OBJECTIVES: This study investigates whether Korean news media pay more attention to emerging diseases than chronic ones, and whether they closely follow the changes in the magnitude of health risks of chronic or well-known diseases. These two features are expected to appear as the result of surveillance function served by health journalism that should be the main source of the public's risk perception. METHODS: The number of stories published in 10 newspapers containing the words, 'SARS,' 'Bovine Spongiform Encephalopathy,' 'Avian Influenza,' and 'Influenza A virus' was compared with the number of stories on chronic or well-known diseases. We also counted the annual number of stories, published in a 12-year period, containing following terms: 'cancer,' 'diabetes,' 'hypertension,' 'pneumonia,' and 'tuberculosis.' The number was compared with the actual mortality of each disease. RESULTS: Although cancer represented the primary cause of mortality, the newspapers covered key emerging diseases more than cancer or other well-known diseases. Also, media coverage of 'pneumonia' and 'tuberculosis' did not vary in accordance with changes in the mortality of each disease. However, the news media coverage did vary in accordance with the mortality of 'cancer,' 'diabetes,' and 'hypertension.' CONCLUSIONS: Korean health journalism was found to have both strong and weak points. The news media reduced the relative level of attention given to pneumonia and tuberculosis. Bearing in mind the major influence of news coverage on risk perception, health professionals need to be more proactive about helping to improve Korean health journalism.
*Access to Information ; Bibliometrics ; *Chronic Disease ; *Disease Outbreaks ; Humans ; *Journalism, Medical ; Newspapers ; Population Surveillance ; Public Health ; Republic of Korea ; *Risk Assessment

OBJECTIVES: This report describes the results of an investigation on an outbreak of novel influenza A (H1N1) in an English language Institute in Seoul, Korea in May 2009. METHODS: In this outbreak, novel influenza A (H1N1) was confirmed in 22 of 91 trainees, trainers and staff members. The trainees and 2 staff members were isolated in an assigned facility and the rest were isolated in their homes after we discovered the first patient with novel influenza A (H1N1). After the isolation, the people in the assigned facility were educated to use N95 respirators and they received oseltamivir for prophylaxis. RESULTS: The initial findings in this study suggest that the symptoms were mild and similar to those of seasonal influenza. The classmates and roommates of the infected patients were more likely to get infected with novel influenza A (H1N1) than the trainees who were not classmates or roommates of the patients (OR: 3.19, 95% CI=0.91 - 11.11 for classmates and OR: 40.0, 95% CI=7.4-215.7 for roommates). CONCLUSIONS: The public health response seems successful in terms of preventing the spread of this virus into the local community.
Adult ; *Disease Outbreaks ; Humans ; Influenza A Virus, H1N1 Subtype/*isolation & purification ; Influenza, Human/diagnosis/drug therapy/*epidemiology/physiopathology ; Republic of Korea/epidemiology ; *Schools ; Young Adult

OBJECTIVES: Due to the economic crisis and globalization, many workers have been suffering from severe occupational stress due to job insecurity and struggles related to downsizing and restructuring. This study aims to assess the stress levels among workers involved in fierce labor disputes and massive layoffs and to evaluate their specific needs and satisfaction with counseling services set up to help workers cope with severely stressful situations? METHODS: The authors provided crisis intervention to workers in traumatic situations to compare the differential level of stress responses and needs among the workers remaining employed in a large auto factory, those laid off by it, and those laid off by other companies in the same region (Pyeongtaek, Gyeonggi Province). We measured stress levels using the worker's stress response inventory (WSRI) and heart rate variability (HRV), and assessed workers' satisfaction with the counseling services. RESULTS: 502 workers participated in the program. Fifty-seven percent of them consulted with occupational problems. The mean WSRI score of the workers remaining employed in the automobile factory was higher than that of the unemployed (employed: 39.8+/-19.9, unemployed: 29.3+/-18.8). Ninety-five percent of workers responded that they were satisfied or very satisfied with the counseling services. CONCLUSIONS: This study suggests the urgent need for the establishment of a national crisis intervention program dedicated to supporting workers in severely stressful situations.
Adult ; *Crisis Intervention ; Employment/*psychology ; Female ; Humans ; Industry ; *Labor Unions ; Male ; Middle Aged ; *Negotiating ; Occupational Health Services ; Questionnaires ; Republic of Korea ; Severity of Illness Index ; Stress, Psychological/*therapy ; Young Adult

OBJECTIVES: An accurate estimation of cancer patients is the basis of epidemiological studies and health services. However in Korea, cancer patients visiting out-patient clinics are usually ruled out of such studies and so these studies are suspected of underestimating the cancer patient population. The purpose of this study is to construct a more complete, hospital-based cancer patient registry using multiple sources of medical information. METHODS: We constructed a cancer patient detection algorithm using records from various sources that were obtained from both the in-patients and out-patients seen at Asan Medical Center (AMC) for any reason. The medical data from the potentially incident cancer patients was reviewed four months after first being detected by the algorithm to determine whether these patients actually did or did not have cancer. RESULTS: Besides the traditional practice of reviewing the charts of in-patients upon their discharge, five more sources of information were added for this algorithm, i.e., pathology reports, the national severe disease registry, the reason for treatment, prescriptions of chemotherapeutic agents and radiation therapy reports. The constructed algorithm was observed to have a PPV of 87.04%. Compared to the results of traditional practice, 36.8% of registry failures were avoided using the AMC algorithm. CONCLUSIONS: To minimize loss in the cancer registry, various data sources should be utilized, and the AMC algorithm can be a successful model for this. Further research will be required in order to apply novel and innovative technology to the electronic medical records system in order to generate new signals from data that has not been previously used.
Adult ; Female ; Hospitals ; Humans ; Male ; *Medical Records ; Middle Aged ; Neoplasms/*diagnosis ; Organizational Case Studies ; *Program Development ; *Registries ; Republic of Korea

OBJECTIVES: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. METHODS: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). RESULTS: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI=0.43-0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb> or =11 g/dL, blood pressure within the range of 100-140/60-90 mmHg, calcium x phosphate< or =55 g2/dL2 and albumin> or =4 g/dL were not significantly different between the groups. CONCLUSIONS: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.
Aged ; Female ; Humans ; Insurance, Health/*classification ; Male ; Medical Audit ; Middle Aged ; *Quality Indicators, Health Care ; *Quality of Health Care ; Renal Dialysis/*standards ; Republic of Korea

OBJECTIVES: To examine the prophylactic antibiotic use in reducing surgical site infection. METHODS: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. RESULTS: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. CONCLUSIONS: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.
Adolescent ; Adult ; Antibiotic Prophylaxis/*standards ; Female ; Humans ; Male ; *Quality Indicators, Health Care ; Republic of Korea ; Retrospective Studies ; Surgical Wound Infection/*prevention & control ; Young Adult

OBJECTIVES: Limited research has investigated the specific needs of patients with cancer. This study was performed to explore patients needs and the related factors. METHODS: The data were collected by 1 National Cancer Center and 9 regional cancer centers in Korea. An interview survey was performed with using a structured questionnaire for the subjects(2661 patients who gave written informed consent to particiate) survey 4 months after diagnosis and review of medical records. Data were analyzed using t-test, ANOVA and multiple regression analysis. RESULTS: When comparing the relating factors related with patient needs to the sociodemographic characteristics, the female group showed a higher level of recognition for physical symptoms, social support needs. The younger group showed a significantly higher level of recognition for health care staff, psychological problems, information and education, social support, hospital services needs. In addition, the higher educated group showed a higher level of recognition for health care staff, physical symptoms, social support needs. The higher income and office workers group showed a higher level of recognition for hospital services needs. When comparing the relating factors related with patient needs to the cancer, the breast cancer group showed a higher level of recognition for all needs excluding physical symptoms, accessibility and financial support needs. The combined radiotherapy with surgery and chemotherapy group showed a higher level of recognition for psychological problems, information and education, social support needs. CONCLUSIONS: This study showed that needs on patient with cancer was significantly influenced by female, higher educagion, lower income, having religion, office worker, liver cancer, breast cancer, colon cancer, chemotherapy, and combined therapy.
Adult ; Female ; *Health Services Needs and Demand ; Humans ; Interviews as Topic ; Male ; Medical Audit ; Middle Aged ; Neoplasms/classification/psychology/*therapy ; Regression Analysis ; Republic of Korea

OBJECTIVES: Plasma lipid profiles and Apolipoprotein E (ApoE) are established risk factors for cardiovascular disease (CVD). The knowledge of lipid profile may estimate the potential victims of cardiovascular disease before its initiation and progression and offers the opportunity for primary prevention. The most common ApoE polymorphism has been found to influence plasma lipid concentrations and its correlation with CVD has been extensively investigated in the last decade. METHODS: The ApoE polymorphism and its influence on plasma lipid were investigated in healthy woman workers. The information on confounding factors was obtained through a self-administered questionnaire and ApoE polymorphism was investigated using PCR. RESULTS: The relative frequencies of alleles E2, E3 and E4 for the study population (n=305) were 0.127, 0.750 and 0.121, respectively. ApoE polymorphism was associated with variations in plasma HDL-cholesterol lipid profile. In order to estimate the independent effects of alleles E2 and E4, as compared with E3, on lipid profile, multiple regression was performed after adjustment for confounding variables such as age, BMI, blood pressure, education status, insulin, fasting glucose, HOMA-IR, menopause. ApoE2 had a negative association with HDL cholesterol and ApoE4 had a positive association with LDL cholesterol. CONCLUSIONS: This study identified that the ApoE and CVD risk factors contribute to the lipid profiles, similar to other studies. The analysis including dietary intake and other gene in further studies may help to identify clear effects on lipid profiles as risk factor for CVD.
Adult ; Apolipoproteins E/blood/*genetics/metabolism ; Cardiovascular Diseases/epidemiology/prevention & control ; Cholesterol, HDL/genetics ; Female ; *Genotype ; Humans ; Lipid Metabolism/*genetics ; Polymerase Chain Reaction ; Primary Prevention

OBJECTIVES: The prevalence of work-related musculoskeletal symptoms (WMS) among Korean dairy farmers has not been investigated. The purpose of this study was to assess the prevalence of WMS and to evaluate the relationship between WMS and risk factors. METHODS: Self-developed questionnaires including the questionnaire developed by the Korean Occupational Safety and Health agency (KOSHA) were used to investigate WMS among dairy farmers in Gyeonggi Province, Korea. We informed selected dairy farmers about the study and sent the questionnaires by registered mail. They visited a public health center nearby or a branch of public health center on the appointed date and skillful researchers identified or conducted the questionnaires by interview. We analyzed 598 (32.8%) of the 1824 dairy farmers. Multiple logistic regression was implemented to estimate the odds ratios of risk factors. RESULTS: The mean age of the respondents was 50.4 +/- 8.7 years and the proportion of males was 63.0%. The prevalence of WMS at any site was 33.3%. The prevalence of neck WMS was 2.2%, shoulders 10.0%, arms/elbows 5.0%, hands/wrists/fingers 4.2%, low back 11.5%, and legs/feet 11.7%. The adjusted odds ratio of low back WMS for milking 4 or more hours per day was 4.231 (95% CI = 1.124 - 15.932) and statistically significant. Low back WMS (2.827, 95% CI = 1.545 - 5.174) was significantly decreased by education. CONCLUSIONS: Low back WMS increased with milking hours and milking 4 or more hours per day was significantly associated with low back WMS. Low back WMS was significantly reduced with education. We hope that there will be increased attention about WMS in dairy farmers and the subject of future investigations.
Adult ; Animals ; Cattle ; *Dairying ; Female ; Health Surveys ; Humans ; Male ; Middle Aged ; Musculoskeletal Diseases/epidemiology/etiology/*physiopathology ; Occupational Exposure/*adverse effects ; Republic of Korea/epidemiology ; Risk Factors

OBJECTIVES: The objective of this study was to analyze the causal relationship between smoking and depression using longitudinal data. METHODS: Two waves of the Korea Welfare Panel collected in 2006 and 2007 were used. The sample consisted of 14 426 in 2006 and 13 052 in 2007 who were aged 20 and older. Smoking was measured by smoking amount (none/ or = two packs). Depression was defined when the summated CESD (center for epidemiological studies depression)-11 score was greater than or equal to 16. The causal relationship between smoking and depression was tested using logistic regression. In order to test the causal effect of smoking on depression, depression at year 2 was regressed on smoking status at year 1 only using the sample without depression at year 1. Likewise, smoking status at year 2 was regressed on depression at year 1 only using those who were not smoking at year 1 in order to test the causal effect of depression on smoking. The statistical package used was Stata 10.0. Sampling weights were applied to obtain the population estimation. RESULTS: The logistic regression testing for the causal relationship between smoking and depression showed that smoking at year 1 was significantly related to depression at year 2. Smoking amounts associated with depression were different among age groups. On the other hand, the results from the logistic regression testing for the opposite direction of the relationship between smoking and depression found no significant association regardless of age group. CONCLUSIONS: The study results showed some evidence that smoking caused depression but not the other way around.
Adult ; Aged ; Causality ; Depression/epidemiology/*etiology ; Female ; Health Surveys ; Humans ; Logistic Models ; Longitudinal Studies ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Smoking/*psychology ; Young Adult