• 한국임상약학회지
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• 제28권2호
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• pp.95-100
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• 2018

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis that can affect many organs of the body but usually affects the lungs. The prevalence of TB in Korea is considerably higher than that in other countries with similar economic levels, and is much higher in elderly people. Pharmacotherapy is important in the treatment of TB and requires relatively high compliance for a prolonged duration. Methods: We analyzed sample data of elderly patients obtained from the Health Insurance Review and Assessment Service. We used logistic regression analysis and frequency analysis to identify factors that could affect prevalence of TB in elderly patients, compliance with prescribed medication regimes in these patients, and use of medical institutions. Korean Standard Classification of Diseases, version 7 (KCD-7) was used to diagnose pulmonary TB, and medications were analyzed using Korean standardized drug classification codes. Results: 1,276,331 patients were analyzed in the sample of the elderly population, and 16,658 TB patients were included in the study. The mean age of the TB patients was 76.19 years (SD 6.899). A total of 699 patients were prescribed isoniazid, rifampicin, ethambutol, or pyrazinamide at least once. Of these, 352 (50.4%) were prescribed all four medications and 101 (14.4%) were prescribed only isoniazid, rifampicin, and ethambutol. The mean duration of prescription was 28.75 days (SD 36.13). Conclusion: In the elderly population, old age and poor socioeconomic conditions correlated with TB prevalence. Most patients did not meet the criteria for effective pharmacotherapy of TB.

• 대한지역사회영양학회지
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• 제16권1호
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• pp.136-144
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• 2011

Assessment of quality of life (QOL) is a new method to investigate the effectiveness of dietary regimen. Particularly, diet-related QOL is the most appropriate method to estimate social and psychological problems originated from dietary regimen practice. The purpose of this study was to evaluate the diet-related QOL and the correlation between diet-related QOL and health-related QOL, and dietary regimen practice in online diabetes self-help patients who practice the dietary regimen. Sixty one subjects who intended to practice dietary regimen were recruited from online diabetes self-help community, and instructed to fill-up the self report questionnaires. Contents of questionnaire were comprised of general characteristics, clinical characteristics, dietary compliance, and dietary regimen practice. As a result, the mean score of the 'Dietary impact' among the diet-related QOL sub-scales was the lowest suggesting most of the subjects suffer from burden of dietary regimen practice. The "Dietary impact" was correlated with "Taste", "Convenience" and "Cost" (p < 0.05). "Self-care" and "Satisfaction" were positively associated with well-controlled blood glucose and dietary regimen compliance, but negatively associated with "Dietary impact". Diet-related QOL was significantly correlated with the Health-related QOL, particularly the mental and social component (p < 0.05). Diet-related QOL was negatively associated with BMI, and self monitoring blood glucose was negatively correlated with "Self-care" (p < 0.05). In conclusion, Diet-related QOL might be appropriate to evaluate the effects of dietary regimen or nutrition education. The need for dietary education of cognitive-behavioral strategies and problem-solving ability is required.

• Journal of Periodontal and Implant Science
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• 제49권2호
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• pp.60-75
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• 2019

The primary aim of this systematic review was to assess the evidence on periodontal disease progression after treatment in patients receiving supportive periodontal therapy (SPT) and to identify predictors of clinical attachment level (CAL) loss. A protocol was developed to answer the following focused question: In adult patients treated for periodontitis, what is the disease progression in terms of CAL loss after surgical or non-surgical treatment? Randomized controlled clinical trials, prospective cohort studies, and longitudinal observational human studies with a minimum of 5 years of follow-up after surgical or non-surgical treatment that reported CAL and probing depth changes were selected. Seventeen publications reporting data from 14 investigations were included. Data from 964 patients with a follow-up range of 5-15 years was evaluated. When the CAL at the latest follow-up was compared to the CAL after active periodontal therapy, 10 of the included studies reported an overall mean CAL loss of ${\leq}0.5mm$, 3 studies reported a mean CAL loss of 0.5-1 mm, and 4 studies reported a mean CAL loss of >1 mm. Based on 7 publications, the percentage of sites showing a CAL loss of ${\geq}2mm$ varied from 3% to 20%, and a high percentage of sites with CAL loss was associated with poor oral hygiene, smoking, and poor compliance with SPT. The outcomes after periodontal therapy remained stable over time. Disease progression occurred in a reduced number of sites and patients, mostly associated with poor oral hygiene, poor compliance with SPT, and smoking.

• 보건의료산업학회지
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• 제12권4호
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• pp.1-15
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• 2018

Objectives: We analyzed the importance and performance of hospital social responsibility (HSR) according to the characteristics of hospitals, and presented strategies for HSR activities. Methods: An online HSR questionnaire was sent to hospitals nationwide from October 12 to 26, 2018. The 206 responses received were analyzed in accordance with the IPA to assess the performance and importance of HSR. Results: There was a statistically significant difference between the employees and hospitals regarding the importance and performance of HSR activities. In the area of "sustained maintenance", items related to consumer issues such as "compliance with personal information processing policy", "patient confidentiality", "fair information provision", and "system for patient safety and infection prevention" were derived. In the area of "'high priority for improvement", there were three common items between hospitals and general hospitals: "regular donations and support from local communities", "active cooperation with related institutions", and "compliance with process-related laws and regulations". In the area of "low priority", four items were derived: "support for employee participation in community activities", "efforts to hire local residents", "education and cultural programs for local communities", and "transparent support for political activities". In the area of "sublation of excessive efforts", two items of "employee welfare efforts" and "efforts to improve labor relations", were commonly found in hospitals and general hospitals. Conclusions: It is necessary to improve the management efficiency of hospitals by the systematic allocation of manpower and resources through the establishment of four regional strategies based on the results of IPA analysis.

• 한국환경보건학회지
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• 제47권1호
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• pp.101-109
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• 2021

Objectives: The objectives of this study are to introduce the development process of work situations and types in the revised regulations on wearing personal protective equipment (PPE) for hazardous chemical handlers, analyze the implementation of the regulations, and then provide basic data for future education strategies. Methods: The development process of work situations for regulation was explained through a flowchart by year. In 2018, a survey of 30 chemical managers and 201 managers and handlers was conducted based on recognition of work situations and the related regulations. In 2019, 91 chemical managers and 204 handlers were surveyed to find the degree of compliance with regulations, direction for improvement of understanding the regulations, and training methods. Results: Only 78.0% of chemical managers and 66.7% of handlers said they were aware of the regulations (p<0.05). Just 79.0% of handlers knowing the regulations said they would wear PPE in compliance with these regulations. Therefore, the best way to make workers wear proper PPE in accordance with regulations is to strengthen the promotion of education on regulations. In order to improve the quality of education, 51.7% of managers and 33.3% of handlers cited educational content (video, ppt, etc.) as the top priority. Conclusion: This study suggested that more educational opportunities should be provided and educational content should be developed in order for workers handling hazardous chemicals to wear PPE as prescribed in regulations.

• 한국동물위생학회지
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• 제44권1호
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• pp.51-59
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• 2021

Various infectious diseases have threatened swine industries in Korea. One of the major risk factors of disease spread is livestock transport vehicle. For this reason, all abattoirs are required by law to have vehicle washing and disinfection facilities. However, detailed guidelines for cleaning and disinfection procedures were not provided. So in this study, assessment by visual observation was conducted to evaluate how well the cleaning and disinfection procedures of livestock transport vehicles have been performed in four different abattoirs in Jeonbuk, Korea. The observation included length of car washing time, the number of washing bay, type of washperson, type of disinfectant application, length of disinfection time, and compliance of driver's hygienic procedure. Every vehicle in all abattoirs conducted washing and disinfection procedure. However, there were procedural differences for each abattoirs and defects in the washing and disinfection procedures. In addition to that, the compliance of driver's hygienic procedure was not sufficient. Hence, detailed manuals on washing and disinfection procedures for involved people are required and it is necessary to establish an inspection and evaluation system.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1737-1742
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• 2013

Early diagnosis has a major role in improving prognosis of breast cancer. The purpose of this study was to assess the risk status of women 35-69 years of age using risk assessment models and the prevalence of mammography in a community setting. The sample of this cross sectional study consisted of 227 women, 35-69 years of age residing in Izmir, a city located in western region of Turkey. A questionnaire was used to collect data and the Gail and Cuzick-Tyrer models were applied to assess the risk of breast cancer. In this study, 52.7% of women had mammography at least once, and 41.3% of the women over the age of 40 had mammography screening in the last two years. The five years risk for breast cancer was high in 15.8% of women according to the Gail model and ten years risk was high in 21.7% with the Cuzick-Tyrer model. In the present study, the breast cancer risk levels were assessed in a population setting for the first time in Turkey using breast cancer risk level assessment models. Being in 60-69 age group, having low education and not being in menopause were significant risk factors for not having mammography according to logistic regression analysis. Mammography utilization rate was low. Women must be educated about breast cancer screening methods and early diagnosis. The women in the high risk group should be informed on their risk status which may increase their attendance at breast cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2329-2336
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• 2016

Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

• 간호행정학회지
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• 제15권1호
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• pp.91-105
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• 2009

Purpose: The aim of this study was to analyze the needs of HIV/AIDS care and to develop the job description of HIV/AIDS Counselling nurse in Korea. Methods: The needs assessment was done by focus group interview with HIV/AIDS care recipients who are 16 persons living with HIV/AIDS and four their family members, seven persons from HIV/AIDS high risk group, and five nurses working on HIV/AIDS clinics. Based on the result of needs assessment, job description was developed using the DACUM. Mail survey was done to identify the frequency, importance, and difficulty of duties, tasks, and task elements. Results: The job description was classified under 8 duties, 36 tasks, and 290 task elements. Duties were categorized as needs assessment, health promotion and quality of life, improvement of treatment compliance, symptom care, health education, resource network, administrative activity, and career development. The importance of all duties and tasks showed high score from the survey, but the frequency and the performance level were middle range. Conclusion: It is suggested that the special training program based on the job description needs to be developed. In the political aspects, the introduction of HIV/AIDS nurse specialist certification could be considered.

• Journal of Radiation Protection and Research
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• 제47권4호
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• pp.181-194
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• 2022

Internal dosimetry is a discipline which brings together a set of knowledge, tools and procedures for calculating the dose received after incorporation of radionuclides into the body. Several steps are necessary to calculate the committed effective dose (CED) for workers or members of the public. Each step uses the best available knowledge in the field of radionuclide biokinetics, energy deposition in organs and tissues, the efficiency of radiation to cause a stochastic effect, or in the contributions of individual organs and tissues to overall detriment from radiation. In all these fields, knowledge is abundant and supported by many works initiated several decades ago. That makes the CED a very robust quantity, representing exposure for reference persons in reference situation of exposure and to be used for optimization and assessment of compliance with dose limits. However, the CED suffers from certain limitations, accepted by the International Commission on Radiological Protection (ICRP) for reasons of simplification. Some of its limitations deserve to be overcome and the ICRP is continuously working on this. Beyond the efforts to make the CED an even more reliable and precise tool, there is an increasing demand for personalized dosimetry, particularly in the medical field. To respond to this demand, currently available tools in dosimetry can be adjusted. However, this would require coupling these efforts with a better assessment of the individual risk, which would then have to consider the physiology of the persons concerned but also their lifestyle and medical history. Dosimetry and risk assessment are closely linked and can only be developed in parallel. This paper presents the state of the art of internal dosimetry knowledge and the limitations to be overcome both to make the CED more precise and to develop other dosimetric quantities, which would make it possible to better approximate the individual dose.