• Journal of Oral Medicine and Pain
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• 제41권4호
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• pp.155-160
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• 2016

Purpose: It has been reported that xylitol and sorbitol affect antifungal activities by enhancing antimicrobial activities of other substances. The purpose of this study was to investigate the direct candidacidal activities of xylitol and sorbitol at a wide range of concentration. Methods: Xylitol and sorbitol solubilized with simulated salivary buffer at a range of $0.8{\mu}M$ to 1.05 M were used. Candida albicans strains, ATCC strains 10231, 11006, and 18804 were used for the candidacidal assay. The candidacidal activities of xylitol and sorbitol were determined by comparing the numbers of colony forming units between in the presence and absence of xylitol or sorbitol and calculating the percent loss of cell viability. Results: There were some differences in the candidacidal activities according to the types of sugar alcohols and C. albicans strains. The candidacidal activity of more than 10% was observed when a final concentration of 32.9 mM in xylitol or sorbitol was maintained and that of about 20% was observed when a final concentration of 131 mM was maintained. Even at a high concentration of 1.05 M, the candidacidal activity of xylitol or sorbitol was about 20%. Conclusions: Xylitol and sorbitol at the concentrations used in commercial oral health care products had some levels of candidacidal activities.

• Journal of Preventive Medicine and Public Health
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• 제48권5호
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• pp.239-248
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• 2015

Objectives: The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events. Methods: We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detect the presence of 41 screening criteria (SC). The second stage was an implicit structured review by two physicians to identify the occurrence of adverse events from the positive cases on the SC. The inter-rater reliability of two nurses and that of two physicians were assessed. The intra-rater reliability was also evaluated by using test-retest method at approximately two weeks later. Results: In 84.2% of the patient medical records, the nurses agreed as to the necessity for the second stage review (kappa, 0.68; 95% confidence interval [CI], 0.54 to 0.83). In 93.0% of the patient medical records screened by nurses, the physicians agreed about the absence or presence of adverse events (kappa, 0.71; 95% CI, 0.44 to 0.97). When assessing intra-rater reliability, the kappa indices of two nurses were 0.54 (95% CI, 0.31 to 0.77) and 0.67 (95% CI, 0.47 to 0.87), whereas those of two physicians were 0.87 (95% CI, 0.62 to 1.00) and 0.37 (95% CI, -0.16 to 0.89). Conclusions: In this study, the medical record review for detecting adverse events showed intermediate to good level of inter-rater and intra-rater reliability. Well organized training program for reviewers and clearly defining SC are required to get more reliable results in the hospital adverse event study.

• 지역사회간호학회지
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• 제13권4호
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• pp.757-766
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• 2002

Purpose: Recently there have been many changes in health care environments in Korea. To perform public health programs effectively and efficiently, it is necessary to analyze and identify the demand and supply for the public health nurses. Method: The study analyzed experts' opinions regarding the supply of public health nurses, as well as national and foreign statistical data on workforce supply of public health nurses. Two methods for estimating the amount of demand for public health nurses were used: one was applying the indicators of developed countries for public health nurses based on population: the other was to refer to regulations and/or recommended guidelines in Korea. Result: 1) The number of public health centers, public health sub-centers, and primary health care posts have decreased between 1990 and 2001, from 260 to 242, 1318 to 1270, 2038 to 1907, respectively. 2) Between 1997 and 2002, the number of public health nurses has also decreased from 5572 to 5112. 3) In the case of applying regulations, the number (5112) of existing public health nurses falls shortly by 942. 4) In 2001, the Korean population per one public health nurse was 9262. 5) In the case of applying regulations, the number of public health nurses required to meet the demand for health services in 2001 and 2020 is estimated at 5932 and 6347, respectively. 6) In the case of applying the indicators of developed countries, the number of public health nurses required to meet the demand for health service in 2001 and 2020 is estimated at 9.469 and 10.310, respectively. Conclusion and suggestions: Because of the importance of public health industry, public health nurses have been approved as a field specialist and specialized nurse practitioner by the newly revised legal regulation, there have been absence of approval of their role differentiation and capability. In addition, organizational activity and insufficient number of the public health nurses have contributed to the inactive utilization of them. As community public health is focused on caring individuals as well as organizations, it requires more autonomy and special skills than other fields. Therefore, public health nurses need to enhance the capability as health educator, consultant, and information management persons through advanced education course for public health nurses. Public health nurses need to be prepared as advanced nurse practitioners by receiving advanced education courses and field experiences.

• Journal of Preventive Medicine and Public Health
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• 제23권4호
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• pp.416-427
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• 1990

Unfortunately, we have poor knowledge of medical technology in North Korea. This study has thus attempted to identify the level and status of medical technology development through analyzing the contents of medical textbooks currently in use. This study has assumed that three factors are influencing the level and status of medical technology in a society ; the level of socio-economic development in general, the level of scientific technology revolution and health policy. Forty textbooks are collected for this purpose. The main findings are summarized as follows : 1) North Korea s strengths in that (1) its herb drugs, which are in a broad use, are cheaper, more safe and more attainable than bio-equivalent chemical ones, and (2) the development of its medical technology was carried out with emphasis on the practical and basic health needs. 2) North Korea has weaknesses in that (1) its medical diagnostic method largely depends on manual procedures, (2) the R & D investment in the development of chemical drugs, especially antibiotics, is very small, (3) the amount of medical equipments is in a absolute shortage, and (4) the medical technology is destitute of specialty, caused mainly by the overemphasis on Juche-Uihak or herb medicine. 3) Medical technology has two faces, positive and negative so that it cannot be successfully evaluated by one. It eventually acts a positive function for public health through developments of drug, equipment and new medical treatment method. But it is also true that it has negative effects such as the dehumanization of high cost medical technology, cost hike due to over-investments in expensive equipment and the absence of wholistic care from overspecialization. 4) We have to consider economic status and the social needs of medical care in order to evaluate the medical technology of a society. It is also the case with North Korea. A whole picture of the North Korean medical technology could be understood only if further comprehensive studies of medical technology are to be carried out for North Korea.

• 의학교육논단
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• 제20권3호
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• pp.164-172
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• 2018

The aim of this study is to determine whether the 65 competencies, defined in "the role of Korean doctor, 2014", are suitable for basic medical education phase in Korea. It seeks to analyze the gap among the educational reality and expectation, assessment situation of the competencies above. We also try to define issues of the development, application and assessment phases of competency-based medical education (CBME) at individual medical schools. We designed survey tools based on the Miller's assessment pyramid (knowledge, explanation, demonstration, and performance) for each of the 65 competencies. The survey distributed to 41 medical schools in April 2015 and 38 replies were received (92.7%). Competencies that matched both the educational reality and expectation were numbers 1 (patient care), 33 (social accountability), and 49 (professionalism). However, all the other competencies ranked lower in current status than that of desirable level. 54 out of 65 competencies (83.07%) remained at the knowledge and explanation level when each competence were assessed. In the development, application, and assessment phases of CBME, common issues that medical schools commonly noted were difficulty linking competencies to curriculum preparation and student assessment, the lack of faculty's understanding, difficulty to reach consensus among faculties, and absence of teaching and learning methods and assessment tools that fits CBME. For the successful settle down of CBME, there is a need for efforts to develop the model of graduate outcomes, to share information and experience, and to operate faculty development program by the medical education communities.

• Perspectives in Nursing Science
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• 제5권1호
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• pp.59-71
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• 2008

e-Health/u-Health has generally been considered as an expansion of current medical and medical relevant segments. However. as e-Health/u-Health has been known to have typical attributes and characteristics of services supporting a physically and mentally well-balanced life of its users, we can rationally assume that e-Health/u-Health can be not only an expansion of the existing medical field but also a result of the complex and sophisticated convergence among diverse industries such as the ICT industry. traditional care-relevant segments, etc. Thus, in this study, we carefully and cautiously consider e-Health/u-Health in accordance with both possible scenarios: 1) an expansion of a typical industry, and 2) a result of a convergence among various industries. The advent of new technologies, rapid development of current technologies, and convergence trends in various fields are creating dramatic innovations in the next generation health services market. Consumerism as a characteristic of c-Health/u-Health can be expected to find a solution of the existing healthcare service problems. In the initial phase. mainly due to the absence of a vanguard, as well as to various legalistic and regulative limitations, the role of the government would be immensely critical for the successful early settlement of the e-Health/u-Health industry. Both the government and private sector need to practice continuous and effective public education and publicity mainly to increase the overall recognition and usability of e-Health/u-Health services. Nursing as a unique professional discipline should be well aware of the new paradigm shift of the healthcare market, and make maximum use of the possibility of this trend to the advent of the professional nursing's new role.

• 여성건강간호학회지
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• 제17권5호
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• pp.463-473
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• 2011

Purpose: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire. Methods: A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion. Results: Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability. Conclusion: The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.

• Korean Journal of Radiology
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• 제21권5호
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• pp.526-536
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• 2020

Objective: This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection. Materials and Methods: This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range, 17-91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient's treatment were measured. Multivariate analyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured. Results: CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.7; p = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2-3.5; p = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1-5.8; p = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient's treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0-3.7; p = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5-3.8; p < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0-2.8; p = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351). Conclusion: In patients with suspected pulmonary infection, approximately 30-40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.

• 대한간호학회지
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• 제3권1호
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• pp.97-104
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• 1972

This study was designed to investigate differences in some aspects of value conceptions in fundamentals of nursing functions between nursing service personnel and nurse-educators. The purpose of the study was to identify the difference of value conceptions between the hospital nurses and school instructors, to contribute as a reference in strengthening the educational program in establishing nay hinder professional growth. The questionaries of this study were focused in the following aspects: 1) establishment of nursing service management system, 2) strengthening of the professionalization of nursing service, 3) hindrance in accomplishment of independent nursing functions, 4) communication skills in nurse-patient relationship, 5) activities directly related to nursing care planning, 6) communication skills in nurse-doctor relationship, 7) attitude towards taking responsibilities for patient- centered nursing approach, and 8) nursing educational approach towards preparation of professional competence in practicing independent nursing functions. 265 graduate nurses from 14 general hospitals and 88 nursing instructors from 18 schools, collegiate and diploma, were sampled. The main findings of the study were as follows; 1. Both groups responded highly in the lack of public recognition of nursing profession and hospital administrators support in establishment of nursing service management system. Further investigation is needed to define some relationship between the intrinsic and extrinsic factors which might give influence to the professional development. 2. while hospital nursing personnel responded on environmental pressure such as a heavy nursing load as the factor giving hindrance to independent nursing functions, the nurse educators responded highly on lack of nursing competence of individual nurses. An emphasis should be placed on the development of nursing interaction through professional education. If the professional model is not well established, nursing function will be limited to medical assistance. 3. 3. The patient-centered approach for nurse-patient communication had given positive respond for both group, tut lacks in team concept in problem solving process. There exist a social distance between nurses and other professional co-workers in the hospital hierarchy. 4. It was indicated that, as an intrinsic factor in the development of nursing service and nursing education, building up a philosophical basis is an utmost importance. This question is opened for further and extensive study to clarify whether existence of philosophical absence or philosophical stasis in nursing profession hinders the development.

• 대한지역사회영양학회지
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• 제21권5호
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• pp.426-439
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• 2016

Objectives: This study was performed to measure the food allergy (FA) awareness and management by the parents of preschool children. Methods: A questionnaire survey was conducted with the parents of preschool children. The questionnaire was designed to identify the prevalence of food allergies, requirements of food allergy support and differences in food management according to the presence or absence allergic diseases, using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. After excluding incomplete responses, the data of 158 parents of preschool children (90.3%) was used for statistical analysis. Results: The rate of the preschool children who had experienced food allergy (FA, ever) was 38.6% while diagnosed for food allergy by doctor (Diagnosis of FA, ever) was 17.7%. Forty nine preschool children (80.3%) had food restriction, and twenty three of them (37.7%) had self-restriction without diagnosis. The consumption frequencies of allergenic foods in FA group, such as ramyeon, noodles, bread, eggs, yogurt and ice cream were significantly (p<0.001) lower than those of the other two groups. The major allergenic foods were eggs, milk, wheat and processed foods in FA group. The overall food allergy-related knowledge level of parents was insufficient. Only 26 parents (16.5%) had received training about food allergies. All parents wanted to receive food allergy-related supports. In addition, most of parents wanted information on substitute menu for children with food allergy. Conclusions: This study identified a lack of food allergy training for the parents of preschool children and the necessity for food allergy education. Food allergy-related supports, such as menus without allergenic ingredients, guidelines for managing food allergy & anaphylaxis emergency care plan etc, should be provided to the parents in order to avoid events related to food allergies.