1. Local Governance for COVID-19Response of Daegu Metropolitan City
Kyeong-Soo LEE ; Jung Jeung LEE ; Keon-Yeop KIM ; Jong-Yeon KIM ; Tae-Yoon HWANG ; Nam-Soo HONG ; Jun Hyun HWANG ; Jaeyoung HA
Journal of Agricultural Medicine & Community Health 2024;49(1):13-36
Objectives:
The purpose of this field case report is 1) to analyze the community's strategy and performance in responding to infectious diseases through the case of COVID-19 infectious disease crisis response of Daegu Metropolitan City, and 2) to interpret this case using governance theory and infectious disease response governance framework. and 3) to propose a strategic model to prepare for future infectious disease outbreaks of the community.
Methods:
Cases of Daegu Metropolitan City's infectious disease crisis response were analyzed through researchers' participatory observations. And review of OVID-19 White Paper of Daegu Metropolitan City, Daegu Medical Association's COVID-19 White Paper, and literature review of domestic and international governance, and administrative documents.
Results:
Through the researcher's participatory observation and literature review, 1) establishment of leadership and response system to respond to the infectious disease crisis in Daegu Metropolitan City, 2) citizen’s participation and communication strategy through the pan-citizen response committee, 3) cooperation between Daegu Metropolitan City and governance of public-private medical facilities, 4) decision-making and crisis response through participation and communication between the Daegu Metropolitan City Medical Association, Medi-City Daegu Council, and medical experts of private sector, 5) symptom monitoring and patient triage strategies and treatment response for confirmed infectious disease patients by member of Daegu Medical Association, 6) strategies and implications for establishing and utilizing a local infectious disease crisis response information system were derived.
Conclusions
The results of the study empirically demonstrate that collaborative governance of the community through the participation of citizens, private sector experts, and community medical facilities is a key element for effective response to infectious disease crises.
2.Effect of the Community-Based Chronic Disease Management Service Using Information and Communication Technology
Eun Jin PARK ; Yun Su LEE ; Tae Yon KIM ; Seung Hee YOO ; Hye Ran JIN ; Noor Afif MAHMUDAH ; MinSu OCK ; Tae-Yoon HWANG ; Yeong Mi KIM ; Jung Jeung LEE
Journal of Agricultural Medicine & Community Health 2024;49(3):257-270
Objective:
This study aimed to empirically evaluate the effectiveness of chronic disease management services utilizing ICT for patients with chronic illnesses.
Methods:
From May to December, 2023, 452 people who were diagnosed with hypertension and diabetes at 9 participating public health centers were provided with customized health care services for 24 weeks, and 15 performance indicators were analyzed to evaluate their effectiveness.
Results:
Health behavior indicators and health risk factors decreased before and after participation in the project, blood pressure control rate, hypertension and diabetes management rate, medication compliance, weight, BMI, BP, WC, FBG, and HDL-cholesterol improved(p<0.001).Service factors that influence the improvement of health behaviors included the number of activity monitor transmissions(p=0.049), confirmed concentrated consultations on physical activity(p=0.003) and nutrition(p=0.005), and the adherence to medication missions for hypertension(p=0.020).As for service factors influencing chronic disease management, the improvement in blood pressure regulation rate was due to the number of times the blood pressure monitor was linked(p=0.004), and the number of confirmed intensive consultations on physical activity(p=0.026), and nutrition(p=0.049); the improvement in hypertension control rate was due to the number of times the activity monitor and blood pressure monitor were linked(p<0.001), and the number of hypertension medication missions carried out (p=0.004); and the improvement in diabetes control rate was due to the number of times the blood pressure monitor(p=0.022) and blood sugar system were linked(p=0.017).
Conclusion
Although this study has limitations as a comparative study before and after the service, it has proved that chronic disease management using ICT has a positive effect on improvement of health behavior indicator, reduction of health risk factors, hypertension, diabetes management index, weight, BMI, TG, BP, FBG improvement.
3. Local Governance for COVID-19Response of Daegu Metropolitan City
Kyeong-Soo LEE ; Jung Jeung LEE ; Keon-Yeop KIM ; Jong-Yeon KIM ; Tae-Yoon HWANG ; Nam-Soo HONG ; Jun Hyun HWANG ; Jaeyoung HA
Journal of Agricultural Medicine & Community Health 2024;49(1):13-36
Objectives:
The purpose of this field case report is 1) to analyze the community's strategy and performance in responding to infectious diseases through the case of COVID-19 infectious disease crisis response of Daegu Metropolitan City, and 2) to interpret this case using governance theory and infectious disease response governance framework. and 3) to propose a strategic model to prepare for future infectious disease outbreaks of the community.
Methods:
Cases of Daegu Metropolitan City's infectious disease crisis response were analyzed through researchers' participatory observations. And review of OVID-19 White Paper of Daegu Metropolitan City, Daegu Medical Association's COVID-19 White Paper, and literature review of domestic and international governance, and administrative documents.
Results:
Through the researcher's participatory observation and literature review, 1) establishment of leadership and response system to respond to the infectious disease crisis in Daegu Metropolitan City, 2) citizen’s participation and communication strategy through the pan-citizen response committee, 3) cooperation between Daegu Metropolitan City and governance of public-private medical facilities, 4) decision-making and crisis response through participation and communication between the Daegu Metropolitan City Medical Association, Medi-City Daegu Council, and medical experts of private sector, 5) symptom monitoring and patient triage strategies and treatment response for confirmed infectious disease patients by member of Daegu Medical Association, 6) strategies and implications for establishing and utilizing a local infectious disease crisis response information system were derived.
Conclusions
The results of the study empirically demonstrate that collaborative governance of the community through the participation of citizens, private sector experts, and community medical facilities is a key element for effective response to infectious disease crises.
4.Effect of the Community-Based Chronic Disease Management Service Using Information and Communication Technology
Eun Jin PARK ; Yun Su LEE ; Tae Yon KIM ; Seung Hee YOO ; Hye Ran JIN ; Noor Afif MAHMUDAH ; MinSu OCK ; Tae-Yoon HWANG ; Yeong Mi KIM ; Jung Jeung LEE
Journal of Agricultural Medicine & Community Health 2024;49(3):257-270
Objective:
This study aimed to empirically evaluate the effectiveness of chronic disease management services utilizing ICT for patients with chronic illnesses.
Methods:
From May to December, 2023, 452 people who were diagnosed with hypertension and diabetes at 9 participating public health centers were provided with customized health care services for 24 weeks, and 15 performance indicators were analyzed to evaluate their effectiveness.
Results:
Health behavior indicators and health risk factors decreased before and after participation in the project, blood pressure control rate, hypertension and diabetes management rate, medication compliance, weight, BMI, BP, WC, FBG, and HDL-cholesterol improved(p<0.001).Service factors that influence the improvement of health behaviors included the number of activity monitor transmissions(p=0.049), confirmed concentrated consultations on physical activity(p=0.003) and nutrition(p=0.005), and the adherence to medication missions for hypertension(p=0.020).As for service factors influencing chronic disease management, the improvement in blood pressure regulation rate was due to the number of times the blood pressure monitor was linked(p=0.004), and the number of confirmed intensive consultations on physical activity(p=0.026), and nutrition(p=0.049); the improvement in hypertension control rate was due to the number of times the activity monitor and blood pressure monitor were linked(p<0.001), and the number of hypertension medication missions carried out (p=0.004); and the improvement in diabetes control rate was due to the number of times the blood pressure monitor(p=0.022) and blood sugar system were linked(p=0.017).
Conclusion
Although this study has limitations as a comparative study before and after the service, it has proved that chronic disease management using ICT has a positive effect on improvement of health behavior indicator, reduction of health risk factors, hypertension, diabetes management index, weight, BMI, TG, BP, FBG improvement.
5. Local Governance for COVID-19Response of Daegu Metropolitan City
Kyeong-Soo LEE ; Jung Jeung LEE ; Keon-Yeop KIM ; Jong-Yeon KIM ; Tae-Yoon HWANG ; Nam-Soo HONG ; Jun Hyun HWANG ; Jaeyoung HA
Journal of Agricultural Medicine & Community Health 2024;49(1):13-36
Objectives:
The purpose of this field case report is 1) to analyze the community's strategy and performance in responding to infectious diseases through the case of COVID-19 infectious disease crisis response of Daegu Metropolitan City, and 2) to interpret this case using governance theory and infectious disease response governance framework. and 3) to propose a strategic model to prepare for future infectious disease outbreaks of the community.
Methods:
Cases of Daegu Metropolitan City's infectious disease crisis response were analyzed through researchers' participatory observations. And review of OVID-19 White Paper of Daegu Metropolitan City, Daegu Medical Association's COVID-19 White Paper, and literature review of domestic and international governance, and administrative documents.
Results:
Through the researcher's participatory observation and literature review, 1) establishment of leadership and response system to respond to the infectious disease crisis in Daegu Metropolitan City, 2) citizen’s participation and communication strategy through the pan-citizen response committee, 3) cooperation between Daegu Metropolitan City and governance of public-private medical facilities, 4) decision-making and crisis response through participation and communication between the Daegu Metropolitan City Medical Association, Medi-City Daegu Council, and medical experts of private sector, 5) symptom monitoring and patient triage strategies and treatment response for confirmed infectious disease patients by member of Daegu Medical Association, 6) strategies and implications for establishing and utilizing a local infectious disease crisis response information system were derived.
Conclusions
The results of the study empirically demonstrate that collaborative governance of the community through the participation of citizens, private sector experts, and community medical facilities is a key element for effective response to infectious disease crises.
6.Effect of the Community-Based Chronic Disease Management Service Using Information and Communication Technology
Eun Jin PARK ; Yun Su LEE ; Tae Yon KIM ; Seung Hee YOO ; Hye Ran JIN ; Noor Afif MAHMUDAH ; MinSu OCK ; Tae-Yoon HWANG ; Yeong Mi KIM ; Jung Jeung LEE
Journal of Agricultural Medicine & Community Health 2024;49(3):257-270
Objective:
This study aimed to empirically evaluate the effectiveness of chronic disease management services utilizing ICT for patients with chronic illnesses.
Methods:
From May to December, 2023, 452 people who were diagnosed with hypertension and diabetes at 9 participating public health centers were provided with customized health care services for 24 weeks, and 15 performance indicators were analyzed to evaluate their effectiveness.
Results:
Health behavior indicators and health risk factors decreased before and after participation in the project, blood pressure control rate, hypertension and diabetes management rate, medication compliance, weight, BMI, BP, WC, FBG, and HDL-cholesterol improved(p<0.001).Service factors that influence the improvement of health behaviors included the number of activity monitor transmissions(p=0.049), confirmed concentrated consultations on physical activity(p=0.003) and nutrition(p=0.005), and the adherence to medication missions for hypertension(p=0.020).As for service factors influencing chronic disease management, the improvement in blood pressure regulation rate was due to the number of times the blood pressure monitor was linked(p=0.004), and the number of confirmed intensive consultations on physical activity(p=0.026), and nutrition(p=0.049); the improvement in hypertension control rate was due to the number of times the activity monitor and blood pressure monitor were linked(p<0.001), and the number of hypertension medication missions carried out (p=0.004); and the improvement in diabetes control rate was due to the number of times the blood pressure monitor(p=0.022) and blood sugar system were linked(p=0.017).
Conclusion
Although this study has limitations as a comparative study before and after the service, it has proved that chronic disease management using ICT has a positive effect on improvement of health behavior indicator, reduction of health risk factors, hypertension, diabetes management index, weight, BMI, TG, BP, FBG improvement.
7.Treatment and Prognosis for Tumors of the Foot and Ankle
Seung Soo HAN ; Jeung Il KIM ; Tae Sik GOH ; Seung Hun WOO ; Ji Youn KIM
Journal of Korean Foot and Ankle Society 2024;28(2):55-59
Purpose:
Tumors of the foot and ankle account for approximately 3%~5% of all musculoskeletal tumors, and accurate diagnosis is often delayed due to their rare prevalence. Therefore, the authors aimed to analyze the incidence, treatment methods, and prognostic factors of foot and ankle tumors treated at the authors’ hospital.
Materials and Methods:
A retrospective single-center study examined 342 patients treated for foot and ankle tumors at the authors’ hospital from January 2011 to February 2022. Data were collected from the electronic medical records (EMR) and picture archiving and communication systems (PACS). The information analyzed included gender, age, follow-up period, diagnosis, tumor occurrence and recurrence, treatment, and clinical outcomes.
Results:
Most cases (93.3%) were benign, but 6.7% were malignant. The main treatment for malignant tumors was surgical resection (91.3%). Approximately 53.1% of benign tumors and 91.3% of malignant tumors were treated with surgery, and two of the malignant tumors that did not undergo surgery had metastatic cancer. After surgery, 8.2% of benign lesions and 19.0% of malignant lesions recurred, and 9.5% of the patients with malignant tumors died after surgery.
Conclusion
Most foot and ankle tumors are benign tumors, and the prognosis is not poor if treated properly, but most malignant tumors often require amputation. In some cases, however, amputation can be avoided with a combination of chemotherapy and radiation therapy.
8.Outcomes of Endoscopic Resection for Early Gastric Cancer in Very Elderly Patients: A Nationwide Population-Based Study
Tae Jun KIM ; Jeung Hui PYO ; Hyuk LEE ; Sung Chul CHOI ; Yang Won MIN ; Byung-Hoon MIN ; Jun Haeng LEE ; Poong-Lyul RHEE ; Minku SONG ; Yoon-Ho CHOI ; Jae J. KIM
Gut and Liver 2023;17(4):529-536
Background/Aims:
Few studies have investigated the long-term outcomes of endoscopic resection for early gastric cancer (EGC) in very elderly patients. The aim of this study was to determine the appropriate treatment strategy and identify the risk factors for mortality in these patients.
Methods:
Patients with EGC who underwent endoscopic resection from 2006 to 2017 were iden-tified using National Health Insurance Data and divided into three age groups: very elderly (≥85 years), elderly (65 to 84 years), and non-elderly (≤64 years). Their long- and short-term outcomes were compared in the three age groups, and the survival in the groups was compared with that in the control group, matched by age and sex. We also evaluated the risk factors for long- and short-term outcomes.
Results:
A total of 8,426 patients were included in our study: 118 very elderly, 4,583 elderly, and 3,725 non-elderly. The overall survival and cancer-specific survival rates were significantly lower in the very elderly group than in the elderly and the non-elderly groups. Congestive heart failure was negatively associated with cancer-specific survival. A significantly decreased risk for mortality was observed in all groups (p<0.001). The very elderly group had significantly higher readmission and mortality rates within 3 months of endoscopic resection than the non-elderly and elderly groups. Furthermore, the cerebrovascular disease was associated with mortality within 3 months after endoscopic resection.
Conclusions
Endoscopic resection for EGC can be helpful for very elderly patients, and it may play a role in achieving overall survival comparable to that of the control group.
9.Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample
Jina HAN ; Hye Jin BAEK ; Eunbi NOH ; Kyuhyun YOON ; Jung Ae KIM ; Sukhyun RYU ; Kay O LEE ; No Yai PARK ; Eunok JUNG ; Sangil KIM ; Hyukmin LEE ; Yoo-Sung HWANG ; Jaehun JUNG ; Hun Jae LEE ; Sung-il CHO ; Sangcheol OH ; Migyeong KIM ; Chang-Mo OH ; Byengchul YU ; Young-Seoub HONG ; Keonyeop KIM ; Sunjae JUNG ; Mi Ah HAN ; Moo-Sik LEE ; Jung-Jeung LEE ; Young HWANGBO ; Hyeon Woo YIM ; Yu-Mi KIM ; Joongyub LEE ; Weon-Young LEE ; Jae-Hyun PARK ; Sungsoo OH ; Heui Sug JO ; Hyeongsu KIM ; Gilwon KANG ; Hae-Sung NAM ; Ju-Hyung LEE ; Gyung-Jae OH ; Min-Ho SHIN ; Soyeon RYU ; Tae-Yoon HWANG ; Soon-Woo PARK ; Sang Kyu KIM ; Roma SEOL ; Ki-Soo PARK ; Su Young KIM ; Jun-wook KWON ; Sung Soon KIM ; Byoungguk KIM ; June-Woo LEE ; Eun Young JANG ; Ah-Ra KIM ; Jeonghyun NAM ; ; Soon Young LEE ; Dong-Hyun KIM
Epidemiology and Health 2023;45(1):e2023075-
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.
10.Evaluation of the Public Health Emergency Response to the COVID-19 Pandemic in Daegu, Korea During the First Half of 2020
Hwajin LEE ; Keon-Yeop KIM ; Jong-Yeon KIM ; Sin KAM ; Kyeong Soo LEE ; Jung Jeung LEE ; Nam Soo HONG ; Tae-Yoon HWANG
Journal of Preventive Medicine and Public Health 2022;55(4):360-370
Objectives:
This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model.
Methods:
After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu’s responses were organized into 4 phases and evaluated by applying the response model.
Results:
In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation–based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing.
Conclusions
This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.

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