• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.835-840
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• 2008

Acupuncture has long been contended to be effective in an ischemic stroke. A real-time monitoring of glutamate, an excitotoxin in the process of ischemic neuronal damage, in the striatum is tried in a rat model of global ischemia. Global ischemia was induced by the 11 vessel occlusion method for 10 minutes, during which acupuncture stimulation on GB34 and GB39 points was executed. Glutamate release in the rat striatum was monitored 256 times per second using real-time amperometric biosensor. Real time measurement data of 10 minutes prior to the induction of ischemia served as baseline data. Data acquisition continued for 30 minutes after the initiation of reperfusion. Peak concentration of glutamate release along with incidentally measured EEG and cerebral blood flow was compared between cases with and without acupuncture stimulation. Peak concentration of glutamate lowered when acupuncture stimulation was executed. A real time monitoring system of 11 vessel-occlusion induced global ischemia model was successfully established. The effect by acupuncture on acute global ischemia was successfully observed in this real-time monitoring setting, which may be one of the neuroprotective mechanism of acupuncture.

• Korean Journal of Health Education and Promotion
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• v.27 no.5
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• pp.63-71
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• 2010

Objectives: The field of health education is still relatively new and is therefore evolving and developing rapidly throughout the world. Many countries' certification programs are still being created. This paper will discuss on the US CHES system of regulation, accreditation, and implementation for the future development of international health education programs. Methods: This article focuses on the United States CHES credentialing program, specifically on its historical development and the roles, employment settings and socioeconomic demographics of current CHES professionals through literature review. Results: The roles and skills required vary by employment setting, with seven universally recognized responsibilities of health educators. There are also 35 key competencies which are crucial to the role of the health educator, with 163 sub-competencies performed by all health educators. The employment of health educators will increase from 62,000 in 2006 to 78,000 in 2016. As the costs of healthcare increase, employers are projected to hire more health educators to decrease healthcare costs through prevention and early detection of chronic illnesses. Community health non-profit agencies, academia, healthcare (hospital/clinic), schools, government/government contracting, and businesses are some of the most widespread employment settings for health educators in the United States. Conclusion: Better understanding of this longstanding and successful program will benefit countries developing their own certification system. The variety and specificity of the information on the US CHES program may be of value as South Korea continues to develop its Korean CHES program.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.33-43
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• 2024

Purpose:The acute hospital accreditation program launched in South Korea has shown positive effects on safety culture and quality of care. However, relative weights have not yet been investigated for accreditation criteria with a hierarchical structure. This study aimed to derive the relative weights of acute-care hospital accreditation criteria. Methods: We conducted an online survey using the analytic hierarchy process (AHP) technique to assess the validity, importance, and urgency of acute hospital accreditation criteria. The AHP online survey link was distributed in November 2022 after obtaining informed consent from 10 experts in hospital accreditation. Results: 'Basic value system' ranked highest, while 'patient care system' ranked second in terms of validity, importance, and urgency. 'Performance management system' had the lowest validity and urgency, while 'organizational management system' carried the lowest importance. Within the 'patient care system' domain, 'surgery and anesthesia sedation management' scored highest in validity and importance, and 'patient care' scored highest in urgency. 'Care delivery system and evaluation' received the lowest scores for all three aspects. In the 'organizational management system' domain, infection control ranked highest in terms of validity, importance, and urgency. The lowest validity was observed for 'management and organizational operation' and the lowest importance and urgency were noted for 'human resource management'. Conclusion: The weights for validity, importance, and urgency, as shown in each domain and chapter, and the number of measurable elements included, are largely inconsistent. This study will contribute to the development of the structure and scientific improvement of accreditation standards.

• Korean Journal of Health Education and Promotion
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• v.31 no.4
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• pp.63-72
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• 2014

Objectives: The current study reviews the implementation and evaluation of the Chronic Disease Self-Management Program (CDSMP) in the United States (U.S.) to illustrate the program's potential contribution to improving health among Korean adults with chronic conditions while saving healthcare costs. Methods: This study examines existing literature on the history, theoretical background, essential elements, and delivery outcomes of CDSMP with special focus on the successes and challenges to be faced in the implementation of CDSMP to Koreans with chronic conditions. Results: CDSMP is designed to empower people with chronic conditions to develop skills necessary for medical, social role, and emotional management of chronic conditions. Recent studies show the utility of CDSMP in achieving the Triple Aim health reform goals (i.e., better care, better health, better value). Lessons learned from the U.S. experience emphasize the importance of establishing evidence-based studies, collaborating with community partners, and diversifying funding sources to make CDSMP more sustainable. Conclusion: The current study demonstrates the replicability of CDSMP and potential for expansion in Korea. More concerted efforts among academia, government, and communities are needed to deliver CDSMP to Korean adults and identify its effectiveness within the Korean context in terms of meeting the Triple Aim goals of better care, better health, and better value.

• Quality Improvement in Health Care
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• v.21 no.1
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• pp.12-31
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• 2015

Objectives : The purpose of this study was to develop the qualification system for training of Quality improvement professionals who work for improving patients' safety and healthcare quality. Methods : Based on the various laws and regulations, and the operational status of other professionals' qualification systems, a basic plan of professional qualification system of QI was drawn. And through meetings with QI experts, the final scheme of the concrete qualification system was developed. Results : For management of professionals's certification or qualification, fairness and reliability are important. To do this, setting the official standard, providing a standardized training program and having appropriate qualification test are required. In order to operate the qualification system strategically, 1) the introduction step, 2) dissemination and expansion step, and 3) fusing step should be considered. As a governing body for QI specialists' qualification, 'QI professionals' qualification Center (tentative)' must have the committee to assure fairness, professionalism, and reliability. In addition, 'QI Experts Certification Department (tentative)" to develop standards for the qualification tests and conduct the tests program,' QI experts Education Department (tentative name)" must be able to operate and maintain the QI training for professional qualifications. QI professional qualification exam must be taken by everyone regardless of age, gender, race, occupation, education, and work experience. The examination should include management, leadership, strategic planning and design, quality management, health care information, patient safety culture. Practical training courses can have three step programs; beginning, intermediate and special level. Conclusion : The QI qualification system need strategic approaches for the experts working for healthcare quality improvement and patient safety. It should include the program of standardized contents and test, and operating protocol of the qualificaton system.

• Health Policy and Management
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• v.27 no.3
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• Journal of Biomedical Engineering Research
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• v.35 no.4
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• pp.87-94
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• 2014

Recent technological advances have increased interest in personal health monitoring. Electrocardiogram(ECG) monitoring is a basic healthcare activity and can provide decisive information regarding cardiovascular system status. In this study, we developed a capacitive ECG measurement system that can be included within a cloth mattress pad. The device permits ECG data to be obtained during sleep by using capacitive electrodes. However, it is difficult to detect R-wave peaks automatically because signals obtained from the system can include a high level of noise from various sources. Because R-peak detection is important in ECG applications, we developed an algorithm that can reduce noise and improve detection accuracy under noisy conditions. Algorithm reliability was evaluated by determining its sensitivity(Se), positive predictivity(+P), and error rate(Er) by using data from the MIT-BIH Polysomnographic Database and from our capacitive ECG system. The results showed that Se = 99.75%, +P = 99.77%, and Er = 0.47% for MIT-BIH Polysomnographic Database while Se = 96.47%, +P = 99.32%, and Er = 4.34% for our capacitive ECG system. Based on those results, we conclude that our R-peak detection method is capable of providing useful ECG information, even under noisy signal conditions.

• Clinical and Experimental Reproductive Medicine
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• v.29 no.4
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• pp.303-310
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• 2002

Objective s: To estimate the frequency of Y chromosome microdeletions in the Korean population of infertile men and to evaluate the relationship between microdeletion on the Y chromosome and clinical phenotypes of infertile men with idiopathic azoospermia and oligozoospermia. Materials and Methods: Genomic DNA was extracted from blood samples collected from 330 infertile men attending the Infertility Clinic at Samsung Cheil Hospital, Korea. Six sequence tagged sites (STSs) spanning the azoospermia factor (AZF) regions of the Y chromosome were amplified by polymerase chain reactions (PCRs). Results: Microdeletions on Y chromosome were detected in 35 (10.6%) of the 330 infertile men. Most of the microdeletions (91.4%) involved AZFb or AZFc. The high incidence of microdeletions were found in AZFc region (57.1%), but the low in AZFa (8.6%) and AZFb (5.7%). Larger microdeletions involving two or three AZF regions were detected in 28.6% of cases. All patients (6 patients) with deletion of AZFa region showed no germ cell phenotypes, Sertoli cell only syndrome or Leydig cell hyperplasia in histopathologic examinations. Conclusion: Microdeletions on the Y chromosome, especially, at AZFc/DAZ regions may be the major cause of azoospermia and severe oligozoospermia. We suggest that idiopathic infertile men have genetic counselling and microdeletion analysis on the Y chromosome before IVF-ET and ART program.

• Journal of Service Research and Studies
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• v.9 no.3
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• pp.87-99
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• 2019

Healthcare and data science are often linked through finances as the industry attempts to reduce its expenses with the help of large amounts of data. Data science and medicine are rapidly developing, and it is important that they advance together. Data science is a driving force in transition of healthcare systems from treatment-oriented to preventive care in healthcare 3.0 era. It enables customized precision-based medicine that current healthcare systems cannot facilitate, and discovers more cost-effective treatment. Currently, healthcare big data is in the reality of medical institution, public health, medical academia, pharmaceutical sector as well as insurance agency. With this motivation, the medical college of Soonchunhyang university has performed a 'healthcare data science initiative(HDSI)' since 2014. Most of domestic HDSI programs focus on short-term contents such as mentoring and sharing cases for data science. Therefore, it is difficult to provide education tailored to the level of skills and job competency required at the practical site. Soonchunhyang HDSI implemented specialized strategies for improving resilience and response to changes in the IT education of current healthcare with the emphasis on the need for systematic activation of the practical HDSI. The HDSI has been performed as a part of on industry-academic link program in CK-1. Through quantitative and qualitative analysis, this paper discussed the HDSI process, performance, achievement, and implications.

• Perspectives in Nursing Science
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• v.8 no.1
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• pp.32-41
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• 2011

Purpose: This study sought to determine the possibility of developing the data-sharing infrastructure of an integrated information system to improve the quality of home and visit-based healthcare services. Methods: The articles of study here were the forms used by a visiting healthcare agency, a home healthcare system of a home healthcare agency, and those used in long-term care insurance for elderly. We visited a visit-based healthcare agency and a home healthcare agency to survey their forms and interviewed relevant practitioners, and we searched for forms associated with long-term care insurance for the elderly on the Internet. We then organized the terms in each form and mapped them among the form after analyzing the concepts as a whole to inquiry into the possibility of integration. Results: The mapping procedure divided the terms into those related to personal information, problems and interventions. Mapping between the standard system (Omaha system) and the type of form was also done. Conclusion: In this study, we found that programs were configured differently depending on the objectives of the service. It is necessary to develop the program with an integrated information system by comparing the three services in terms of their distinct advantages, after which such a service should be utilized. The results of this study can serve as a database for the creation of a new integrated system.