PURPOSE: This study aims at identifying individual- and school-level factors associated with unintentional injuries to Korean adolescents at school by applying multilevel modeling. METHODS: From the database of the eleventh Korea Youth Risk Behavior Web-based Survey (KYRBS), the researchers selected 68,043 adolescents from the 7(th) to the 12(th) grades. Data were analyzed using χ² test for prevalence and multilevel modeling for related factors of unintentional injuries at school. RESULTS: About 22.9 percent of the adolescents had treatment experiences for unintentional injuries at school in the past 12 months. At the individual level, the significant factors associated with unintentional injuries at school included gender, grade, academic achievement, current smoking, alcohol consumption, frequency of high caffeine intake, depression, and relief of fatigue after sleep. At the group level, the significant factors included number of physical education per week and safety education. CONCLUSION: School based injury prevention programs should be sensitive to both individual- and school-level factors associated with unintentional injury at school among Korean adolescents.
Adolescent* ; Alcohol Drinking ; Caffeine ; Depression ; Education ; Fatigue ; Humans ; Korea ; Multilevel Analysis ; Physical Education and Training ; Prevalence ; Risk-Taking ; Smoke ; Smoking

PURPOSE: This study aimed to compare health risk behaviors among adolescents according to whether or not the parents were born in South Korea. METHODS: From the database of the ninth Korea Youth Risk Behavior Web-based Survey (KYRBS), the researchers classify adolescents into four groups: those whose parents were both native Korean, those whose mother only was a native Korean, those whose father only was a native Korean, and those whose parents were both foreign-born. Data were analyzed using chi2-test and multiple logistic regression with the SPSS/WIN 18.0 program. RESULTS: The adolescents with a foreign-born mother were less likely to smoke and drink alcohol than those with native Korean parents, but for other health risk behaviors the two groups were similar to each other. The adolescents with a foreign-born father were at a greater risk of drug use, intercourse, depression and violence at school than those with native Korean parents. The adolescents whose parents were born abroad were at a greater risk of smoking, drug use, intercourse, depression, suicidal ideation and violence at school than those with native Korean parents. CONCLUSION: Health promotion approaches differentiated by the type of multi-cultural family are needed in order to improve multi-cultural adolescents' health.
Adolescent* ; Cultural Diversity ; Depression ; Emigrants and Immigrants ; Fathers ; Health Behavior ; Health Promotion ; Humans ; Korea ; Logistic Models ; Mothers ; Parents ; Risk-Taking* ; Smoke ; Smoking ; Suicidal Ideation ; Violence

No abstract available.
Hemophilia A* ; Humans ; Intussusception*

Spontaneous pneumomediastinum in a term newborn without mechanical ventilation or underlying lung disease is rare. We present a case of a newborn baby who developed respiratory distress after birth and cystic pneumomediastinum which improved spontaneously with thymic hyperplasia as demonstrated on chest radiography, CT and MRI. The combination of cystic pneumomediastinum and thymic hyperplasia in a newborn has not been reported, thus far.
Humans ; Hyperplasia ; Infant, Newborn ; Lung Diseases ; Mediastinal Emphysema ; Parturition ; Respiration, Artificial ; Thorax ; Thymus Gland ; Thymus Hyperplasia

PURPOSE: The purpose of this study was to investigate factors associated with the intention to quit smoking in community-dwelling elderly smokers. METHODS: From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES-IV), the researchers selected 448 elderly smokers over the age of 65. Data were analyzed with the chi2 test and multiple logistic regression using the SPSS/WIN 18.0 program. RESULTS: Of the respondents, 45.5% intended to quit. The factors associated with the intention to quit were relative youth, having limit of activity day living and having past attempts to quit. CONCLUSION: Population-based smoking cessation programs, especially those targeted at the elderly, should take these predictors into consideration in the design of interventions.
Adolescent ; Aged ; Surveys and Questionnaires ; Humans ; Intention ; Logistic Models ; Nutrition Surveys ; Smoke ; Smoking ; Smoking Cessation

It is necessary to produce properly educated Manual Lymph Drainage (MLD) specialists conducted by certified instructors. This study was conducted to introduce a comprehensive understanding, application, historical background, and effect of the MLD and to present a basis for using the frequency MLD as a basic resource for training professional. MLD, a field of manual therapy, is used to treat a variety of diseases such as joint disease, circulatory system disease, lymphedema, and pain et al. However, since there is no proper education for MLD in Korea, there is a need to provide education that meets internationally accepted standards. The Physical Therapists Association and related academic societies will need to prepare a system to train specialists on MLD and to recognize medical insurance through it.

BACKGROUND: This study aims to analyze quality of and satisfaction with Korea medical services and identify factors affecting medical service satisfaction, revisit, and recommendation intention among international patients. METHODS: Secondary analysis of survey data conducted by Korea Health Industry Development Institute from June 10th to July 17th in 2013 was done using multiple regression and logistic regression analysis. The 191 international patients from 9 medical institutions in Seoul were enrolled. RESULTS: The results showed that international patients were satisfied with 85.6 points out of 100.0 points. International patients appraised higher in staff service rather than other services. Factors influencing medical service satisfaction were gender, religion, medical specialty, length of stay, and quality of medical services. Quality of medical service explained 29.8% of medical service satisfaction and especially, ‘doctor's care’ and ‘communication and patient respect‘ were significantly related to medical service satisfaction. Medical specialty had a significant influence on revisit intention. There were no statistically significant influencing factors of recommendation intention. Additionally, more satisfied patients were associated with higher revisit and recommendation intention. CONCLUSION: This study implies that quality of medical services is a critical factor for patient satisfaction and that satisfaction with medical services is an important factor for increasing revisit and recommendation intention among international patients. In addition, health care providers should consider cultural differences to enhance satisfaction with medical services for international patients. Therefore, multidimensional strategy is required to strengthen the cultural competency of healthcare providers.
Cultural Competency ; Health Personnel ; Health Services ; Humans ; Intention* ; Korea* ; Length of Stay ; Logistic Models ; Patient Satisfaction ; Seoul

PURPOSE: This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group. METHODS: Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons. RESULTS: Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower postanalgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase. CONCLUSION: The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.
Analgesia ; Analgesia, Epidural ; Anxiety ; Cervix Uteri ; Female ; Labor Pain ; Labor Stage, First ; Pain Measurement ; Pregnancy ; Sweat ; Sweating

H-type tracheoesophageal fistula (TEF) is extremely rare in infants and children, and clinical manifestations of this condition are diverse based on its severity. Some cases of congenital TEF diagnosed in adulthood have been reported, which indicate the difficulty of early diagnosis of this disease. Gastroesophageal reflux (GER) may induce chronic aspiration, pulmonary aspiration, apparent life-threatening events, and failure to thrive. We report a 5-month- old boy whose recurrent pneumonia and wheezing did not improve under usual treatment and led to acute respiratory distress syndrome. He was found to have severe GER on the second-trial of the esophagogram and was eventually revealed to have congenital H-type TEF upon repeated evaluation.
Child ; Early Diagnosis ; Failure to Thrive ; Gastroesophageal Reflux ; Humans ; Infant ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Respiratory Sounds ; Tracheoesophageal Fistula

PURPOSE: A prospective, controlled trial was conducted to evaluate growth, efficacy, safety and nutritional status for very low birth weight infants fed with human milk fortified with Maeil human milk fortifier (Maeil HMF(R); Maeil Dairies Co., Ltd.). METHODS: We enrolled 45 premature infants with a birth weight <1,500 g and gestational age <33 weeks, who were born at Dong-A University Hospital from October, 2006 through December, 2007. They were divided into 2 groups: infants in one group were fed with human milk fortified with HMF(R), and the second were fed with preterm formula. Growth, biochemical indices, feeding tolerance, and other adverse events in each group were assessed serially and compared relatively. Follow-up data were also collected after discharge at 1, 3, and 6 months corrected age. RESULTS: Characteristics of the 2 groups including average gestational age, birth weight, sex, respiratory distress syndrome, patent ductus arteriosus, and other adverse events (sepsis, retinopathy of prematurity, and intraventricular hemorrhage) showed no significant difference. Average feeding start day (8.00+/-3.27 d vs. 8.86+/-5.37 d) (P=0.99) and the number of days required to reach full feeding after start feeding (41.78+/-20.47 d vs 36.86+/-20.63 d) (P=0.55) were not significantly different in the group fed human milk fortified with HMF(R) when compared with the group that was fed preterm formula. The duration of total parenteral nutrition and the incidence of feeding intolerance also showed no differences between the 2 groups. Although infants fed with human milk fortified with HMF(R) showed faster weight gain than those fed with preterm formula at the end stage of the admission period, other growth indices of the two groups showed no significant difference. No significant correlations were found between the 2 groups with regard to weight gain velocity, height gain velocity, head circumference velocity, and post- discharge follow up growth indices. CONCLUSION: Premature infants fed human milk fortified with HMF(R) showed no significant difference compared with those fed preterm formula in growth, biochemical indices, and adverse events. Using human milk fortifier can be an alternative choice for very low birth weight infants, who need high levels nutritional support even after discharge from NICU.
Birth Weight ; Ductus Arteriosus, Patent ; Follow-Up Studies ; Gestational Age ; Head ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Milk, Human ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition, Total ; Prospective Studies ; Retinopathy of Prematurity ; Weight Gain