Woo Kyung Bae

Effectiveness of 6 Months of Tailored Text Message Reminders for Obese Male Participants in a Worksite Weight Loss Program: Randomized Controlled Trial

Background Worksite nutrition and physical activity interventions are important to help overweight and obese employees lose weight, but costs and insufficient sustained motivation prevent the majority of these programs from succeeding. Tailored text messaging in aiding weight management has been effective in several studies, but no studies have evaluated the effect of a tailored text message service on weight loss in a worksite health promotion program. Objective We studied the efficacy of a tailored text-messaging intervention for obese male participants in a worksite weight loss program of 6 months duration. Methods The study was an unblinded, randomized controlled trial. Men with a body mass index greater than 25 kg/m2 were recruited from the Korea District Heating Corporation, the Korea Expressway Corporation, and the Korea Gas Corporation. The participants were identified by nurse managers. Participants were randomly allocated to 1 of the following 2 groups for 24 weeks: (1) intervention group, which received tailored text message reminders every other day plus 4 offline education sessions and brief counseling with monthly weight check by nurses for weight control over 6 months and (2) control group, which received the 4 offline education sessions and brief counseling with monthly weight check by nurses about weight control over 6 months. The primary outcome was the difference in weight loss at 6 months. A mixed-model repeated-measures analysis was performed to evaluate the effect of the intervention group’s weight loss compared with the control group. Results A total of 205 obese men were randomized into either the intervention (n=104) or the control group (n=101). At the end of 6 months, the intervention group (n=63) had lost 1.71 kg (95% CI –2.53 to –0.88) and the control group (n=59) had lost 1.56 kg (95% CI –2.45 to –0.66); the difference between the 2 groups was not significant (mean difference –0.15, 95% CI –1.36 to 1.07). At the end of the study, 60% (34/57) of the intervention group rated the message program as helpful for weight control and 46% (26/57) would recommend the text message service to their friends. Conclusions Tailored text message reminders did not have a significant effect on weight loss in obese men as part of a worksite weight loss program. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 39629189; http://www.isrctn.com/ISRCTN39629189?q=39629189&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search (Archived by WebCite at http://www.webcitation.org/6VsFkwJH6).

Prevalence of Chronic Obstructive Lung Disease in Korea Using Data from the Fifth Korea National Health and Nutrition Examination Survey

Background Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death worldwide. The awareness and treatment rate of the disease are low despite its relatively high prevalence. With the added data, this study aimed to identify changes in prevalence and risk factors of COPD using the data from the 5th KNHNES. Methods The subjects of this study were 8,969 individuals aged 40 and older who satisfied suitability and reproducibility for pulmonary function tests. The prevalence, awareness and risk factors of COPD were predicted based on the questionnaires on gender, age, educational level, income level, smoking history, body mass index (BMI) and other COPD related questions. Results Diagnosis of COPD was based on the airflow limitation (forced expiratory volume in one second/forced vital capacity <0.7) of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The prevalence of COPD from 2010 to 2012 was 13.7%, of which 23.3% was men and 6.5% women. The prevalence was on the rise, with 12.2% in 2010, 13.2% in 2011, and 15.5% in 2012. In GOLD stage 1, the percentages of those who had cough or sputum and smoking history were 12.1% and 75.5%, respectively, but only 0.1% was diagnosed with COPD. Even after adjusting for asthma and tuberculosis, men, old age, larger amount of smoking were linked with a higher prevalence of COPD, and obese and higher educational level were associated with a lower prevalence of COPD. Conclusion The prevalence of COPD in Korea has been increasing every year, and a higher prevalence was associated with male, older age, more amount of smoking, lower educational level and lower BMI.

Association between secondhand smoke exposure and blood lead and cadmium concentration in community dwelling women: the fifth Korea National Health and Nutrition Examination Survey (2010–2012)

Objectives To assess the association between secondhand smoke exposure and blood lead and cadmium concentration in women in South Korea. Design Population-based cross-sectional study. Setting South Korea (Korea National Health and Nutrition Examination Survey V). Participants 1490 non-smoking women who took part in the fifth Korea National Health and Nutrition Examination Survey (2010–2012), in which blood levels of lead and cadmium were measured. Primary outcome measures The primary outcome was blood levels of lead and cadmium in accordance with the duration of secondhand smoke exposure. Results The adjusted mean level of blood cadmium in women who were never exposed to secondhand smoke was 1.21 (0.02) µg/L. Among women who were exposed less than 1 h/day, the mean cadmium level was 1.13 (0.03) µg/L, and for those exposed for more than 1 h, the mean level was 1.46 (0.06) µg/L. In particular, there was a significant association between duration of secondhand smoke exposure at the workplace and blood cadmium concentration. The adjusted mean level of blood cadmium concentration in the never exposed womens group was less than that in the 1 h and more exposed group, and the 1 h and more at workplace exposed group: 1.20, 1.24 and 1.50 µg/L, respectively. We could not find any association between lead concentration in the blood and secondhand smoke exposure status. Conclusions This study showed that exposure to secondhand smoke and blood cadmium levels are associated. Especially, there was a significant association at the workplace. Therefore, social and political efforts for reducing the exposure to secondhand smoke at the workplace are needed in order to promote a healthier working environment for women.

Implementation of a Videoconferencing System between Multiple Family Medicine Departments.

Attending conferences is important for doctors and residents in family medicine. Nevertheless, departments of family medicine at many hospitals find it difficult to hold regular conferences. Holding joint videoconferences between Family Medicine Departments of several hospitals through a videoconferencing system could solve this problem. Therefore, Family Medicine Departments of Seoul National University Hospital, Seoul National University Bundang Hospital, and Kangwon National University Hospital decided to hold regular joint videoconferences via a videoconferencing system. Eighty-one joint videoconferences were held from April 1 to October 29, 2010. PowerPoint slideshows were transferred to the other two locations in the same resolution as presenters monitor. Image and voice of the speaker were transferred in real time and in acceptable quality. Joint videoconferences are feasible, satisfactory and useful for medical education, especially when individual family medicine departments are small and lack resources to hold face-to-face conferences. We expect that more family medicine departments will choose to participate in implementing similar joint videoconferencing systems in the future.

Efficacy of Carboxymethylcellulose and Hyaluronate in Dry Eye Disease: A Systematic Review and Meta-Analysis

Background The efficacy of two artificial tears, carboxymethylcellulose (CMC) and hyaluronate (HA), was compared in the treatment of patients with dry eye disease. Methods We conducted a systematic review and meta-analysis on randomized controlled trials in the PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases. The efficacy was compared in terms of the mean change from baseline in tear break-up time. The meta-analysis was conducted using both random and fixed effect models. The quality of the selected studies was assessed for risk of bias. Results Five studies were included involving 251 participants. Random effect model meta-analysis showed no significant difference between CMC and HA in treating dry eye disease (pooled standardized mean difference [SMD]=-0.452; 95% confidence interval [CI], -0.911 to 0.007; P=0.053). In contrast, fixed effect model meta-analysis revealed significant improvements in the CMC group when compared to the HA group (pooled SMD=-0.334; 95% CI, -0.588 to -0.081; P=0.010). Conclusion The efficacy of CMC appeared to be better than that of HA in treating dry eye disease, although meta-analysis results were not statistically significant. Further research is needed to better elucidate the difference in efficacy between CMC and HA in treating dry eye disease.

Validity and Reliability of the Korean Version of Neighborhood Physical Activity Questionnaire

Background Given that a substantial number of daily activities take place in neighborhoods, a convenient and effective method for measuring the physical activity of individuals is needed. Therefore, we tested the validity and reliability of the Korean version of the Neighborhood Physical Activity Questionnaire (K-NPAQ), which was developed through translation and back-translation of the NPAQ. Methods The K-NPAQ was administered twice, with a 1-week interval, to participants in the study who were recruited at a health promotion center. We assessed energy expenditure and compliance using an accelerometer and an activity diary. The Kappa statistic and Spearman correlation coefficient were used to evaluate the test-retest reliability of the K-NPAQ, and the Spearman rank correlation was used to assess the validity. Results Of the 122 participants, 43 were excluded owing to a lack of compliance. The Kappa values for all items that were used to assess walking or cycling within or outside the neighborhood were >0.424; 0.251-0.902 for 5 items related to the purpose of the physical activity; 0.232-0.912 for most items related to the number of times and the duration for each types of physical activity. The total energy expenditure and the energy expenditure in the neighborhood were significantly correlated with the K-NPAQ and the accelerometer, with correlation coefficients of 0.192-0.264. Conclusion The K-NPAQ is a valid and reliable tool for measuring physical activity in the neighborhood, and it can be used for individual education and counseling in order to augment physical activity in specific neighborhood environments.

Osteoarthritis Affects Health-Related Quality of Life in Korean Adults with Chronic Diseases: The Korea National Health and Nutritional Examination Surveys 2009–2013

Background Osteoarthritis (OA) is a chronic disease that commonly afflicts the elderly. This disease reduces the health-related quality of life (HRQoL) and causes a significant social burden. Whether the effect of coexisting chronic conditions on HRQoL varies according to the presence of OA remains unclear. Therefore, this study aimed to investigate this notion. Methods A total of 13,395 participants were identified from the 2009–2013 Korean National Health and Nutrition Examination Survey for analysis. HRQoL was assessed using the European quality of life-5 dimensions (EQ-5D) index. Patients with OA were defined as those diagnosed by a physician or those who displayed both, symptoms and radiological findings consistent with OA at the time of the survey. Associations between OA and 8 chronic conditions were tested using regression analysis. Results The EQ-5D index was lower in patients with OA than in those without (mean difference, −0.145; 95% confidence interval [CI], −0.138 to −0.151; P<0.001). Most patients with OA and chronic conditions showed a lower score than those without. EQ-5D was particularly lower in OA patients with hypertension, dyslipidemia, stroke, and renal failure. The estimated β coefficient for the interaction term was significant in renal failure (−0.034; 95% CI, −0.055 to −0.012), after adjusting for demographic and socio-economic variables. Conclusion OA significantly affects HRQoL of Korean elderly individuals alone or when combined with other conditions. OA combined with renal failure is particularly detrimental. These results indicate the importance of managing OA, which is an underestimated disease in public health surveys.

Validation of the Korean Version of Schedule of Fatigue and Anergia: General Physician Questionnaire

The Schedule of Fatigue and Anergy/General Physician (SOFA/GP) was developed to screen for prolonged fatigue in the primary care setting. We aimed to evaluate the reliability and validity of the Korean version of the SOFA/GP (SOFA/GP-K), which is adapted from the original English version. We performed translation and back translation, and after conducting a pilot study, we tested the final version of the questionnaire for its reliability and validity in a Korean primary care setting. Two hundred participants that visited a health examination center in a university hospital completed the survey between September and November 2012. A second survey was performed within 2 weeks of the primary survey to test for reliability. We evaluated concurrent validity between the SOFA/GP-K score, the Fatigue Severity Scale (FSS), and Brief Fatigue Index (BFI) scores. The Spearman correlation coefficient between SOFA/GP-K and FSS was 0.71 and 0.61 between SOFA/GP-K and BFI. Internal consistency of SOFA/GP-K was observed (Cronbachs alpha = 0.82) and construct validity was confirmed by factor analysis. The Kappa scores for test-retest reliability for each survey item were between 0.28 and 0.64. The SOFA/GP-K is a valid and reliable questionnaire for screening fatigue in a primary care setting.

Establishing a Personal Health Record System in an Academic Hospital: One Year's Experience

Background Personal health records (PHRs) are web based tools that help people to access and manage their personalized medical information. Although needs for PHR are increasing, current serviced PHRs are unsatisfactory and researches on them remain limited. The purpose of this study is to show the process of developing Seoul National University Bundang Hospital (SNUBH)s own PHR system and to analyze consumers use pattern after providing PHR service. Methods Task force team was organized to decide service range and set the program. They made the system available on both mobile application and internet web page. The study enrolled PHR consumers who assessed PHR system between June 2013 and June 2014. We analyzed the total number of users on a monthly basis and the using pattern according to each component. Results The PHR service named Health4U has been provided from June 2013. Every patient who visited SNUBH could register Health4U service and view their medical data. The PHR user has been increasing, especially they tend to approach via one way of either web page or mobile application. The most frequently used service is to check laboratory test result. Conclusion For paradigm shift toward patient-centered care, there is a growing interest in PHR. This study about experience of establishing and servicing the Health4U would contribute to development of interconnected PHR.

Monitor preference for electronic medical record in outpatient clinic.

Objectives The objective of this paper is to assess which wide type monitor configurations are preferred when physicians use an Electronic Medical Record (EMR) system in an outpatient clinic setting. Methods We selected three kinds of monitor configurations available for adoption at outpatient clinics with reference to monitor market trends. Fifteen attending physicians of the Seoul National University Bundang Hospital used each monitor configuration in their outpatient clinics. After completing the outpatient sessions, they selected the best monitor configuration for criteria described in five questionnaire items. We counted the number of votes and reviewed opinions of participants. Results The Wide Quad High Definition (WQHD) 27-inch single monitor configuration was most preferred for all questionnaire items. All participants answered that the WQHD 27-inch single monitor configuration was the best for desk space utilization. Eleven out of fifteen participants chose the WQHD 27-inch single monitor configuration as the most suitable monitor for outpatient practice. Conclusions This study found that physicians preferred the WQHD 27-inch single monitor configuration in outpatient clinic settings. Healthcare organizations need to consider this finding when they purchase wide type monitors for EMR systems instead of the standard type monitor.