• Journal of Chest Surgery
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• v.56 no.2
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• pp.128-135
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• 2023

Background: Pneumonia caused by severe acute respiratory syndrome coronavirus 2 can cause acute respiratory distress syndrome, often requiring prolonged mechanical ventilation and eventually tracheostomy. Both procedures occur in isolation units where personal protective equipment is needed. Additionally, the high bleeding risk in patients with extracorporeal membrane oxygenation (ECMO) places a great strain on surgeons. We investigated the clinical characteristics and outcomes of percutaneous dilatational tracheostomy (PDT) in patients with coronavirus disease 2019 (COVID-19) supported by ECMO, and compared the outcomes of patients with and without ECMO. Methods: This retrospective, single-center, observational study included patients with severe COVID-19 who underwent elective PDT (n=29) from April 1, 2020, to October 31, 2021. The patients were divided into ECMO and non-ECMO groups. Data were collected from electronic medical records at Ajou University Hospital in Suwon, Korea. Results: Twenty-nine COVID-19 patients underwent PDT (24 men [82.8%] and 5 women [17.2%]; median age, 61 years; range, 26-87 years; interquartile range, 54-71 years). The mean procedure time was 17±10.07 minutes. No clinically or statistically significant difference in procedure time was noted between the ECMO and non-ECMO groups (16.35±7.34 vs. 18.25±13.32, p=0.661). Overall, 12 patients (41.4%) had minor complications; 10 had mild subdermal bleeding from the skin incision, which was resolved with local gauze packing, and 2 (6.9%) had dislodgement. No healthcare provider infection was reported. Conclusion: Our PDT approach is safe for patients and healthcare providers. With bronchoscopy assistance, PDT can be performed quickly and easily even in isolation units and with acceptable risk, regardless of the hypo-coagulable condition of patients on ECMO.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.1-10
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• 2023

Purpose : This study explores the professional status of Advanced Practice Nurses (APNs) in Korea, who, despite being legally certified, face instability in their professional standing, including their scope of practice and compensation. Method : The study uses Flexner's professional characteristics as a framework to analyze and project the future trajectory of Korean APNs. Results : First, to ensure social accountability, professional bodies need to establish uniform nursing policies related to job roles, and healthcare institutions must adhere to these policies. Second, nursing leaders should spearhead the creation of nursing knowledge essential for the profession's advancement, aiming to establish it as the foundation for nursing practice through a consensus process within the nursing community. Third, the curriculum for APNs should enhance the quantitative and qualitative aspects of practice in response to societal needs. Fourth, professional bodies should formulate consistent nursing policies based on a thorough analysis of the healthcare environment and legal considerations, and guide their implementation in clinical practice through a consensus process within the nursing community. Lastly, guidelines should be established for professional standards suitable for the Korean context. Conclusion : Based on this review, it is recommended that all APNs adhere to the professional standards set by their respective organizations, actively participate in personal quality improvement initiatives, and fulfill their duties and roles as members of these professional bodies. Furthermore, these organizations should devise practical strategies to solidify the APN system and should spearhead a systematic consensus process that garners the agreement of all members within the nursing community.

• Journal of Preventive Medicine and Public Health
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• v.57 no.4
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• pp.347-355
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• 2024

Objectives: This study was conducted to investigate the prevalence of mental health (MH) symptoms and associated factors among medical students who were engaged in combating the coronavirus disease 2019 (COVID-19) epidemic in 4 provinces/cities of Vietnam. Methods: A cross-sectional study with 580 participants was conducted at a medical university in Northern Vietnam. MH was assessed using the 21-item Depression, Anxiety, and Stress Scale, which was previously standardized in Vietnam. Data were collected through a structured self-administered questionnaire. Multivariate logistic regression was employed to examine the association between MH symptoms and relevant factors. Results: Out of a total of 2703 medical students, 21.5% responded to the questionnaire. Among the 580 respondents, the prevalence rates of depression, anxiety, and stress were 43.3%, 44.0%, and 24.7%, respectively. Factors significantly associated with self-reported depression included being female and having a COVID-19 infection. Similarly, being female and having a COVID-19 infection were significantly associated with self-reported anxiety. Factors associated with self-reported stress included being female, having a personal or family history of MH symptoms, working more than 8 hr/day, and having a COVID-19 infection. Conclusions: COVID-19 has adversely impacted the MH of medical students. Our findings are valuable in their potential to motivate universities, MH professionals, and authorities to offer mental healthcare services to this group. Furthermore, there is a pressing need for training courses designed to equip future healthcare workers with the skills to manage crises effectively.

• Journal of Internet Computing and Services
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• v.15 no.3
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• pp.21-30
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• 2014

Hypertension is one of the major causes of death in the world as it is related with cardiovascular or cerebrovascular disease, so it is needed to provide continuos management for blood pressure. This study selected Health Level 7 Fast Health Interoperability Resources (HL7 FHIR) as a bio-signal data exchange service model that can provide constant blood pressure management in the rapidly growing mobile health care environment. The HL7 FHIR framework developed communicates with the IEEE 11073-10407 Personal Health Device (PHD) protocol through the bluetooth Health Device Profile (HDP) between the manager (smart phone) and the agent (hemomanometer) and acquires information about blood pressure. According to the test results, it performed its tasks successfully including hypertension patients' blood pressure monitoring, management on measured records, generation of document, or transmission of measured information. Because in the actual, clinical environment, it is possible to transmit measured information through the TCP/IP protocol, it will be needed to conduct constant research on it and vitalize it in the field of mobile health care afterwards.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.16 no.4
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• pp.139-145
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• 2016

On the ICT healing platform designed to issue early disease alerts, TOS connected between the provider of personal health-related data and the service provider and relayed personalized health data. In the previous study, TOS proposed how to monitor the retrieval and management of document/measurement resources by taking mobile devices into account. Recently the healthcare field, however, defined the standard items needed for communication and data exchanges with a mobile device through HL7 FHIR. This study designed a data grid model between TOS and FHIR to provide personal health resources relayed through TOS in FHIR bundle search sets. The proposed design was organized as follows: first, it stated similarities between the method of TOS resource request and that of FHIR observation request. Then, it designed an eventbus module to process a retrieval request for FHIR service based on the imdb and cluster technologies. The proposed design can be used to expand the old service terminals of ICT healing platform to mobile health devices capable of using FHIR resources.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.1
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• pp.63-81
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• 2004

Purpose: To identify job satisfaction of hospital employees and the relating factors Methods: The study sample was a total of 1,031 healthcare workers(doctors, nurses, pharmacists, medical engineers, office workers, etc) at a tertiary teaching hospital. The data were collected using a questionnaire developed by a expert group. The questionnaire consisted of 21 items including job characteristics, organizational culture, and personal characteristics on the five Likert scale. Results: The overall satisfaction on job characteristics was 3.24 on the five Likert scale. The satisfaction of each item was 4.14 in role clarity, 3.26 in communication participating rate, 3.10 in work variety, 3.06 in autonomy, and 2.64 in workload. The overall satisfaction on organizational culture was 3.00. Particularly, the satisfaction on collaboration was 3.83, co-worker's support. 3.73, identity, 3.62, education/training opportunity, 3.12, pay, 2.62, welfare, 2.35, promotion, 2.34, and organizational conflict, 2.00. The level of satisfaction on personal characteristics was 3.00. In the satisfaction of each item, the score of disposition was 3.83, contribution to the hospital, 3.75, pride as a member of hospital, 3.70, and attitude on job performance, 3.68. The correlation between satisfaction and other variables was statistically significant with the exception of work variety. The satisfaction related significantly to loyalty index(r=.486, p=.000), autonomy(r=.415, p=.000), pride as a member of hospital(r=.411, p=.000), supervisor support(r=.364, p=.000). Conclusions: The results showed developing organizational strategy to promote job satisfaction can decrease the turnover rate and increase loyalty to the organization. It will contribute to enhance productivity in hospital.

• Women's Health Nursing
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• v.8 no.4
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• pp.550-558
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• 2002

This study was designed to examine the factors that influence the burnout of nurses practice healthcare in a hospital setting. Subjects for this study were 245 nurses working at University K hospital in Seoul, Korea. Data for this study was collected from 15 to 27 April, 2002. The data collection instruments used for this study are as follows: Maslach Burnout Inventory(1981), Orientation to Life Questionnaire(Sense of Coherence, SOC) by Antonovsky (1987) and Modified Coping Resources Inventory developed by author. The analysis of the data was completed using the descriptive, ANOVA, Pearson correlation analysis, and stepwise multiple regression using the SAS program software. The results of this study were as follows: 1. Total mean score of burnout was 4.0. Mean scores of the subscales were; emotional exhausion 4.7, personalization 3.7, and personal accomplishment 3.4.2. Significant statistical differences according to demographic characteristics of the subjects were found in the variables of age, job position, years of working, perceived job stress, and burnout. 3. Burnout was negatively related to sense of coherence(r=-.65) and coping resources (r=-.40); subscales of SOC of comprehensibility(r=-.57), manageability (r= -.55), and meaningfulness(r= -.52); subscales of coping of self-care(r=-.36), and cognitive coping(r=-.39). 4. Job stress was the highest factor influence burnout. Sixty-one percent of the total variance of burnout was experienced by variables of comprehensibility, meaningfulness, age, self-care, manageability and leisure activities including job stress. In conclusion, it was found that a low level of burnout was related to high scores of SOC and coping resources. Job stress, manageability, and meaningfulness were the highest factors influencing the level of subscale of emotional exhausion, depersonalization, and personal accomplishment. Therefore, it is necessary to search for strategies to promote SOC and coping resources for reducing the level of burnout of nurses.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.3
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• pp.46-63
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• 2017

Objectives The Korean Medicine (KM) PHR platform is a personalized healthcare service which allows individuals to keep and manage their own health records. When parents are reporting for their children from their memories, there is high possibility of recall errors. In these cases, it could be useful for doctors to collect the patient's symptoms through PHR platform. In this study, we aimed to investigate the clinical significance of the PHR by using the KM PHR platform in the pediatric clinic. Methods The PHR platform was used to collect child health information from parents and child care teachers. The collected data were analyzed in comparison with the results of screening by pediatrician. Results A total of 58 children were recruited, 44 of which health information were collected from their parents and their child care teachers. The remaining 14 children's health information were collected from their parents only. As a result the parents tended to perceive their children weaker than the child care teacher. Compared to other organs, there was a only significant difference in the heart weakness score and spleen weakness score in the comparison of the weak and healthy children. Conclusions Although the study was conducted on a small group of subjects, and used PHR platform developed specifically for adults to indirectly input child's symptoms, and analyzed their health information, there was a difference in health records between information providers. Development of PHR platform for children is needed to collect more reliable information.

• Journal of the Korea Convergence Society
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• v.8 no.10
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• pp.9-17
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• 2017

The current study attempted to develop and operate an exercise prescription expert system based on cloud computing. Recently, concerns on health are increasing due to the development of healthcare technology, increased life expectancy, and enhanced concerns on the body figure and wellbeing among Koreans. This trend pushes up the demand for the personal trainers and exercise specialists. However, supply of the exercise specialists are less than the demand. This study tries to develop exercise prescription system, aggregate diverse data, develop artificial intelligence rule, and operate exercise prescription expert system and education system. This system may assist training exercise professionals by replacing off-line training programs into on-line training programs. Further researches are recommended to connect diverse IoT devices and big data.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.20 no.8
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• pp.1494-1502
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• 2016

With the increasing availability of medical sensors and Internet of Things(IoT) devices for personal use, considering the interaction with users, it is planned to add intelligent function design to the fashionable jewelry, and develop composite multi-function intelligent jewelry through sensors identification. By means of IoT technology, while possessing communication function of intelligent jewelry, the function of intelligent jewelry can be expanded to the linkage network. In order to rapidly manage the mass data produced by intelligent jewelry sensors based on IoT, an intelligent jewelry system for health management is designed and an ontology model of intelligent jewelry system based on IoT is worked out. After the state of the services through the smart phone application is shown. The application provides a personalized service to the user and to determine the risk to show the guide lines according to the disease.