• Journal of agricultural medicine and community health
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• v.37 no.4
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• pp.233-245
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• 2012

Objectives: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. Methods: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. Results: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. Conclusions: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.

• Journal of agricultural medicine and community health
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• v.22 no.1
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• pp.1-18
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• 1997

This study was carried out to reveal the status of health examination among farmers and to attract more attention to the health care system for farmers. Ten pre-trained medical students interviewed the rural residents 18 years of age and older in eight villages which were randomly selected from a county near Taegu city in Korea, in August 1996. Finally 751 persons were interviewed of whom the percentages of male and female were 41.8%, 58.2% respectively. Among the subjects, 361(48.3%) were fully engaged in farming, 184(24.4%) were partly engaged, and the remaining 206(27.3%) were not engaged in farming at all. The overall prevalence of farmer's disease was 23.0% and there was no significant difference between the group of fully engaged in farming(23.3%) and the group of not-fully engaged(22.9%). But the prevalence of farmer's disease in female subjects(27.8%) was significantly higher than that in male(16.2%)(p<0.01). Among the 288 farmer engaged in spraying pesticide, 113(39.2%) had experienced one or more pesticide related symptoms during last one year, but only 18(15.9%) of them had visited medical facilities due to their symptoms. The experience of receiving education about pesticide was significantly correlated with the degree of wearing protectors during pesticide spraying(p<0.001). Among the 736 persons excluding non-respondents, 281(38.2%) received health examination during last one year ; 176(62.6%) of them received free health examination, and 105(37.4%) received charged one. Among the 533 persons 40 years age and older, only 124(23.3%) had received the 'health examination for the elderly' during last one year, which is provided for the 40 years age and older by Korea medical insurance corporation and medical insurance societies. Most of all beneficiaries of self-employed medical insurance thought the imposed contributions as very expensive(77.4%) or moderately expensive(13.2%). The great majority of farmers are exposed to various health risk factors including pesticide, high temperature, overwork etc. comparable to industrial workers. But farmers are excluded from the regular yearly worker's health examination because of not belonging to a company despite they pay relatively more medical insurance contributions compared with the industrial workers and the urban self-employed medical insureds. It is necessary to develop special health management program for farmers such as the special health examination for the industrial workers exposed harmful agents.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.36-46
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• 2015

Objectives: To understand the risk factors of demographic data in geriatric depression scale, and suicidality among in elderly who live alone at one urban region. Methods:In 2009, 589 elderly who live alone(age${\geq}$65) were carried out a survey about several socio-demographic data, Korean version of the Geriatric Depression Scale(SGDS-K) and Suicidal Ideation Questionnaire (SIQ). Statistical analysis was performed for the collected data. Results: Mean age of elderly who live alone is 75.69(SD 6.17). 40.1% of participants uneducated, 31.4% graduate from elementary school, 12.9% graduate from high school, 11.7% graduate from middle school, 3.2% graduate from university. Religionless, having past history of depression or physical diseases, low subjective satisfaction of family situation, and not having any social group activity have significance to depressive symptoms of elderly who live alone. Having past history of depression, religionless, low subjective satisfaction of family situation have significance to suicidality. Especially, low subjective satisfaction of family situation and having past history of depression are powerful demographic factor both depressive symptoms and suicidality of elderly who live alone. Conclusions: When we take care elderly who live alone, we should consider many things, but especially the social support network such as family satisfaction and past history of depression for reducing or preventing their depression and suicide both elderly depression and suicide who live alone.

• Journal of Korean Medical Science
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• v.33 no.52
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• pp.346.1-346.11
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• 2018

Background: To evaluate the therapeutic benefits of the treat-to-target (T2T) strategy for Asian patients with early rheumatoid arthritis (RA) in Korea. Methods: In a 1-year, multicenter, open-label strategy trial, 346 patients with early RA were recruited from 20 institutions across Korea and stratified into 2 groups, depending on whether they were recruited by rheumatologists who have adopted the T2T strategy (T2T group) or by rheumatologists who provided usual care (non-T2T group). Data regarding demographics, rheumatoid factor titer, anti-cyclic citrullinated peptide antibody titer, disease activity score of 28 joints (DAS28), and Korean Health Assessment Questionnaire (KHAQ) score were obtained at baseline and after 1 year of treatment. In the T2T group, the prescription for disease-modifying antirheumatic drugs was tailored to the predefined treatment target in each patient, namely remission (DAS28 < 2.6) or low disease activity (LDA) ($2.6{\leq}DAS28$ < 3.2). Results: Data were available for 163 T2T patients and 162 non-T2T patients. At the end of the study period, clinical outcomes were better in the T2T group than in the non-T2T group (LDA or remission, 59.5% vs. 35.8%; P < 0.001; remission, 43.6% vs. 19.8%; P < 0.001). Compared with non-T2T, T2T was also associated with higher rate of good European League Against Rheumatism response (63.0% vs. 39.8%; P < 0.001), improved KHAQ scores (-0.38 vs. -0.13; P = 0.008), and higher frequency of follow-up visits (5.0 vs. 2.0 visits/year; P < 0.001). Conclusion: In Asian patients with early RA, T2T improves disease activity and physical function. Setting a pre-defined treatment target in terms of DAS28 is recommended.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8607-8612
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• 2014

Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.24 no.4
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• pp.528-535
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• 2014

Objectives: This study compares the differences of fit factors before and after training on the N95 mask. The results will be utilized to suggest the need of providing effective training on respirator use. Methods: A total of 49 study subjects were tested, comprised of nurses from a general hospital and undergraduate nursing students from a medical school. Anthropometric measurements of face length and face width were compared with the NIOSH(National Institute for Occupational Safety and Health) panel. Fit factors(FF) were measured with TSI Portacount Pro+8038 before and after on-site training regarding the proper use of respirators. The FF pass/fail criterion was set at 100. Results: Two subjects(4.1 %) passed the fit test before training on use of the N95. However, 36(73.5%) of the 49 passed the test after training. Overall the FF(GM(GSD)) was 13.4(3.2) before training, but improved to 106.6(2.1) after training, which was statistically significant. These findings suggest the efficacy of educational intervention, and the performance of the direct on-site training proved to be better than that of the traditional educational methods. Conclusions: This study showed the effect of on-site training of the N95 respirator among health care workers(HCW). Therefore, providing effective training on the use of N95 for HCWs before their work assignments will greatly reduce exposure to harmful agents. It is recommended that fit testing be mandated to check for adequate protection being provided by the given respirators.

• Korea Journal of Hospital Management
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• v.14 no.4
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• pp.149-162
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• 2009

The purpose of this study is to design strategic hospital service based on each hospital's features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.

• Korea Journal of Hospital Management
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• v.13 no.1
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• pp.42-64
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• 2008

This study was conducted to evaluate the quality in medical records by analyzing its completeness through setting up the level of record on the patient's past history and through examining the actual medial records. Targeting the information on the patient's past history in interns' records, residents' records and nurses' records toward 403 inpatients who were admitted first in 2004 at an university hospital due to stomach cancer. We analyzed whether the charts were recorded or not, recording level, the satisfaction with the expectant level of the records in the hospital targeted for a research and the level of agreement. The results were as follows; first, as for the rate of recording those each items, they were high in the chief complaint & present illness and the past illness history. Depending on the group of recorders, the recording rate showed big difference by items. Second, as a result of measuring the level after dividing the recording level of items for the patient's past history from Level 1 to Level 4 by each item, the admission history, the past illness history, and the family history were about Level 3, and the smoking history, the medication history, the chief complaint & present illness, the drinking history and allergy were about Level 2. In the admission department, it was excellent in the interns' records for the medical department. Third, as a result of its satisfactory level by comparing the expect level of a record and the actual record by item in information on the patient's past history, which was expected by the medical-record committee members of the hospital targeted for a study. And forth, we analyzed the level of agreement with Kappa score in the level of 'Yes' or 'None' related to the corresponding matter in Level 1, in terms of information on the past history in the intern's record, the resident's record, and the nurse's record. The level of agreement in the resident's record & the nurse's record, and in the intern's record & the resident's record was from "excellent" to "a little good". There were differences in the level of completeness and in reliability for the information on the past history by the recorder group or by the admission department. The encounter process that was performed by the admission department or the recorder group, indicated the result that was directly reflected on the quality of medical records, thus it was required further study about the medical record documentation process and quality of care. The items that showed the high recording rate quantitatively were rather low, consequently we'd should develop the tool for the qualitative inspection and evaluate the medical records further. And the items were needed to be detailed in the record level were rather low, and hence there needed to be a documentation guideline and education by the clinical departments.

• Journal of the Korea Institute of Building Construction
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• v.19 no.6
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• pp.557-566
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• 2019

The construction industry has the most safety accidents of any of the domestic industries. Special care must be taken because disasters in the construction industry lead to social problems caused by huge property losses and casualties. As a result, there is a growing awareness of disasters occurring in the construction industry, and government departments are tightening their regulations on safety management. In particular, the OSHA (Occupational Safety and Health Agency) focuses on the expansion of protection targets and the clarification of responsibility in the full amendment OSHA. As a result, a study that focuses on the client's responsibility for safety management is needed. In this study, the project performance capability assessment of construction project management contractors, which is being carried out with uniform assessment criteria without considering the characteristics of the construction project, is considered and all the amendments to the OSHA are considered, and the factors were derived for improvement measures.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.11
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• pp.324-334
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• 2019

This study investigates the characteristics of patients hospitalized at a convalescent hospital, by considering patient groups based on their medical record information. It further analyzes and correlates the factors, thus providing basic data required to improve the patient classification system at convalescent hospitals. The data includes total information of 213 medical records of patients discharged from a convalescent hospital in the Jeonbuk region during a period of one year, from January to December 2016. The study examines and correlates the days of hospitalization and the number of diseases, revealing a positive correlation having a correlation coefficient, thereby indicating that infliction with a greater number of diseases results in longer hospitalization. Based on these findings, the study raises the need to revise and supplement items on the patient assessment report to help determine the patient groups and identify medical efforts to be actually provided to patients. In addition, a proper care service system for each patient group based on their respective problems that are intensively managed according to the patient groups will be an essential element in the efficient management of convalescent hospitals. Furthermore, an important task addressed will be in managing the health of the elderly population at the national level.