Incidence-Based versus Prevalence-Based Approaches on Measuring Disability-Adjusted Life Years for Injury

Park, Bohyun,Park, Bomi,Lee, Won Kyung,Kim, Young-Eun,Yoon, Seok-Jun,Park, Hyesook The Korean Academy of Medical Sciences 2019 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.34 No.11

<P><B>Background</B></P><P>Injury represents an important aspect of disease that affects everyone at some point in their lives. To better understand and prevent these injuries, various analytical methods have been developed to assess both the magnitude and features of injury burden. In this study, we attempted to estimate the injury burden of Korea in 2014 by comparing the prevalence-based approach used by the Global Burden of Diseases (GBD) team and the World Health Organization against an alternative incidence-based approach, and to assess the different implications of these measurements.</P><P><B>Methods</B></P><P>The 10th Korean National Hospital Discharge survey data and causes of death statistics in 2014 were used as data sources. Years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALYs) were calculated using both the incidence- and prevalence-based approaches. The Korean Classification of Diseases (KCD) version 5 diagnostic codes were used to classify the mechanism of injury.</P><P><B>Results</B></P><P>The prevalence-based injury burden tended to be higher (1,670,229 DALYs) than the incidence-based injury burden (1,544,467 DALYs). The elderly population exhibited a higher prevalence-based YLD and DALY relative to incidence-based outcomes. In order of significance, the three most common causes of injury as calculated using an incidence-based approach were road injury, fall, and self-harm, compared with a prevalence-based method, which identified self-harm, road injury, and falls as the most common injuries.</P><P><B>Conclusion</B></P><P>An appropriate prevention program is needed for injuries with potential to cause long-lasting morbidity. Accordingly, a tailored injury-prevention strategy should be developed for each high-risk group.</P>

키워드 네트워크 분석을 통해 살펴본 접종취약 계층별 예방접종 미접종 사유

박보현 ( Bohyun Park ),한혜진 ( Hye-jin Han ),김남은 ( Nam-eun Kim ),박보미 ( Bomi Park ),이선화 ( Sun-hwa Lee ),이혜아 ( Hye-ah Lee ),최희정 ( Hee-jung Choi ),조수진 ( Su-jin Cho ),박혜숙 ( Hyesook Park ) 대한보건협회 2018 대한보건연구 Vol.44 No.3

연구목적: 이번 연구는 접종취약 계층별 우리나라 아동 예방접종 미접종 사유를 분석하고자 수행되었다. 연구방법: 질병관리본부에서 통합, 관리 중인 일반적 미접종자(1,669명의 16,383건) 및 사회적 취약계층 데이터베이스(371명), 온라인 커뮤니티에서 수집한 텍스트 자료(60건)를 사용하여 미접종 사유의 빈도 및 퍼센트를 산출하고, 키워드 네트워크 분석으로 미접종과 관련하여 높은 빈도로 언급된 핵심 단어를 시각화하였다. 연구결과: 일반 아동에서 미접종의 주요 원인으로 ‘해외 거주’가 55.1%로 가장 높은 빈도를 차지하였으며, 그 다음으로 접종 거부가 26.4%로 조사되었다. 사회적 취약계층에서의 미접종 사유로는 ‘연락두절’, ‘건강상의 이유로 접종지연’, ‘해외거주’, ‘출국’ 순으로 높았다. 일반 아동을 대상으로 수행한 키워드 분석에서는 ‘아토피’, ‘피로’, ‘알레르기’ 등의 단어가 높은 빈도로 사용된 것으로 나타났고, 사회적 취약계층을 대상으로 한 분석에서는 ‘감기’, ‘페렴 구균’, ‘수두’ 등 질병과 관련된 단어가 많이 언급된 것으로 분석되었다. 인터넷 커뮤니티를 자료에서는 ‘백신’, ‘바이러스’, ‘부작용’ 등의 단어가 접종을 기피하는 주요 원인으로 많이 언급되었다. 결론: 우리나라의 전반적인 아동 예방접종률 향상을 위해서는 표적 미접종 집단별 맞춤형 중재 전략이 필요하며, 각 계층에서 예방접종을 저해하는 장애요인을 진단하고, 개인 수준에서 신념 및 행동 변화를 가져올 근거 기반의 다수준 전략이 모색되어야 할 것이다. Objective: The purpose of this study was to examine barriers to childhood vaccination in three different groups (general population, socially vulnerable group, internet community). Methods: We constructed a database of the unvaccinated management system that was integrated and managed by the Korea Centers for Disease Control and Prevention (KCDC). We also analyzed internet community data generated by people who decided against vaccination. Keyword network analysis was conducted to visualize the main keywords derived from the barriers set by the guardians of unvaccinated children. Results: In the general population, more than 50% of the subjects answered that ‘living outside of Korea’ is the main cause of non-vaccination. In the same group 26.4% refused vaccination. In the socially vulnerable groups, the top ranking reason for refusal were ‘not contacted’, ‘delayed vaccination for health problem’, ‘overseas residence’ and ‘departure’. In the internet community analysis, vaccine safety, unnecessary of vaccine and freedom of choice were the main reasons for refusing vaccination. Keyword analysis was used to visualize the analysis result more intuitively. The analysis highlighted main keywords such as 'atopy', 'fatigue', 'allergy', 'cold', 'pneumococcus', 'chicken pox'. Conclusion: In conclusion, tailor-made strategies for target populations would be needed to improve overall vaccination rates for the various vulnerable groups. To do this, it is necessary to categorize each vulnerable group who decided against immunization. An evidence based strategy should be established to bring about belief and behavioral changes at the individual level, based on the identifying factors affecting immunization in each group. In addition, considering the reality and limited resources of Korea's medical system, the most cost effective vaccination policy should be planned.

임산부의 Myeloperoxidase 유전자다형성과 혈중 비타민 C 수준에 따른 모체의 산화 스트레스와 출생체중

박보현(Bohyun Park),김영주(Young-Ju Kim),박은애(Eun Ae Park),이화영(Hwayoung Lee),하은희(Eun-Hee Ha),박종순(Jongsoon Park),김정연(Jeongyoun Kim),홍윤철(Yun-Chul Hong),박혜숙(Hyesook Park) 한국독성학회 2004 Toxicological Research Vol.20 No.3

This study aimed to determine the association of maternal oxidative stress and<br/> adverse pregnancy outcome with serum vitamin C concentration and a myeloperoxidase (MPO)<br/> genetic polymorphism during pregnancy. We investigated 450 pregnant women who visited Ewha<br/> Womans University Hospital for prenatal care during gestational weeks 24~28. During the second trimester,<br/> we measured serum vitamin C levels and urinary 8-hydroxyde-2'-deoxyguanosine (8-OHdG)<br/> and malondialdehyde (MDA) as an oxidative stress biomarker. We determined the presence of a<br/> maternal MPO polymorphism (G-to-A substitution at nucleotide 463) using a PCR-RFLP assay. We<br/> compared the level of oxidative stress and birth weight with the vitamin C concentration and the<br/> presence of the MPO polymorphism. The mean level of maternal oxidative stress tended to be<br/> higher and the birth weight lower for MPO type A/A than for types A/G and G/G. Vitamin C levels<br/> above the 75 percentiles were associated with reduced concentrations of urinary MDA and 8-OHdG<br/> but increased birth weight. Our data demonstrate that oxidative stress and neonatal birth weight are<br/> associated with the MPO genetic polymorphism, with the association modified by the maternal vitamin<br/> C levels.

The Pyramid of Injury: Estimation of the Scale of Adolescent Injuries According to Severity

Han, Hyejin,Park, Bomi,Park, Bohyun,Park, Namsoo,Park, Ju Ok,Ahn, Ki Ok,Tak, Yang Ju,Lee, Hye Ah,Park, Hyesook The Korean Society for Preventive Medicine 2018 Journal of Preventive Medicine and Public Health Vol.51 No.3

Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

A study on the factors affecting the follow-up participation in birth cohorts

Bohyun Park,Eun Jeung Choi,Eunhee Ha,Jong Hyuk Choi,Yangho Kim,Yun-Chul Hong,Mina Ha,Hyesook Park 환경독성보건학회 2016 환경독성보건학회지 Vol.31 No.-

Objectives A stable follow-up participation rate is a very important factor for validity in a cohort study. This study analyzed the factors that affect the participation rate at one hospital-based birth cohort in South Korean. Methods The participants were recruited from the Mothers’ and Children’s Environmental Health study between 2006 and 2010. The analysis targeted 1751 mothers who participated in a birth cohort. We conducted analyses of general characteristics during pregnancy and those of infants at birth that affect the participation rate of the 6-month follow-up survey. Results The participation rate for the 6-month follow-up survey was 60.4%. The participation rate in the follow-up of the subsequent period decreased within a 5% to 10% range compared to the number of subjects. The participation rate of premature infants was 16.9% lower than that of a full-term infant (52.6% vs. 69.5%). Analysis showed a 16.7% difference between the participation rate of low-birthweight infants in follow-ups (53.7%) and the participation rate of infants with normal weight (70.4%). The participation rate of mothers who were employed during pregnancy was significantly lower for the 6-month follow-up compared to the participation rate of mothers who were unemployed during pregnancy. Conclusions In this study, factors such as premature birth, low-birthweight, and the employment status of the mother during pregnancy affected the participation rate of the follow-up survey for the birth cohort at six months. A specific strategy is needed to encourage survey participation for the high risk groups in the follow-ups.

Ankle Foot Orthosis for Patients with Drop Foot Using Shape-Memory-Alloy Actuators

Bohyun Lee,Jisu Park,Shinsuk Park,Choong Hyun Kim 한국정밀공학회 2023 International Journal of Precision Engineering and Vol.24 No.11

Gait disorders can lower the quality of life of patients. Drop foot, a causative factor of deviated gait patterns, renders patients unable to lift their forefoot towards the body. Hence, a light and compact ankle–foot orthosis (AFO), which is the most common treatment for drop foot, must be designed, especially for patients with impaired lower limb muscles as oxygen consumption increases by 30% per 1.96 N load on their foot. Furthermore, the limited range of ankle angles in the first 10% of the gait cycle (GC) is a major drawback for patients with drop foot compared to healthy individuals. This limited range of ankle angles can be improved by gaining support from an AFO composed of shape memory alloy (SMA) actuators (SMA-AFO). Therefore, in this study, an SMA was used to fabricate a soft actuator to reduce the weight of the AFO. An adaptive frequency oscillator (AO) was implemented in real time for continuous gait phase detection. Walk tests were performed on a treadmill with the SMA-AFO attached to the participants (N = 3). The experimental results showed that the participants could lift their forefoot in the dorsiflexion direction with an ankle angle of 8.75° in the first 10% of the GC. Furthermore, the current required to operate the SMA actuator can be supplied to only 45.3% of the GC, reducing the power consumption. Therefore, the proposed SMA-AFO can be used in patients with drop foot.

Factors Influencing Vaccination in Korea: Findings From Focus Group Interviews

Park, Bomi,Choi, Eun Jeong,Park, Bohyun,Han, Hyejin,Cho, Su Jin,Choi, Hee Jung,Lee, Seonhwa,Park, Hyesook The Korean Society for Preventive Medicine 2018 예방의학회지 Vol.51 No.4

Objectives: Immunization is considered one of the most successful and cost-effective public health interventions protecting communities from preventable infectious diseases. The Korean government set up a dedicated workforce for national immunization in 2003, and since then has made strides in improving vaccination coverage across the nation. However, some groups remain relatively vulnerable and require intervention, and it is necessary to address unmet needs to prevent outbreaks of communicable diseases. This study was conducted to characterize persistent challenges to vaccination. Methods: The study adopted a qualitative method in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Three focus group interviews were conducted with 15 professionals in charge of vaccination-related duties. The interviews were conducted according to a semi-structured guideline, and thematic analysis was carried out. Data saturation was confirmed when the researchers agreed that no more new codes could be found. Results: A total of 4 main topics and 11 subtopics were introduced regarding barriers to vaccination. The main topics were vaccine hesitancy, personal circumstances, lack of information, and misclassification. Among them, vaccine hesitancy was confirmed to be the most significant factor impeding vaccination. It was also found that the factors hindering vaccination had changed over time and disproportionately affected certain groups. Conclusions: The study identified ongoing unmet needs and barriers to vaccination despite the accomplishments of the National Immunization Program. The results have implications for establishing tailored interventions that target context- and group-specific barriers to improve timely and complete vaccination coverage.

A study on the factors affecting the follow-up participation in birth cohorts

Park, Bohyun,Choi, Eun Jeung,Ha, Eunhee,Choi, Jong Hyuk,Kim, Yangho,Hong, Yun-Chul,Ha, Mina,Park, Hyesook The Korean Society of Environmental Toxicology 2016 환경독성보건학회지 Vol.31 No.-

Objectives A stable follow-up participation rate is a very important factor for validity in a cohort study. This study analyzed the factors that affect the participation rate at one hospital-based birth cohort in South Korean. Methods The participants were recruited from the Mothers' and Children's Environmental Health study between 2006 and 2010. The analysis targeted 1751 mothers who participated in a birth cohort. We conducted analyses of general characteristics during pregnancy and those of infants at birth that affect the participation rate of the 6-month follow-up survey. Results The participation rate for the 6-month follow-up survey was 60.4%. The participation rate in the follow-up of the subsequent period decreased within a 5% to 10% range compared to the number of subjects. The participation rate of premature infants was 16.9% lower than that of a full-term infant (52.6% vs. 69.5%). Analysis showed a 16.7% difference between the participation rate of low-birthweight infants in follow-ups (53.7%) and the participation rate of infants with normal weight (70.4%). The participation rate of mothers who were employed during pregnancy was significantly lower for the 6-month follow-up compared to the participation rate of mothers who were unemployed during pregnancy. Conclusions In this study, factors such as premature birth, low-birthweight, and the employment status of the mother during pregnancy affected the participation rate of the follow-up survey for the birth cohort at six months. A specific strategy is needed to encourage survey participation for the high risk groups in the follow-ups.

온라인 수업에 대한 학습자 반응 연구 - 교양 글쓰기 수업을 중심으로

박보현 ( Park Bohyun ) 고려대학교 한국어문교육연구소 2021 한국어문교육 Vol.34 No.-

본 연구는 전면 온라인 수업으로 진행된 대학 교양 글쓰기 수업에 대한 학습자 강의 평가의 서술형 문항을 분석하여 포스트 코로나 시대의 대학 글쓰기 수업에 시사점을 제공하는 데 목적이 있다. 이를 위해 A대학 학습자 148명의 서술형 강의평가 결과를 분석하였는데 먼저 단어와 아이디어 중심으로 읽으면서 하위 요소를 나열한 후 관련 요소들끼리 범주화하여 자료원의 분류 체계를 설정하였다. 이후 범주별 하위 요소들에 대한 학생들의 응답 빈도를 분석하고, 마지막으로 강의에 대한 학습자들의 긍정적 반응과 부정적 반응을 구분하여 학습자의 반응을 분석하였다. 분석 결과 <글쓰기> 수업에 대한 학습자의 긍정적 반응 요인은 ‘수업 내용 적절성(17회)’, ‘피드백 제공(15회)’, ‘학생 이해 및 배려(8회)’, ‘열정(7회)’, ‘온라인 수업(7회)’의 순으로 나타났고, 부정적 반응 요인은 ‘피드백 제공(8회)’, ‘온라인 수업(7회)’, ‘과제 부담(3회)’, ‘평가 기준(3회)’, ‘수업 내용 적절성(3회)’의 순으로 나타났다. 이를 통해 수업 방식에 상관없이 수업의 본질은 교육 내용에 있으며, ‘피드백 제공’은 글쓰기 수업의 학습자 만족도를 좌우하는 핵심 요소라는 것을 확인하였다. The purpose of this study is to provide implications for university writing classes in the post-COVID-19 era by analyzing descriptive items in the student lecture evaluation on university liberal arts writing classes conducted entirely online. To this end, the results of the narrative lecture evaluation of 148 students at A university were analyzed. Accoording to the results of the analysis, the positive reaction factors of learners to the < Writing > class were Class content appropriateness, Providing feedback, Student understanding and consideration, Passion ',Online classes , and the negative reaction factors were Feedback, Online classes, Task burden, Evaluation criteria and relevance of class content. Through this, it was confirmed that the true nature of class is in the content of what is being taught, regardless of teaching methods, and the 'providing feedback' is the key factor in determines the level of students’ satisfaction with the writing class.

국어과 중등교사 임용시험 문법 문항의 인지적 성격 분석 연구

박보현 ( Bohyun Park ) 국어교육학회 2016 國語敎育學硏究 Vol.51 No.1

본 연구는 bloom의 신 교육목표분류체계를 기준으로 2009-2013학년도까지 출제된 5년간의 국어과 중등 임용시험 1차 시험 문법 문항의 인지적 성격을 분석하였고 결과는 다음과 같다. 첫째, 지식 차원에 대한 분석 결과 총 41문항 중 ``사실적 지식`` 범주에 해당하는 문항은 17문항(약 41.5%), ``개념적 지식`` 범주에 해당하는 문항은 23문항(약 56.1%), ``메타인지 지식`` 범주에 해당하는 문항은 1문항(약 2.4%)으로 분석되었다. 둘째, 인지 과정 차원에 대한 분석 결과 총 41문항 중 ``이해하다`` 범주에 해당하는 문항은 35문항(약 85.4%), ``분석하다``와 ``평가하다`` 범주에 해당하는 문항은 각 2문항(약 4.9%), ``적용하다``와 ``창안하다`` 범주에 해당하는 문항은 각 1문항(약 2.4%)으로 분석되었다. 즉 2009-2013학년도 국어과 임용시험 문법 영역에서는 ``사실적 지식이나 개념적 지식을 이해하는`` 문항이 주로 출제되었다. 이를 통해 기존 문항들은 문항의 인지적 성격이 편향되어 있어 국어교사의 ``인지적 복합성``을 평가하기에 충분하지 못했음을 알 수 있다. 앞으로는 국어과 교사 양성과 선발에 필요한 지식의 성격을 고려하여 보다 종합적인 차원에서 인지적 영역의 교사 양성 및 선발의 목표를 설정하고 설정된 목표에 부합하는 평가 문항을 개발해야 할 것이다. The purpose of this study is to analyze the cognitive classification of the items for grammar which had been in the national level qualifying tests for Korean language teacher candidates of secondary schools from 2009 to 2013. This study`s analysis standards are classified using Anderson & Krathwohl`s educational taxonomy that was written by Krathwohl who is co-author of Bloom et al.`s taxonomy, so this taxonomy has a meaning as a revised edition of original taxonomy. The result of this study is summarized as follows. First, in the structure of the knowledge dimension of the revised taxonomy, there had been 17 items for factual knowledge, 23 items for conceptual knowledge, 1 item for metacognitive knowledge. But no item for procedural knowledge of the total 41 test items. Second, in the structure of the cognitive process dimension of the revised taxonomy, there had been 35 items for ``understand``, 2 items for ``analyze`` and ``evaluate`` respectively, 1 item for ``apply`` and ``create`` respectively. But no item for ``remember`` of the total 41 test items. As above data show, test item for grammar had been focused mainly on ``understand of factual and conceptual knowledge``. This is not enough to evaluate teacher`s speciality. So the concept of cognitive complexity needs to be considered at the question items for the national level qualifying tests for Korean language teacher candidates of secondary schools.