1.Characteristics of Restless Leg Syndrome in Shift Workers
Yun Ji KIM ; Haein KIM ; Yunsu KIM ; Jihye AHN ; Hyewon YEO ; Seog Ju KIM
Sleep Medicine and Psychophysiology 2024;31(2):48-53
		                        		
		                        			 Objectives:
		                        			Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). 
		                        		
		                        			Methods:
		                        			This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. 
		                        		
		                        			Results:
		                        			Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. 
		                        		
		                        			Conclusion
		                        			Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS. 
		                        		
		                        		
		                        		
		                        	
2.Epidemiological Characteristics of HIV-Infected Individuals by the Registration for Special Exempted Calculation: A Nationwide Cohort Study
Yunsu CHOI ; Kyoung Hwan AHN ; Soo Min KIM ; Bo Youl CHOI ; Jungsoon CHOI ; Jung Ho KIM ; Shin-Woo KIM ; Youn Jeong KIM ; Yoon Hee JUN ; Bo Young PARK
Infection and Chemotherapy 2024;56(4):510-521
		                        		
		                        			 Background:
		                        			The Korean government is implementing policy to reduce medical costs and improve treatment related for human immunodeficiency virus (HIV) patients. The level of cost reduction and the benefits provided vary depending on how individuals with HIV utilize the system. This study aims to determine exact HIV prevalence by analyzing healthcare utilization patterns and examining differences in healthcare usage based on how individuals pay for their medical expenses. 
		                        		
		                        			Materials and Methods:
		                        			We analyzed National Health Insurance Service (NHIS) claims data from 2002 to 2021. From a total of 106,675 individuals with at least one HIV-related claim, 22,779 participants were selected for this study. 
		                        		
		                        			Results:
		                        			Data from Korea Disease Control and Prevention Agency annual reports indicated that 93% of HIV patients were male, while NHIS data showed 84%. In the analysis of those exempted from registration, it was found that the registration rate for female patients is notably low, with adults between the ages of 20 and 40 making up 80% of the total. The registration rate in Gangwon State was lower than Seoul. The treatment experience rate was much higher in the registered group (93.0%) than the unregistered group (4.9%). Also, there was a big difference in treatment continuity rates: 76.2% for registered individuals and 2.8% for non-registered individuals. 
		                        		
		                        			Conclusion
		                        			The exempt calculation system for health insurance improves HIV care. However, those diagnosed anonymously or with reduced medical costs may be less likely to continue HIV treatment, so a new policy is needed to ensure anonymity and treatment continuity. 
		                        		
		                        		
		                        		
		                        	
3.Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea
Boyoung PARK ; Yoonyoung JANG ; Taehwa KIM ; Yunsu CHOI ; Kyoung Hwan AHN ; Jung Ho KIM ; Hye SEONG ; Jun Yong CHOI ; Hyo Youl KIM ; Joon Young SONG ; Shin-Woo KIM ; Hee Jung CHOI ; Dae Won PARK ; Young Kyung YOON ; Sang Il KIM
Epidemiology and Health 2024;46(1):e2024097-
		                        		
		                        			 OBJECTIVES:
		                        			This study compared the current smoking prevalence among adults with human immunodeficiency virus (HIV) infection to that of the general Korean population and analyzed changes in smoking prevalence and cessation rates from 2009 to 2020. 
		                        		
		                        			METHODS:
		                        			The study included a total of 10,980 adults with HIV infection who underwent a health screening examination (National Health Insurance Service-National Health Information Database; NHIS-NHID), 1,230 individuals with HIV infection who participated in the Korea HIV/AIDS Cohort (KoCosHIV), and 76,783 participants from the Korea National Health and Nutrition Examination Survey (KNHANES). We estimated the current smoking prevalence and the quit ratio, defined as the ratio of former smokers to ever-smokers. 
		                        		
		                        			RESULTS:
		                        			In the NHIS-NHID and KoCosHIV studies, the prevalence of current and former smoking among adults with HIV was 44.2% (95% confidence interval [CI], 43.2 to 45.1) and 15.6% (95% CI, 14.9 to 16.3), and 47.7% (95% CI, 43.7 to 51.8) and 16.9% (95% CI, 11.8 to 22.0), respectively. In the KNHANES, these rates were 22.5% and 18.1%, respectively. The standardized prevalence ratio of current smoking among adults with HIV was 1.76 in the NHIS-NHID and 1.97 in the KoCosHIV. Furthermore, the likelihood of quitting smoking was lower among adults with HIV than in the general population (NHIS-NHID: 26.1%; 95% CI, 25.0 to 27.1; KoCosHIV: 26.2%; 95% CI, 20.2 to 32.1; KNHANES: 44.6%; 95% CI, 44.5 to 44.6). Among HIV-positive adults, there was a 1.53% decline in the current smoking rate and a 2.86% increase in the quit ratio. 
		                        		
		                        			CONCLUSIONS
		                        			Adults with HIV were more likely to smoke and less likely to quit smoking than the general adult population. Tobacco screening and cessation strategies should specifically target this population. 
		                        		
		                        		
		                        		
		                        	
4.Comparison of HIV characteristics across 3 datasets: the Korea HIV/AIDS Cohort Study prospective, retrospective, and national reporting system
Yunsu CHOI ; Jun Yong CHOI ; Bo Youl CHOI ; Bo Young PARK ; Shin-Woo KIM ; Joon Young SONG ; Jung Ho KIM ; Sang Il KIM
Epidemiology and Health 2024;46(1):e2024055-
		                        		
		                        			 OBJECTIVES:
		                        			The Korea HIV/AIDS Cohort Study has been conducted prospectively for 18 years. However, it faces limitations in representing the entire population of patients with human immunodeficiency virus (HIV) in Korea. To address these limitations and validate the study design, we analyzed characteristics across several HIV datasets. 
		                        		
		                        			METHODS:
		                        			We compared epidemiological and clinical characteristics from 3 datasets: the Korea HIV/AIDS Cohort Study (dataset 1, n=1,562), retrospective cohort data (dataset 2, n=2,665), and the national HIV reporting system of the Korea Disease Control and Prevention Agency (KDCA) (dataset 3, n=17,403). 
		                        		
		                        			RESULTS:
		                        			The demographic characteristics of age, sex, and age at HIV diagnosis did not differ significantly across datasets. However, dataset 3 contained a higher proportion of patients diagnosed after 2008 (69.5%) than the other datasets. Regarding transmission routes, same-sex contact accounted for a greater proportion of dataset 1 (59.8%) compared to datasets 2 (20.9%) and 3 (32.6%). The proportion of patients with CD4 T-cell counts below 200/mm3 at HIV diagnosis was higher in datasets 1 (39.4%) and 2 (33.3%) compared to dataset 3 (16.3%). Initial HIV viral load measurements were not obtained for dataset 3. 
		                        		
		                        			CONCLUSIONS
		                        			The Korea HIV/AIDS Cohort Study demonstrated representativeness regarding the demographic characteristics of Korean patients. Of the sources, dataset 1 contained the most data on transmission routes. While the KDCA data encompassed all HIV patients, it lacked detailed clinical information. To improve the representativeness of the Korea HIV/AIDS Cohort Study, we propose expanding and revising the cohort design and enrolling more patients who have been recently diagnosed. 
		                        		
		                        		
		                        		
		                        	
5.Characteristics of Restless Leg Syndrome in Shift Workers
Yun Ji KIM ; Haein KIM ; Yunsu KIM ; Jihye AHN ; Hyewon YEO ; Seog Ju KIM
Sleep Medicine and Psychophysiology 2024;31(2):48-53
		                        		
		                        			 Objectives:
		                        			Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). 
		                        		
		                        			Methods:
		                        			This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. 
		                        		
		                        			Results:
		                        			Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. 
		                        		
		                        			Conclusion
		                        			Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS. 
		                        		
		                        		
		                        		
		                        	
6.Characteristics of Restless Leg Syndrome in Shift Workers
Yun Ji KIM ; Haein KIM ; Yunsu KIM ; Jihye AHN ; Hyewon YEO ; Seog Ju KIM
Sleep Medicine and Psychophysiology 2024;31(2):48-53
		                        		
		                        			 Objectives:
		                        			Both shift work and restless legs syndrome (RLS) are common and can disrupt sleep and mood. However, the effects of shift work on RLS remain unclear. The current study aims to explore the prevalence, severity, and related sleep and mood symptoms of RLS in shift workers (SWs) compared to non-shift workers (Non-SWs). 
		                        		
		                        			Methods:
		                        			This study recruited 4,562 SWs (age 36.98±9.84, 2,150 males and 2,422 females) and 2,093 NSWs (age 37.79±9.73, 999 males and 1,094 females). All participants completed online self-report questionnaires regarding RLS, sleep, and depression. The presence of RLS was screened using a single standard question for rapid screening of RLS. The severity of RLS was assessed using the International Restless Legs Syndrome Rating Scale (iRLS). Additionally, the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess daytime sleepiness, insomnia, and depressive symptoms, respectively. 
		                        		
		                        			Results:
		                        			Of participants, 1,255 (27.45%) of SWs and 548 (26.18%) of Non-SWs were screened as having RLS, with no significant differences in the prevalence of RLS between the groups. However, among those with RLS, SWs with RLS showed higher iRLS scores compared to Non-SWs with RLS after controlling for age and sex (SWs: 9.55±7.26, NSWs: 6.75±6.05, F=64.15, p<0.01). In addition, SWs with RLS exhibited higher ISI scores (F=46.09, p<0.01), higher ESS scores (F=4.80, p=0.03), and higher CES-D scores (F=33.50, p<0.01) than Non-SWs with RLS. 
		                        		
		                        			Conclusion
		                        			Although there was no significant difference in RLS prevalence between SWs and Non-SWs, SWs with RLS exhibited more severe RLS symptoms and RLS-related symptoms, such as insomnia, sleepiness, and depression, compared to NSWs with RLS. The current study suggests that shift work may exacerbate RLS severity and RLS-related sleep and mood symptoms, although it may not be associated with the onset of RLS. 
		                        		
		                        		
		                        		
		                        	
7.Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea
Boyoung PARK ; Yoonyoung JANG ; Taehwa KIM ; Yunsu CHOI ; Kyoung Hwan AHN ; Jung Ho KIM ; Hye SEONG ; Jun Yong CHOI ; Hyo Youl KIM ; Joon Young SONG ; Shin-Woo KIM ; Hee Jung CHOI ; Dae Won PARK ; Young Kyung YOON ; Sang Il KIM
Epidemiology and Health 2024;46(1):e2024097-
		                        		
		                        			 OBJECTIVES:
		                        			This study compared the current smoking prevalence among adults with human immunodeficiency virus (HIV) infection to that of the general Korean population and analyzed changes in smoking prevalence and cessation rates from 2009 to 2020. 
		                        		
		                        			METHODS:
		                        			The study included a total of 10,980 adults with HIV infection who underwent a health screening examination (National Health Insurance Service-National Health Information Database; NHIS-NHID), 1,230 individuals with HIV infection who participated in the Korea HIV/AIDS Cohort (KoCosHIV), and 76,783 participants from the Korea National Health and Nutrition Examination Survey (KNHANES). We estimated the current smoking prevalence and the quit ratio, defined as the ratio of former smokers to ever-smokers. 
		                        		
		                        			RESULTS:
		                        			In the NHIS-NHID and KoCosHIV studies, the prevalence of current and former smoking among adults with HIV was 44.2% (95% confidence interval [CI], 43.2 to 45.1) and 15.6% (95% CI, 14.9 to 16.3), and 47.7% (95% CI, 43.7 to 51.8) and 16.9% (95% CI, 11.8 to 22.0), respectively. In the KNHANES, these rates were 22.5% and 18.1%, respectively. The standardized prevalence ratio of current smoking among adults with HIV was 1.76 in the NHIS-NHID and 1.97 in the KoCosHIV. Furthermore, the likelihood of quitting smoking was lower among adults with HIV than in the general population (NHIS-NHID: 26.1%; 95% CI, 25.0 to 27.1; KoCosHIV: 26.2%; 95% CI, 20.2 to 32.1; KNHANES: 44.6%; 95% CI, 44.5 to 44.6). Among HIV-positive adults, there was a 1.53% decline in the current smoking rate and a 2.86% increase in the quit ratio. 
		                        		
		                        			CONCLUSIONS
		                        			Adults with HIV were more likely to smoke and less likely to quit smoking than the general adult population. Tobacco screening and cessation strategies should specifically target this population. 
		                        		
		                        		
		                        		
		                        	
8.Comparison of HIV characteristics across 3 datasets: the Korea HIV/AIDS Cohort Study prospective, retrospective, and national reporting system
Yunsu CHOI ; Jun Yong CHOI ; Bo Youl CHOI ; Bo Young PARK ; Shin-Woo KIM ; Joon Young SONG ; Jung Ho KIM ; Sang Il KIM
Epidemiology and Health 2024;46(1):e2024055-
		                        		
		                        			 OBJECTIVES:
		                        			The Korea HIV/AIDS Cohort Study has been conducted prospectively for 18 years. However, it faces limitations in representing the entire population of patients with human immunodeficiency virus (HIV) in Korea. To address these limitations and validate the study design, we analyzed characteristics across several HIV datasets. 
		                        		
		                        			METHODS:
		                        			We compared epidemiological and clinical characteristics from 3 datasets: the Korea HIV/AIDS Cohort Study (dataset 1, n=1,562), retrospective cohort data (dataset 2, n=2,665), and the national HIV reporting system of the Korea Disease Control and Prevention Agency (KDCA) (dataset 3, n=17,403). 
		                        		
		                        			RESULTS:
		                        			The demographic characteristics of age, sex, and age at HIV diagnosis did not differ significantly across datasets. However, dataset 3 contained a higher proportion of patients diagnosed after 2008 (69.5%) than the other datasets. Regarding transmission routes, same-sex contact accounted for a greater proportion of dataset 1 (59.8%) compared to datasets 2 (20.9%) and 3 (32.6%). The proportion of patients with CD4 T-cell counts below 200/mm3 at HIV diagnosis was higher in datasets 1 (39.4%) and 2 (33.3%) compared to dataset 3 (16.3%). Initial HIV viral load measurements were not obtained for dataset 3. 
		                        		
		                        			CONCLUSIONS
		                        			The Korea HIV/AIDS Cohort Study demonstrated representativeness regarding the demographic characteristics of Korean patients. Of the sources, dataset 1 contained the most data on transmission routes. While the KDCA data encompassed all HIV patients, it lacked detailed clinical information. To improve the representativeness of the Korea HIV/AIDS Cohort Study, we propose expanding and revising the cohort design and enrolling more patients who have been recently diagnosed. 
		                        		
		                        		
		                        		
		                        	
9.Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea
Boyoung PARK ; Yoonyoung JANG ; Taehwa KIM ; Yunsu CHOI ; Kyoung Hwan AHN ; Jung Ho KIM ; Hye SEONG ; Jun Yong CHOI ; Hyo Youl KIM ; Joon Young SONG ; Shin-Woo KIM ; Hee Jung CHOI ; Dae Won PARK ; Young Kyung YOON ; Sang Il KIM
Epidemiology and Health 2024;46(1):e2024097-
		                        		
		                        			 OBJECTIVES:
		                        			This study compared the current smoking prevalence among adults with human immunodeficiency virus (HIV) infection to that of the general Korean population and analyzed changes in smoking prevalence and cessation rates from 2009 to 2020. 
		                        		
		                        			METHODS:
		                        			The study included a total of 10,980 adults with HIV infection who underwent a health screening examination (National Health Insurance Service-National Health Information Database; NHIS-NHID), 1,230 individuals with HIV infection who participated in the Korea HIV/AIDS Cohort (KoCosHIV), and 76,783 participants from the Korea National Health and Nutrition Examination Survey (KNHANES). We estimated the current smoking prevalence and the quit ratio, defined as the ratio of former smokers to ever-smokers. 
		                        		
		                        			RESULTS:
		                        			In the NHIS-NHID and KoCosHIV studies, the prevalence of current and former smoking among adults with HIV was 44.2% (95% confidence interval [CI], 43.2 to 45.1) and 15.6% (95% CI, 14.9 to 16.3), and 47.7% (95% CI, 43.7 to 51.8) and 16.9% (95% CI, 11.8 to 22.0), respectively. In the KNHANES, these rates were 22.5% and 18.1%, respectively. The standardized prevalence ratio of current smoking among adults with HIV was 1.76 in the NHIS-NHID and 1.97 in the KoCosHIV. Furthermore, the likelihood of quitting smoking was lower among adults with HIV than in the general population (NHIS-NHID: 26.1%; 95% CI, 25.0 to 27.1; KoCosHIV: 26.2%; 95% CI, 20.2 to 32.1; KNHANES: 44.6%; 95% CI, 44.5 to 44.6). Among HIV-positive adults, there was a 1.53% decline in the current smoking rate and a 2.86% increase in the quit ratio. 
		                        		
		                        			CONCLUSIONS
		                        			Adults with HIV were more likely to smoke and less likely to quit smoking than the general adult population. Tobacco screening and cessation strategies should specifically target this population. 
		                        		
		                        		
		                        		
		                        	
10.Comparison of HIV characteristics across 3 datasets: the Korea HIV/AIDS Cohort Study prospective, retrospective, and national reporting system
Yunsu CHOI ; Jun Yong CHOI ; Bo Youl CHOI ; Bo Young PARK ; Shin-Woo KIM ; Joon Young SONG ; Jung Ho KIM ; Sang Il KIM
Epidemiology and Health 2024;46(1):e2024055-
		                        		
		                        			 OBJECTIVES:
		                        			The Korea HIV/AIDS Cohort Study has been conducted prospectively for 18 years. However, it faces limitations in representing the entire population of patients with human immunodeficiency virus (HIV) in Korea. To address these limitations and validate the study design, we analyzed characteristics across several HIV datasets. 
		                        		
		                        			METHODS:
		                        			We compared epidemiological and clinical characteristics from 3 datasets: the Korea HIV/AIDS Cohort Study (dataset 1, n=1,562), retrospective cohort data (dataset 2, n=2,665), and the national HIV reporting system of the Korea Disease Control and Prevention Agency (KDCA) (dataset 3, n=17,403). 
		                        		
		                        			RESULTS:
		                        			The demographic characteristics of age, sex, and age at HIV diagnosis did not differ significantly across datasets. However, dataset 3 contained a higher proportion of patients diagnosed after 2008 (69.5%) than the other datasets. Regarding transmission routes, same-sex contact accounted for a greater proportion of dataset 1 (59.8%) compared to datasets 2 (20.9%) and 3 (32.6%). The proportion of patients with CD4 T-cell counts below 200/mm3 at HIV diagnosis was higher in datasets 1 (39.4%) and 2 (33.3%) compared to dataset 3 (16.3%). Initial HIV viral load measurements were not obtained for dataset 3. 
		                        		
		                        			CONCLUSIONS
		                        			The Korea HIV/AIDS Cohort Study demonstrated representativeness regarding the demographic characteristics of Korean patients. Of the sources, dataset 1 contained the most data on transmission routes. While the KDCA data encompassed all HIV patients, it lacked detailed clinical information. To improve the representativeness of the Korea HIV/AIDS Cohort Study, we propose expanding and revising the cohort design and enrolling more patients who have been recently diagnosed. 
		                        		
		                        		
		                        		
		                        	
            
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