This study was designed to estimate the improvement of Validity for food frequency questionnaire(FFQ) by offering multiple choice portion size in developing a questionnaire. Validity of the two methods(food frequency questionnaire I=FFQ I & Food frequency questionnaire II=FFQ II) was tested in comparison with reference method of the 7-day weighed record(7DWR). Dietary consumption data of the thred methods(FFQ I, FFQ II & 7DWR) were colleced from 101 female university students for the analysis. Validity was measured in two categories : One was the nutrient intake value from the three methods, the other was the identification of between individual variation within the group. Spearman's rank order correlation test and distributio graphs were used for the analysis. The result showed that individual intake value of the FFQ II was closer to that of the 7DWR than that of the FFQ I.Spearman's rank order correlation between the FFQ II and the 7DWR did not show any improved correlation. The distribution graphs of nutrient intake derived from both the FFQ I and the FFQ II were different from that of the 7DWR. Therefore, it could be sugested that single one protion size food frequency questionnaire is an equally efficient method as a multiple choice food frequency questionnaire to be adopted in epidemiologic studies.
Epidemiologic Studies ; Female ; Humans ; Portion Size* ; Surveys and Questionnaires

OBJECTIVE: As the accelerated development and use of Electronic Health Record have grown exponentially, the possible disclosure of patient healthcare information is increased. The purpose of this study is to examine the perception gap on disclosure of EHR information among the patient/guardian group, healthcare provider group, and administration group. METHODS: A questionnaire survey from a hospital located in Incheon City of Korea was conducted and over 200 responses were collected. Outcome measures include healthcare information protection, disclosure of unidentifiable information, possible losses from the disclosure of healthcare information, and the ownership of healthcare information. RESULTS: Regarding healthcare information protection, three groups have a general consensus over some issues. In contrast, the healthcare providers and the administration group have a higher consideration regarding possible losses resulting from the disclosure of healthcare information than the patient group. In addition, the healthcare provider group considered the ownership of healthcare information to belong to the hospital in contrast with the patients' view that the ownership and disclosure rights belong to the patient. CONCLUSION: These findings indicate that the high level of interest and concern that our results revealed, suggests that more attention should be directed toward designing and developing policy, organization and legislative systems.
Computer Security ; Consensus ; Delivery of Health Care* ; Disclosure ; Electronic Health Records* ; Health Personnel* ; Human Rights ; Humans ; Incheon ; Korea ; Outcome Assessment (Health Care) ; Ownership ; Privacy* ; Surveys and Questionnaires

OBJECTIVE: Even though abundant studies and models have tried to explain and predict the adoption and use of new information systems, the research on the adoption of Diabetes Management Systems in multiple clinical settings is relatively scarce. This paper addresses this issue by outlining Georgetown University's experience with implementing its MyCareTeam diabetes telemedicine application, which is a web.based, interactive diabetes management application. METHODS: Case study is used to explore the influencial factors on web.based diabetes telemedicine systems in multiclinical setting. The experience of the Georgetown University deploying MyCareTeam system in six different geographical areas was analyzed by secondary literature review and interviews. RESULTS: This study finds several problems and possible resolutions to expand the telemedicine systems of single institution into the multiple clinical settings. The application systems must be able to transfer data from diverse medical devices and integrate with web.based diabetes management application. Therefore, the system needs to support diverse data transfer type, diverse cable, and different network environment. In addition, there is a need for more dedicated technical and operational support, to prevent frequent turnover among the overburdened nurses who currently interact remotely with telemedicine patients. CONCLUSIONS: To apply currently developed telemedicine technology into the real clinical settings, the proposed technical as well as organizational infrastructure should be established. The findings of this study will be guideline for multi.center diabetes management system in Korea.
Diabetes Mellitus ; Humans ; Information Systems ; Korea ; Telemedicine*

The Arden Syntax is a language for expressing computable medical decisions. It was developed and published under the direction of Health Level Seven, Inc (HL7), and is a standard of the American National Standards Institute (ANSI). It is used to construct executable Medical Logic Modules (MLMs) that represent individual clinical decisions. The authors introduced brief explanation of the Arden Syntaxand gave an example to help readers understand it with easy. Although Arden Syntax is the HL7 standard, there are problems related to the adoption of Arden Syntax as the standard tool for describing medical logic: the curly-braces problem, and the compiler problem. GELLO as well as virtual Medical Record based on the HL7 Reference Information Model (RIM) may provide solutions to the former problem. The latter problem would be resolved by introducing XML based expression of Arden Syntax, the ArdenML: the next generation of Arden Syntax. Unfortunately, Korean hospital information systems are not yet ready to adopt clinical decision support system including Arden Syntax. However, when Arden Syntax version 3.0 (ArdenML) with Korean rule-base engines is introduced into the hospital information system, it would be easier to build up clinical decision support system in Korea.
Adoption ; Health Level Seven ; Hospital Information Systems ; Korea ; Logic ; Medical Records

Background: 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) is known as a lung carcinogen. The objective of this study was to investigate associations of urine NNAL concentrations and smoking status. Methods: This was a cross-sectionally designed study based on data from the 2016–2018 Korean National Health and Nutrition Examination Survey. A total of 2,845 participants were classified into past-smoker, electronic cigarette (e-cigar) only, dual-user, and cigarette only smoker groups. All sampling and weight variables were stratified and analysis was conducted accounting for the complex sampling design. Analysis of covariance was used to compare the geometric mean of urine NNAL concentrations and log-transformed urine NNAL level among smoking status with weighted survey design. Post hoc paired comparisons with Bonferroni adjustment was performed according to smoking status. Results: The estimated geometric mean concentrations of urine NNAL were 1.974 ± 0.091, 14.349 ± 5.218, 89.002 ± 11.444, and 117.597 ± 5.459 pg/mL in past-smoker, e-cigar only, dualuser, and cigarette only smoker groups, respectively. After fully adjusting, log-transformed urine NNAL level was significantly different among groups (P < 0.001). Compared with the past-smoker group, e-cigar only, dual-user, and cigarette only smoker groups showed significantly higher log-transformed urine NNAL concentrations in post hoc test (all P < 0.05). Conclusion E-cigar only, dual-user, and cigarette only smoker groups showed significantly higher geometric mean concentrations of urine NNAL than the past-smoker group.Conventional cigarette, dual users, and e-cigar users can potentially show harmful health effects from NNAL.

OBJECTIVE: Suicide is a leading cause of death in college age students. Identification of the associated risk factors has important implications for how to prevent and respond to this population; however, few studies have been performed on this topic in this age group. The purpose of this study was to evaluate the prevalence and risk factors associated with suicide ideation and attempts in college students. METHODS: Three hundred sixty-eight college students participated in this cross-sectional observational study. The recent (over two weeks) suicide ideation and lifetime suicide attempts were defined according to Moscicki's suicide behavior index. Sociodemographic variables were assessed and psychopathology measured using the Beck Depression Inventory, the Bipolar Spectrum Diagnostic Scale and the Alcohol Use Disorders Identification Test. A hierarchical multiple logistic regression analysis was used to identify the significant risk factors related to suicide ideation and attempts. RESULTS: The two-week prevalence of suicidal ideation was 9.8%, and the lifetime prevalence of suicide attempts was 3.3%. The univariate analysis showed that students who had more severe depression (p<0.001), a higher probability for bipolar disorder (p<0.001) and decrement of academic achievement (p<0.005) were more likely to have suicide ideation. Those with factors such as severe depression (p<0.05), a higher probability of bipolar disorder (p<0.001), a low socioeconomic status (p<0.001), who lived alone (p<0.01), and were female (p<0.05) had a higher risk for suicide attempts. The most important predictors of suicide ideation, by the logistic regression analysis, were depression, probability for bipolar disorder and academic achievement, and the risks identified for suicide attempts were socioeconomic status and probability of bipolar disorder. CONCLUSION: Suicide ideation and attempts were common in college students. The results of this study suggest that early identification and management of mood disorders and other sociodemographic risk factors may have implications for intervention and prevention.
Bipolar Disorder ; Cause of Death ; Depression ; Female ; Humans ; Logistic Models ; Mood Disorders ; Observational Study ; Prevalence* ; Psychopathology ; Risk Factors* ; Social Class ; Suicidal Ideation ; Suicide*

OBJECTIVES: This study was conducted to investigate the current status of outsourcing in Korean hospital information systems and the factors influencing its introduction. METHODS: The authors surveyed 136 hospitals located in Seoul and its surrounding vicinities from June 7 to June 23, 2006. The facilitators and inhibitors to outsourcing in hospital information systems were derived from literature and expert reviews. Multiple logistic regression analysis was applied to identify the major influencing factors on outsourcing in hospital information systems. RESULTS: Eighty-six (63.2%) of the 136 hospitals surveyed, which were mainly tertiary hospitals, responded to using outsourcing for their hospital information systems. "Hardware and software maintenance and support," "application development," and "management of service and staff" were the major areas of outsourcing. Outsourcing had been employed for 4~7 years by 45.5% of the hospitals and the proportion of the budget used for outsourcing was less than 20%. A need for an extension in outsourcing was agreed on by 76.5% of the hospitals. The multiple logistic regression analysis showed that both consumer satisfaction and security risk have an influence on hospital information system outsourcing. CONCLUSIONS: Outsourcing in hospital information systems is expected to increase just as in other industries. One primary facilitator to outsourcing in other industries is consumer satisfaction. We found that this was also a facilitator to outsourcing in hospital information systems. Security risk, which is usually considered an inhibitor to information technology outsourcing, was proven to be an inhibitor here as well. The results of this study may help hospital information systems establish a strategy and management plan for outsourcing.
Security Measures ; Outsourced Services/economics/*utilization ; Maintenance ; Logistic Models ; Korea ; Hospital Information Systems/*organization & administration ; Health Services Research ; Decision Making, Organizational ; Consumer Satisfaction ; Computer Security

OBJECTIVES: To explore the information sources and knowledge on infant vaccinations of pro-vaccination community members and anti- accination community members on the internet. METHODS: An online survey of 245 parents from three pro-vaccination communities and 92 parents from one antivaccination community was conducted from June 7 to June 23, 2006. RESULTS: Parents from pro-vaccination communities usually gained the information regarding vaccination efficacy and risk mainly from healthcare providers (49.8%) and mass media (47.7%). Pro-vaccination community members considered healthcare providers as the most credible sources of information on vaccination, whereas the anti-vaccination community members usually gained their information regarding vaccine efficiency and risk from Internet child-care cafes and online vaccination communities. Parents of the anti-vaccination community considered the internet as the most credible information source (77.6% for efficacy, 94.8% for risk). In addition, the major reason why anti-vaccination community members didn't vaccinate and, will not vaccinate, was concern about possible side effects of the vaccine. The knowledge level on infant vaccination, education and economic status was higher in the anti-vaccination community. CONCLUSIONS: On-line communities concerned with vaccination are getting popular. The influence of antivaccination parents on the Internet is expected to be high. The government and healthcare providers need to increase their efforts to improve the credibility of information about vaccination. Our findings suggest that online communication regarding vaccinations needs to be considered as a means to increase vaccination rates.
Adult ; Child, Preschool ; Female ; Health Education/*methods ; *Health Knowledge, Attitudes, Practice ; Health Personnel ; Humans ; Infant ; Internet/*utilization ; Male ; Parents ; Socioeconomic Factors ; *Vaccination

Objective: The aim of this study was to investigate the prevalence of depression and suicidal ideation among older Korean adults and the predictors of suicidal ideation. Methods: We analyzed data from 5,604 Koreans aged 65 or older collected by the Korea National Health and Nutrition Examination Survey in 2012–2016, an annual national, cross-sectional, epidemiologic study of the Korean population. A chi-square test was used to assess differences in socio-demographic characteristics by suicidal ideation. Psychological variables, self-rated physical health, and the five dimensions of the Korean version of the EQ-5D (EuroQoL) were compared between four subgroups categorized according to the presence/absence of suicidal ideation and depression. Multiple logistic regression was used to estimate the predictive power of health-related quality of life variables, as well as physical and psychological factors regarding suicidal ideation. Results: Overall, 11.5% of the sample reported suicidal ideation, and 20.0% of the suicidal ideation group were diagnosed with depression. Respondents with suicidal ideation had significantly lower levels of health-related quality of life than those without suicidal ideation. EQ-5D self-control (OR=1.42), anxiety/depression (OR=2.32), depression (OR=2.07), and self-rated physical health (OR=1.36) were found to significantly predict suicidal ideation. Conclusion Suicidal ideation without depression was prevalent among older Koreans. Self-control, anxiety/depression of EQ-5D, selfrated physical health, and depression predicted suicidal ideation. Interventions to screen older Koreans for early detection of suicide risk and prevention strategies should consider evaluating each EQ-5D dimension.

Background: Few studies evaluate the epidemiology and risk factors of Clostridioides difficile infection (CDI) in Asian patients with inflammatory bowel disease (IBD). We investigated the year-end prevalence, cumulative incidence and risk factors of CDI in Asian patients with IBD using a large-scale population-based cohort in Korea. Methods: Using the National Health Insurance Service database, we identified patients with IBD and sex- and age-matched controls without IBD between 2008 and 2018. The year-end prevalence and cumulative incidence of CDI were compared among patients with Crohn’s disease (CD) and ulcerative colitis (UC) with controls. The risk factors for CDI were evaluated. Results: Among the 54,836 patients with IBD and 109,178 controls, CDI occurred in 293 patients with IBD and 87 controls. The annual year-end prevalence of CDI in patients with IBD increased from 8.6/10,000 persons in 2008 to 22.3/10,000 persons in 2018. The risk of CDI was higher in both patients with CD and UC than that in the matched controls (hazard ratio [HR], 7.285; 95% confidence interval [CI], 5.388–9.851; P < 0.001 and HR, 7.487; 95% CI, 5.796–9.670; P < 0.001, respectively). Among patients with IBD, the risk factors for CDI included older age, female sex, high Charlson comorbidity index score, and IBD-related medications including oral 5-aminosalicylic acid, immunomodulatory agents, biologics, and steroids used for > 90 days. Conclusion The risk of CDI in Korean patients with IBD was approximately seven times higher than that in controls without IBD, and the annual year-end prevalence of CDI continuously increased from 2008 to 2018.