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1.
PLoS One ; 15(1): e0227190, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31917784

RESUMO

STUDY OBJECTIVES: Insomnia is the most common sleep disorder with significant psychiatric/physical comorbidities in the general population. The aim of this study is to investigate whether socioeconomic and demographic factors are associated with gender differences in insomnia and subtypes in Korean population. METHOD: The present study used data from the nationwide, cross-sectional study on sleep among all Koreans aged 19 to 69 years. The Insomnia Severity Index (ISI) was used to classify insomnia symptoms and their subtypes (cutoff value: 9.5). The Pittsburgh Sleep Quality Index (PSQI), Goldberg Anxiety Scale (GAS) and Patient Health Questionnaire-9 (PHQ-9) were used to measure sleep quality, anxiety and depression. RESULTS: A total of 2695 participants completed the survey. The overall prevalence of insomnia symptoms was 10.7%, including difficulty in initiating sleep (DIS) (6.8%), difficulty in maintaining sleep (DMS) (6.5%) and early morning awakening (EMA) (6.5%), and these symptoms were more prevalent in women than in men. Multivariate analysis showed that female gender, shorter sleep time and psychiatric complications were found to be independent predictors for insomnia symptoms and subtypes. After adjusting for covariates among these factors, female gender remained a significant risk factor for insomnia symptoms and their subtypes. As for men, low income was related to insomnia. CONCLUSION: Approximately one-tenth of the sample from the Korean general population had insomnia symptoms. The prevalence of insomnia symptom and the subtypes were more prevalent in women than men. Gender is an independent factor for insomnia symptoms.

2.
Support Care Cancer ; 28(2): 713-723, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31129760

RESUMO

PURPOSE: To develop a Cancer Symptom Management System: Symptom Management Improves your LifE (SMILE) and evaluate the effect and feasibility of the system in cancer symptom management. METHODS: The Cancer Symptom Management System: SMILE was developed, and a nonblinded, randomized controlled trial was conducted. Cancer patients starting adjuvant or palliative chemotherapy (CTx) were enrolled and randomized to control (symptom monitoring), experimental 1 (Exp 1; symptom monitoring + report), or experimental 2 (Exp 2; symptom monitoring + report + Oncology Nursing Society putting evidence into practice (ONS PEP)-guided evidence-based symptom management education) groups in a 1:2:2 ratio (N = 249). To evaluate whether symptom management education provided additional benefit to continuous symptom monitoring, the Exp 1 and Exp 2 groups were compared utilizing Mann-Whitney U test and generalized estimating equations (n = 199). RESULTS: Symptom severity (symptom total score) at each measurement point was not different among the three groups (p > .05). Fatigue and sleep disturbance changes were different between Exp 1 and Exp 2 among patients receiving adjuvant CTx (p = .042 and p = .008). Fatigue gradually decreased after a peak at the 1st CTx cycle in Exp 2, whereas Exp 1 experienced increasing fatigue until the 3rd CTx cycle. A gradual decrease in sleep disturbance was observed in Exp 2 after the 2nd CTx cycle, whereas Exp 1 experienced a steady increase in the symptom. Participants were willing to participate in symptom monitoring using the cancer symptom management system. Symptom management education was easy to follow and helpful. CONCLUSION: The application of the Cancer Symptom Management System: SMILE incorporating ONS PEP-guided evidence-based symptom management education effectively managed fatigue and sleep disturbance after adjuvant CTx. The feasibility of the system has been demonstrated. Incorporating the system into electronic medical systems and integrating provider input will be necessary.

3.
Brachytherapy ; 14(4): 449-57, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25906951

RESUMO

PURPOSE: We performed a meta-analysis to compare the treatment outcomes between high-dose-rate (HDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for the treatment of cervical cancer. METHODS AND MATERIALS: We searched the PubMed database for articles and the related referenced articles that compared HDR-ICBT and LDR-ICBT. A total of 15 published articles, 3 prospective randomized trials, and 12 retrospective studies performed between 1966 and December 2013 were selected using predefined inclusion and exclusion criteria for each study. The effect sizes were obtained from the odds ratios of the 5-year overall survival, 5-year disease-free survival (DFS), pelvic (locoregional) recurrence, and rectal and bladder complication rates in each study. The common effect sizes and 95% confidence intervals (CIs) were calculated using either the fixed or the random-effect model, according to the results of the homogeneity tests. RESULTS: We analyzed the outcome data for 18,937 patients, including 10,807 patients in the HDR-ICBT treatment group and 8,130 patients in the LDR-ICBT group. The common effect sizes (95% CI) for the 5-year survival rate, 5-year DFS rate, and pelvic recurrence rate were 1.1350 (0.9231-1.3955), 1.0777 (0.4896-2.3720), and 0.9521 (0.7624-1.1890), respectively. The common effect sizes (95% CI) for moderate-to-severe complication rates of the rectum and the bladder were 0.7645 (0.5099-1.1463) and 0.9051 (0.6140-1.3342), respectively. There were no significant differences between HDR- and LDR-ICBT considering the 5-year survival, 5-year DFS, pelvic recurrence, and the rectal and bladder complication rates. CONCLUSION: The treatment outcome after HDR-ICBT seems to be equivalent to that following LDR-ICBT in terms of survival, pelvic recurrence, and major complications.


Assuntos
Braquiterapia/métodos , Neoplasias do Colo do Útero/radioterapia , Braquiterapia/efeitos adversos , Protocolos Clínicos , Intervalo Livre de Doença , Feminino , Humanos , Recidiva Local de Neoplasia/radioterapia , Órgãos em Risco/efeitos da radiação , Estudos Prospectivos , Lesões por Radiação/etiologia , Dosagem Radioterapêutica , Reto/efeitos da radiação , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Bexiga Urinária/efeitos da radiação
4.
BMC Public Health ; 14: 178, 2014 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-24548553

RESUMO

BACKGROUND: Type II diabetes is not only major public health problem but also heavy fiscal burden to each nation's health care system around the world. This study aimed to investigate the effect of early onset and pack-years of smoking on type II diabetes risk. METHODS: We used the most recent cross-sectional National Health and Nutrition Examination Survey set of South Korea (2010) and the United States (2009-2010). Participants who were diagnosed with diabetes after age 20 were included (South Korea: n = 7273, 44% male; U.S.: n = 3271, 52% male). Cox proportional models, stratified by sex and country, were used to estimate hazard ratios. RESULTS: 7.1% of South Korean men, 5.5% of South Korean women, 15.5% of U.S. men, and 12.4% of U.S. women had type II diabetes; 40% of South Korean men, 34% of U.S. men, and 21% of U.S. women began smoking before age 20 (57%, 49%, 36% of those who had type II diabetes, respectively). Type II diabetic participants were older and married; have a higher BMI, low income, and less education; lack moderate physical activity, smoked more and earlier compared to those without type II diabetes. Differences in risk factors including life-style behaviors and SES were found in both diabetic and non-diabetic populations. Men who began smoking before age 16 had a higher type II diabetes risk than who never smoked (South Korea: hazard ratio [HR] 2.46, 95% confidence interval [CI] 1.04-5.79; U.S.: HR 1.64, 95% CI 1.01-2.67), as did U.S. men who began smoking between 16 and 20 years (HR 1.58, 95% CI 1.05-2.37). Smoking pack-years were also associated with type II diabetes in U.S. men (HR 1.07, 95% CI 1.01-1.12). In women population, however, associations were not found. CONCLUSIONS: Early onset of smoking increases type II diabetic risk among men in South Korea and the U.S., and type II diabetic risk increases with higher pack-years in U.S. men, however, no associations were found in women population. Underage tobacco policy and education programs are strongly needed in both countries.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Estilo de Vida , Fumar/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diabetes Mellitus Tipo 2/etiologia , Feminino , Indicadores Básicos de Saúde , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia
5.
Health Policy ; 115(1): 92-9, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24365032

RESUMO

Limited healthcare resources make it necessary to maximize efficiency in disease management at the country level by priority-setting according to disease burden. To make the best priority settings, it is necessary to measure health status and have standards for its judgment, as well as consider disease management trends among nations. We used 17 International Classification of Diseases (ICD) categories of potential years of life lost (YPLL) from Organization for Economic Co-operation and Development (OECD) health data for 2012, 37 disease diagnoses YPLL from OECD health data for 2009 across 22 countries and disability-adjusted life years (DALY) from the World Health Organization (WHO). We set a range of 1-1 for each YPLL per disease in a nation (position value for relative comparison, PARC). Changes over 5 years were also accounted for in this disease management index (disease management index, DMI). In terms of ICD categories, the DMI indicated specific areas for priority setting for different countries with regard to managing disease treatment and diagnosis. Our study suggests that DMI is a realistic index that reflects trend changes over the past 5 years to the present state, and PARC is an easy index for identifying relative status. Moreover, unlike existing indices, DMI and PARC make it easy to conduct multiple comparisons among countries and diseases. DMI and PARC are therefore useful tools for policy implications and for future studies incorporating them and other existing indexes.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Prioridades em Saúde/organização & administração , Expectativa de Vida , Organização para a Cooperação e Desenvolvimento Econômico/estatística & dados numéricos , Política de Saúde , Prioridades em Saúde/estatística & dados numéricos , Humanos , Modelos Estatísticos , Formulação de Políticas , Anos de Vida Ajustados por Qualidade de Vida
6.
Asian Pac J Cancer Prev ; 14(7): 4141-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23991967

RESUMO

BACKGROUND: Mammography is considered the gold standard of breast cancer mass screening and many countries have implemented this as an established breast cancer screening strategy. However, although the incidence of breast cancer and racial characteristics are different between Western and Asian countries, many Asian countries adopted mammography for mass screening. Therefore, the objective of this research was to determine whether mammography mass screening is cost-effective for both Western and Asian countries. MATERIALS AND METHODS: A systematic review was performed of 17 national mammography cost-effectiveness data sets. Per capita gross domestic product (GDP), breast cancer incidence rate, and the most optimal cost- effectiveness results [cost per life year saved (LYS)] of a mammography screening strategy for each data set were extracted. The CE/per capita GDP ratio is used to compare the cost-effectiveness of mammography by countries. Non-parametric regression was used to find a cut-off point which indicated the breast cancer incidence rate boundary line determining whether mammography screening is cost-effective or not. RESULTS: We found that the cost-effective cut-off point of breast cancer incidence rate was 45.04; it exactly divided countries into Western and Asian countries (p<0.0014). CONCLUSIONS: Mammography screening is cost-effective in most of Western countries, but not in Asian countries. The reason for this result may be the issues of incidence rate or racial characteristics, such as dense breast tissue. The results indicate that mammography screening should be adopted prudently in Asian countries and other countries with low incidence rates.


Assuntos
Neoplasias da Mama/economia , Detecção Precoce de Câncer/economia , Mamografia/economia , Ásia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/prevenção & controle , Análise Custo-Benefício , Europa (Continente) , Feminino , Humanos , Prognóstico , Reino Unido , Estados Unidos
7.
PLoS One ; 8(12): e84876, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24386428

RESUMO

PURPOSE: Suicide is a major health problem in Korea. Extensive media exposure of celebrity suicide may induce imitative suicide, a phenomenon called the Werther effect. We examined the increased suicide risk following the suicides of an entertainer and a politician, and identified the relative suicide risks. METHODS: News articles about the celebrity suicides were obtained from three major newspapers and analysed for quantitative and qualitative features. Imitative suicide risk was investigated by applying a Poisson time series autoregression model with suicide mortality data from the National Statistics Office for 1.5 years before and 1.5 years after each celebrity's suicide. The period with a significantly increased number of suicides immediately after the celebrity's suicide determined the Werther effect band. The relative risk during this period was examined for different ages, genders, and suicide methods. RESULTS: News reports were more numerous and they contained more positive definitions about the entertainer's suicide. The risk of suicide deaths rose markedly after both celebrity suicides. However, the Werther effect band was longer for the entertainer (6 weeks) than for the politician (4 weeks). The relative suicide risk was significant for almost all ages and both genders during that of both individuals. Use of the same suicide method was a prominent risk factor after both celebrity suicides. CONCLUSIONS: Our results confirm the existence of imitative suicide behaviours, suggesting a facilitation effect of media reports. Guidelines for responsible media reporting need to be implemented to enhance public mental health in Korea.


Assuntos
Cura Mental , Modelos Biológicos , Suicídio/psicologia , Feminino , Humanos , Masculino , Jornais como Assunto , República da Coreia/epidemiologia , Fatores de Risco , Fatores de Tempo
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