• Journal of Digital Convergence
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• v.13 no.9
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• pp.323-332
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• 2015

This paper examines the level of the primary care continuity for patients with high blood pressure and the effects of the primary care continuity on their convergence health outcomes. We conducted a retrospective cohort study. A total of 315,791 patients who had received new diagnoses of hypertension. We determined standard indices of continuity of care-MFPC, MMCI, and COC and evaluated their association with study outcomes over three years of follow-up. Outcome measures included hospitalization and emergency room visits. The result of the primary care continuity levels and hazard ratios of health outcome showed that, comparing continuity group, non-continuity group had higher rates of hospitalization by 1.655(95% CI: 1.547-1.771) and emergency room visits by 1.669(95% CI: 1.465-1.903). This paper argues that medical costs of chronic diseases will reduce if low continuity of care turns into high continuity of care.

• Interdisciplinary Bio Central
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• v.1 no.2
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• pp.6.1-6.4
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• 2009

We stand at the brink of a fundamental change in how medicine will be practiced. Over the next 5-20 years medicine will move from being largely reactive to being predictive, personalized, preventive and participatory (P4). Technology and new scientific strategies have always been the drivers of revolutions and this is certainly the case for P4 medicine, where a systems approach to disease, new and emerging technologies and powerful computational tools will open new windows for the investigation of disease. Systems approaches are driving the emergence of fascinating new technologies that will permit billions of measurements on each individual patient. The challenge for health information technology will be how to reduce this enormous amount of data to simple hypotheses about health and disease. We predict that emerging technologies, together with the systems approaches to diagnosis, therapy and prevention will lead to a down turn in the escalating costs of healthcare. In time we will be able to export P4 medicine to the developing world and it will become the foundation of global medicine. The "democratization" of healthcare will come from P4 medicine. Its first real emergence will require the unprecedented integration of biology, medicine, technology and computation. as well as societal issues of major importance: ethical, regulatory, public policy, economic, and others. In order to effectively move the P4 scientific agenda forward new strategic partnerships are now being created with the large-scale integration of complementary skills, technologies, computational tools, patient records and samples and analysis of societal issues. It is evident that the business plans of every sector of the healthcare industry will need to be entirely transformed over the next 10 years.and the extent to which this will be done by existing companies as opposed to newly created companies is a fascinating question.

• Journal of Korean Academy of Nursing
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• v.47 no.6
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• pp.806-816
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• 2017

Purpose: As comprehensive nursing care service has gradually expanded, it has become necessary to explore the various opinions about it. The purpose of this study is to explore the large amount of text data regarding comprehensive nursing care service extracted from online news and social media by applying a semantic network analysis. Methods: The web pages of the Korean Nurses Association (KNA) News, major daily newspapers, and Twitter were crawled by searching the keyword 'comprehensive nursing care service' using Python. A morphological analysis was performed using KoNLPy. Nodes on a 'comprehensive nursing care service' cluster were selected, and frequency, edge weight, and degree centrality were calculated and visualized with Gephi for the semantic network. Results: A total of 536 news pages and 464 tweets were analyzed. In the KNA News and major daily newspapers, 'nursing workforce' and 'nursing service' were highly rated in frequency, edge weight, and degree centrality. On Twitter, the most frequent nodes were 'National Health Insurance Service' and 'comprehensive nursing care service hospital.' The nodes with the highest edge weight were 'national health insurance,' 'wards without caregiver presence,' and 'caregiving costs.' 'National Health Insurance Service' was highest in degree centrality. Conclusion: This study provides an example of how to use atypical big data for a nursing issue through semantic network analysis to explore diverse perspectives surrounding the nursing community through various media sources. Applying semantic network analysis to online big data to gather information regarding various nursing issues would help to explore opinions for formulating and implementing nursing policies.

• Journal of Home Health Care Nursing
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• v.16 no.1
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• pp.49-58
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• 2009

Purpose: This study aimed to clarify the needs for hospital-based home care nursing medical services in elder care institutions by analyzing the details and frequency of medical services provided by, and the needs for, hospital based home care nursing in select institutions in Korea. Methods: Seventy-seven staffs at elderly care institutions located throughout the country completed self-report questionnaires between February 1 and May 31, 2009. SPSS ver. 14.0 was used for data analysis regarding frequency and percentage, mean and standard deviation. Results: Forty-eight hospital-based home care nursing medical services in eight domains were identified as being needed in elderly care institutions. The most commonly used medical services were providing instruction in oral drug administration, checking drug beneficial/adverse effects, and administering blood glucose test, while the most needed medical services requiring hospital based home care nursing were complex pressure ulcer care, followed by diabetic foot ulcer management and nutrient injection. Conclusion: The present results should provide fundamental data for better healthcare services with hospital based home care nursing at elderly care institutions as part of a 'win-win' strategy through which medical expenses are reduced, insurance costs are kept stable, and safe and high-quality medical services are provided for residents of elder care institutions. Political decisions intended to promote visits by hospital based home care nurses to elder care institutions would be a prudent course.

• Journal of Clinical Nutrition
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• v.10 no.2
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• pp.31-37
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• 2018

Recently, in Korea, the importance of preparation and use of injectable drugs has been emphasized due to successive fatal accidents caused by injection infections. Parenteral nutrition (PN) has also been identified as a cause of infection. Cases of infection due to PN have been reported not only in Korea, but also abroad, and contamination occurs mainly during the preparation of PN. Because sterile preparation and compounding of injections are very important for infection control and patient safety, this article reviews the major guidelines outlined thus far. The Korea Ministry of Food and Drug Safety in 2006 published guidelines and the KSHP (Korean Society of Health-System Pharmacists) recently issued guidelines for the aseptic preparation of injections. In addition, as US guidelines, the ASHP (American Society of Health-System Pharmacists) guidelines and United States Pharmacopeia (USP) <797> are also reviewed. The recent guidelines published by the KSHP have significance in that they were adopted in accordance with the domestic reality, even though they conform to foreign guidelines, and are expected to be guidelines for hospital pharmacists performing aseptic preparation work. In addition, the Korea Ministry of Health and Welfare is considering appropriate guidelines for the safe management of medications, training staff for infection prevention and strengthening staff capacity. Furthermore, the gradual expansion of aseptic compounding facilities and human resources, as well as the provision of adequate medical costs are also considered. Based on the establishment and standardization of injectable drugs compounding guidelines for Korean hospitals, it is believed that if human resources and facilities are supported and medical charges are improved, it will be possible to expect the safer preparation and use of injections.

• Integrative Medicine Research
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• v.7 no.4
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• pp.333-340
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• 2018

Background: Traditional Korean medicine (TKM) is widely used to treat children with cerebral palsy (CP) in Korea; however, studies investigating factors that influence the use of TKM are scarce. Thus, we investigated the clinical factors that might influence the use of TKM. Methods: A population-based, cross-sectional, multicenter survey was performed from August 2014 to May 2016. The history of TKM use, type and severity of CP, current treatment characteristics, presence of accompanying disabilities or other health problems not directly related to CP, and monthly cost for the treatment of CP were surveyed. Results: In total, 182 children were recruited, and 78 children (42.9%) had used TKM. Among these 78 children, 50 (64.1% of the TKM-use group) had used both acupuncture and herbal medication, 15 (19.2%) had used acupuncture only, and 13 (16.7%) had used herbal medication only. Children with non-typical CP, accompanying disabilities and general health problems tended to use TKM. The monthly cost of treatment for CP was significantly higher in the TKM-use group than that in the no-TKM-use group, suggesting that economically disadvantaged children may have difficulty in accessing TKM. Dietary supplements, conventional pharmacological treatments, and rehabilitation therapies did not affect TKM use. Conclusion: Children with non-typical symptoms or those with poor overall health status are likely to use TKM. Additionally, TKM use leads to increased treatment costs. Studies investigating the motivation for starting or ceasing TKM therapy, socioeconomic factors and the attitude of parents towards complementary and alternative medicine should be performed.

• Korean Journal of Clinical Pharmacy
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• v.31 no.1
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• pp.35-43
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• 2021

Background: Migraine is a common neurological disorder that affects the quality of life and causes several health problems. Preventive migraine treatment can reduce migraine frequency, headache severity, and health care costs. This study aimed to estimate the utilization of migraine preventive therapy and associated factors in eligible patients. Methods: We studied 534 patients with migraine who were eligible for migraine preventive therapy using 2017 National Patient Sample (NPS) data from the Health Insurance Review and Assessment Service (HIRA). We estimated the migraine days by calculating the monthly average number of defined daily dose (DDD) of migraine-specific acute drug. Patients with a monthly average number of DDD of 4 or more were considered as subjects for preventive treatment. Chi-square test and multiple logistic regression analysis were used to determine the association between the preventive therapy and the influencing variables. Results: Less than half of the eligible patients for prophylaxis (n=234, 43.8%) were prescribed preventive therapy. Multiple logistic regression results show that migraine preventive therapy was influenced by age, the type of migraine, and some comorbidities. Patients over the age of 50 tend to receive less prophylactic treatment than under the age of 40. On the other hand, migraine patients with epilepsy or depression were more likely to receive preventive therapy. Sumatriptan was the most preferred medication for acute treatment, and propranolol was the most commonly prescribed drug for prevention. Conclusions: More than half of the patients who were candidates for migraine prophylaxis were not receiving suitable preventive treatment. Positive factors affecting the use of migraine prevention were the presence of comorbidities such as epilepsy and depression.

• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.141-169
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• 2022

Article 34 of 'Medical Service Act' of Korea provides telemedicine service between medical personnel. Telemedicine between medical personnel and patients, therefor, in principle, is not recongnized. Increasing demand for telemedicine fueled by COVID-19 pandemic and accumulation of telemedicine experience lead a change in stubborn opposition of the medical community, tenuous though it may be. This article focuses on the telemedicine legislation in France, which can be used as a reference for the telemedicine legislation premised on telemedicine between medical personnel and patients. The legislation stipulates the concept, types, and conditions of telemedicine performance through 'Code de la santé publique'. The principle that telemedicine shall be performed alternately with direct medical treatment to a patient and details relating to such telemedicine performance as telemedicine costs, medical fees, and telemedicine equipment support are stipulated through an agreement between the medical community and health insurance organizations. From this point, the implications for our legal system were presented.

• Korean Journal of Construction Engineering and Management
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• v.24 no.4
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• pp.44-51
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• 2023

Occupational safety and health management cost (OSHMC) is helpful for managing safety in construction sites. However, OSHMC has been criticized for various aspects, including the fact that OSHMC cannot reflect features of individual constructions when counting up and executing OSHMC. This study proposes the approach to distribute OSHMC by project size and activity type with the consideration of accident rates for various activities. Using 1,046 data obtained from Construction Safety Management Integrated Information (CSI), this study calculated the relative risk factors for each activity. The distribution of OSHMC is proposed based on the risk factors. The results were validated by industry expert interviews. The distribution proposed in this study will help construction managers establish and execute OSHMC usage plan effectively.

• Journal of the Society of Naval Architects of Korea
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• v.61 no.2
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• pp.115-124
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• 2024

To detect and prevent structural damage caused by various loads on marine structures and ships, structural health monitoring procedure is essential. Estimating loads acting on the structures which are measured by sensors that are mounted properly are crucial for structural health monitoring. However, attaching an excessive number of sensors to the structure without consideration can be inefficient due to the high costs involved and the potential for inducing structural instability. In this study, we introduce a method to determine the optimal number of sensors and their optimized locations for strain measurement sensors, allowing for accurate load estimation throughout the structure using model expansion method. To estimate the loads exerted on the entire structure with minimal sensors, we construct a strain-load interpolation matrix using the strain mode shapes of the finite element (FE) model and select the optimal sensor locations by applying D-Optimal Design and the row exchange algorithm. Finally, we estimate the loads exerted on the entire structure using the model expansion method. To validate the proposed method, we compare the results obtained by applying the optimal sensor placement and model expansion method to an FE model subjected to arbitrary loads with the loads exerted on the entire FE model, demonstrating efficiency and accuracy.