Analysis of Tertiary Hospital Utilization in Pediatric Orthopaedics: a Study Using Nationwide Sample Data from Korea

Bae Kunhyung,Park Soo-Sung,Park Jinhee,Kang Michael Seungcheol 대한의학회 2021 Journal of Korean medical science Vol.36 No.45

Background: In the Korean medical system, the severity classification for a specific disease depends primarily on its nationwide admission rate in tertiary hospitals. Inversely, one of the important designation criteria for a tertiary hospital is the hospital's treatment ratio of patients classified as having a specific severe disease. Most diseases requiring pediatric orthopaedic surgery (POS) are not currently classified as high severity in terms of disease severity. We investigated the admission rates for the representative POS diseases in tertiary hospitals and compared these rates with those for adult orthopaedic surgery (AOS) diseases. Methods: Seven POS diagnoses and three AOS diagnoses were selected based on frequency of admission. Nationwide sample data were used to investigate the admission rates for these representative diagnoses from 2008 to 2017. Results: Six of the seven frequent POS diagnoses presented high admission rates in tertiary hospitals (62.5–92.3%). In contrast, all frequent AOS diagnoses presented low admission rates in tertiary hospitals. Conclusion: The admission rates of frequent POS diagnoses in tertiary hospitals are high. Considering that these rates are the most important factors for the classification of disease severity, POS diseases seem to be underestimated in terms of severity. This may lead to a tendency for tertiary hospitals to intentionally reduce the admission of children with POS diseases. As a result, these children may not receive appropriate professional care. Therefore, for the disease severity, POS diseases should be classified differently from general AOS diseases by using different criteria reflecting the patient's age.

Effects of shift work on abdominal obesity among 20–39-year-old female nurses

Gyeong-Jin Lee,Kunhyung Kim,Se-yeong Kim,Jeong-Ho Kim,Chunhui Suh,Byung-Chul Son,Chae-Kwan Lee,Junghye Choi 대한직업환경의학회 2016 대한직업환경의학회지 Vol.28 No.-

Background: This study aimed to investigate the effects of shift work on abdominal obesity among young and middle-aged female nurses during a 5-year retrospective study. Methods: This retrospective study included female nurses (20–39 years old) who worked at a university hospital in Korea and had available health screening results from 2010–2015. Among 2,611 employees, 934 healthy 20–39-year-old female nurses were identified, and data regarding their demographic information (age and date of employment), waist circumferences (WC), and lifestyle factors (alcohol and exercise) were obtained. Abdominal obesity was defined as a WC of ≥80 cm, based on the World Health Organization’s Asia-West Pacific standard in 2000. The mean WC change from baseline was analyzed using the paired t test, and the association between shift work and abdominal obesity was analyzed using the generalized estimating equation. Results: Compared to all day workers (both age groups), the 20–29-year-old nurses did not exhibit significant changes in WC at each follow-up. However, among the 30–39-year-old nurses, shift workers exhibited a significant change in WC (vs. baseline) during years 4 and 5, compared to day workers. After adjusting for effective confounders and stratifying the participants according to age, the 20–29-year-old nurses exhibited an odds ratio of 3.21 (95 % confidence interval: 1.29–7.98) for shift work-associated obesity, although the odds ratio for the 30–39-year-old nurses was not statistically significant. Conclusion: In the study population, shift work was associated with a significant change in mean WC among 30–39-yearold nurses, and the shift work-associated risk of abdominal obesity was significant among 20–29-year-old nurses. These results indicate that shift work may influence abdominal obesity differently in 20–29-year-old and 30–39-year-old female nurses.

PR 및 PC-SAFT 상태방정식을 이용한 메탄과 에탄 이성분계의 기액 상평형 예측

박종기(Jongkee Park),조정호(Jungho Cho),최건형(Kunhyung Choe),이상규(Sanggyu Lee),양영명(Young-myung Yang) 한국가스학회 2009 한국가스학회 학술대회논문집 Vol.2009 No.4

Distribution of PFOA and PFOS in maternal blood, cord blood and breast milk in Busan

Chunhui Suh,Chae Kwan Lee,Kunhyung Kim,Byung Chul Son,Jong Tae Lee 환경독성보건학회 2013 한국독성학회 심포지움 및 학술발표회 Vol.2013 No.10

인력의 고령화와 인적자원관리 연구: 국외연구의 동향과 국내연구의 향후 과제

김나정(Najung Kim),김성철(Sungchul Kim),박근형(Kunhyung Park) 한국인사조직학회 2017 인사조직연구 Vol.25 No.4

한국 사회는 현재 전 세계에서 가장 빠르게 고령화가 진행되고 있으며 국내 기업 현장에 있는 인적자원관리 실무자들에게 고령노동자와 인력의 고령화는 중요한 화두이다. 하지만 고령화가 급격하게 진행되는 만큼 국내 인적자원관리 문헌에서 고령노동자들에 대한 논의는 갓 시작되었으며, 이론적인 측면이나 실무적인 측면에서 의의 있는 학문 분야로써 부족함이 많은 것이 현실이다. 이에 본 연구는 궁극적으로 (1) 고령노동자에 대한 이해와 관리에 도움이 될 인적자원관리 연구주제들에 대해 제언하고 (2) 고령노동자와 상대적으로 젊은 노동자 간의 차이점과 유사점을 설명할 수 있는 고령화 과정에 대한 이론적인 접근법들을 정리하려 한다. 이를 위해 국내 인적자원관리 분야와 관련된다고 판단한 21개의 학술지를 대상으로 인력의 고령화, 고령노동자, 연령 차이에 대한 연구들을 망라하는 광범위한 조사를 실시하였다. 최종적으로 9개의 학술지에 게재된 105편의 논문들을 대상으로 문헌고찰이 진행되었고 결과는 다음과 같았다. 고령노동자에 대해 인사관리 기능별로 다양한 주제들에 대한 연구가 필요함에도 그간의 문헌에서는 한정적인 주제에 대해서 연구가 진행되어 왔으며 고령노동자의 행동, 태도, 특성에 대한 설명을 위해서 고령화에 대한 이론이 도입된 경우가 극히 적었다. 따라서 아직은 미흡한 해당 분야 연구 발전을 위하여 본 논문에서는 국외문헌을 참고하여 평생발달심리학, 노인학등 여러 분야에서 개발된 고령화에 대한 이론들을 정리하고, 고령노동자에 대한 인적 자원관리 연구 주제들을 제시하였다. 또한, 고령노동자에 대한 정의와 인식은 국가 환경의 영향을 받을 수밖에 없기 때문에 한국 사회의 특수성을 고려하여 고령노동자 정의에 사용될 수 있는 여러 기준들에 대해 고찰하였으며, 고령노동자를 포함하여 다양한 연령대의 노동자들의 경제활동에 도움을 줄 수 있는 인적자원관리 프로그램들에 대해 구체적으로 논의하였다. 향후 인적자원관리 연구 분야에서 인력의 고령화와 고령노동자에 대한 이론적으로도 실무적으로 체계적인 연구가 진행되기를 기대하며 제언하였다. Korea is one of the fastest-aging societies in the world and the graying workforce has become a focal issue for Korean human resource managers. However, due to the rapid aging, the discussion on how to manage older workers has only just begun in Korea’s human resources management literature, and plenty of room for improvement remains in how the literature should handle the aging workforce phenomenon, both theoretically and practically. The ultimate goal of this article is therefore to provide (1) the list of HR-related topics that can improve the understanding of older workers and (2) the set of theories that explain why older workers may or may not be different from younger workers. Specifically, this article first reviews the studies on aging workforce and older workers published in Korea. The result highlights that only a paucity of research has implemented theories that explain the effects of aging and that the research topics have been surprisingly limited. Based on the extensive review on various HR-related research topics and multiple theories of aging from the literature abroad, we propose ways of strengthening the theoretical framework and the practical contribution of the literature on aging and work in Korea. In the last part of the article, we underline the importance of developing the literature on older workers and aging workforce that reflects the unique conditions in Korea.

Deciphering the role of a membrane-targeting domain in assisting endosomal and autophagic membrane localization of a RavZ protein catalytic domain

( Jui-hee Park ),( Seung-hwan Lee ),( Sang-won Park ),( Yong-woo Jun ),( Kunhyung Kim ),( Pureum Jeon ),( Myungjin Kim ),( Jin-a Lee ),( Deok-jin Jang ) 생화학분자생물학회(구 한국생화학분자생물학회) 2021 BMB Reports Vol.54 No.2

The bacterial effector protein RavZ from a pathogen can impair autophagy in the host by delipidating the mammalian autophagy- related gene 8 (mATG8)-phosphatidylethanolamine (PE) on autophagic membranes. In RavZ, the membrane-targeting (MT) domain is an essential function. However, the molecular mechanism of this domain in regulating the intracellular localization of RavZ in cells is unclear. In this study, we found that the fusion of the green fluorescent protein (GFP) to the MT domain of RavZ (GFP-MT) resulted in localization primarily to the cytosol and nucleus, whereas the GFP-fused duplicated-MT domain (GFP-2xMT) localized to Rab5- or Rab7-positive endosomes. Similarly, GFP fusion to the catalytic domain (CA) of RavZ (GFP-CA) resulted in localization primarily to the cytosol and nucleus, even in autophagy-induced cells. However, by adding the MT domain to GFP-CA (GFP-CA-MT), the cooperation of MT and CA led to localization on the Rab5-positive endosomal membranes in a wortmannin-sensitive manner under nutrient-rich conditions, and to autophagic membranes in autophagy- induced cells. In autophagic membranes, GFP-CA-MT delipidated overexpressed or endogenous mATG8-PE. Furthermore, GFP-CA_Δα3-MT, an α3 helix deletion within the CA domain, failed to localize to the endosomal or autophagic membranes and could not delipidate overexpressed mATG8-PE. Thus, the CA or MT domain alone is insufficient for stable membrane localization in cells, but the cooperation of MT and CA leads to localization to the endosomal and autophagic membranes. In autophagic membranes, the CA domain can delipidate mATG8-PE without requiring substrate recognition mediated by LC3-interacting region (LIR) motifs. [BMB Reports 2021; 54(2): 118-123]

Effectiveness of a Comprehensive Stress Management Program to Reduce Work-Related Stress in a Medium-Sized Enterprise

Shin-Ae Kim,Chunhui Suh,Mi-Hee Park,Kunhyung Kim,Chae-Kwan Lee,Byung-Chul Son,Jeong-Ho Kim,Jong-Tae Lee,Kuck-Hyun Woo,Kabsoon Kang,Hyunjin Jung 대한직업환경의학회 2014 대한직업환경의학회지 Vol.26 No.-

Objectives: To assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management. Methods: A comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker’s Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011. Results: Most of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved. Conclusions: In light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan.

Population attributable fraction of indicators for musculoskeletal diseases: a cross-sectional study of fishers in Korea

Jaehoo Lee,Bohyun Sim,Bonggyun Ju,Chul Gab Lee,Ki-Soo Park,Mi-Ji Kim,Jeong Ho Kim,Kunhyung Kim,Hansoo Song 대한직업환경의학회 2022 대한직업환경의학회지 Vol.34 No.-

Background: The musculoskeletal disease (MSD) burden is an important health problem among Korean fishers. We aimed to investigate the indicators of the prevalence of MSD and contributions of significant indicators to MSD in Korean fishers. Methods: This cross-section study included 927 fishers (male, 371; female, 556) aged 40 to 79 years who were enrolled from 3 fishery safety and health centers. The outcome variable was one-year prevalence of MSD in 5 body parts (the neck, shoulder, hand, back, and knee). Independent variables were sex, age, educational attainment, household income, job classification, employment xlink:type, hazardous working environment (cold, heat, and noise), ergonomic risk by the 5 body parts, anxiety disorder, depression, hypertension, diabetes, and hyperlipidemia. The adjusted odds ratio of MSDs by the 5 body parts were calculated using multiple logistic regression analysis. We computed the population attributable fraction (PAF) for each indicators of MSDs using binary regression models. Results: The one-year prevalence of MSD in the neck, shoulder, hand, back, and knee was 7.8%, 17.8%, 7.8%, 27.2%, and 16.2% in males vs. 16.4%, 28.1%, 23.0%, 38.7%, and 30.0% in females, respectively. The ergonomic risk PAF according to the body parts ranged from 22.8%–59.6% in males and 22.8%–50.3% in female. Mental diseases showed a significant PAF for all body parts only among female (PAF 9.1%–21.4%). Cold exposure showed a significant PAF for the neck, shoulder, and hand MSD only among female (25.6%–26.8%). Age was not a significant indicator except for the knee MSD among female. Conclusions: Ergonomic risk contributed majorly as indicators of MSDs in both sexes of fishers. Mental disease and cold exposure were indicators of MSDs only among female fishers. This information may be important for determining priority risk groups for the prevention of work-related MSD among Korean fishers.

Relationship between residence characteristics and polycyclic aromatic hydrocarbon exposure in housewives

Hyung-Gue Park,Na-Young Ha,Dae Hwan Kim,Jeong-Ho Kim,Chae-Kwan Lee,Kunhyung Kim,Ji Young Ryu 대한직업환경의학회 2018 대한직업환경의학회지 Vol.30 No.-

Background: Polycyclic aromatic hydrocarbons (PAHs) produced by incomplete combustion have negative effects on human health due to their carcinogenicity and teratogenicity. Indoor sources of PAHs include tobacco smoke, heating sources, and cooking. This study evaluated the relationship between human PAH exposure and residence characteristics. Method: This study was based on the second Korean National Environmental Health Survey (2012-2014). Non-smoking housewives were included in the analyses (n = 1269). The concentrations of urinary PAH metabolites (2-naphthol, 2-hydroxyfluorene, 1-hydroxyphenanthrene, and 1-hydroxypyrene) were adjusted by urine creatinine level. The geometric mean concentrations of urinary PAH metabolites by residential factors were examined. Logistic regression models were used to evaluate associations between residential variables and PAH exposures. Results: The adjusted geometric mean concentrations of urinary 2-hydroxyfluorene and 1-hydroxyphenanthrene were significantly higher in the group residing within 100 m of a major road (p 〈 0.05) than in those residing 〉 100 m from a major road. In logistic regression analyses, the odds ratio (OR) for exceeding the third quartile of urinary 1-hydroxypyrene concentration was significantly higher in the group using coal or wood fuel for residential heating than in the group using gas (OR = 2.745, 95% confidence interval [CI] = 1.295-5.819). The detached house group had a significantly higher OR for 1-hydroxyphenanthrene compared with the apartment group (OR = 1.515, 95% CI = 1.023-2.243). Conclusion: Our study shows the evidence of associations between some urinary PAH metabolite levels (1-hydroxyphenanthrene and 1-hydroxypyrene) and residence characteristics. Additional studies are needed to clarify these associations.

The relationship between urinary BTEX metabolites and residence setting among Korean homemakers

Hyoun Ho Oh,Hyungkyu Park,Dae Hwan Kim,Byung-Chul Son,Chae-Kwan Lee,Kunhyung Kim,Ji Young Ryu 대한직업환경의학회 2017 대한직업환경의학회지 Vol.29 No.-

Background: Benzene, toluene, ethylbenzene, and xylene (BTEX) are emitted in the combustion or volatilization of hazardous wastes and fossil fuels. Paint, varnishing agents, and cigarette smoke are also sources of BTEX in living environments. Few studies have examined indoor exposure to BTEX using biomarkers, especially in residential settings. In this study, we evaluated the relationship between residence factors and BTEX exposure using biomarkers among Korean homemakers. Method: We obtained data on 893 non-smoking homemakers older than 19 years from the Korean National Environmental Health Survey (2009–2011). The concentrations of urinary BTEX metabolites (t,t-muconic acid, hippuric acid, mandelic acid, phenylglyoxylic acid, and total methylhippuric acid) were adjusted using the urinary creatinine. Analysis of covariance (ANCOVA) and logistic regression analysis were used to evaluate the associations between residence parameters and urinary BTEX metabolites. Results: The geometric mean concentrations of t,t-muconic acid and methylhippuric acid were significantly higher in the group that had remodeled within the previous 6 months (p < 0.05) compared with the no-remodeling group. In logistic regression analyses, the odds ratio for exceeding the median urinary concentration of t,t-muconic acid was significantly higher in the group that had remodeled compared with the no-remodeling group (OR = 1.591, 95% CI = 1.063–2.382). Urinary methylhippuric acid was significantly associated with residing in a home located within 100 m of a major road (OR = 1.399, 95% CI = 1.071–1.826). Conclusion: Our study found some significant associations between urinary BTEX metabolites and residence parameters. To find clear associations, additional and more detailed studies are needed.