• 보건행정학회지
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• 제28권4호
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• pp.369-377
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• 2018

Background: Catastrophic health expenditure (CHE) occurs when medical expenditure of a household passes over a certain ratio of household income. This research studied the effect of gender on CHE based on Korea Health Panel data. Methods: This study implemented binary logistic regression model to figure out whether gender affects CHE and how different gender groups show pattern of CHE process. With gender, age, marital status, income level, economic activity, membership of private insurance, existence of chronic disease, and self-rated health were included in the model. Results: Results showed that females faced CHE 1.5 times more than males (odds ratio, 1.241). Also, main determinants of CHE in female groups were marital status, while age and economic activity status were significant in male groups. Subgroup analysis displayed that married female under 35 years old are located in intersectionality of CHE including pregnancy and delivery, multiple health risk behaviors, mental stress, and relatively vulnerable social status due to lower income. Meanwhile, both gender above 50 years old faced remarkably high chance of CHE, which seems to be caused by complex health risk behaviors and chronic diseases. Conclusion: Such results implied not only that gender is an important determinant of CHE, but also other determinants of CHE differ according to gender, which suggests a necessity of gender-based CHE support and rescue policy.

• Parasites, Hosts and Diseases
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• 제57권2호
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• pp.207-211
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• 2019

Anisakiasis is a zoonotic disease induced by anisakid nematodes, and endoscopic inspection is used for a diagnosis or remedy for it. Anisakis simplex, Anisakis physeteris, and Pseudoterranova decipiens had been reported to be the major species causing human infections, particularly, in Japan. However, in Korea, recent studies strongly suggested that Anisakis pegreffii is the major species of human infections. To support this suggestion, we collected anisakid larvae (n=20) from 20 human patients who were undergone gastrointestinal endoscopy at a health check-up center in Korea, and molecular identification was performed on the larvae using PCR-RFLP analysis and gene sequencing of rDNA ITS regions and mtDNA cox2. In addition, anisakid larvae (n=53) collected from the sea eel (Astroconger myriaster) were also examined for comparison with those extracted from humans. The results showed that all human samples (100%) were identified as A. pegreffii, whereas 90.7% of the samples from the sea eel were A. pegreffii with the remaining 9.3% being Hysterothylacium aduncum. Our study confirmed that A. pegreffii is the predominant species causing human anisakiasis in Korea, and this seems to be due to the predominance of this larval type in the fish (sea eels) popularly consumed by the Korean people. The possibility of human infection with H. aduncum in Korea is also suggested.

• Journal of Periodontal and Implant Science
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• 제49권2호
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• pp.105-113
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• 2019

Purpose: An unresolved inflammatory state contributes to the pathogenesis of periodontal disease and metabolic syndrome (MetS). Therefore, the purpose of this study was to evaluate the role of lipoxin A4 (LXA4), a proresolving lipid mediator, in the association between periodontal disease and MetS. Methods: Sixty-seven patients with MetS and 65 patients without MetS were included in the study. Sociodemographic information was obtained via a questionnaire, and detailed medical diagnoses were made. Periodontal parameters (plaque index [PI], gingival index [GI], probing pocket depth [PD], and clinical attachment level [CAL]) and metabolic parameters were measured, and serum LXA4 levels were determined. The associations among MetS, periodontal parameters, and serum LX levels were evaluated by adjusted multivariate linear regression analyses. Results: Patients with MetS were older and had a higher body mass index than patients without MetS. Periodontal parameters (PI, GI, PD, and CAL) were higher in patients with MetS than in those without MetS. Serum LXA4 levels were higher in patients without MetS. Multivariate linear regression analysis indicated a positive association between MetS and periodontal parameters (PD and CAL). Negative associations were established between MetS and LXA4 levels, and between LXA4 and periodontal parameters (PI, PD, and CAL). Conclusions: The presence of higher values of periodontal parameters in patients with MetS and the negative relationship of LXA4 with MetS and periodontal disease may support the protective role of proresolving lipid mediators in the association between periodontal disease and MetS.

• 대한통합의학회지
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• 제9권4호
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• pp.85-89
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• 2021

Background : Klippel-Trenaunay-Weber syndrome (KTS) is a rare congenital medical condition characterized by complex vascular malformation. KTS consists of a classic triad of capillary malformation (hemangioma), venous malformations and bone or soft tissue hypertrophy causing limb asymmetry. The aim of this report is to describe management for gait disturbance and foot pain in a Patient with KTS using custom-made total contact insole. Case presentation : A 32-year-old man with KTS presented with a 3-year history of gait disturbance on hard surface due to right first toe pain and Achilles tendon tightness. The patient had soft tissue hypertrophy, varicose veins and port-wine stains over the right lower limb associated with KTS. True leg length discrepancy was 2 cm. We prescribed custom-made total contact insole to protect his deformed foot and correct leg length discrepancy. The insole of right side included wedge shaped heel lift and the insole of left side included full length lift to add extra support on unaffected side. Also, we provided compression stocking and physiotherapy including manual lymphatic drainage for lymphedema and stretching exercise for tightness in right lower extremity. At 3 years follow-up, postural alignment including pelvic obliquity was improved using a custom-made total contact insole. The degree of scoliosis and foot pain were also reduced. Conclusion : An individualized and multidisciplinary approach is essential regarding the complexity of comorbidities in patients with KTS. For patients with KTS, orthotic management should be considered to prevent and correct deformities related to KTS. Active orthotic management, compression stocking and physiotherapy can enhance the quality of life and function in patients.

• 임상간호연구
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• 제27권1호
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• pp.35-44
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• 2021

Purpose: The aim of this study was to identify the individual, job, and organizational factors affecting the individual innovative behaviors among tertiary care hospitals' nurses. Methods: The participants in this study were 230 nurses who have worked more than one year in tertiary care hospitals. Data were collected using self-administered questionnaires that included individual factors (self efficacy, and empowerment), job factors (knowledge and skills for evidence-based practice, and beliefs for evidence-based practice), organizational factors (perceived organizational support), and individual innovation behavior. The SPSS/WIN 25.0 program was used for data analysis which included descriptive analysis, t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, and hierarchical regression analysis. Results: Individual innovative behavior had significant positive correlations with all of individual, job, and organizational factors. The results of hierarchical regression analysis showed that knowledge and skills for evidence-based practice (β=.28, p<.001), self efficacy (β=.25, p=.002), gender (female, β=.23, p<.001), and beliefs for evidence-based practice (β=.17, p=.016) were significant factors influencing on individual innovative behavior. Conclusion: These findings suggest that knowledge, skills and beliefs for evidence-based practice, and self efficacy were linked to individual innovative behaviors. Therefore, education and human resource management improving self efficacy, knowledge, skills and beliefs for evidence-based practice are needed to increase nurses' individual innovative behaviors in tertiary care hospitals.

• 대한건축학회논문집:계획계
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• 제34권11호
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• pp.95-104
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• 2018

Healthcare technology has been growing and fostering cooperation between industry, university and hospitals as growth engines in korea. So, the medibio research institutes in hospital have been constructed to promote research and industrialization centering on healthcare technology. The purpose of this study is to investigate the cases of research institutes in hospitals, and search the characteristics of building organization of medibio research laboratory facilities. Case study is investigated by floor plan, homepage and site visits about five research institutes selected in research-driven hospitals. The facility title and size of research laboratory is originated from site area and research building location. The building function include not only the research lab and business office reflecting on the development platform, and but assembly and meeting room in the ground level. Laboratory floor plans have three types, rectangular, rectangular+linear and linear type, one is traditional and efficient, the others are people and friendly. And building core types are correlated with lab space unit modules, single and double side core are shown in rectangular type. All the laboratories are open lab, composed with laboratory bench and research note writing desk facing the lab service and enclosed lab-support area. And they have communication space looking as warm and cozy common area for the innovation, convergence and collaboration. As the high risk of contamination and high standard for safety and security, equipment and facilities are well managed with biological environment including BSC, fume hood, PCR classification, eye washing and emergency shower.

• 대한건축학회논문집:계획계
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• 제34권11호
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• pp.3-12
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• 2018

Hospice is the wholistic caring service for terminally ill patient and his family so that he can live in dignity and maintain the quality of life until he passes away peacefully. The purpose of this study is to compare the development of hospice movement in UK, USA, Japan and Korea, to analyze space configuration characteristics of facilities built between 1980-2009 through case study. The result is as follows. First, The modern hospice started in England and it has spread around the world rapidly. In Korea, hospice service was introduced even prior to US and Japan and developed in spite of poor medical environment. The application of health insurance subsidies were late compared to other countries, but the hospice and palliative care system was quickly set on the basis of precedent cases. Second, the number of hospital beds per facility is decreasing, and it has been divided into smaller clusters for the residential atmosphere. The controversy between private rooms and multi-patient room is still ongoing, and increasing facilities without in-patient service. Rather than establishing uniform and absolute regulations, it is necessary to design a flexible space which can cope with various situations such as patients' needs, service changes, and manpower status. Third, the spaces for family members and friends to stay in both private rooms and communal spaces are increasing. Forth, Facilities for patients with different needs, such as children and adolescents and AIDS patients, have been developed in UK and USA. Further research on of patients' diverse needs and customized environmental support is necessary.

• 대한정형도수물리치료학회지
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• 제27권1호
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• pp.1-11
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• 2021

Background: The purpose of this study is to identify the elements for the construction of the Korean academy of orthopedic manipulative physical therapy's (KAOMPT's) non-face-to-face lecture system using the Delphi method. Methods: The Delphi method was applied to 50 expert panel members of the Central Committee and the Provincial Branch of the KAOMPT. The Delphi survey was conducted in two rounds, and the first Delphi survey collected opinions on 40 questions on 12 topics. The second Delphi survey was collected into 25 questions on 4 topics. As a result of the survey, the content validity ratio (CVR), consensus and convergence were measured. Referring to the number of expert panels and previous studies were determine a CVR of at least 2.29, a consensus of at least .75 and a convergence of 0 to .5. Result: In the first Delphi result, out of the total 40 items, 20 items with high content validity ratio were found, and 10 items found double agreement. In the second Delphi result, 13 out of the total 25 items had a content validity ratio higher than 2.29, and 5 items found a double agreement. Conclusion: This study derived items on the role of central and municipal councils, lecture support and lecture room construction, non-face regular course and special lecture operation and personnel for the establishment of non-face-to-face lecture system. Based on this content, it is expected that it will help establish a non-face-to-face lecture system in 2021 through a pilot non-face-to-face lecture that will be implemented in the future.

• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.74-83
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• 2021

Background: This study compared the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) before and after the implementation of public-private mix (PPM). Factors affecting treatment success were also investigated. Methods: Data from culture-confirmed pulmonary MDR-TB patients who commenced MDR-TB treatment at Pusan National University Hospital between January 2003 and December 2017 were retrospectively reviewed. Patients were divided into two groups in terms of PPM status: pre-PPM period, patients who commenced MDR-TB treatment between 2003 and 2010; and post-PPM period, patients treated between 2011 and 2017. Results: A total of 176 patients were included (64 and 112 in the pre- and post-PPM periods, respectively). 36.9% of the patients were resistant to a fluoroquinolone or a second-line injectable drug, or both. The overall treatment success rate was 72.7%. The success rate of post-PPM patients was higher than that of pre-PPM patients (79.5% vs. 60.9%, p=0.008). Also, loss to follow-up was lower in the post-PPM period (5.4% vs. 15.6%, p=0.023). In multivariate regression analysis, age ≥65 years, body mass index ≤18.5 kg/m², previous TB treatment, bilateral lung involvement, and extensively drug-resistant (XDR)- or pre-XDR-TB were associated with poorer treatment outcomes. However, the use of bedaquiline or delamanid for ≥1 month increased the treatment success. Conclusion: The treatment success rate in MDR-TB patients was higher in the post-PPM period than in the pre-PPM period, particularly because of the low rate of loss to follow-up. To ensure comprehensive patient-centered PPM in South Korea, investment and other support must be adequate.

• 중환자간호학회지
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• 제14권2호
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• pp.24-41
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• 2021

Purpose : The aim of this integrative review was to describe communication experiences and needs among the critically ill with an artificial airway and evaluate relevant intervention studies. Methods : Using the method employed by Whittemore and Knafl (2005), we searched for papers on PubMed, CINAHL, and Web of Science published from January 1, 2015 to September 25, 2020. A total of 26 papers (11 descriptive studies, 15 experimental ones) were identified and evaluated. Results : Communication experiences while having an artificial airway, identified either by patients' recall or direct observation, were predominantly negative. However, positive experiences were reported in patients with improvements in physical conditions and functions. Patients' communication needs were diverse, encompassing physical, psycho-emotional, social, spiritual, and medical issues. Interventions tested included alternative and augmentative communication strategies, communication intervention packages, and voice restorative devices. Physical, psychosocial, and communication-related patient outcomes were evaluated using various methods including self-report surveys, interviews, and observations. Conclusions : The findings from this review represent the state of science regarding communication of the critically ill whose vocal abilities are inhibited by the presence of an artificial airway. Future studies with rigorous experimental designs and measures are warranted to better understand and support the complex needs of this highly vulnerable patient population.