• Journal of Trauma and Injury
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• v.18 no.1
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• pp.1-16
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• 2005

An ideal trauma care system would include all the components identified with optimal trauma care, such as prevention, access, acute hospital care, rehabilitation, and research activities. Central to an ideal system is a large resource-rich trauma center. The need for resources is primarily based on the concept of being able to provide immediate medical care for unlimited numbers of injured patients at any time. Optimal resources at such a trauma center would include inhouse board-certified emergency medicine physicians, general surgeons, anesthesiologists, neurosurgeons, and orthopedic surgeons. Other board-certified specialists would be available, within a short time frame, to all patients who require their expertise. This center would require a certain volume of injured patients to be admitted each year, and these patients would include the most severely injured patients within the system. Additionally, certain injuries that are infrequently seen would be concentrated in this special center to ensure that these patients could be properly treated and studied, providing the opportunity to improve the care of these patients. These research activities are necessary to enhance our knowledge of the care of the injured. Basic science research in areas such as shock, brain edema, organ failure, and rehabilitation would also be present in the ideal center. This trauma center would have an integrated concurrent performance improvement program to ensure optimal care and continuous improvement in care. This center would not only be responsible for assessing care delivered within its trauma program, but for helping to organize the assessment of care within the entire trauma system. This ideal trauma center would serve as a total resource for all organizations dealing with the injured patient in the regional area.

• Health Policy and Management
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• v.16 no.2
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• pp.77-95
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• 2006

The present study was conducted to examine the degree of variation in length-of-stay (LOS) among health care institutions participating in 17 diagnosis-related groups (DRGs) payment system and to find out hospital characteristics affecting the variation. Electronic medical claims data for treatments of severity classification '0' of 17 DRGs provided for two $years(2003{\sim}2004)$ were collected. For each DRG, the degree of variation in average LOS among health care institutions were analyzed using the random effect model. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS. Significant variations in LOS were observed 9 DRGs including unilateral/bilateral lens procedures, adult/child tonsilectomy, other anal procedures, bilateral adult/child herniorraphy, unilateral child herniorraphy, and hysterectomy, and hysterectomy using laparoscopic procedure. Among the 9 DRGs, five DRGs were selected to investigate the factors explaining for the variation. It was observed that the location of institution was significant predictors for all five DRGs. Within the same DRGs, LOS was significantly shorter among the institutions located in Seoul than those in other areas. As compared to clinics, hospitals and general hospitals/tertiary care institutions showed significantly longer LOS for DRGs of lens procedures, tonsilectomy, and other anal procedures. It is recommended that the institutions located in other than Seoul area benchmark the strategies of the institution in Seoul in efficiently managing LOS. Also, significant variation within the same severity classification such as other anal procedures implies the imminent need for improvement of patient classification system.

• The Journal of Korean Medicine
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• v.41 no.2
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• pp.137-149
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• 2020

Background: Opioids are a class of drugs found in the opium poppy, and used primarily as a pain reliever. About 130 people die every day from opioid abuse in the U.S., and the number of deaths was 6 times higher than it was 20 years ago. Objectives: To derive the implications on Korean Medicine(KM), this study aimed to investigate the current state of opioids abuse in the U.S. and analyze cases to solve opioids abuse using acupuncture. Methods: Literature on opioids abuse in the U.S. were searched through the websites of government, agency, and research institute. Results: There were several cases using acupuncture on opioids abuse. First, the Act on the use of acupuncture was enacted. Second, the clinical practice guidelines by the American College of Physicians recommended using acupuncture. Third, a large clinical study was conducted on whether acupuncture could replace opioids. Fourth, Vermont and Washington State conducted pilot projects on insurance coverage of acupuncture. Conclusions: As opioids issues are also valid in Korea, KM can serve a critical role in pain management to pursue expanded insurance coverage. In order to do so, building the discourses of KM in opioid issues is critical by defining its medical advantage, conducting large-scale clinical researches and implementing pilot projects to tackle social problems.

• Journal of Distribution Science
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• v.15 no.7
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• pp.73-83
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• 2017

Purpose - The purpose of this paper is to explore the CSR activities of small enterprises in hospitality and tourism industry in South Korea. Since previous research on CSR activities has considerably focused on large enterprises whereas small enterprises have relatively less attention, this study aims to explore the characteristics of small enterprises in hospitality and tourism industry and their CSR activities. Research design, data, and methodology - The population of interest for this study was social enterprises registered in Korea Social Enterprise Promotion Agency (2016), and it was used to verify the social enterprises which has a certification for social enterprises. From 1672 companies in total, the sampling frame was a database with 117 companies in hospitality and tourism industry. This study investigates social enterprises' CSR activities on the company's official websites (e.g., company reports, magazines, the news articles, and interviews). The websites of the selected enterprises in hospitality and tourism industry were analyzed for examining CSR activities by the quantitative content analysis. All of the CSR activities in small social enterprises were classified into six dimensions based on the stakeholder theory. Results - The findings of this study provide the characteristics of the 117 small social enterprises and their specific CSR initiatives. A total of eight main business lines were identified: 1) fair travel, 2) leisure/sports, 3) accommodation/camping, 4) medical tourism, 5) exhibitions/art events/cultural events, 6) leisure activities for vulnerable social groups, 7) Korean traditional culture, and 8) ecotourism/agricultural tourism. The CSR initiatives were classified into six dimensions: 1) environment, 2) employment, 3) multicultural families and vulnerable social groups, 4) local community, 5) economic prosperity, and 6) product. Conclusions - This study revealed the special CSR initiative examples of small enterprises in hospitality and tourism industry. Small social enterprises participate in CSR activities mainly related to their own business lines. Moreover, these enterprises are more closely embedded in their local community development, job creation and education for local residents and vulnerable social groups, and traditional heritage preservation. The findings of this study provide theoretical and practical implications and they can contribute to enrich CSR with literature for small enterprises in hospitality and tourism industry.

• Safety and Health at Work
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• v.7 no.3
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• pp.201-207
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• 2016

Background: Korean Working Conditions Surveys (KWCS), referencing European Working Conditions Surveys, have been conducted three times in order to survey working condition and develop work-related policies. However, we found three limitations for managing the collected KWCS data: (1) there was no computerized system for managing data; (2) statistical KWCS data were provided by limited one-way communication; and (3) the concept of a one-time provision of information was pursued. We suggest a web-based public service system that enables ordinary people to make greater use of the KWCS data, which can be managed constantly in the future. Methods: After considering data characteristics, we designed a database, which was able to have the result of all pairwise combinations with two extracted data to construct an analysis system. Using the data of the social network for each user, the tailored analysis system was developed. This system was developed with three methods: clustering and classification for building a social network, and an infographic method for improving readability through a friendly user interface. Results: We developed a database including one input entity consisting of the sociodemographic characteristics and one output entity consisting of working condition characteristics, such as working pattern and work satisfaction. A web-based public service system to provide tailored contents was completed. Conclusion: This study aimed to present a customized analysis system to use the KWCS data efficiently, provide a large amount of data in a form that can give users a better understanding, and lay the ground for helping researchers and policy makers understand the characteristics.

• Safety and Health at Work
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• v.6 no.3
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• pp.256-262
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• 2015

Background: Heart attack is the most common cause of line-of-duty death in the fire service. Daily aspirin therapy is a preventative measure used to reduce the morbidity of heart attacks but may decrease the ability to dissipate heat by reducing skin blood flow. Methods: In this double-blind, placebo-controlled, crossover study, firefighters were randomized to receive 14 days of therapy (81-mg aspirin or placebo) before performing treadmill exercise in thermal-protective clothing in a hot room [$38.8{\pm}2.1^{\circ}C$, $24.9{\pm}9.1%$ relative humidity (RH)]. Three weeks without therapy was provided before crossing to the other arm. Firefighters completed a baseline skin blood-flow assessment via laser Doppler flowmetry; skin was heated to $44^{\circ}C$ to achieve maximal cutaneous vasodilation. Skin blood flow was measured before and after exercise in a hot room, and at 0 minutes, 10 minutes, 20 minutes, and 30 minutes of recovery under temperature conditions ($25.3{\pm}1.2^{\circ}C$, $40.3{\pm}13.7%\;RH$). Platelet clotting time was assessed before drug administration, and before and after exercise. Results: Fifteen firefighters completed the study. Aspirin increased clotting time before and after exercise compared with placebo (p = 0.003). There were no differences in absolute skin blood flow between groups (p = 0.35). Following exercise, cutaneous vascular conductance (CVC) was $85{\pm}42%$ of maximum in the aspirin and $76{\pm}37%$ in the placebo groups. The percentage of maximal CVC did not differ by treatment before or after recovery. Neither maximal core body temperature nor heart rate responses to exercise differed between trials. Conclusion: There were no differences in skin blood flow during uncompensable heat stress following exercise after aspirin or placebo therapy.

• Safety and Health at Work
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• v.2 no.1
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• pp.9-16
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• 2011

The majority of people diagnosed with diabetes mellitus are in the working age group in developing countries. The interrelationship of diabetes and work, that is, diabetes affecting work and work affecting diabetes, becomes an important issue for these people. Therapeutic options for the diabetic worker have been developed, and currently include various insulins, insulin sensitizers and secretagogues, incretin mimetics and enhancers, and alpha glucosidase inhibitors. Hypoglycemia and hypoglycaemic unawareness are important and unwanted treatment side effects. The risk they pose with respect to cognitive impairment can have safety implications. The understanding of the therapeutic options in the management of diabetic workers, blood glucose awareness training, and self-monitoring blood glucose will help to mitigate this risk. Employment decisions must also take into account the extent to which the jobs performed by the worker are safety sensitive. A risk assessment matrix, based on the extent to which a job is considered safety sensitive and based on the severity of the hypoglycaemia, may assist in determining one's fitness to work. Support at the workplace, such as a provision of healthy food options and arrangements for affected workers will be helpful for such workers. Arrangements include permission to carry and consume emergency sugar, flexible meal times, selfmonitoring blood glucose when required, storage/disposal facilities for medicine such as insulin and needles, time off for medical appointments, and structured self-help programs.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.3
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• pp.243-253
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• 2015

Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

• Proceedings of the Korean Institute of Navigation and Port Research Conference
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• v.29 no.1
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• pp.125-129
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• 2005

This study aims to provide divers with improved safe diving practices by analyzing reports on scuba diving casualties that recently(from 1997-2003)occurred in Korea, Japan and USA. The result of this study can contribute toward preventing the diving accident. All the data were collected through the diving accident reports of various sourse, which include KUA(Korea Underwater Association) technical committee, the accident statistical data of National Maritime Police Agency, articles of domestic and foreign scuba diving magazine, accident reports of various newspaper, annual report on decompression illness and diving fatalities by DAN(Diver Alert Network), various type of data on diving accident from local as well as national seminars, and medical treatment data of diving accident.

• The Journal of Korean Medicine
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• v.35 no.2
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• pp.1-11
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• 2014

Objectives: To evaluate the effect of acupuncture as an adjunct treatment to increase the success rate of in vitro fertilisation (IVF). Methods: A review of the English and Korean literature was conducted to identify studies on acupuncture as an adjunct treatment to IVF. The main outcome measures were the biochemical pregnancy rate (BPR), the implantation rate (IR), the clinical pregnancy rate (CPR), the miscarriage rate (MR), the on-going pregnancy rate (OPR) and the live birth rate (LBR). Results: Nine meta-analyses of 11 systematic reviews (SRs) were included in this review. In four SRs, the overall IVF outcomes regardless of the procedural steps were documented; two of these SRs reported a significant effect on the CPR. One SR reported that acupuncture at the time of controlled ovarian hyperstimulation had a significant effect on the BPR. Seven SRs reported that acupuncture had no significant impact on transvaginal oocyte retrieval (TVOR). In eight SRs, significant impacts on the CPR, LIBR and OPR were reported when acupuncture was performed around the time of embryo transfer (ET). The results of repeated acupuncture after ET were included in two SRs, which included the same primary studies. The results of the SRs showed that acupuncture had a positive effect on the CPR. Conclusions: When the complete IVF procedure is analysed, there is conflicting evidence in that some reviews have found that acupuncture leads to an increased CPR but others have not. In addition, the reviews presented no evidence to suggest that acupuncture has any specific risks.