• Korea Journal of Hospital Management
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• v.10 no.2
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• pp.64-80
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• 2005

The objectives of this study were to identify factors associated with unexpected revisit to an emergency medical center (EMC) located in Seoul and to examine reasons for revisit. During March, June, September and December, 2002, a total of 168 patients had unexpected revisits to the EMC within 48 hours of a previous discharge. As a 1:1 matched control, we included 136 patients who: discharged from the EMC during the same time period: did not return to the EMC; had the same diagnosis and age(${\pm}5$) with the case. In this study, factors associated with unexpected revisits were defined as characteristics of a previous discharge, which were classified into three: sociodemographic, EMC visit-related, and discharge management factors. Reasons for revisit were categorized into disease, physician, patients, and system-related factors. Data were collected by medical chart review with assistance from clinicians of the EMC. Logistic regression results showed that patients who headed home after discharge without follow-up schedule had a 27.6 times higher risk of revisiting EMC than those who were hospitalized following EMC visit. Patients discharged on his own will had a 5.9 times higher risk of revisiting than those discharged following physician's advice. Patients requiring continual observation at the time of discharge were more likely to revisit by 8.7 times than those discharged with improved condition. About 69.13% of the revisits were due to disease-related factors, followed by 13.90% due to patient-related factors, 8.64% due to system-related factors, and 8.34% due to physician-related factors. It appears that the most significant factors influencing revisits are discharge management factors such as patient's condition at discharge, whether the discharge was accorded with physician's advice, and whether returning home without follow-up schedule. Therefore, appropriate discharge management is necessary to prevent EMC revisit.

• Korean Journal of Radiology
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• v.23 no.12
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• pp.1269-1280
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• 2022

Objective: This study aimed to evaluate the usefulness of quantitative indices obtained from deep learning analysis of gadoxetic acid-enhanced hepatobiliary phase (HBP) MRI and their longitudinal changes in predicting decompensation and death in patients with advanced chronic liver disease (ACLD). Materials and Methods: We included patients who underwent baseline and 1-year follow-up MRI from a prospective cohort that underwent gadoxetic acid-enhanced MRI for hepatocellular carcinoma surveillance between November 2011 and August 2012 at a tertiary medical center. Baseline liver condition was categorized as non-ACLD, compensated ACLD, and decompensated ACLD. The liver-to-spleen signal intensity ratio (LS-SIR) and liver-to-spleen volume ratio (LS-VR) were automatically measured on the HBP images using a deep learning algorithm, and their percentage changes at the 1-year follow-up (ΔLS-SIR and ΔLS-VR) were calculated. The associations of the MRI indices with hepatic decompensation and a composite endpoint of liver-related death or transplantation were evaluated using a competing risk analysis with multivariable Fine and Gray regression models, including baseline parameters alone and both baseline and follow-up parameters. Results: Our study included 280 patients (153 male; mean age ± standard deviation, 57 ± 7.95 years) with non-ACLD, compensated ACLD, and decompensated ACLD in 32, 186, and 62 patients, respectively. Patients were followed for 11-117 months (median, 104 months). In patients with compensated ACLD, baseline LS-SIR (sub-distribution hazard ratio [sHR], 0.81; p = 0.034) and LS-VR (sHR, 0.71; p = 0.01) were independently associated with hepatic decompensation. The ΔLS-VR (sHR, 0.54; p = 0.002) was predictive of hepatic decompensation after adjusting for baseline variables. ΔLS-VR was an independent predictor of liver-related death or transplantation in patients with compensated ACLD (sHR, 0.46; p = 0.026) and decompensated ACLD (sHR, 0.61; p = 0.023). Conclusion: MRI indices automatically derived from the deep learning analysis of gadoxetic acid-enhanced HBP MRI can be used as prognostic markers in patients with ACLD.

• Journal of the Korea Convergence Society
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• v.13 no.4
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• pp.409-419
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• 2022

The purpose of this study was to investigate how the increased sedentary behavior due to COVID-19 on physical factors to maintain health. The subjects of the study were 33 office women who mainly lead a sedentary behavior. The group settings were divided into high sedentary behavior groups(n=11), middle sedentary behavior groups(n=11), and low sedentary behavior groups(n=11) according to the hours of sitting down living. There was no significant difference between the groups in the VO₂max and EPOC, the level of lactate in blood showed a significant difference immediately after exercise(p<.05) and at 15(p<.001) and 20(p<.001) minutes of recovery, and the degree of recovery was more smooth in the low sedentary behavior groups. These results suggest that the difference in time according to the degree of sedentary behavior will affect the factors for maintaining health. Therefore, it is considered necessary to minimize sedentary behavior time even in the COVID-19 situation where the time spent in a personal space increases.

• Journal of Society of Occupational Therapy for the Aged and Dementia
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• v.12 no.2
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• pp.57-65
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• 2018

Objective : The purpose of this study was to compare the demographic characteristics, health and quality of life between general adults and adults living with dementia. Method : The data were collected using raw data of the 2016 community health survey and compared between 2,592 adults living with dementia patients and 225,840 general adults. health were assessed for sleep time, stress level, depression, and subjective health status, and quality of life was measured by EQ-5D. Result : In comparison of demographic characteristics, age and family number of adults living with dementia patients were significantly higher than general adults (p<.001), income and eduation levels were low (p<.001), and marital status was higher rate of living with spouse (p<.05). In comparison of health status, adults living with dementia patients were significantly longer in sleep time than the general adults (p<.001), and stress level was higher (p<.001), the percentage of experience of depression was higher (p<.001), and the subjective health status was worse (p<.001). Adults living with dementia patients were significantly lower in quality of life total score and all sub-domain than general adults (p<.001). Conclusion : Based on the results of this study, it is necessary to seek ways to improve the health and quality of life of dementia patients' families.

• Korean Journal of Mineralogy and Petrology
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• v.35 no.4
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• pp.447-455
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• 2022

Fully dehydrated Tl₁₂-LTA (|Tl₁₂|[Si₁₂Al₁₂O₄₈]-LTA,Tl₁₂-A) was treated with 6.0×10³ Pa of ZrI₄ (g) at 623 K for 72 hr under anhydrous conditions. The crystal structure of product, |Zr_0.25I_1.5Tl₁₂|[Si₁₂Al₁₂O₄₈]-LTA, was determined by single-crystal crystallography using synchrotron X-radiation in the cubic space group Pm3m (a = 12.337(2) Å). It was refined using all data to the final error index (for the 712 unique reflections for which F_o> 4σ(F_o) R₁/wR₂= 0.055/0.189. In this structure, octahedral ZrI₆^2- ions center about 25% of the large cavities (Zr-I = 2.91(4) Å). Each coordinates to eight Tl⁺ ions and they are further bridged by Tl⁺ ions in the planes of 8-rings to form a cubic three-dimensional ZrI₆Tl₁₁⁹⁺ cationic cluster. About 1.5 Tl⁺ ions per unit cell moved to deeper side of sodalite cavity after reaction with ZrI₄(g). The remaining Tl⁺ ions occupy well-established cation positions near 6- and 8-rings.

• Journal of agricultural medicine and community health
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• v.22 no.2
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• pp.277-293
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• 1997

This study was conducted to provide basic materials required to enforce and develop welfare policies, as well as the health system, for the aged, by surveying the status of health care utilized by the daily increasing old population and the importance of receiving physical therapy. Data that need in this research was gathered from over ages of 65, during the period from Jan 4, 1996 to Jan 31, using the inquiries previously made by geriatric researchers and through literatures investigator by this writer. The data were analyzed by $X^2$, Z-test, Likert scale. The findings were as follows : 1) General characteristics of subjects. People in the age group between 65 and 69 were 55.6% and the highest number, while male were 37% and female 63%. Analysis of income group disclosed 60.6% whose monthly income, including the pocket money given by children, was less than 200,000 won. 91.1% of the elderly people surveyed owned houses; only 36.4% live with spouses; while 15.6% live alone. 2) Characteristics with respect to utilization of health care institution. 56% of the total medical institutions used by the elderly people were clinics and the rates of chronic disease and musculoskeletal disease were 73.2%. 3) Characteristics with respect to approach of health care institution. 45.1% of the respondent stated it took 20 minutes to arrive at hospital, and bus accounted for 48.6% of all transportation means used to go to hospital. 4) Degree of cognition with respect to the rights of geriatric patients. (1) There is no financial support from the government for geriatric patients(71.4%). (2) Government financial support is needed for geriatric patients(95.3%). (3) Have never been regionally surveyed or called upon for interviews with respect to treatment desire and problems relating to geriatric patients(87.2%). (4) Health and medical policies for geriatric patients must be established rapidly(98.4). (5) Expansion and construction of specialized medical facilities for geriatric patients such as elderly hospital and medical center are needed(90.2%). (6) Government's welfare policies for the elderly people is insufficient(82.0%) 5) Degree of cognition on importance of physical therapy with respect to geriatric patient. (1) Physical therapy is considered most effective in treating geriatric patients(82.9%). (2) Physical therapists specializing in only elderly people must be need of separately(76.2%). (3) It is desirable for medical specialists to visit geriatric patients at home to provide physical therapy(82.9%). (4) Hospitals specializing in physical therapy for geriatric patient are required(85.6%). Based on the result for this research, the following suggestions are presented to facilitate the utilization of health care institution for the welfare of geriatric patients. Medical facilities such as elderly hospital and geriatric patient's medical center specializing in elderly people must be constructed as early as possible; and home-visiting physical therapist system must be important to treat chronic geriatric patients; our government must establish policies to provide the old ages with means for the health care and curing chronic diseases, and carry out the plans of reasonable distribution and effective untilization of medical resources.

• Journal of Korean Academy of Rural Health Nursing
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• v.3 no.1
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• pp.34-43
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• 2008

Purpose: The purpose of this study was to suggest new direction for domiciliary care for elders provided by public institutions in rural areas. Method: The participants in the study were elders using one of 11 public health care institutions, of which 8 operated day care services exclusively, and 3 operated both day care and short-term respite care services. A survey was conducted using a structured questionnaire that included items on general characteristics of the service users, conditions of the services, personnel, financial status, facilities, and perception of the tasks of the staff. Result: The service content of the day care centers included Western and Chinese medical service, physical services, activities of ADL, nursing care services, meal services and transportation services. Domiciliary care centers provided a wide variety of health and social welfare service for elders. Personnel consisted of 3 to 8 staff for day care centers and 7 to 10 for domiciliary care centers. Both types of centers rely on financial support from local government for operation. The perception of the staff was the need for operation of these centers by public health facilities such as public health centers and sub-centers. Conclusion: The result suggest a need to activate the function of public institutions to provide domiciliary care for elders. For this new change, the role as a social support system must be developed.

• Quality Improvement in Health Care
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• v.24 no.2
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• pp.62-75
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• 2018

Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

• Nutrition Research and Practice
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• v.16 no.1
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• pp.120-131
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• 2022

BACKGROUND/OBJECTIVES: Low early pregnancy serum 25-hydroxy vitamin D (25[OH]D) levels can increase gestational diabetes mellitus (GDM) risk, although inconsistent findings related to that association have been reported. This study examined the association of serum vitamin D with GDM and the possible influencers on this association. SUBJECTS/METHODS: This study included 259 pregnant women within the Seremban Cohort Study (SECOST). Blood samples at < 14 weeks of gestation were drawn to determine serum 25(OH)D levels. GDM diagnosis was made at 24 to 32 weeks of gestation using a standard procedure. Association between serum vitamin D and GDM was tested using binary logistic regression. RESULTS: Nearly all women (90%) had mild (68.3%) or severe (32.2%) vitamin D deficiency (VDD). Non-GDM women with mild VDD had a significantly higher mean vitamin D intake than GDM women with mild VDD (t = 2.04, p < 0.05). Women with higher early pregnancy serum vitamin D levels had a greater risk of GDM. However, this significant association was only identified among those with a family history of type 2 diabetes mellitus (T2DM) and in women with a body mass index indicating overweight or obese status. CONCLUSIONS: The high prevalence of VDD in this sample of pregnant women underscores the need for effective preventive public health strategies. Further investigation of this unexpected association between serum vitamin D level and GDM risk in predominantly VDD pregnant women and the potential effects of adiposity and family history of T2DM on that association is warranted.

• Asian Journal for Public Opinion Research
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• v.12 no.1
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• pp.53-74
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• 2024

The proliferation of health misinformation gained momentum amidst the outbreak of the novel coronavirus disease 2019 (COVID-19). People stuck in their homes, without work pressure, regardless of health concerns towards personal, family, or peer groups, consistently demanded information. People became engaged with misinformation while attempting to find health information content. This study used the content analysis method and analyzed 1,154 misinformation stories from four prominent signatories of the International Fact-Checking Network during the pandemic. The study finds the five main categories of misinformation related to the COVID-19 pandemic. These are 1) the severity of the virus, 2) cure, prevention, and treatment, 3) myths and rumors about vaccines, 4) health authorities' guidelines, and 5) personal and social impacts. Various sub-categories supported the content characteristics of these categories. The study also analyzed the emotional valence of health misinformation. It was found that misinformation containing negative sentiments got higher engagement during the pandemic. Positive and neutral sentiment misinformation has less reach. Surprise, fear, and anger/aggressive emotions highly affected people during the pandemic; in general, people and social media users warning people to safeguard themselves from COVID-19 and creating a confusing state were found as the primary motivation behind the propagation of misinformation. The present study offers valuable perspectives on the mechanisms underlying the spread of health-related misinformation amidst the COVID-19 outbreak. It highlights the significance of discerning the accuracy of information and the feelings it conveys in minimizing the adverse effects on the well-being of public health.