• YAKHAK HOEJI
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• v.58 no.2
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• pp.107-111
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• 2014

Unused medication disposal is a problem due to the cost of disposing as well as potential risk of inadvertent dosing. Investigating medication returns is expected to suggest areas for targeting interventions to reduce medication waste. Therefore, the aim of this study was to examine types of medications and identify the expiration date of the medications returned to the community pharmacies through "Drug-Take Back" program. Method: From October 10, 2012 to November 14, 2012, the medications returned to the 58 community pharmacies in Korea were examined. Results: A total of 22,160 g of pill medications were collected; 52.8% for prescription drugs and 47.2% for non-prescription drugs, respectively. The weight of the expired pill medications was more than 5 times that of the non-expired pill medications. On the other hand, 6,168 ml of liquid medications were returned; 80.0% for prescription medication and 20.0% for non-prescription medications, respectively. Of the total oral liquid medications, the volume of the expired medications was more than 5 times that of the non-expired medications. Conclusion: The majority of medications returned to the community pharmacies were prescription drugs rather than non-prescription drugs. In addition, most of the drugs were expired when they returned.

• YAKHAK HOEJI
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• v.58 no.4
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• pp.262-267
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• 2014

Unused medication disposal is a burden due to the cost of disposing as well as the cost of the drugs. Investigating medication returns is expected to suggest areas of intervention to reduce unused medications. Purpose: The aim of this study was to examine types, quantity, costs, active pharmaceutical ingredients, and therapeutic category of the medications returned to community pharmacies. Method: From January 15, 2014 to February 28, 2014, the medications returned to the 17 community pharmacies in Gimhae, Jinju, and Incheon, Korea were examined. The pharmacists and student volunteers worked cooperatively to identify the medications and analyze drug cost of prescription pill medications returned to the pharmacies. Results: A total of 2,720 pills of prescription medication were analyzed and 91 active pharmaceutical ingredients were identified. According to the Anatomical Therapeutic Chemical (ATC) classification, the most predominant group was A (alimentary tract and metabolism) with 33.3%, followed by N (nervous system) with 15.0%. With regard to the drug cost of groups, group A was the highest with 26.6%, followed by J01 (antibacterials for systemic use) with 20.2% and N (nervous system) with 18.3%. The total cost of the oral pill prescription medications was 468,477 won. Conclusion: The result from this study implies that unused drugs impose a significant cost to the health care system in Korea. In this study, medicines used to treat gastrointestinal conditions were returned most frequently with the highest drug cost. Further research in nationwide level is necessary to establish strategies to reduce the wastage of unused medicines.

• Korean Management Science Review
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• v.29 no.3
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• pp.81-89
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• 2012

Since introduced by Vining and Myers in 1990, the concept of dual response approach based on response surface methodology has widely been investigated and adopted for the purpose of robust design. Separately estimating mean and variance responses, dual response approach may take advantages of optimization modeling for finding optimum settings of input factors. Explicitly assuming functional relationship between responses and input factors, however, it may not work well enough especially when the behavior of responses are poorly represented. A sufficient number of experimentations are required to improve the precision of estimations. This study proposes an alternative to dual response approach in which additional experiments are not required. An artificial neural network has been applied to model relationships between responses and input factors. Mean and variance responses correspond to output nodes while input factors are used for input nodes. Training, validating, and testing a neural network with empirical process data, an artificial data based on the neural network may be generated and used to estimate response functions without performing real experimentations. A drug formulation example from pharmaceutical industry has been investigated to demonstrate the procedures and applicability of the proposed approach.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.283-290
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• 2012

Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.119-133
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• 1997

Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

• The Journal of Korean Physical Therapy
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• v.3 no.1
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• pp.109-121
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• 1991

To investigate the period prevalence rate and therapeutic practic for low back pain (LBP) in the adult population of rural area, a personal interview was conducted for 2.024 persons or 20-59 years old in Seohu Myon, Andong County, Kyungpook Province between 1st and 20th of April, 1991. The period prevalence rate (l February 1990-31 January 1991) of LBP for 1,106 adults who were interviewed was $47.9\%$. The age adjusted period prevalence rate for males was $43.7\%$ and that for females was $52.3\%$ and the difference was statistically significant (p<0.005). Clinical course of th LBP was acute in $14.1\%$ of males and $9.0\%$ of females, recurrent in $57.0\%$ and $55.2\%$, and chronic in $28.9\%$ and $35.8\%$, respectively. Common causes of the LBP were insidious on set with aging without known cause$(48.1\%)$, heavy work $(15.1\%)$, and trauma $(11.3\%)$. Due to LBP $12.5\%$ of the patients were not able to stand or walk for more than an hour and $2.5\%$ were bed-ridden or unable to carry out daily routine. To have the LBP diagnosed $10.2\%$ of the patients utilized a oriental medical clinic or hospital, $31.3\%$ visited a clinic or hospital, and $56.6\%$ hat not utilized any medical facility. Main reason for not having the LBP diagnosed was that the LBP was tolerable. The most popular therapeutic method that the LBP patients chose at the first was drug and physical therapy. Herb medicine was most commonly used when the first therapeutic method was not effective and the acupuncture was the most popular choice of therapy when the second therapeutic method failed. Folk medicine was utilized in $15.5\%$ of the LBP patients and it included 36 regimens such as tincture of motherwort (Leonurus sibiricus), boiled chicken with liquor, etc. It was revealed by this survey that the LBP is a serious health problem in the rural area and many of the LBP patients do not utilize a clinic or hospital but take non-scientific folk remedy. To prevent the economic waste and side effects of the folk remedy, public health education is needed for tile rational therapy of LBP.

• The Journal of the Korean Society for Microbiology
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• v.21 no.3
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• pp.311-329
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• 1986

The experimental exposure of animals to sources of ultraviolet radiation (UVR) which emit their energy primarily in the UVB region (280-320nm) is known to result in a number of well-described changes in the recipient's immune competence. Two such changes include a depressed capacity to effectively respond immunologically to transplants of syngeneic UVR tumors and a markedly reduced responsiveness to known inducers of delayedtype (DTH) and contact hypersensitivity (CH) reactions. The results of experiments that were designed to elucidate the mechanisms responsible for UVR-induced immunomodulation have implicated: 1) an altered pattern of lymphocyte recirculation, 2) suppressor T cells(Ts), 3) deviations in systemic antigen presenting cell (APC) potential. 4) changes in the production of interleukin-1-like molecules, and 5) the functional inactivation of epidermal Langerhans cells in this process. The exposure of skin to UVR, therefore, causes a number of both local and systemic alterations to the normal host immune system. In spite of this seeming complexity and diversity of responses, our recent studies have established that each of the UVR-mediated changes is probably of equal importance to creating the UVR-induced immunocompromised state. Normal animals were exposed to low dose UVR radiation on their dorsal surfaces under conditions where a $3.0\;cm^2$ area of skin was physically protected from the light energy. Contact sensitization of these animals with DNFB, to either the irradiated or protected back skin, resulted in markedly reduced CH responses. This was observed in spite of a normal responsiveness following the skin sensitization to ventral surfaces of the UVR-exposed animals. Systemic treatment of the low dose UVR recipients with the drug indomethacin (1-3 micrograms/day) during the UVR exposures resulted in a complete reversal of the depressions observed following DNFB sensitization to "protected" dorsal skin while the altered responsiveness found in the group exposed to the skin reactive chemical through directly UVR-exposed sites was maintained. These studies implicate the importance of EC as effective APC in the skin and also suggest that some of the systemic influences caused by UVR exposure involve the production of prostaglandins. This concept was further supported by finding that indomethacin treatment was also capable of totally reversing the systemic depressions in CH responsiveness caused by high dose UVR exposure (30K joules/$m^2$) of mice. Attempts to analyze the cellular mechanisms responsible established that the spleens of all animals which demonstrated altered CH responses, regardless of whether sensitization was through a normal or an irradiated skin site, contained suppressor cells. Interestingly, we also found normal levels of T effector cells in the peripheral lymph nodes of the UVR-exposed mice that were contact sensitized through normal skin. No effector cells were found when skin sensitization took place through irradiated skin sites. In spite of such an apparent paradox, insight into the probable mechanisms responsible for these observations was provided by establishing that UVR exposure of skin results in a striking and dose-dependent blockade of the efferent lymphatic vessels in all peripheral lymph nodes. Therefore, the afferent phases of immune responses can apparently take place normally in UVR exposed animals when antigen is applied to normal skin. The final effector responses, however, appear to be inhibited in the UVR-exposed animals by an apparent block of effector cell mobility. This contrasts with findings in the normal animals. Following contact sensitization, normal animals were also found to simultaneously contain both antigen specific suppressor T cells and lymph node effector cells. However, these normal animals were fully capable of mobilizing their effector cells into the systemic circulation, thereby allowing a localization of these cells to peripheral sites of antigen challenge. Our results suggest that UVR is probably not a significant inducer of suppressor T-cell activity to topically applied antigens. Rather, UVR exposure appears to modify the normal relationship which exists between effector and regulatory immune responses in vivo. It does so by either causing a direct reduction in the skin's APC function, a situation which results in an absence of effector cell generation to antigens applied to UVR-exposed skin sites, inhibiting the capacity of effector cells to gain access to skin sites of antigen challenge or by sequestering the lymphocytes with effector cell potential into the draining peripheral lymph nodes. Each of these situations result in a similar effect on the UVR-exposed host, that being a reduced capacity to elicit a CH response. We hypothesize that altered DTH responses, altered alloresponses, and altered graft-versus-host responses, all of which have been observed in UVR exposed animals, may result from similar mechanisms.