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The purpose of this study was to define the alcohol consumption norms and attitudes toward alcohol regulation policies among citizens of Seoul and the relationships between such norms and the favored regulatory policies. The study population consisted of 1001 adults aged 19-80 years living in Seoul. We collected demographic data and data on health behaviors, attitudes towards drinking, and preferred alcohol regulation policies. The correlations between drinking and the favored regulatory policies were analyzed. Male, as well as being employed, aged 19-39 years, single, a smoker, and a current or heavy episodic drinker were associated with more positive attitudes toward drinking (all p < 0.001) and less desire for alcohol regulation policies (all p < 0.001). We found a significant negative correlation between attitudes toward drinking and preferred alcohol regulation policies (p < 0.001). Participants who favored reduced or no alcohol consumption and a reduction in alcohol-related harm were more accepting of restrictive alcohol consumption policies. To establish alcohol control polices, differences in drinking norms within populations should be considered. Furthermore, for a successful alcohol control policy, efforts should be made to change drinking norms, as well as consider differences in regulatory policy preferences between population groups.
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Consumo de Bebidas Alcoólicas , Humanos , Masculino , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/epidemiologia , Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Adulto Jovem , Idoso de 80 Anos ou mais , Seul , Normas Sociais , Política de SaúdeRESUMO
OBJECTIVE: This study aims to investigate the implementation rate and influencing factors of confirmatory tests for women with abnormal cervical cytology results in the Korean nationwide cervical cancer screening program. METHODS: The National Health Insurance Service (NHIS) database was utilized to identify all Korean women who have participated in the Korean nationwide cervical cancer screening program from January 2011 and December 2021 using the NHIS database. Multiple logistic regression analysis was performed to estimate the multivariate odds ratio and evaluate the patients' characteristics. RESULTS: The rate of abnormal Papanicolaou (Pap) smears showed an initial increase from 2011 to 2015 and subsequently reached a plateau after 2016. When examining specific subcategories, cases of atypical squamous cells of undetermined significance (ASC-US) increased from 28,546 cases (1.1%) in 2011 to 62,850 cases (1.7%) in 2021. In contrast, cases of HSIL and SCC declined from 3,535 cases (0.14%) to 2,763 cases (0.07%) and from 383 cases (0.01%) to 179 cases (0.005%), respectively. Furthermore, the implementation rate of confirmatory tests for women with abnormal cytology increased from 8,865 cases (21.0%) in 2011 to 39,045 cases (51.2%) in 2021. Regarding the specific subcategory of ASC-US, the number of confirmatory tests exhibited a substantial increase from 4,101 cases (14.4%) in 2011 to 30,482 cases (48.5%) in 2021. For SCC, there was no significant change, with 216 cases (56.4%) in 2011 and 102 cases (57.0%) in 2021. The implementation rate of confirmatory tests was found to be significantly associated with results of abnormal Pap smear, age, and residence. Notably, economic status did not emerge as a significant factor affecting the likelihood of undergoing confirmatory tests. CONCLUSIONS: The severity of abnormal Pap smear results is a reliable indicator of the probability of undergoing a confirmatory test. Additional endeavors are required to improve the implementation rate among women who have received abnormal Pap smear results.
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Detecção Precoce de Câncer , Programas Nacionais de Saúde , Teste de Papanicolaou , Neoplasias do Colo do Útero , Esfregaço Vaginal , Humanos , Feminino , Teste de Papanicolaou/estatística & dados numéricos , Adulto , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Esfregaço Vaginal/estatística & dados numéricos , Idoso , Células Escamosas Atípicas do Colo do Útero/patologia , Bases de Dados Factuais , Adulto Jovem , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/patologiaRESUMO
Large epidemiological studies show U-shaped relationships between high-density lipoprotein cholesterol (HDL-C) levels and all-cause mortality in individuals without atherosclerotic cardiovascular diseases (ASCVD). Association in those with ASCVD by sex is unclear. We examined the association between HDL-C levels and 10-year all-cause mortality in subjects (≥40 years of age) with ASCVD using the 2010 National Health Insurance Service and the National Death Registry of Korea. We categorized HDL-C levels into three groups (low: <40 mg/dL for males, <50 mg/dL for females; high: 40-90 mg/dL for males, 50-90 mg/dL for females; extremely high: >90 mg/dL) and 10 mg/dL intervals. We conducted a sex-stratified and adjusted Cox proportional hazards analysis. Out of 1,711,548 individuals (54% female, mean age 61.4 years), 10-year mortality was observed in 218,252 (12.8%). Males had a higher mortality rate than females (16.2% vs. 9.8%; p < 0.001). When adjusting for age, body mass index, LDL-cholesterol, triglycerides, hypertension, diabetes, smoking, and alcohol consumption, the low and extremely high HDL-C groups had significantly higher hazard ratios for 10-year mortality compared to the high HDL-C group in males [1.183 (1.166-1.199), 1.359 (1.288-1.434)] and in females [1.153 (1.138-1.169), 1.095 (1.029-1.167)]. The frequency distribution bars for the 10-year mortality rate showed sex-specific nadirs of 50-59 mg/dL in males and 70-79 mg/dL in females. In this ASCVD cohort, the extremely high HDL-C (>90 mg/dL) group had 35.9% and 9.5% higher 10-year mortality risks than the high HDL-C group for males and females, respectively. There was a slightly U-shaped relationship between baseline HDL-C levels and a 10-year mortality rate, with earlier inflection in males than in females.
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Neuromorphic hardware using nonvolatile analog synaptic devices provides promising advantages of reducing energy and time consumption for performing large-scale vector-matrix multiplication (VMM) operations. However, the reported training methods for neuromorphic hardware have appreciably shown reduced accuracy due to the nonideal nature of analog devices, and use conductance tuning protocols that require substantial cost for training. Here, we propose a novel hybrid training method that efficiently trains the neuromorphic hardware using nonvolatile analog memory cells, and experimentally demonstrate the high performance of the method using the fabricated hardware. Our training method does not rely on the conductance tuning protocol to reflect weight updates to analog synaptic devices, which significantly reduces online training costs. When the proposed method is applied, the accuracy of the hardware-based neural network approaches to that of the software-based neural network after only one-epoch training, even if the fabricated synaptic array is trained for only the first synaptic layer. Also, the proposed hybrid training method can be efficiently applied to low-power neuromorphic hardware, including various types of synaptic devices whose weight update characteristics are extremely nonlinear. This successful demonstration of the proposed method in the fabricated hardware shows that neuromorphic hardware using nonvolatile analog memory cells becomes a more promising platform for future artificial intelligence.
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OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS: The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.
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COVID-19 , SARS-CoV-2 , Humanos , Estudos Soroepidemiológicos , Teste para COVID-19 , COVID-19/epidemiologia , Anticorpos Antivirais , República da Coreia/epidemiologiaRESUMO
Neuromorphic computing (NC) architecture inspired by biological nervous systems has been actively studied to overcome the limitations of conventional von Neumann architectures. In this work, we propose a reconfigurable NC block using a flash-type synapse array, emerging positive feedback (PF) neuron devices, and CMOS peripheral circuits, and integrate them on the same substrate to experimentally demonstrate the operations of the proposed NC block. Conductance modulation in the flash memory enables the NC block to be easily calibrated for output signals. In addition, the proposed NC block uses a reduced number of devices for analog-to-digital conversions due to the super-steep switching characteristics of the PF neuron device, substantially reducing the area overhead of NC block. Our NC block shows high energy efficiency (37.9 TOPS/W) with high accuracy for CIFAR-10 image classification (91.80%), outperforming prior works. This work shows the high engineering potential of integrating synapses and neurons in terms of system efficiency and high performance.
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Redes Neurais de Computação , Sinapses , Sinapses/fisiologia , Neurônios/fisiologiaRESUMO
Although several regulations have been implemented for medical school admission, such as a quota system, the uneven distribution of healthcare personnel across regions is an unresolved problem in Korea. This study explores the distribution and retention rate of clinicians across regions according to the degree of experience staying in the current clinical area during high school/medical school/resident training using 2016 Korean Physician Survey data. Both in metropolitan and non-metropolitan areas, clinicians who completed high school, medical school, and resident training in the current practice region (Subgroup D) accounted for the largest proportion (Metro, n = 1611, 46.1%; non-metro, n = 1917, 52.9%). The retention rate was the highest in Subgroup D both in metropolitan (84.3%) and non-metropolitan areas (Chungcheong 86.2%, Jeolla 79.9%, Daegu/Gyeongbuk 81.6%, Busan/Ulsan/Gyeongnam 93.3%) except Gangwon and Jeju. The second, third, and fourth highest retention rates were observed in cases where clinicians completed their high school and resident training, medical school and resident training, and resident training only, respectively, in all regions, although the ranking differs by region. To increase the retention rate of physicians, this study shows that it is necessary for a student to seek ways to continue training in the same region in which they graduated from medical school.
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OBJECTIVES: This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA). METHODS: We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups. RESULTS: Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups. CONCLUSIONS: In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.
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Antirreumáticos , Artrite Reumatoide , Doenças Cardiovasculares , Inibidores de Janus Quinases , Infarto do Miocárdio , Neoplasias , Tromboembolia Venosa , Humanos , Inibidores de Janus Quinases/uso terapêutico , Antirreumáticos/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/induzido quimicamente , Tromboembolia Venosa/tratamento farmacológico , Fator de Necrose Tumoral alfa/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/induzido quimicamente , Infarto do Miocárdio/epidemiologia , Seguro Saúde , Neoplasias/tratamento farmacológico , República da Coreia/epidemiologiaRESUMO
Background: Due to the prolonged period of COVID-19, the uncertainty related to COVID-19 is bound to increase for healthcare workers (HCWs) in tertiary medical institutions as much as for the HCWs in dedicated hospitals. Purpose: To assess anxiety, depression, and uncertainty appraisal, and to determine the factors affecting uncertainty risk and opportunity appraisal experienced by HCWs at the forefront of COVID-19 treatment. Method: This was a descriptive, cross-sectional study. The participants were HCWs at a tertiary medical center in Seoul. HCWs included medical (doctors, nurses) and non-medical (nutritionists, pathologists, radiologists, office workers, etc.) personnel. Self-reported structured questionnaires (patient health questionnaire, generalized anxiety disorder scale, and uncertainty appraisal) were obtained. Finally, responses from 1337 people were used to evaluate factors affecting uncertainty risk and opportunity appraisal using a quantile regression analysis. Results: The average ages of medical and non-medical HCWs were 31.69 ± 7.87 and 38.66 ± 11.42 years, and the proportion of females was high. The rates of moderate to severe depression (23.23%) and anxiety (6.83%) were higher in medical HCWs. The uncertainty risk score was higher than the uncertainty opportunity score for all the HCWs. Factors that increased uncertainty opportunity were a decrease in depression in medical HCWs and a decrease in anxiety in non-medical HCWs. Increase in age was directly proportional to uncertainty opportunity in both groups. Conclusion: There is a need to devise a strategy to reduce uncertainty among HCWs who inevitably face various infectious diseases that appear in the near future. In particular, since there are various types of non-medical as well as medical HCWs in medical institutions who can prepare an intervention plan that comprehensively considers the characteristics of each occupation and the distribution of risks and opportunities of uncertainty will be able to improve the quality of life of HCWs and further promote the health of the people.
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This study aimed to determine whether prehospital visits to other medical institutions before admission are associated with prolonged hospital stay, readmission, or mortality rates in acute stroke patients. Using the claims data from the Korean Health Insurance Service, a cross-sectional study was conducted on 58,418 newly diagnosed stroke patients aged ≥ 20 years from 1 January 2019 to 31 December 2019. Extended hospital stay (≥7 days; median value) following initial admission, readmission within 180 days after discharge, and all-cause mortality within 30 days were measured as health outcomes using multiple logistic regression analysis after adjusting for age, sex, income, residential area, and medical history. Stroke patients with a prehospital visit (10,992 patients, 18.8%) had a higher risk of long hospitalization (odds ratio = 1.06; 95% confidence interval = 1.02-1.10), readmission (1.19; 1.14-1.25), and mortality (1.23; 1.13-1.33) compared with patients without a prehospital visit. Female patients and those under 65 years of age had increased unfavorable outcomes (p < 0.05). Prehospital visits were associated with unfavorable health outcomes.
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Serviços Médicos de Emergência , Acidente Vascular Cerebral , Humanos , Feminino , Idoso , Readmissão do Paciente , Estudos Transversais , Estudos Retrospectivos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia , Tempo de Internação , Seguro Saúde , Programas Nacionais de Saúde , República da Coreia/epidemiologia , Avaliação de Resultados em Cuidados de SaúdeRESUMO
Background: A prehospital delay from symptom onset to hospital arrival resulted in stroke-related complications or in-hospital deaths in acute stroke patients. We aimed to investigate trends in prehospital visits as a cause of prehospital delay using data from the Korean Health Insurance Service. Methods: This nationwide, population-based, retrospective cohort study included 524,524 newly-diagnosed stroke patients admitted via the emergency departments of secondary and tertiary hospitals. We obtained the prehospital visits rate from 2010 to 2019 and identified the related characteristics. Results: Prehospital visits were observed in 111,465 patients (21.3%). The prehospital visits rate decreased from 25.1% in 2010 to 17.8% in 2019, but the number of patients increased from 11,255 cases in 2010 to 11,747 cases in 2019. Fortunately, the rate of delayed admission for more than one day decreased from 26.7% to 21.3%. However, 10.4% of patients were diagnosed more than two days later. Young, females, or patients with higher income status and living in low urbanization areas exhibited a higher rate of prehospital visits. Conclusions: Prehospital visits in Korean stroke patients decreased from 25.1% in 2010 to 17.8% in 2019. However, more than 10,000 patients still visited other medical institutions before admission to treatment.
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Background: Limited data is available between metabolic syndrome (MetS) and the development of peripheral arterial disease (PAD) or venous thromboembolism (VTE) in the Asian population. We investigated the incidence of PAD and VTE according to the prevalence of MetS and evaluated the impact of individual components in MetS on the development of PAD and VTE using Korean national data. Methods: Data obtained from national health screening examinations of the Korean National Health Insurance Service from January 1, to December 31, 2009. In total, 9,927,538 participants, 7,830,602 participants were included in this study and the incidence rate of PAD and VTE was investigated retrospectively during a 7-year follow-up. Using the National Cholesterol Education Program Adult Treatment Panel III criteria, patients were placed into one of three groups depending on MetS component numbers: 0 (normal), 1-2 (Pre-MetS), or 3-5 (MetS). Results: The incidence rates of PAD and VTE in MetS were 2.25% and 0.71%, respectively. After multivariable adjustment, the risk of PAD was significantly associated with MetS (hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.42-1.49), the risk of VTE was not associated with MetS (HR 1.01, 95% CI 0.96-1.05). When subgroup analyses were conducted according to MetS components, elevated fasting glucose (HR 1.26, 95% CI 1.23-1.27), abdominal obesity (HR 1.15, 95% CI 1.12-1.17), and elevated blood pressure (HR 1.13, 95% CI 1.12-1.15) were the most related to PAD. Abdominal obesity (HR 1.104, 95% CI 1.064-1.146) was associated with an increased risk of VTE. Conclusions: MetS was significantly associated with an increased incidence rate of PAD among the general Korean population. On the other hand, MetS was not associated with the VTE incidence rate. Of the MetS components, only abdominal obesity was a significant predictor of VTE.
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OBJECTIVES: Although an association is known to exist between metabolic syndrome (MetS) and heart failure (HF) risk, large longitudinal studies are limited. We investigated metabolic status as a risk factor for HF in middle-aged male and female and considered sex differences in various risk factors for HF using nationwide real-world data. METHODS: Data obtained from the Korean National Health Insurance Service from 2009 to 2016 were analyzed. A total of 2,151,597 middle-aged subjects (between 50 and 59 years old) were enrolled. Subjects were divided into 3 groups (normal, pre- MetS, and MetS). Cox proportional hazard models were used to estimate the association between MetS and incident HF after adjusting for clinical risk factors. RESULTS: At baseline, MetS existed in 23.77% of male and 10.58% of female. Pre-MetS and MetS increased the risk of HF: the hazard ratios of pre-MetS for incident HF were 1.508 (95% confidence interval [CI], 1.287 to 1.767) in male and 1.395 (95% CI, 1.158 to 1.681) in female, and those of MetS were 1.711 (95% CI, 1.433 to 2.044) in male and 2.144 (95% CI, 1.674 to 2.747) in female. Current smoking, a low hemoglobin level, underweight (body mass index < 18.5 kg/m2), a high creatinine level, and acute myocardial infarction were also predictors of HF in both sexes. CONCLUSIONS: Pre-MetS and MetS were identified as risk factors for HF in middle-aged male and female. The effect of MetS on the occurrence of HF was stronger in female than in male. Pre-MetS was also a predictor of HF, but was associated with a lower risk than MetS.
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Insuficiência Cardíaca , Síndrome Metabólica , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Síndrome Metabólica/epidemiologia , Insuficiência Cardíaca/epidemiologia , Fatores de Risco , Estudos Longitudinais , República da Coreia/epidemiologia , IncidênciaRESUMO
The global desire to improve the performance of road pavements and move towards a sustainable transportation system has immensely encouraged the usage of fibers in asphalt paving materials. In this study, glass fibers trademarked as ESGFIBER produced by the ESG Industry company Limited from Daejeon, Korea were added in dense-graded asphalt mix. The purpose of this study was to evaluate effects that fibers have on volumetric properties, mechanical properties, and long-term performance of asphalt concrete mixes. ESGFIBER were mixed together with aggregates and asphalt binder in asphalt mix and five different asphalt mixes with different dosage of fibers were evaluated in this study. The Marshall mix design method was used for designing all asphalt mixes, and laboratory tests indirect tensile strength test, deformation strength test and Hamburg wheel tracking test were conducted to evaluate moisture susceptibility, fatigue cracking behavior and rutting resistance of asphalt concrete mixes. The results showed that when ESGFIBER were added in asphalt mix moisture susceptibility, fatigue cracking and rutting resistance were both improved. The usage of ESGFIBER in asphalt concrete mixes can be very beneficial since the mechanical and long-term performance were improved upon the addition of fibers.
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OBJECTIVE: Ischaemic stroke incidence is on the decline globally, but the trend in South Korea is unknown. In this study, the 10-year incidence trends of first-ever ischaemic stroke in South Korea were evaluated. DESIGN, SETTING AND PARTICIPANTS: The National Health Insurance Services medical claim data were used to construct 10 annual cohorts of adults aged 20 years and older, who had not been diagnosed with stroke, to find out the incidence trends of first-ever ischaemic stroke from 2010 to 2019. OUTCOME MEASURES: The primary outcomes were crude and age-adjusted incidence rates for 10 years. Crude incidence rates of the age groups and incidence age statistics were calculated. For comparison among the income groups, age-adjusted incidence rates were used. Incidence rates in all the groups were analysed separately by sex. RESULTS: Age-standardised incidence rates of ischaemic stroke per 100 000 were 101.0 in men, and 67.6 in women in 2010; and 92.2 in men, and 55.0 in women in 2019. By age group, there was a decrease in women over 40 years of age, and men over 60 years of age. The relative difference in stroke incidence rates between medical aid beneficiaries and the highest income group increased from 1.5 to 1.87 over 10 years. CONCLUSIONS: Age-standardised incidence rate of ischaemic stroke has decreased from 2010 to 2019 for both man and women. The incidence rate was stable in the younger age groups and decreased in the older age groups, and the disparities between income groups have widened over the past decade. Stroke prevention strategies are needed for the younger age group and the low-income group. Further research is needed to study the risk factors contributing to the incidence of ischaemic stroke in different groups.
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Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Adulto , Idoso , Isquemia Encefálica/complicações , Isquemia Encefálica/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologiaRESUMO
PURPOSE: This study examined characteristics and patterns of interorganizational networks for smoking prevention and cessation in Korea. METHODS: We surveyed two community health centers, ninety-five hospitals or clinics, ninety-two pharmacies, and sixty-five health welfare organizations in two districts of Seoul in 2020. Data on the organizations' characteristics of smoking cessation and interorganizational activities for information sharing, client referral, and program collaboration were collected and analyzed using network statistics and blockmodeling. RESULTS: Network size was in the order of information sharing, client referral, and program collaboration networks. Network patterns for interorganizational activities on information sharing, client referral, and program collaboration among four organizations were similar between the two districts. Community health centers provided information and received clients from a majority of the organizations. Their interactions were not unidirectional but mutual with other organizations. Pharmacies were involved in information sharing with health welfare organizations and client referrals to hospitals or clinics. Health welfare organizations were primarily connected with the community health centers for client referrals and program collaboration. CONCLUSION: A community health center is the lead agency in interorganizational activities for smoking prevention and cessation. However, hospitals or clinics, pharmacies, and health welfare organizations also participate in interorganizational networks for smoking prevention and cessation with diverse roles. This study would be evidence for developing future interorganizational networks for smoking prevention and cessation.
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Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Comportamentos Relacionados com a Saúde , Humanos , Encaminhamento e Consulta , República da CoreiaRESUMO
With the rapidly aging population, taxi drivers are aging at a fast pace, and competition in the taxi industry is intensifying due to the emergence of various transportation platforms. A descriptive secondary data study was conducted (on a total of 936 subjects) to determine the factors affecting the deterioration of taxi drivers' physical health status (PHS) according to their age group. The increased incidence of chronic diseases and cognitive decline among taxi drivers aged 55−64 years had the greatest influence on the deterioration of their PHS. Driver obesity was more likely to be related to deterioration of the PHS in the drivers aged 55−64 years (OR: 2.459, <0.001) and 35−54 years (OR: 2.133, <0.001). Among the financial factors, a driver's income and their number of dependent family members were correlated with the deterioration of the PHS for drivers aged 55 years or over. Therefore, chronic diseases, obesity and cognitive decline were related with deterioration of the physical health status. This suggests that attention should be paid to healthcare policies not only for the elderly aged over 65 years but also those aged 50 to 64 years, i.e., middle-aged people at the beginning of the transition to old age.
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Condução de Veículo , Idoso , Automóveis , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Obesidade/epidemiologia , Meios de TransporteRESUMO
A complete enumeration study was conducted to evaluate trends related to reperfusion therapies (intravenous thrombolysis (IVT) and endovascular treatment (EVT)) in acute ischemic stroke (AIS) in South Korea, according to sex, economic status, and age, over a 10-year period retrospectively, using the National Health Information Database (NHIS-2020-1-481). This study included AIS patients aged ≥20 years who were hospitalized in a general hospital or tertiary hospital for ≥4 days and underwent brain imaging during the same period. Study participants were classified by sex, economic status (Medical Aid beneficiaries and National Health Insurance beneficiaries) and age (20-44, 45-64, 65-79, and ≥80 years). Women showed a significantly lower OR (Odds ratio) than men in IVT (OR: 0.75; 95% CI: 0.73-0.77), EVT (OR: 0.96; 95% CI: 0.93-0.99), and any therapy (OR: 0.82; 95% CI: 0.80-0.84). The Medical Aid beneficiaries showed significantly lower OR in IVT (OR 0.91, 95% CI 0.88-0.95), EVT (OR 0.93, 95% CI 0.89-0.98), and either therapy (OR 0.92, 95% CI 0.90-0.95) than the National Health Insurance beneficiaries. This study showed sex and economic disparity related to reperfusion therapies in patients with AIS in Korea.
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Isquemia Encefálica , Procedimentos Endovasculares , AVC Isquêmico , Acidente Vascular Cerebral , Isquemia Encefálica/epidemiologia , Isquemia Encefálica/terapia , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/métodos , Feminino , Humanos , AVC Isquêmico/epidemiologia , AVC Isquêmico/terapia , Masculino , Programas Nacionais de Saúde , Reperfusão , Estudos Retrospectivos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/terapia , Terapia Trombolítica , Resultado do TratamentoRESUMO
BACKGROUND: High-density lipoprotein cholesterol (HDL-C) is a well-known predictor of atherosclerotic cardiovascular diseases (ASCVD). We explored the relationships between HDL-C levels and 10-year major adverse cardiovascular events (MACE) and provided sex-specific upper reference limits for HDL-C levels. METHODS: Based on the Korean National Health Insurance Sharing Service, we identified 5,703,897 subjects (women, 48%) with age ≥40 years, eligible HDL-C results, and no prior ASCVD in 2009. We investigated the distribution of 10-year MACE according to HDL-C levels in 10 mg/dL (0.26 mmol/L) intervals and in three HDL-C groups (low: men <40 mg/dL [1.03 mmol/L], women <50 mg/dL [1.29 mmol/L]; high: between low and extremely high levels; and extremely high: >90 mg/dL [2.33 mmol/L]). RESULTS: There were U-shaped relationships between HDL-C levels and 10-year MACE with later inflection in women than in men (nadir: 80-99 mg/dL [2.07-2.56 mmol/L] and 50-59 mg/dL [1.29-1.53 mmol/L], respectively). In men, the extremely high HDL-C group showed significantly higher 10-year MACE than the high group (28.1% vs. 24.6%, P< 0.0001). In women, the extremely high group showed the lowest 10-year MACE; if the extremely high starting point was raised to 130 mg/dL, it became similar to that in men and showed higher 10-year MACE than the high group (25.6% vs. 20.1%, P<0.0001). CONCLUSIONS: The 10-year MACE showed U-shaped relationships with HDL-C levels, and extremely high HDL-C level at 90 mg/dL (2.33 mmol/L) in men was corresponding in risk to 130 mg/dL (3.36 mmol/L) in women.