• pp.67-81
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• 2017

Objectives : The purpose of this study was to analyze the report conducted in 2014 by the Ministry of Health and Welfares on influences of private insurance coverage on the use of Korean medicine. Methods : We analyzed Ministry of Health and welfares report on the use and consumption of Korean medicine to fit the purpose of this study. Comparison between private insurance holders and non-holders was made in the areas of sociodemographic characteristics, patient distribution by disorders, total number of disorders and existence of complex diseases, general perception of Korean medicine, and medical expenses and visits. Logistic regression analysis was made to verify the private insurance coverage. Results : Among sociodemographic characteristics, significant differences were observed in age distribution, education, professions, income level, and housing factors. But genders, area of residence, and marital status didn't show significant differences. Other significant differences including side effects, experience with Korean medicine, herbal medicine and acupuncture treatments, and main visiting facilities were shown between private insurance holders and non-holders. Majority of disorders treated with Korean medicine were musculoskeletal issues, and criteria of number of disorders, multiple diseases factors, and medical expenses/visits showed significant differences between the two groups. Conclusions : Summarizing above results indicate that holding a private insurance in addition to National Health Insurance contributes significant influences on the use of Korean medicine.

• 농촌의학ㆍ지역보건
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• 제21권1호
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• pp.47-60
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• 1996

Home health care is one of the important components of health care services. Today, the need and demand for the home health care is increasing. To assess the effects of home visit health services by public health nurses in health center on the stat of health, use of medical services and quality of life by elderly people living at home, a randomized controlled trial was implemented for 65 years or more old people randomly allocated to intervention(93) and control(118) group. Intervention group received 2 visits a month over 6 months. Control group received no home visits. The data was collected in a one-year follow-up survey conducted at Kyongju before and after the intervention which composed of health risk assessment, risk factor education and health related behavior counseling. The prevalence rate of chronic illness was more decreased in intervention group than control group after intervention. The intervention group visited medical facilities less frequently than control group. And the home visit health services encouraged the elderly to practice regular exercise. After the intervention, the score of ADL(activities of daily living), LSI(life satisfaction index) and SSI(social support index) in intervention group were more increased than control group. And the increase of scores was more prominent in 70 years or more old people, female, non-smoker and non-chronic illed elderly rather than others. In conclusion, the regular home visit health services provided by public health nurses were beneficial for the elderly in terms of health promotion and quality of life.