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1.
Saf Health Work ; 15(2): 151-157, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39035809

RESUMEN

Background: Replacement drivers represent a significant portion of platform labor in the Republic of Korea, often facing night shifts and the demands of emotional labor. Research on replacement drivers is limited due to their widespread nature. This study examined the levels of presenteeism and absenteeism among replacement drivers in comparison to those of paid male workers in the Republic of Korea. Methods: This study collected data for replacement drivers and used data from the 6th Korean Working Conditions Survey for paid male workers over the age of 20 years. Propensity score matching was performed to balance the differences between paid workers and replacement drivers. Multivariable logistic regression was used to estimate the adjusted odds ratio (OR) and 95% confidence intervals for presenteeism and absenteeism by replacement drivers. Stratified analysis was conducted for age groups, educational levels, income levels, and working hours. The analysis was adjusted for variables including age, education, income, working hours, working days per week, and working duration. Results: Among the 1,417 participants, the prevalence of presenteeism and absenteeism among replacement drivers was 53.6% (n = 210) and 51.3% (n = 201), respectively. The association of presenteeism and absenteeism (adjusted OR [95% CI] = 8.42 [6.36-11.16] and 20.80 [95% CI = 14.60-29.62], respectively) with replacement drivers being significant, with a prominent association among the young age group, high educational, and medium income levels. Conclusion: The results demonstrated that replacement drivers were more significantly associated with presenteeism and absenteeism than paid workers. Further studies are necessary to establish a strategy to decrease the risk factors among replacement drivers.

2.
Am J Gastroenterol ; 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38934496

RESUMEN

INTRODUCTION: New terminologies of metabolic dysfunction-associated steatotic liver disease (MASLD) have been developed. We assessed hepatocellular carcinoma (HCC) risk across MASLD and/or alcohol intake. METHODS: We included participants aged 40-79 years receiving a national health checkup from 2009 to 2010 in the Republic of Korea, classified as follows: non-MASLD, MASLD, MASLD with increased alcohol intake (MetALD; weekly alcohol 210-420 g for male and 140-350 g for female individuals), and alcohol-associated liver disease (ALD; excessive alcohol intake with weekly alcohol ≥420 g for male or ≥350 g for female individuals). The primary outcome was HCC incidence. HCC risk was estimated using multivariable Cox proportional hazard models. RESULTS: Among 6,412,209 participants, proportions of non-MASLD, MASLD, MetALD, and ALD cases were 59.5%, 32.4%, 4.8%, and 3.4%, respectively. During follow-up (median 13.3 years), 27,118 had newly developed HCC. Compared with non-MASLD, the HCC risk increased from MASLD (adjusted hazard ratio [aHR] 1.66, 95% confidence interval [CI] 1.62-1.71) and MetALD (aHR 2.17, 95% CI 2.08-2.27) to ALD (aHR 2.34, 95% CI 2.24-2.45) in a stepwise manner. Furthermore, the older and non-cirrhosis subgroups were more vulnerable to detrimental effects of MASLD and/or alcohol intake, concerning HCC risk. Among the older, female, and cirrhosis subgroups, MetALD poses similar HCC risks as ALD. DISCUSSION: HCC risk increased from MASLD and MetALD to ALD in a stepwise manner, compared with non-MASLD. For an effective primary prevention of HCC, a comprehensive approach should be required to modify both metabolic dysfunction and alcohol intake habit.

3.
J Clin Med ; 13(3)2024 Jan 24.
Artículo en Inglés | MEDLINE | ID: mdl-38337364

RESUMEN

(1) Background: The physiological and pharmacological variations between men and women are known to influence drug efficacy. The objective of this study was to determine the 50% and 95% effective doses (ED50 and ED95) of remimazolam required for i-gel supraglottic airway (ISA) insertion under remifentanil infusion without neuromuscular blocking agents (NMBAs) in both males and females. (2) Methods: Patients aged 19-65 years, scheduled for general anesthesia using ISA, were enrolled in this study. Patients were divided into two groups based on their sex. The anesthesia process began with a remifentanil infusion targeting an effect-site concentration of 3.0 ng/mL, accompanied by a remimazolam injection. The initial remimazolam dose was 0.25 mg/kg, and it was adjusted with a step size of 0.05 mg/kg based on the outcome of ISA insertion in the preceding patient. (3) Results: The ED50 of remimazolam (mean ± standard error) was 0.28 ± 0.02 mg/kg in the male group and 0.18 ± 0.02 mg/kg in the female group (p < 0.001). Additionally, ED95, which was calculated using the isotonic regression method, was significantly comparable between the male and female groups (male: 0.35 mg/kg, 95% confidence interval [CI] = 0.34-0.35; female: 0.29 mg/kg, 95% CI = 0.25-0.30). (4) Conclusions: This study showed that both the ED50 and the ED95 of remimazolam for successful ISA insertion was higher for men than that for women. Therefore, while using remimazolam alongside remifentanil infusion without NMBAs for ISA insertion, one should consider the patient's sex for appropriate dosing.

4.
Comput Inform Nurs ; 42(3): 218-225, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38261420

RESUMEN

Game-based virtual reality simulation programs can capitalize on the advantages of non-face-to-face education while effectively stimulating the interest of trainees and improving training efficiency. This study aimed to develop a game-based virtual reality simulation program for nervous system assessment and to evaluate the effects of the program on the learning attitudes of nursing students. Using a one-group pretest-posttest design, 41 senior nursing students were enrolled, and their learning attitudes (self-directed learning attitude, academic self-efficacy, flow-learning experience, and learning presence) were evaluated. The effect of the program was statistically significant in self-directed learning attitude ( t = -2.27, P = .027) and learning presence ( t = -3.07, P = .003), but the difference was not statistically significant in academic self-efficacy ( t = -1.97, P = .054) and learning flow ( t = -0.74, P = .459). The virtual gaming simulation program can be used to effectively replace field training in situations wherein field training is limited, such as during the COVID-19 pandemic.


Asunto(s)
Bachillerato en Enfermería , Estudiantes de Enfermería , Humanos , Pandemias , Aprendizaje , Simulación por Computador
5.
BMC Nurs ; 23(1): 75, 2024 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-38287331

RESUMEN

BACKGROUND: As amyotrophic lateral sclerosis/motor neuron disease (ALS/MND) is a fatal progressive neurodegenerative disorder, patients experience severe impairments, with patients and family caregivers facing emotional distress and exhaustion. Several psychosocial interventions are aimed at providing tailored support for ALS/MND patients and caregivers. The aim of this study was to conduct a scoping review and present a comprehensive overview of psychosocial interventions designed for individuals and families affected by ALS/MND, while also pinpointing research gaps. METHODS: This scoping review utilized Arksey and O'Malley's methodological framework to investigate psychosocial interventions designed for individuals with ALS/MND and their families. The study adhered to the PRISMA-ScR checklist for reporting. RESULTS: A total of 27 articles describing 25 interventions met the inclusion criteria. The predominant interventions observed in the research encompassed education-related strategies, closely followed by behavior therapy, counseling, social support interventions, and psychotherapy interventions. Across the majority of the studies, findings indicated promising feasibility and acceptability of these interventions. Notably, a significant proportion of quantitative investigations yielded one or more statistically significant effects, while qualitative studies consistently reported favorable outcomes, including enhancements in well-being and heightened awareness of individual circumstances. CONCLUSIONS: Given the progressive and debilitating nature of this condition, coupled with the absence of a cure, the adoption of a psychosocial approach can prove beneficial for both ALS/MND patients and their families. However, high-quality RCTs with a large sample size are recommended to examine and confirm the effectiveness.

6.
J Korean Med Sci ; 38(50): e384, 2023 Dec 25.
Artículo en Inglés | MEDLINE | ID: mdl-38147834

RESUMEN

BACKGROUND: This study assessed the relationship between non-participation in health check-ups and all-cause mortality and morbidity, considering socioeconomic status. METHODS: Healthy, middle-aged (35-54 years) working individuals who maintained either self-employed or employee status from 2006-2010 were recruited in this retrospective cohort study from the National Health Insurance Service in Korea. Health check-up participation was calculated as the sum of the number of health check-ups in 2007-2008 and 2009-2010. Adjusted hazard ratio (HR) and 95% confidence interval (CI) of all-cause mortality were estimated for each gender using multivariable Cox proportional hazard models, adjusting for age, income, residential area, and employment status. Interaction of non-participation in health check-ups and employment status on the risk of all-cause mortality was further analyzed. RESULTS: Among 4,267,243 individuals with a median 12-year follow-up (median age, 44; men, 74.43%), 89,030 (2.09%) died. The proportion (number) of deaths of individuals with no, one-time, and two-time participation in health check-ups was 3.53% (n = 47,496), 1.66% (n = 13,835), and 1.33% (n = 27,699), respectively. The association between health check-up participation and all-cause mortality showed a reverse J-shaped curve with the highest adjusted HR (95% CI) of 1.575 (1.541-1.611) and 1.718 (1.628-1.813) for men and women who did not attend any health check-ups, respectively. According to the interaction analysis, both genders showed significant additive and multiplicative interaction, with more pronounced additive interaction among women who did not attend health check-ups (relative excess risk due to interaction, 1.014 [0.871-1.158]). CONCLUSION: Our study highlights the significant reverse J-shaped association between health check-up participation and all-cause mortality. A pronounced association was found among self-employed individuals, regardless of gender.


Asunto(s)
Empleo , Disparidades Socioeconómicas en Salud , Persona de Mediana Edad , Humanos , Masculino , Femenino , Adulto , Estudios Retrospectivos , Riesgo , Estado de Salud
7.
Front Psychol ; 14: 1257233, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38144977

RESUMEN

Introduction: Despite several studies on the association between work-family conflict (WFC) and sleep disturbances, a more comprehensive approach considering occupational factors is lacking. We aimed to analyze this association among Korean workers and the combined effects of WFC and job-related factors on sleep disturbance. Methods: Data on paid workers from the sixth Korean Working Conditions Survey were analyzed. Odds ratios (ORs) with 95% confidence intervals (CIs) for sleep disturbances with WFC were calculated using a multiple logistic regression model among Korean workers. Furthermore, stratification and interaction analyses were conducted between WFC and socioeconomic factors related to sleep disturbance. Results: Among the 24,923 workers (male: 11,752, female: 13,171) examined, 35.40% of males and 39.95% of females experienced sleep disturbances. In both sexes, the WFC group was significantly associated with sleep disturbance [adjusted OR (95% CI): male, 2.90 [2.67-3.16]; female, 2.54 [2.35-2.74]]. According to the stratification analysis, the association between sleep disturbance and WFC was prominent among younger and highly educated individuals, those engaged in quick returns, and larger companies in both sexes. In the interactions between WFC, quick return, occupation, and company size on sleep disturbance, there were significant additive associations, except between WFC and occupation among female workers. Conclusion: This study highlights the association between WFC and sleep disturbances in male and female workers and emphasizes the importance of maintaining work-life balance.

8.
Ann Occup Environ Med ; 35: e43, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38029274

RESUMEN

Background: Gig workers, also known as platform workers, are independent workers who are not employed by any particular company. The number of gig economy workers has rapidly increased worldwide in the past decade. There is a dearth of occupational health studies among gig economy workers. We aimed to investigate the association between exposure to violence and job stress in gig economy workers and depressive symptoms. Methods: A total of 955 individuals (521 gig workers and 434 general workers) participated in this study and variables were measured through self-report questionnaires. Depressive symptoms were evaluated by the Patient Health Questionnaire-9 when the score was greater than or equal to 10 points. The odds ratio with 95% confidence interval was calculated using multivariable logistic regression adjusted for age, sex, working hours, education level, exposure to violence and job stress. Results: 19% of gig economy workers reported depressive symptoms, while only 11% of general workers reported the depressive symptoms. In association to depressive symptoms among gig economy workers, the mainly result of odds ratios for depressive symptoms were as follows: 1.81 for workers type, 3.53 for humiliating treatment, 2.65 for sexual harassment, 3.55 for less than three meals per day, 3.69 for feeling too tired to do housework after leaving work. Conclusions: Gig economic workers are exposed to violence and job stress in the workplace more than general workers, and the proportion of workers reporting depressive symptoms is also high. These factors are associated to depressive symptoms. Furthermore, the gig workers associated between depressive symptoms and exposure to violence, job stress.

9.
J Addict Nurs ; 34(4): E163-E171, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38015584

RESUMEN

ABSTRACT: This study aimed to analyze the differences in sleep quality according to drinking patterns and identify factors associated with poor sleepers among Korean male adults younger than 65 years. Data from 68,711 male participants from the Korean Community Health Survey collected in Korea in 2018 were analyzed. After dividing them into binge drinking and nonbinge drinking groups, each group was further categorized into three subgroups according to the frequency of drinking: less than occasionally, frequent, and very frequent. The quality of sleep and depression were assessed through face-to-face interviews using the Pittsburgh Sleep Quality Index and the Patient Health Questionnaire-9, respectively. Total sleep quality was the lowest in the group that participated in "very frequent" binge drinking; the groups that participated in "frequent" binge drinking and "very frequent" nonbinge drinking had similar levels of sleep quality. Poisson regression with robust variance analysis revealed an almost 50% higher prevalence of poor sleep in the "very frequent" binge drinking group (prevalence ratio = 1.49, p < .001) compared with the reference group (nonbinge drinking, less than occasionally) after controlling for confounding variables. Significantly higher prevalence ratios of poor sleep were found in the "frequent" and "very frequent" drinking groups compared with the reference group. Health policies could emphasize the importance of reducing one's frequency and amount of drinking. In addition, it is also necessary for healthcare professionals to assess drinking patterns when caring for people experiencing poor quality sleep and support them in correcting such drinking behaviors.


Asunto(s)
Consumo Excesivo de Bebidas Alcohólicas , Calidad del Sueño , Adulto , Masculino , Humanos , Consumo Excesivo de Bebidas Alcohólicas/epidemiología , Sueño , Análisis de Varianza , República de Corea/epidemiología
10.
Front Public Health ; 11: 1056768, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37234769

RESUMEN

Introduction: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2-virus. COVID-19 has officially been declared as the latest in the list of pandemics by WHO at the start of 2020. This study investigates the associations among decrease in economic activity, gender, age, and psychological distress during the COVID-19 pandemic considering the economic status and education level of countries using multinational surveys. Methods: Online self-report questionnaires were administered in 15 countries which were spontaneously participate to 14,243 respondents in August 2020. Prevalence of decrease in economic activity and psychological distress was stratified by age, gender, education level, and Human Development Index (HDI). With 7,090 of female (49.8%), mean age 40.67, 5,734 (12.75%) lost their job and 5,734 (40.26%) suffered from psychological distress. Results: Associations among psychological distress and economic status, age, and gender was assessed using multivariate logistic regression, adjusted for country and education as random effects of the mixed model. We then measured the associations between HDI and age using multivariate logistic regression. Women had a higher prevalence of psychological distress than men with 1.067 Odds ratio, and younger age was significantly associated with decrease in economic activity for 0.998 for age increasing. Moreover, countries with lower HDI showed a higher prevalence of decrease in economic activity, especially at lower education levels. Discussion: Psychological distress due to COVID-19 revealed a significant association with decrease in economic activity, women, and younger age. While the proportion of decrease in economic activity population was different for each country, the degree of association of the individual factors was the same. Our findings are relevant, as women in high HDI countries and low education level in lower HDI countries are considered vulnerable. Policies and guidelines for both financial aid and psychological intervention are recommended.


Asunto(s)
COVID-19 , Distrés Psicológico , Masculino , Humanos , Femenino , SARS-CoV-2 , COVID-19/epidemiología , COVID-19/psicología , Pandemias , Encuestas y Cuestionarios
11.
Front Aging Neurosci ; 15: 1148444, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37122380

RESUMEN

Objective: Neuronata-R® (lenzumestrocel) is an autologous bone marrow-derived mesenchymal stem cell (BM-MSC) product, which was conditionally approved by the Korean Ministry of Food and Drug Safety (KMFDS, Republic of Korea) in 2013 for the treatment of amyotrophic lateral sclerosis (ALS). In the present study, we aimed to investigate the long-term survival benefits of treatment with intrathecal lenzumestrocel. Methods: A total of 157 participants who received lenzumestrocel and whose symptom duration was less than 2 years were included in the analysis (BM-MSC group). The survival data of placebo participants from the Pooled-Resource Open-Access ALS Clinical Trials (PROACT) database were used as the external control, and propensity score matching (PSM) was used to reduce confounding biases in baseline characteristics. Adverse events were recorded during the entire follow-up period after the first treatment. Results: Survival probability was significantly higher in the BM-MSC group compared to the external control group from the PROACT database (log-rank, p < 0.001). Multivariate Cox proportional hazard analysis showed a significantly lower hazard ratio for death in the BM-MSC group and indicated that multiple injections were more effective. Additionally, there were no serious adverse drug reactions found during the safety assessment, lasting a year after the first administration. Conclusion: The results of the present study showed that lenzumestrocel treatment had a long-term survival benefit in real-world ALS patients.

12.
BMC Anesthesiol ; 23(1): 81, 2023 03 16.
Artículo en Inglés | MEDLINE | ID: mdl-36927413

RESUMEN

BACKGROUND: Remimazolam is a new anesthetic drug developed and is an ultra-short-acting agent with rapid onset and offset. The pharmacology of this drug seems to be ideal for short surgeries eligible for I-gel insertion. Therefore, this study aimed to determine the optimal bolus dose of remimazolam for I-gel insertion when co-administered with remifentanil without neuromuscular blocking agents (NMBAs). METHODS: Patients aged 19-65 years with American Society of Anesthesiologists physical status I or II scheduled for general anesthesia were enrolled. The first dose of remimazolam was 0.15 mg/kg and remifentanil was co-administered at an effect-site concentration (Ce) of 3.0 ng/mL. The dose of remimazolam for the following patient was decreased or increased by 0.05 mg/kg depending on the success or failure of I-gel insertion in the previous patient. RESULTS: The remimazolam bolus dose required for successful I-gel insertion in 50% of adult patients using modified Dixon's up-and-down method with remifentanil Ce 3.0 ng/mL and no NMBAs was 0.280 ± 0.048 mg/kg. Isotonic regression analysis showed that the 50% and 95% effective doses were 0.244 (83% confidence interval [CI] 0.213-0.313) mg/kg and 0.444 (95% CI 0.436-0.448) mg/kg, respectively. The mean time to loss of consciousness (Modified Observer's Assessment of Alertness/Sedation score < 2) was 52.2 s. Three patients (12.0%) showed a reduction in systolic blood pressure of more than 30% from baseline. CONCLUSIONS: Selecting the appropriate dose of remimazolam/remifentanil without NMBAs makes it feasible to insert the I-gel. TRIAL REGISTRATION: This study protocol was registered at http://cris.nih.go.kr (KCT0007801, 12th, October, 2022).


Asunto(s)
Bloqueantes Neuromusculares , Piperidinas , Adulto , Humanos , Anestesia General , Remifentanilo
14.
Eur J Clin Invest ; 53(4): e13936, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36504405

RESUMEN

BACKGROUND: The high postoperative recurrence rate of hepatocellular carcinoma (HCC) is a significant challenge. Patient metabolic factors are potential disease modifiers and should be examined as risk factors for postoperative prognosis. Here, we assessed the association between long-term statin use and HCC recurrence after surgical resection of hepatitis B virus (HBV)-related HCC. METHODS: Patients who initially underwent curative resection for HBV-related HCC between 2005 and 2015 were recruited and followed up until December 2019. Patients were classified into statin user and non-statin user groups based on whether or not they had been prescribed statins for ≥2 years. The primary outcome was HCC recurrence, and the secondary outcome was liver-related mortality. The cumulative incidence by statin use was estimated using the Kaplan-Meier method and compared using the log-rank test. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression. RESULTS: Among 5653 patients with a median 6.1 years of follow-up, HCC recurrence and liver-related mortality occurred in 1603 and 316 patients, respectively. The 5-year cumulative incidence of HCC recurrence in the statin user group (15.9%) was significantly lower than that in the non-user group (21.3%; p = .019). From multivariable Cox regression analysis, statin use was significantly associated with a reduced risk of HCC recurrence (aHR 0.77, 95% CI: 0.61-0.98; p = .035) and liver-related mortality (aHR 0.48, 95% CI: 0.25-0.90; p = .023). CONCLUSION: Long-term statin use was significantly associated with reduced risk of HCC recurrence and liver-related mortality after curative resection of HBV-related HCC.


Asunto(s)
Carcinoma Hepatocelular , Virus de la Hepatitis B , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Neoplasias Hepáticas , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma Hepatocelular/tratamiento farmacológico , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/cirugía , Carcinoma Hepatocelular/virología , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/virología , Recurrencia Local de Neoplasia/epidemiología , Pronóstico , Medición de Riesgo
15.
Am J Gastroenterol ; 118(6): 1001-1009, 2023 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-36288330

RESUMEN

INTRODUCTION: Antiviral therapy (AVT) substantially improved the prognosis for patients with chronic hepatitis B (CHB). Head-to-head comparisons of prognosis between treated patients with CHB and the general population are scarce. We directly compared the prognosis between Asian patients with CHB receiving AVT and the general population. METHODS: From the South Korean National Health Insurance Service database, patients with CHB receiving AVT ≥3 years, aged 40-64 years, who underwent health examinations between 2011 and 2012 (AVT-CHB group) were recruited. As a control, propensity score-matched general population was chosen among patients without CHB. The primary outcome was all-cause mortality; secondary outcomes were cardiovascular disease (CVD), hepatocellular carcinoma (HCC), and all types of non-HCC malignancies. RESULTS: During follow-up (median 7.2 years), 26,467 and 75,469 individuals in the AVT-CHB group and matched general population were analyzed. The 5- and 7-year cumulative all-cause mortality rates were 0.40% and 1.0% for the AVT-CHB group vs 0.50% and 1.0% for the matched general population (adjusted hazard ratio [aHR] 0.96, 95% confidence interval [CI] 0.83-1.10; P = 0.51). The AVT-CHB group had a lower risk of CVD than the matched general population (aHR 0.70, 95% CI: 0.62-0.79; P < 0.001). Although the AVT-CHB group was more likely to develop HCC than the matched general population (aHR 13.16, 95% CI: 10.90-15.89; P < 0.001), the non-HCC malignancy risks in the AVT-CHB group were comparable to the matched general population (aHR 1.05, 95% CI 0.98-1.13; P = 0.137). DISCUSSION: The AVT-CHB group had a similar risk of all-cause mortality and non-HCC malignancies and a lower risk of CVD than the matched general population.


Asunto(s)
Carcinoma Hepatocelular , Enfermedades Cardiovasculares , Hepatitis B Crónica , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/etiología , Antivirales/uso terapéutico , Hepatitis B Crónica/complicaciones , Carcinoma Hepatocelular/etiología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/complicaciones , Virus de la Hepatitis B , Estudios Retrospectivos , Cirrosis Hepática/complicaciones
16.
Eur J Intern Med ; 107: 66-72, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36347739

RESUMEN

BACKGROUND: High postoperative recurrence of hepatitis B virus (HBV)-infected hepatocellular carcinoma (HCC) remains a significant challenge. Here, we aimed to compare the postoperative HCC recurrence between patients with AVT for detectable serum HBV-DNA vs. those without. METHODS: Data of patients undergoing curative resection of HBV-infected HCC as an initial therapy from 2015 to 2017 were obtained from the National Health Insurance Service database in South Korea. AVT was initiated when serum HBV-DNA was detectable. The primary outcome was HCC recurrence. The cumulative risk of HCC recurrence between AVT users and non-users was estimated using the Kaplan-Meier method. RESULTS: During follow-up (median 2.7 years) with 3034 patients, 25.7% and 23.6% of AVT users and non-users experienced HCC recurrence, respectively. The 1-, 2-, and 3-year cumulative recurrence rates were similar (p = 0.57): 15.6%, 23.3%, and 26.4% in AVT users versus 15.3%, 22.0%, and 24.9% in non-users, respectively. After adjusting for covariates, multivariable Cox regression analysis showed comparable outcomes between the two groups with adjusted hazard ratios (aHR 1.08, 95% confidence interval [CI] 0.89-1.31; p = 0.439). Similar outcomes between the two groups were reproduced after stratification of liver cirrhosis. Inverse probability treatment weighting analysis also showed comparable outcomes between the two groups in the subgroups with liver cirrhosis (aHR 1.01, 95% CI 0.80-1.29; p = 0.92) and non-cirrhosis (aHR 1.08, 95% CI 0.87-1.34; p = 0.472). CONCLUSIONS: Initiating AVT based on detectable serum HBV-DNA provided the similar risk of postoperative HCC recurrence in HBV-infected HCC patients with and without detectable serum HBV-DNA.


Asunto(s)
Carcinoma Hepatocelular , Hepatitis B Crónica , Hepatitis B , Neoplasias Hepáticas , Humanos , Neoplasias Hepáticas/cirugía , Carcinoma Hepatocelular/cirugía , ADN Viral , Viremia/tratamiento farmacológico , Hepatitis B/complicaciones , Hepatitis B/tratamiento farmacológico , Virus de la Hepatitis B , Cirrosis Hepática , Antivirales/uso terapéutico , Hepatitis B Crónica/complicaciones , Hepatitis B Crónica/tratamiento farmacológico , Estudios Retrospectivos
17.
Health Syst Reform ; 9(3): 2338308, 2023 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-38715186

RESUMEN

This study charts the chronological developments of the three institutions that were established in South Korea for priority setting in health. In 2007, the Evidence-based Medicine Team and the Center for New Health Technology Assessment (CnHTA) were established and nested in the Health Insurance Review and Assessment Service (HIRA). In December 2008, the National Evidence-based Healthcare Collaborating Agency (NECA) was launched, to which the CnHTA was transferred in 2010. Since then, non-drug technologies have been reviewed by NECA and drugs have been reviewed by HIRA. Political debates about how to embrace expensive but important health technologies that were not on the benefits list led to the creation of the Participatory Priority Setting Committee (PPSC) in 2012. The PPSC, led by the general public, has played a key role in advancing the path toward universal health coverage by revitalizing the list of essential, yet previously overlooked, medical technologies. PPSC offers these technologies a second chance at coverage. HIRA and NECA served to strengthen evidence-based and efficiency-based decision-making in the health system via CnHTA, and PPSC served to strengthen social value-based decision making via priority setting in Korea. The reassessment by PPSC may be relevant in countries where the economy is growing and citizens want to rapidly expand the benefits list.


Asunto(s)
Prioridades en Salud , Evaluación de la Tecnología Biomédica , Cobertura Universal del Seguro de Salud , República de Corea , Cobertura Universal del Seguro de Salud/tendencias , Evaluación de la Tecnología Biomédica/métodos , Humanos , Prioridades en Salud/tendencias
18.
PLoS One ; 17(11): e0277016, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36374920

RESUMEN

Social capital (SC) has been documented to effectively reduce the spread of diseases, including COVID-19; however, research pertaining to SC and COVID-19 vaccination in Korea is lacking. This cross-sectional study conducted in the city of Wonju, Gangwon Province, Korea (n = 1,096) examined the differences in COVID-19 vaccine trust and hesitancy considering individual characteristics and investigated the effects of SC on COVID-19 vaccine trust and hesitancy. SC was measured based on 14 items pertaining to social trust, network, and norms. Responses regarding COVID-19 screening history, vaccine trust, and vaccine hesitancy were also assessed. SC scores did not differ between sexes, but differed significantly according to age and household income; thus, adults aged 70-79 years had the highest SC scores, and mean SC score increased significantly with income. COVID-19 vaccine trust differed significantly according to age, average household income, social organization involvement, and SC score. COVID-19 vaccine hesitancy differed significantly with age, SC score, and COVID-19 screening history. In univariate logistic regression, age, average household income, social organization involvement, and SC score were significant predictors of vaccine trust; in multivariable analysis, however, the identified predictors were age and SC. In particular, people with an SC score ≥50 were 2.660 times more likely to trust COVID-19 vaccines than those with lower scores. In multivariable analysis, age and SC were significant predictors of vaccine hesitancy. In particular, people with an SC score ≥50 were 1.400 times more likely not to be hesitant about receiving COVID-19 vaccines than people with lower scores. These results indicate that prioritizing policies to increase SC and trust in the government could boost the COVID-19 vaccination rate.


Asunto(s)
COVID-19 , Vacunas , Humanos , Adulto , Vacunas contra la COVID-19 , Confianza , Estudios Transversales , COVID-19/epidemiología , COVID-19/prevención & control , Aceptación de la Atención de Salud , Padres , Conocimientos, Actitudes y Práctica en Salud , Vacunación , República de Corea/epidemiología
19.
Geriatr Nurs ; 48: 320-326, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36371879

RESUMEN

This study aimed to identify YouTube videos focused on choosing a nursing home. The contents of the videos were analyzed using 19 items from the guidelines proposed by the Donabedian model. An analysis of 57 videos showed that informal presentations for format (54.39%), laypersons for speaker (36.84%), and personal channel for uploader (61.40%) exhibited the highest frequency. According to the analysis of video content, most videos included the environment (49.12%), programs (38.63%), and cost (35.09%). However, fewer videos focused on care protocols (5.26%), participation (5.26%) and health outcomes (5.26%). More informal presentations, laypersons, and personal channels than health providers, professional groups, and mass media were included in videos focused on choosing nursing homes. It is necessary to provide information regarding the philosophy, care, and health outcomes of residents in addition to the information regarding environment and cost provided by reliable suppliers, such as health professionals, the government, and mass media.


Asunto(s)
Medios de Comunicación Sociales , Humanos , Grabación en Video , Gobierno , Casas de Salud , Difusión de la Información/métodos
20.
Front Public Health ; 10: 990276, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36299768

RESUMEN

Objectives: Although many studies have examined the association between shift work and depression or insomnia, few studies have examined the relationship between quick return (QR) to work and depressive symptoms, regardless of shift work. Thus, in this study, we aimed to assess the association between depressive symptoms (DS)/sleep disturbances (SDs) and QR. Methods: Data from the 6th Korean Working Conditions Survey (2020) were used for this study. Paid workers aged between 20 and 65 years were included. DS were defined using the World Health Organization Well-Being Index (WHO-5) with a cut-off 50, and SD was defined as the occurrence of the following symptoms several times per month: difficulty in falling asleep, waking up in the middle of the night, or feeling tired even after waking up. QR was defined as "at least one case where the working interval between leaving work and the next day's work was < 11 h in the past month." Multivariable logistic regression was performed to estimate the adjusted odd ratios (aORs) and 95% confidence intervals (CIs). Mediation analysis was conducted to examine whether SD was a significant mediator in the association between QR and DS. Results: Among the 27,554 participants, DS occurred in 8,277 patients, while SD occurred in 6,264 patients. The aORs (95% CIs) of DS and SD by QR were 2.01 (1.78-2.27) and 3.24 (2.87-3.66), respectively, after adjusting for age, gender, income, education, working hours, job status, working duration, region, shift work, and occupation. SD was a significant mediator in the association between QR and DS. Conclusion: QR is significantly associated with DS or SD regardless of demographic factors and the working environment. The significant relationship between QR and DS may be mediated by SD.


Asunto(s)
Trastornos del Inicio y del Mantenimiento del Sueño , Trastornos del Sueño-Vigilia , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Depresión/epidemiología , Trastornos del Sueño-Vigilia/epidemiología , Encuestas y Cuestionarios , Sueño
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