• Tuberculosis and Respiratory Diseases
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• v.76 no.2
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• pp.66-74
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• 2014

Background: The increasing number of outpatients with multidrug-resistant (MDR) pathogens has led to a new category of pneumonia, termed healthcare-associated pneumonia (HCAP). We determined the differences in etiology and outcomes between patients with HCAP and those with community-acquired pneumonia (CAP) to clarify the risk factors for HCAP mortality. Methods: A retrospective study comparing patients with HCAP and CAP at Jeju National University Hospital. The primary outcome was 30-day mortality. Results: A total of 483 patients (208 patients HCAP, 275 patients with CAP) were evaluated. Patients with HCAP were older than those with CAP (median, 74 years; interquartile range [IQR], 65-81 vs. median, 69 years; IQR, 52-78; p<0.0001). Streptococcus pneumoniae was the major pathogen in both groups, and MDR pathogens were isolated more frequently from patients with HCAP than with CAP (18.8% vs. 4.9%, p<0.0001). Initial pneumonia severity was greater in patients with HCAP than with CAP. The total 30-day mortality rate was 9.9% and was higher in patients with HCAP based on univariate analysis (16.3% vs. 5.1%; odds ratio (OR), 3.64; 95% confidence interval (CI), 1.90-6.99; p<0.0001). After adjusting for age, sex, comorbidities, and initial severity, the association between HCAP and 30-day mortality became non-significant (OR, 1.98; 95% CI, 0.94-4.18; p=0.167). Conclusion: HCAP was a common cause of hospital admissions and was associated with a high mortality rate. This increased mortality was related primarily to age and initial clinical vital signs, rather than combination antibiotic therapy or type of pneumonia.

• Journal of The Korea Institute of Healthcare Architecture
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• v.22 no.1
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• pp.39-49
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• 2016

Purpose: This is the ex-post evaluation on "the Central General Hospital in Quang Nam Province in Vietnam" funded by Korean ODA. Through this evaluation, this study tries to explore useful ways to improve the effectiveness of Korean ODA projects related to hospital establishment. Methods: Field survey and analysis of questionaire to the staffs and patients of Quang Nam Province General Hospital were conducted twice in 2012 and 2014 after the completion of the Hospital. Two sets of surveys and questionaire outcomes have been comparatively analysed by statistics in order to seek the trend of satisfaction level of hospital users and find out the improvement way in hospital design and construction. Results: The satisfaction level on the hospital was relatively high and that of 2014 is higher than that of 2012. The satisfaction level of the users was recorded in Likert 5 scales. Continuous facility complement and maintenance is considered as the main contributor in increasing the satisfaction level of users. As far as the satisfaction level of outpatient is concerned, that of 2012 was recorded as 3.65 and that of 2014 was 4.05. In case of inpatient, the satisfaction level on the hospital in 2012 was 3.76, and 4.06 in 2014. Implications: In overseas hospital projects, proper hospital project management system including medical service plan, strategic plan, brief, design & construction and maintenance have to be put together effectively and efficiently for the success of the hospital project. At the same time local climate, culture, building material and local code have to be considered in order to build sustainable hospital.

• Journal of the Korea Convergence Society
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• v.9 no.12
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• pp.17-24
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• 2018

This study attempted to analyze technology convergence structure and key technology research sectors in bio-health. For this, network analysis was performed based on the patent outcomes achieved through national R&Ds. Then, a patent network was analyzed to derive problems and collect data from the National Science & Technology Information Service. With the five groups obtained through the analysis of IPC network and national R&D patents in bio-health based on a research frame network, topics were chosen based on the bio-healthcare technology system. Then, the technology with the greatest ripple effects was derived and compared to other sectors, suggesting a direction for national R&D investments. It is anticipated that this study would make a contribution to a search for R&D investment direction by additionally analyzing overseas patent data and improving correlation analysis between technology convergence and government-led R&D expenses.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.2
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• pp.11-20
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• 2021

Objectives The purpose of the study is to evaluate the safety of the Allium Fistulosum extract in children and its effectiveness in height growth. Methods This study is randomized, double-blind, placebo-controlled trial. The participants are children between the 3rd and 25th percentiles in height, and between the ages of 5 and 12 years. They are randomly assigned to treatment group or control group. The treatment group will take 5 g (1 g as Allium Fistulosum extract) for 24 weeks, 1 time a day. The control group will take the 5 g (0 g as Allium Fistulosum extract) of placebo for 24 weeks, 1 time a day. The primary outcome is change in height, and the secondary outcomes are growth rate, height standard deviations, Insulin-like growth factor-1 (IGF-1), Insulin-like growth factor binding protein-3 (IGFBP-3), IGF1-1/IGFBP-3 ratio, growth hormone, bone age, osteocalcin, and Z-score for growth. Results This protocol has been approved by the institutional review board (IRB) of Daejeon Korean Medicine Hospital of Daejeon University (IRB No. DJDSKH-20-BM-15), and registered in the Clinical Research Information Service (CRIS) (Registry No. KCT0005981). Conclusions This study will provide clinical information about the effectiveness and safety of Allium Fistulosum extract in children for their growth.

• Health Policy and Management
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• v.31 no.2
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• pp.148-157
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• 2021

Background: Based on that the key function of health technology is improving the quality of healthcare services, our study purports to explore the process of medical device development in detail and to discuss its policy implications. Methods: A total of 12 in-depth interviews were conducted with four groups of industry, hospital, academia, and civil society. All of the interviewees except those from civil society were involved in the new medical device development between 2009 and 2018. We performed a text network analysis and content analysis of the interview data. Results: The frequency and the degree centrality rankings suggested a close association between the utilization issue and the technology development. Similarly, the results of the content analysis showed that the appropriate intervention in the utilization of technology has a direct impact on the progress of development. Under the continuous industrial effort to boost profits by developing new technology, service providers and citizens should be knowledgeable of and make good use of the new technology for the provision of better services. Conclusion: As the development itself would not guarantee the improvement of service quality and better health outcomes, health technology policies should take a more comprehensive view to serve the unmet needs and even to facilitate the technology development.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.132-152
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• 2024

Purpose: This study aimed to identify and evaluate interprofessional education (IPE) interventions for healthcare professional students in East Asian countries. Methods: The reporting of this study followed the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. A literature search was conducted using seven electronic databases: PubMed, EMBASE, CINAHL, Scopus, Web of Science, ERIC, and ProQuest Dissertations & Theses Global. Joanna Briggs Institute Critical Appraisal Checklists were also used to appraise the quality of the included studies. The outcomes of IPE interventions were classified based on a modified Kirkpatrick model. Results: This review included 30 studies predominantly conducted in Singapore, South Korea, and Taiwan. The prevalent research design was a one-group pre-posttest design, and most IPE interventions occurred as single events. Approximately 70% of the studies involved students from two healthcare professions, mainly nursing and medicine. Simulations, group discussions, and lectures have emerged as the most common teaching methodologies, with almost half of the studies leveraging a combination of these techniques. The IPE content primarily focused on interprofessional teamwork, communication, and clinical patient care situations; these included the management of septic shock. The effectiveness of the IPE interventions was mainly evaluated through self-reported measures, indicating improvements in attitudes, perceptions, knowledge, and skills, aligning with Level 2 of the modified Kirkpatrick model. Nonetheless, the reviewed studies did not assess changes in the participants' behavior and patient results. Conclusion: IPE interventions promise to enhance interprofessional collaboration and communication skills among health professional students. Future studies should implement rigorous designs to assess the effectiveness of IPE interventions. Moreover, when designing IPE interventions, researchers and educators should consider the role of cultural characteristics in East Asian countries.

• Safety and Health at Work
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• v.14 no.4
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• pp.347-357
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• 2023

Introduction: The COVID-19 pandemic turned biological hazards in the working environment into a global concern. This systematized review of published reviews aimed to provide a comprehensive overview of the specific jobs and categories of workers exposed to biological hazards with the related prevention. Methods: We extracted reviews published in English and French in PubMed, Embase, and Web of Science. Two authors, working independently, subsequently screened the potentially relevant titles and abstracts recovered (step 1) and then examined relevant full texts (step 2). Disagreements were resolved by consensus. We built tables summarizing populations of exposed workers, types of hazards, types of outcomes (types of health issues, means of prevention), and routes of transmission. Results: Of 1426 studies initially identified, 79 studies by authors from every continent were selected, mostly published after 2010 (n = 63, 79.7%). About half of the reviews dealt with infectious hazards alone (n = 38, 48.1%). The industrial sectors identified involved healthcare alone (n = 16), laboratories (n = 10), agriculture (including the animal, vegetable, and grain sectors, n = 32), waste (n = 10), in addition of 11 studies without specific sectors. The results also highlighted a range of hazards (infectious and noninfectious agents, endotoxins, bioaerosols, organic dust, and emerging agents). Conclusion: This systematized overview allowed to list the populations of workers exposed to biological hazards and underlined how prevention measures in the healthcare and laboratory sectors were usually well defined and controlled, although this was not the case in the agriculture and waste sectors. Further studies are necessary to quantify these risks and implement prevention measures that can be applied in every country.

• Journal of Preventive Medicine and Public Health
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• v.53 no.6
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• pp.447-454
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• 2020

Objectives: The aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses. Methods: In the current cross-sectional study, the occupational safety climate, patient safety climate, and safety performance of nurses were measured using several questionnaires. Structural equation modeling was applied to test the relationships among occupational safety climate, patient safety climate, and safety performance. Results: A total of 211 nurses participated in this study. Over half of them were female (57.0%). The age of the participants tended to be between 20 years and 30 years old (55.5%), and slightly more than half had less than 5 years of work experience (51.5%). The maximum and minimum scores of occupational safety climate dimensions were found for reporting of errors and cumulative fatigue, respectively. Among the dimensions of patient safety climate, non-punitive response to errors had the highest mean score, and manager expectations and actions promoting patient safety had the lowest mean score. The correlation coefficient for the relationship between occupational safety climate and patient safety climate was 0.63 (p<0.05). Occupational safety climate and patient safety climate also showed significant correlations with safety performance. Conclusions: Close correlations were found among occupational safety climate, patient safety climate, and nurses' safety performance. Therefore, improving both the occupational and patient safety climate can improve nurses' safety performance, consequently decreasing occupational and patient-related adverse outcomes in healthcare units.

• Korean Journal of Clinical Pharmacy
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• v.30 no.1
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• pp.44-50
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• 2020

Background: Drug-drug interactions (DDIs) in patients using oral anticancer treatment are more common than in those using injectable anticancer agents. In addition, DDIs related to anticancer treatment are known to cause clinically significant outcomes, such as treatment failure and severe toxicity. To prevent these negative outcomes, significant DDIs are monitored and managed using the information provided in drug databases. We aimed to evaluate the consistency of information on clinically significant DDIs for tyrosine kinase inhibitors (TKIs) between representative drug databases. Methods: We selected clinically significant DDIs involving medications that are co-prescribed with TKIs and met the following criteria: the severity level of DDIs was equal or greater than "D" in Lexicomp^® or "major" in Micromedex^®. We then analyzed the consistency of the severity classification and evidence level between the drug databases. Spearman's correlation coefficient was used to identify the relationship between DDI information in the drug databases. Results: In total, 627 DDI pairs were identified as clinically significant; information on these was provided by Lexicomp^® and Micromedex^® for 571 and 438 pairs, respectively, and both drug databases provided information on 382 DDI pairs. There was no correlation between the severity and evidence level of DDIs provided in the two databases; Spearman's correlation coefficient for Lexicomp^® and Micromedex^® was -0.009 (p=0.861) and -0.064 (p=0.209), respectively. Conclusion: To judge the significance of DDIs, healthcare providers should consider that the information on DDIs may be different between drug information databases; hence, clinical factors must be considered concurrently.

• Korean Journal of Acupuncture
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• v.33 no.3
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• pp.102-113
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• 2016

Objectives : This study is aimed at developing and discussing the prediction model of blood stasis pattern of traditional Korean medicine(TKM) using machine learning algorithms: multiple logistic regression and decision tree model. Methods : First, we reviewed the blood stasis(BS) questionnaires of Korean, Chinese, and Japanese version to make a integrated BS questionnaire of patient-reported outcomes. Through a human subject research, patients-reported BS symptoms data were acquired. Next, experts decisions of 5 Korean medicine doctor were also acquired, and supervised learning models were developed using multiple logistic regression and decision tree. Results : Integrated BS questionnaire with 24 items was developed. Multiple logistic regression models with accuracy of 0.92(male) and 0.95(female) validated by 10-folds cross-validation were constructed. By decision tree modeling methods, male model with 8 decision node and female model with 6 decision node were made. In the both models, symptoms of 'recent physical trauma', 'chest pain', 'numbness', and 'menstrual disorder(female only)' were considered as important factors. Conclusions : Because machine learning, especially supervised learning, can reveal and suggest important or essential factors among the very various symptoms making up a pattern identification, it can be a very useful tool in researching diagnostics of TKM. With a proper patient-reported outcomes or well-structured database, it can also be applied to a pre-screening solutions of healthcare system in Mibyoung stage.