• The Korean Journal of Pain
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• v.26 no.1
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• pp.3-13
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• 2013

Chronic noncancer pain is a significant and growing public health challenge in the United States. Lacking effective alternative interventions for effective chronic noncancer pain management, many physicians have turned to opioid pharmacotherapy. Increased opioid prescribing brings not only gains in therapeutic benefit but also a higher incidence of adverse drug events including increased medication misuse and opioid related mortality. Currently the United States must confront the dual problems of widespread undertreated chronic noncancer pain and a prescription opioid abuse crisis. Withholding pain relieving drugs from patients in need is unjustifiable, yet drug diversion, abuse and adverse drug events have become major social as well as medical problems. At the heart of this crisis is the lack of definitive evidence about the risk to benefit ratio of opioid pharmacotherapy for chronic noncancer pain both on an individual case and on a population basis. This article describes the extent and severity of the American chronic noncancer pain problem and the history of opioid pharmacotherapy for chronic noncancer pain in the United States. It then discusses the concept of evidence based practice and reviews current evidence supporting opioid pharmacotherapy for chronic noncancer pain as well as adverse drug events related to opioid pharmacotherapy including misuse and abuse. Finally, it considers the conflict of providing pain relief versus protecting society and reviews steps that governmental agencies, industry and others are taking to contain and ultimately resolve the problems of excessive prescribing and conflicting priorities.

• The Journal of the Korean dental association
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• v.49 no.10
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• pp.609-617
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• 2011

The geriatric population is the most rapidly growing part of the general population, which leads to an increase of chronic conditions and illnesses that will influence both oral and systemic health. The most common chronic diseases in elderly population are arthritis, hypertension, heart diseases, diabetes, and cognitive impairment. Chronic impairments such as visual, hearing, orthopedic, and speech disorders are also prevalent among older adults. All these chronic conditions have potential oral complications and the treatments of systemic diseases also has implications for the maintenance of oral health. Therefore, oral health care professionals should catch up with increasing knowledge in this field and can modify the treatment strategy for older adults. In addition, oral health care professionals should understand the changing need of oral health problems in this age and prepare the future demand.

• Perspectives in Nursing Science
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• v.3 no.1
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• pp.73-89
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• 2006

Complementary and alternative medicine has gained popularity and respectability in recent years in the United States. Since aging is often associated with chronic health conditions that commonly lead to physical and psychosocial disabilities (e.g., depression, functional and/or cognitive disabilities, and decreased quality of life), older adults often seek options to maintain health and treat chronic conditions as an adjunct to conventional medical care. Herbal products, the most commonly used among various complementary and alternative medicines (CAM), should be used with caution due to potential herbal-drug interactions (related to polypharmacy) and herbal-disease interactions (related to comorbidities). Five of the most common chronic conditions in older adults are chronic pain, cardiovascular problems, hypertension, diabetes, and chronic lung problems. A high rate of falls or risk of falling is also a problem unique to this older population. For these conditions, only a few types of CAM (e.g., acupuncture, qi gong, tai chi) were tested, with promising results. However, in spite of evidence supporting the use of certain types of CAM to alleviate some common chronic conditions, findings are limited in terms of other types of CAM tested and both short and long-term effects. More rigorous clinical trials of various CAM types are thus warranted to advance scientific knowledge and establish evidence-based practices to care for the growing number of older adults who deserve to have a better quality of life.

• Journal of Korean Academy of Nursing
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• v.32 no.1
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• pp.28-39
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• 2002

The purpose of this study was to measure the prevalence of urinary incontinence (UI), urologic symptoms, chronic health problems they have, and to explore whether the differences in incidence of UI ware by age, sex, voiding pattern, and chronic health problems. Method: 298 subject were selected, age range from 60 to 94 years residing in one city, in republic of Korea. Data was collected presence of UI, urologic symptoms, chronic health problems, knowledge, and the discomfort with incontinent. Collected data was analyzed with frequency, percentage, t-test, and $\chi$2-test. Result: The results of this study are as follows: 1. Mean age was 71.4 years. Prevalent rate of UI was 17.0%, woman showed more than man. 2. UI incidence was significant in age (t=7.84, p=.000), sex ($\chi$2 =9.47, p=.002), and voiding frequency ($\chi$2=18.34, p=.000). Also, UI incidence was significant relationship with chronic health problem of heart disease ($\chi$2 =10.65, p=0.001), hypertension ($\chi$2=4.04, p= 0.046) and respiratory problem ($\chi$2=9.67, p=0.002). 3. The UI was grouped into urgent incontinence (45%), stress incontinence (33%), and combined (22%). UI occurred during the daytime 48% and 17% at night. 4. Only 9.8 % of the UI seek advice and/or treatment for their symptoms, almost 90 % remained untreated due to lack of knowledge or improper information. 5. The discomforts due to their UI was no significant difference in their condition, the urgent use of the rest room, leaking urine, and nocturia. Conclusion: This study suggests that 1 year and 3 year follow-up study is needed to compare health status of UI. Also suggests intervention study for urologic discomfort of incontinent and behavioral education for the elderly are needed.

• Journal of Nutrition and Health
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• v.52 no.1
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• pp.1-5
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• 2019

Purpose: This review describes the historical changes in nutrition philosophy from a reductionist to a holistic approach during the $20^{th}$ century. Also, the role and efficient use of a holistic approach to precision nutrition are discussed. Results: Over the past century, significant progress has been made in human nutrition research, unraveling fundamental mechanisms of single nutrients on single targets or pathways. This kind of a reductionist approach has helped to save populations from nutrient deficiency diseases and improve associated health outcomes in large parts of the world. However, a new set of nutrition problems, like obesity and diet-related chronic diseases, are growing each year worldwide, increasing the financial burden on the health care system. A linear cause-effect association between single nutrients and a single physiologic effect, is insufficient to solve the complex nutrition-health relationships. Research that involves a more holistic rather than reductionist approach is needed to tackle a new set of nutrition problems. Recent advances in technology, informatics, and statistical methods are enabling an understanding of the diversity of individuals and the complex interactions between foods and human bodies, leading to the concept of "precision nutrition." Conclusion: The emerging goal of precision nutrition is to provide tailored dietary advice for maintaining health and preventing obesity and diet-related chronic diseases. The parts are already being installed. To grab the complexity, reductionism and holism must be used interdependently.

• YAKHAK HOEJI
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• v.53 no.3
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• pp.138-144
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• 2009

The purpose was to implement drug utilization review (DUR) for whom were diagnosed with chronic kidney disease (CKD) population using health insurance claim data. This study constructed drug utilization database using Health Insurance Review and Assessment Service (HIRA) database and selected contraindicated drugs with kidney based on previously developed drug utilization guide and reviewing other countries' examples. Main outcome measures were the proportion of prescription for 1 or more drugs of concern. The cohort included 115,948 subjects, who were diagnosed with chronic kidney disease. Inappropriate drugs with CKD patients was some used, and the most commonly prescribed classes were aluminum drugs. However it is difficult to find problems with inappropriate drug because claims data doesn't have laboratory data. Based on the result of retrospective drug utilization review study, more studies should be analysed drug utilization patterns and monitoring system should be developed.

• Journal of Digital Convergence
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• v.19 no.12
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• pp.369-376
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• 2021

The purpose of this study is to identify the effect of depression on chewing problems and the importance of oral aids through a point-in-time analysis. The data are the 4th(2008, 2^nd year) and the 7th(2018, 3^rd year) of the National Health and Nutrition Survey. The analysis method was frequency analysis and regression analysis using the SPSS/WIN 24.0 program. Studies have shown that depression has affected chewing problems(p<.001). Chronic diseases and the use of oral aids affected the chewing problem. The prevalence and treatment of depression affected the chewing problems(p<.001). In addition, private health insurance coverage increased in 2018 compared to 2008. In the future, the comparative studies considering various subjects and chronic diseases, the educational methods for the use of oral aids are needed.

• Korea Journal of Hospital Management
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• v.21 no.1
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• pp.14-31
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• 2016

Obesity of adolescents causes mental and physical problems as well as social problems, which need prevention and management. Although a number of systematic reviews and meta-analyses on obesity programs for adolescents were conducted, there is no study evaluating the programs based on CCM(Chronic Care Model), an organizing framework for improving chronic illness care. This study was conducted to review the features of studies in obesity management programs and interventions of the selected studies were evaluated in terms of inclusion of components of the Chronic Care Model. 4 databases were searched for relevant studies in obesity management programs, which were published from 1994 to 2014 in Korea. Results were analyzed in a qualitative way. 14 studies were satisfied inclusion criteria. The interventions most frequently utilized the elements of self-management support(66.7%) and only 1 of the studies included more than three components of CCM. This study presents the direction of health policies about managements of metabolic syndrome, which means that we identified effective process of the obesity management programs for adolescents in Korea and also this study will be used as a basic information for the development of obesity management program.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.sup1
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• pp.118-126
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• 2009

The incidence of childhood obesity has increased dramatically. Childhood obesity is an increasing health problem because of its strong associations with chronic health problems in children and adults. These health problems significantly contribute to the development of common chronic diseases in later life, including hypertension, type2 diabetes, hyperinsulinemia, coronary heart disease, and other psychological disorders. So it is an important issue to prevent and treat obesity during childhood and adolescent. Diet and exercise are the cornerstones of treatment for obesity and related complications. For obese children, some clinical trials have shown improvement with diet, exercise, and /or behavioral interventions. Promising interventions for high-risk individuals, such as bariatric surgery and novel pharmacological agents, also require rigorous assessment with attention to long-term patient important outcomes. There are various pharmacological approaches to the treatment of obesity in the adolescent population some of which have FDA approval. In the article we discuss pharmacological approaches to guide the treatment of obesity in the pediatric population, including risks of treatment, monitoring of potential side effects.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.2
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• pp.49-59
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• 2022

Purpose : The purpose of this study is to directly understand the health condition of residents of mental health sanatoriums nationwide, which has been difficult to ascertain in surveys conducted to date. The study presents specific measures for improving the health of these residents. Methods : A "physical examination questionnaire for residents of mental health sanatoriums" was developed to check the basic physical condition of residents, and 20 out of 59 mental health sanatoriums nationwide were randomly selected. Medical personnel visited the sanatoriums, interviewing and examining the residents in person. A total of 396 health surveys were completed. Results : Many of the residents were underweight but had abdominal obesity. It was confirmed that chronic diseases among the residents were not diagnosed early or were not properly managed. Among the subjective symptoms complained of by the residents, musculoskeletal symptoms were the most common. Oral examinations revealed a serious level of oral health problems among the residents, including dental caries and missing teeth. Basic physical examinations found health problems that required additional examination or medical treatment. Blood pressure abnormalities made up the highest percentage of the health problems. Conclusion : Regular health surveys are needed to determine the health condition of residents of mental health sanatoriums. Access to and quality of primary medical services within the sanatoriums need to be dramatically improved. A delivery system for severe diseases and emergency medical care in the sanatoriums should also be specifically presented. The residents should be notified upon admission and during their stay that they have the right to the enjoyment of the highest attainable standard of mental and physical health. The issue of health rights should be addressed within a larger framework of reorganizing management plans for people in the community - not only residents - with chronic mental illness.