• Journal of the Korean Society of School Health
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• 제24권2호
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• pp.141-154
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• 2011

Purpose: The purpose is to provide basic information for establishing improvements on performance-based pay's evaluation method of health teachers. Methods: For subjects, 200 teachers at public elementary schools and 200 health teachers at public elementary schools in Gyeonggi-do were conveniently sampled, and then surveyed through a questionnaire. The questionnaire was to recognize recognition of teachers working under the teacher's performance-based pay system, which was quoted in the questionnaire of Choi ji-hye (2005) and Lee mi-gyeong (2008). Inquiry for the recognition of teachers on evaluation of health teacher's performance-based pay system and improvements on the performance-based pay's evaluation method of health teachers were used after consultation with five incumbent health teachers and a review with the thesis director. Results: The performance-based pay's evaluation method of health teachers has the same method with general teachers in schools, so it is not fair to evaluate the performance of health teachers. The ways to improve the performance-based pay evaluation method of health teachers is as follows: first, the approval on improving 'the number of class hours' which is a detailed item of a teacher's performance evaluation criterion to 'the number of health lesson hours per week and the number of students visiting the school infirmary per week'; second, improving 'life guidance' into 'counseling results of medically-treated students, parents of students and personal hygiene guidance'; third, improving 'a teacher in charge' into 'awarding of points by being recognized as a health teacher in charge of all students and considering the economic situation of the region,; forth, improving 'difficulty of position' into 'the number of health-teacher's annual promotion task items and the treatment number of issuing and receiving of official documents', and improving the 'task difficulty' into 'importance and urgency of emergency patient management, risk level and urgency of infectious diseases and avoiding work in charge' appeared to be more than 90% respectively. Conclusion: The performance-based pay system of teachers being carried out every year should be executed by preparing fair evaluation criteria suitable for task properties and the role of health teachers with different evaluation criteria compared to general teachers.

• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.995-1003
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• 2021

Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.

• Journal of Genetic Medicine
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• 제15권2호
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• pp.72-78
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• 2018

Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

• Journal of Korean Society of Health-System Pharmacists
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• 제35권4호
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• pp.418-429
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• 2018

Background : To improve medication adherence in elderly patients, the role of pharmacists in teambased services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital. Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage. Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was "self-adjustment". The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p 0.05) were strong predictors for non-adherence. Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.

• Journal of Digital Convergence
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• 제18권12호
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• pp.445-457
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• 2020

The purpose of this study is to analyze various issues that may arise from the recent deregulation of telemedicine implemented by the government, propose initiative preparations for the implementation of telemedicine policies, and suggest implications for the basic conditions and direction of the deregulation of telemedicine. Recently, deregulation policy cases in telemedicine include that designation of a special zone for regulatory freedom in Gangwon Province, allowing physician-patient telemedicine and telephone counseling and prescription cases in the COVID-19 crisis. There are four main issues that could arise with the deregulation of telemedicine: safety, effectiveness, differences in access to health care and the economic industry, and legal responsibility. As a initiative preparation, this study proposed a pilot project for telemedicine and enhanced support for face-to-face care complementary tools, vitalizing remote co-operation, policy model that do not disrupt the medical delivery system, and legal maintenance. In conclusion, as a suggestion of basic premise and direction in the implementation of telemedicine deregulation, the implementation of initiative measures to address issues concerning telemedicine, the review and regulation of conditions to be considered in the implementation of telemedicine, and the establishment of a close communication and cooperative sturcture with medical providers.

• The Journal of the Convergence on Culture Technology
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• 제8권4호
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• pp.45-51
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• 2022

This study aims to provide basic data on socioeconomic and social activities from the point of view that disability or disease accompanying the suffering of industrial accident subjects is directly related to individual socioeconomic activity and is a major variable affecting current health and daily life satisfaction. The purpose of this study is to investigate the relationship between pain and life satisfaction and to suggest basic data for economic and psychological rehabilitation of industrial accident insurance beneficiaries by linking factors affecting life satisfaction with industrial accident services. As a result of the study, it was found that workers' compensation insurance benefit recipients had an effect on their daily life satisfaction after becoming an industrial accident patient due to industrial accident pain. There was a positive(+) relationship between rehabilitation services and medical counseling services. Occupational accident pain lowers self-esteem, which is a characteristic of an individual, and even if current health improves, satisfaction with daily life decreases. The importance of industrial accident-related services can be seen in that the satisfaction of daily life is increased through rehabilitation services and medical consultation services. In addition, it was indirectly confirmed that satisfaction with rehabilitation services and health can be improved as a result of continuing attempts to improve self-esteem suitable for patients in various problems and situations after an industrial accident.

• The Journal of the Convergence on Culture Technology
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• 제9권3호
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• pp.731-736
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• 2023

Recently, the medical field has been applying mandatory Electronic Medical Records (EMRs) and Electronic Health Records (EHRs) systems that computerize and manage medical records, and distributing them throughout the entire medical industry to utilize patients' past medical records for additional medical procedures. However, the conversations between medical professionals and patients that occur during general medical consultations and counseling sessions are not separately recorded or stored, so additional important patient information cannot be efficiently utilized. Therefore, we propose an electronic medical record system that uses speech recognition and natural language processing deep learning to store conversations between medical professionals and patients in text form, automatically extracts and summarizes important medical consultation information, and generates electronic medical records. The system acquires text information through the recognition process of medical professionals and patients' medical consultation content. The acquired text is then divided into multiple sentences, and the importance of multiple keywords included in the generated sentences is calculated. Based on the calculated importance, the system ranks multiple sentences and summarizes them to create the final electronic medical record data. The proposed system's performance is verified to be excellent through quantitative analysis.

• The Journal of Korean Obstetrics and Gynecology
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• 제36권4호
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• pp.78-95
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• 2023

Objectives: This study aims to analyze the results of the 2022 Gyeonggi-do Oriental Medicine Fertility Treatment Support Project, review the outcomes and satisfaction of Oriental Medicine fertility support initiatives, and propose progressive fertility treatment support strategies by comparing them with the results of the past three years. Methods: Total of 242 women and 205 spouses participated in the Korean Medicine fertility treatment support project, which encompassed herbal medicine, acupuncture, and counseling treatments over a 3-month period, followed by a 3-month post-treatment follow-up. Data pertaining to patients' general, demographic, and fertility-related characteristics were collected before treatment initiation. During treatment, information regarding the treatments administered by Korean medical doctors was recorded, along with post-treatment outcomes and satisfaction levels. Safety assessments included pre- and post-treatment blood tests and monitoring for adverse events. Results: Among the 242 female subjects, 209 successfully completed the treatment program. Of these, 35 (16.7%) achieved pregnancy, with 30 (15%) attaining pregnancy through herbal monotherapy. Out of the 35 pregnancies, 17 were maintained, while 10 resulted in miscarriage. Notably, 83.8% of patients expressed satisfaction with the treatment outcomes. An analysis spanning three years revealed a continuous increase in the average age of patients, surpassing 38 years in 2022, a critical point in fertility decline age. Additionally, there was a notable rise in the prevalence of patients with a history of gynecological issues, advanced spouse age, and semen abnormalities, which is assumed to have contributed to the decrease in the pregnancy success rate. Conclusions: This study compares the clinical results of the 2022 Gyeonggi-do Korean Medicine Fertility Treatment Support Project with those of the past three years. Based on these findings, recommendations are made to enhance the project, including stricter age criteria for patient selection, enhanced specialized treatment tools for medical doctors, and combining Korean Medicine treatment and medical assisted reproductive technologies, all aimed at increasing pregnancy success rates. These results provide a foundation for the development of fertility support projects and related policies.

• Journal of Oriental Neuropsychiatry
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• 제35권1호
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• pp.115-140
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• 2024

Objectives: This study investigates the impact of M&L psychotherapy on an adolescent with anxiety disorders transitioning into adulthood, using a retrospective mixed-method approach. Methods: An adolescent with Diagnostic Statistical Manual of Mental Disorders (DSM)-5-diagnosed anxiety disorders underwent combined treatment with M&L psychotherapy and complex Korean medicine therapy over a period of approximately two years. Patient records tracked the diagnosis, treatments, and progress. In-depth interviews were also conducted. The study used a convergent parallel mixed-method approach, integrating quantitative analysis from psychological assessments, including the State-Trait Anxiety Inventory (STAI-X), the Core Seven Emotions Inventory-short form (CSEI-s), and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), with qualitative analyses of traditional Korean medicine counseling session notes, interviews, and other qualitative psychological assessments. Results: State anxiety decreased from 40 to 36, and trait anxiety decreased from 42 to 34. MMPI-2 L scale scores decreased slightly to 64T, whereas S scale scores increased to 62T, and FRS scores decreased to 70T from an initial score of 78T. Qualitative analysis revealed an increase in the MMPI-2 Es scale, identified as "subjectivity." Joy (喜) emerged as the highest emotional profile score in the CSEI-S. Scores for anger (怒), thought (思), fear (恐), and fright (驚) decreased, indicating improved negative emotions. Qualitatively, expressions of determination to "move forward" and "strengthen the mind" were noted, suggesting enhanced "lower danjeon (下丹田)." Conclusions: Integrating traditional Korean medicine treatment with M&L psychotherapy for a vulnerable adolescent with anxiety disorders demonstrated efficacy. Further research is warranted to substantiate the effectiveness of M&L psychotherapy and advocate for its wider adoption in mainstream practice.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.60-66
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• 2024

Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.