Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternalewborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

BACKGROUND: This study aims to conduct curriculum analysis on health management schools focusing on relationship with licence and certification in Republic of Korea. METHODS: Possible employment field, licence and certification as well as curriculum were collected from the home page of 30 health management schools. The subjects and credits of curriculum were analyzed using descriptive statistics. Main subjects by areas were drew using categorization and ranking within qualitative methods. Comparative analysis was conducted for checking relationship between main subject and possible employment field, licence and certification. RESULTS: First, major employment fields after graduation were public health officer, general hospital and clinic, and National Health Insurance Service. Possible licence and certificate were hospital administrator, medical recorder, health education specialist, and medical insurance specialist. Second, total graduate credits were 133.9 including 79.0 for major education, 30.5 for of general education, and 30.5 for elective courses. Third, main subjects were reviewed by areas including basic medicine, health management, hospital business & management, medical records & information, insurance billing & assessment, healthcare marketing & tourism, and health education. There were highest number of subjects on health education area among 8 categories. By subjects, many health management schools open health law, medical terminology, introduction to public health, and biostatistics. Relationship between main subjects and possible employment field, licence and certification in health management schools was strong. CONCLUSION: It is necessary to review curriculum and for improving educational quality in health management schools. Also, development of curriculum standards for courses in health administration and introduction of accreditation system can be considered.
Accreditation ; Biostatistics ; Certification ; Commerce ; Curriculum ; Education ; Employment ; Health Care Sector ; Health Education ; Hospital Administrators ; Hospitals, General ; Humans ; Insurance ; Jurisprudence ; Medical Records ; National Health Programs ; Public Health ; Republic of Korea ; Specialization

Background: With the development of the information technology industry and the increasing importance of health information, there is a need to analyze the current certification system for health information management education. This study compared and analyzed the health information management education accreditation system between the Republic of Korea and the United States. Methods: Descriptive analysis and quantitative methodologies were used to compare the education accreditation system and understand the current status of health information management curriculum run by universities in the Republic of Korea and the United States. Results: Regardless of the academic year, the Republic of Korea had one certification system based on subject-based criteria. However, the United States had a certification system for associate, baccalaureate, and master’s degree programs with competency-based criteria. The accreditation system was different in terms of the way the curriculum is certified and the options for the different levels of university degree programs. Conclusion Accordingly, it is necessary to consider improving the quality of health information management personnel at different levels by improving the current accreditation system and differentiating the curriculum according to the degree program levels in the Republic of Korea.

A 71-year-old male initially presented with vocal cord palsy and underwent tracheostomy. After thorough examination, urogenital dysfunction, orthostatic hypotension, and Parkinsonism were found, which led to the diagnosis of multiple system atrophy (MSA). After the tracheostomy, bi-level positive airway pressure ventilation was required during the night due to nocturnal hypoxemia. Night-time hypoxemia is related to central sleep apnea, which is one of the manifestations of MSA. This is the first case of MSA manifested by bilateral vocal cord palsy as an initial sign in Korea. This case supports the notion that MSA should be taken into consideration when vocal cord paralysis is observed.
Aged ; Airway Obstruction ; Anoxia ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Korea ; Male ; Multiple System Atrophy* ; Parkinsonian Disorders ; Sleep Apnea, Central ; Tracheostomy ; Ventilation ; Vocal Cord Paralysis*

PURPOSE: We evaluated prognostic value of the 8th edition of the American Joint Committee on Cancer/International Union for Cancer Control (AJCC/UICC) staging system for nasopharyngeal cancer and investigated whether tumor volume/metabolic information refined prognostication of anatomy based staging system. MATERIALS AND METHODS: One hundred thirty-three patients with nasopharyngeal cancer who were staged with magnetic resonance imaging (MRI) and treated with intensity-modulated radiotherapy (IMRT) between 2004 and 2013 were reviewed. Multivariate analyses were performed to evaluate prognostic value of the 8th edition of the AJCC/UICC staging system and other factors including gross tumor volume and maximum standardized uptake value of primary tumor (GTV-T and SUV-T). RESULTS: Median follow-up period was 63 months. In multivariate analysis for overall survival (OS), stage group (stage I-II vs. III-IVA) was the only significant prognostic factor. However, 5-year OS rates were not significantly different between stage I and II (100% vs. 96.2%), and between stage III and IVA (80.1% vs. 71.7%). Although SUV-T and GTV-T were not significant prognostic factors in multivariate analysis, those improved prognostication of stage group. The 5-year OS rates were significantly different between stage I-II, III-IV (SUV-T ≤ 16), and III-IV (SUV-T > 16) (97.2% vs. 78% vs. 53.8%), and between stage I, II-IV (GTV-T ≤ 33 mL), and II-IV (GTV-T > 33 mL) (100% vs. 87.3% vs. 66.7%). CONCLUSION: Current anatomy based staging system has limitations on prognostication for nasopharyngeal cancer despite the most accurate assessment of tumor extent by MRI. Tumor volume/metabolic information seem to improve prognostication of current anatomy based staging system, and further studies are needed to confirm its clinical significance.
Follow-Up Studies ; Humans ; Joints ; Magnetic Resonance Imaging ; Multivariate Analysis ; Nasopharyngeal Neoplasms ; Neoplasm Staging ; Prognosis ; Radiotherapy, Intensity-Modulated ; Tumor Burden

BACKGROUND/OBJECTIVES: Excess intake of dietary sodium, either directly or indirectly, increases the risk of several diseases, including cardio-cerebral vascular diseases such as stroke and hypertension. Excessive sodium intake and increased prevalence of hypertension have emerged as major issues worldwide. Therefore, the present study evaluated the recent trends in dietary sodium intake and the food sources of sodium intake in the Korean population using the Korea National Health and Nutrition Examination Survey (KNHANES, 2013–2017) data. SUBJECTS/METHODS: This study used the one-day 24-h recall dietary intake survey data from the 2013–2017 KNHANES to determine the average daily sodium intake by sex and age and the main dishes and food groups contributing to the dietary sodium intake. RESULTS: The mean sodium intake range was 3,477.2–3,889.6 mg/day during 2013–2017. The major food groups contributing to sodium intake were seasonings (1,597.5–1,870.5 mg/day), vegetables (680.4–756.7 mg/day), and cereal and grains (573.2–609.4 mg/day). Noodles and dumplings (536.7–573.2 mg/day), kimchi (487.3–539.6 mg/day), and soups (367.6–428.9 mg/day) were the top three dish groups that contributed to the sodium intake. In these dishes, the major sources of sodium intake were ramyeon (age groups 10–18 and 19–29 yrs), baechukimchi (age groups 40–49 and 50–59 yrs) and doenjang-kuk (age groups 60–69 and ≥ 70 yrs), respectively. CONCLUSIONS In summary, reducing the consumption of soups and kimchi is an effective way to reduce sodium intake. Personalized nutrition education on dietary sodium intake management is required because of the different food sources contributing to the sodium intake according to the subjects' age.

PURPOSE: Most of studies dealing with abfractions are limited to the buccal surfaces of the teeth. In this study, we analyzed the cause for abfraction by investigating the incidence of palatal side abfractions in maxillary posterior teeth. MATERIALS AND METHODS: We investigated a total of 3193 maxillary posterior teeth by an intraoral examination, model observation, and observation of virtual model fabricated using model scanning. We recorded the results and classified them depending on the type of teeth, age, gender, and side of arches. We also performed Chi-square test to evaluate the statistical significance among the groups (α = 0.05). RESULTS: The incidence of palatal side abfraction of the maxillary molars (10.8%) was higher than the premolars (6.8%), and among them, the incidence of the 1st molars (39.1%) were the highest. The incidence of palatal side abfraction increased with age and was statistically significant (P < 0.05). There was no statistical significance in the difference by gender (P > 0.05); in the case of arches, left arch showed higher incidence and it was statistically significant (P < 0.05). CONCLUSION Palatal side abfraction in maxillary posterior teeth was frequently observed in the maxillary 1st molars, and the incidence increased with age. This result suggests that the main reason for abfraction is due to occlusal force.

BACKGROUND/OBJECTIVES: Excess intake of dietary sodium, either directly or indirectly, increases the risk of several diseases, including cardio-cerebral vascular diseases such as stroke and hypertension. Excessive sodium intake and increased prevalence of hypertension have emerged as major issues worldwide. Therefore, the present study evaluated the recent trends in dietary sodium intake and the food sources of sodium intake in the Korean population using the Korea National Health and Nutrition Examination Survey (KNHANES, 2013–2017) data. SUBJECTS/METHODS: This study used the one-day 24-h recall dietary intake survey data from the 2013–2017 KNHANES to determine the average daily sodium intake by sex and age and the main dishes and food groups contributing to the dietary sodium intake. RESULTS: The mean sodium intake range was 3,477.2–3,889.6 mg/day during 2013–2017. The major food groups contributing to sodium intake were seasonings (1,597.5–1,870.5 mg/day), vegetables (680.4–756.7 mg/day), and cereal and grains (573.2–609.4 mg/day). Noodles and dumplings (536.7–573.2 mg/day), kimchi (487.3–539.6 mg/day), and soups (367.6–428.9 mg/day) were the top three dish groups that contributed to the sodium intake. In these dishes, the major sources of sodium intake were ramyeon (age groups 10–18 and 19–29 yrs), baechukimchi (age groups 40–49 and 50–59 yrs) and doenjang-kuk (age groups 60–69 and ≥ 70 yrs), respectively. CONCLUSIONS In summary, reducing the consumption of soups and kimchi is an effective way to reduce sodium intake. Personalized nutrition education on dietary sodium intake management is required because of the different food sources contributing to the sodium intake according to the subjects' age.