• International Journal of Advanced Culture Technology
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• v.8 no.3
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• pp.159-165
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• 2020

The purpose of this study is to consider the home environment and awareness of elementary school students in the first grade of elementary school, and to find ways to support them. Participants were 31 1st graders in elementary schools nationwide. Data collection was conducted from June 6, 2017 to July 7, 2017. The focus group interview was used as a data collection method for this study. Results were analyzed as 'The Changing family environment that first graders think' and 'First graders' awareness of elementary school'. 'The Changing family environment that first graders think' include 'Changes in language used by parents', 'Changes in how parents and families live', and 'What to do after school'. 'First graders' awareness of elementary school' was analyzed as 'Awareness of Elementary school life', 'Awareness of peers', 'Awareness of homeroom teacher', and 'Awareness of learning'. As the conclusion of this study, we suggest that because the children have more free time than attending kindergarten, they need quality programs and support plans to support their first grade primary adjustment. Also, we propose a common problem facing first-year students: the difficulty of adjusting to study and support for how to study in an easier way.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.6 no.2
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• pp.116-119
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• 2010

Trauma to the lips and tongue can occur by accidental self-biting after dental treatment. After local anesthesia, it is likely that the patient may feel painless even in biting the tongue. In case of young children and disabled patients, the dentists should be careful not to bite the tongue. In this report, we present a case of deep lingual laceration due to biting the tongue in the course of dental treatment under general anesthesia. A 33 year-old male was transferred to our hospital to treat tongue laceration. Before 2 hour on arrival, he had received dental care under general anesthesia at a dental hospital for the disabled because of cooperation difficulty and cerebral palsy. During recovery from general anesthesia, he tried to bite his own tongue involuntary. The doctors and nurses tried to prevent the patient from being injured. Despite these efforts, massive bleeding occurred from the injured sites of the tongue. Because we could not communicate with him, we decided to evaluate the extent of the injury and treat the injured sites under general anesthesia. The laceration wound was sutured for nearly 1 hr general anesthesia. During recovery we inserted mouth prop into the oral cavity to prevent further injuries from tongue biting. After full recovery from general anesthesia he didn't try to bite his tongue. After 4 hour admission, he was discharged without other complications.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.361-367
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• 2013

Background: Nefopam is a centrally acting analgesic that is used to control pain. The aim of this study was to find an appropriate dose of nefopam that demonstrates an analgesic effect when administered in continuous infusion with fentanyl at the end of laparoscopic cholecystectomy. Methods: Ninety patients scheduled for laparoscopic cholecystectomy were randomly assigned to receive analgesia with fentanyl alone (50 ${\mu}g$, Group 1, n = 30), or with fentanyl in combination with nefopam 20 mg (Group 2, n = 30) or in combination with nefopam 40 mg (Group 3, n = 30) at the end of surgery. Pain and side effects were evaluated at 10 minutes, 30 minutes, 1 hour, 2 hours, 6 hours, and 12 hours after arrival in the post-anesthesia care unit (PACU). Results: Pain was statistically significantly lower in Groups 2 and 3 than in Group 1 at 10 minutes, 2 hours, and 6 hours after arrival in the PACU. Nausea was statistically significantly lower in Group 2 than in Groups 1 and 3 at 10 minutes after arrival in the PACU. Shivering was statistically significantly lower in Groups 2 and 3 than in Group 1 at 10 minutes after arrival in the PACU. Conclusions: Nefopam is a drug that can be safely used as an analgesic after surgery, and its side effects can be reduced when fentanyl 50 ${\mu}g$ is injected with nefopam 20 mg.

• Clinical and Experimental Pediatrics
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• v.53 no.8
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• pp.805-808
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• 2010

Although sodium nitroprusside (SNP) is often used in pediatric intensive care units, cyanide toxicity can occur after SNP treatment. To treat SNP-induced cyanide poisoning, antidotes such as amyl nitrite, sodium nitrite, sodium thiosulfate, and hydroxycobalamin should be administered immediately after diagnosis. Here, we report the first case of a very young infant whose SNP-induced cyanide poisoning was successfully treated by exchange transfusion. The success of this alternative method may be related to the fact that exchange transfusion not only removes the cyanide from the blood but also activates detoxification systems by supplying sulfur-rich plasma. Moreover, exchange transfusion replaces cyanide-contaminated erythrocytes with fresh erythrocytes, thereby improving the blood's oxygen carrying capacity more rapidly than antidote therapy. Therefore, we believe that exchange transfusion might be an effective therapeutic modality for critical cases of cyanide poisoning.

• The Journal of Korean Medicine
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• v.42 no.3
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• pp.1-8
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• 2021

Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.

• Health Policy and Management
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• v.27 no.2
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• pp.149-156
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• 2017

Background: This study was conducted to evaluate the performance of the Hierarchical Condition Category (HCC) model, identify potentially high-cost patients, and examine the effects of adding prior utilization to the risk model using Korean claims data. Methods: We incorporated 2 years of data from the National Health Insurance Services-National Sample Cohort. Five risk models were used to predict health expenditures: model 1 (age/sex groups), model 2 (the Center for Medicare and Medicaid Services-HCC with age/sex groups), model 3 (selected 54 HCCs with age/sex groups), model 4 (bed-days of care plus model 3), and model 5 (medication-days plus model 3). We evaluated model performance using $R^2$ at individual level, predictive positive value (PPV) of the top 5% of high-cost patients, and predictive ratio (PR) within subgroups. Results: The suitability of the model, including prior use, bed-days, and medication-days, was better than other models. $R^2$ values were 8%, 39%, 37%, 43%, and 57% with model 1, 2, 3, 4, and 5, respectively. After being removed the extreme values, the corresponding $R^2$ values were slightly improved in all models. PPVs were 16.4%, 25.2%, 25.1%, 33.8%, and 53.8%. Total expenditure was underpredicted for the highest expenditure group and overpredicted for the four other groups. PR had a tendency to decrease from younger group to older group in both female and male. Conclusion: The risk adjustment models are important in plan payment, reimbursement, profiling, and research. Combined prior use and diagnostic data are more powerful to predict health costs and to identify high-cost patients.

• Women's Health Nursing
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• v.2 no.1
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• pp.125-137
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• 1996

This study was conducted to identify the educational need of pregnant women, and to evaluate the effect of the 2-hour childbirth class provided by researchers. The subjects were composed of 183 pregnant women who participated voluntarily in the 2-hour childbirth class, and the data were collected by self reporting structured questionnaire designed by researchers. The data were analyzed with descriptive statistics, paired t test, and McNemar test by SPSS pc program. The results were as follows ; 1. Mean age of th subjects was 27 and most subjects graduated from the high school and the college. 80.3% of the subjects had nuclear family. 82.5% of the subjects were full time housewives. 2. 85.8% of the subjects were ipara. Though 71.6% of the subjects might have antepartal care in the clinic, 67.2% of the subjects had no chance to participate in the childbirth class before this study. 3. Subject's health and lifestyle, especially related to eating habits, were changed in the antepartum period. We found that the pregnancy affected positively on health and lifestyle of the women. Over 75% of the subjects became to understand the progress of labor, breath methods during the labor, and perineal exercise. Most subjects changed to think that they could control their body more actively and positively during the labor after participating in the childbirth class. 93.4% answered that 'childbirth class was necessary and important'. Most subjects wanted to be taught the contents, such as postpartum care, breast feeding, and infant care in the childbirth class. In conclusion, pregnant women to attend the childbirth educational program with their husband, and the 2-hour childbirth class provided by the researchers very effective in many aspects. Therefore we anticipated that the childbirth class on basis of pregnant women's needs will contribute to improvement of pregnant women's health and well-being during the labor.

• Research in Community and Public Health Nursing
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• v.20 no.4
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• pp.453-464
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• 2009

Purpose: This study was conducted to develop health education program components for early childhood and to investigate teachers' awareness of the importance of health education and their performance rate of health education. Methods: Early childhood health education program components were developed using two rounds of the Delphi method. The Delphi group consisted of 21 experts in childhood education. After health education program components were developed, they were used in surveying child care teachers' awareness of importance and performance rate and 151 teachers sampled from 30 child care centers participated in the survey. Results: The early childhood health education program components consisted of 5 areas, 16 subjects and 33 specific contents. Early childhood teachers' awareness of importance was over 4.5 points in all the areas and in 11 out of the 16 subjects. The most frequently educated subjects were 'the importance of hand washing' and the least frequently educated subject was 'obesity prevention'. The teachers' awareness of importance and their performance rate of specific contents were high in 'maintaining order' and 'using children's rides safely,' and low in 'obesity prevention' and 'infectious disease prevention.' Conclusion: The components of this health program were developed in consideration of field feasibility and the relationship of health program education in elementary, middle and high school.

• Korean Medical Education Review
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• v.20 no.2
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• pp.72-77
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• 2018

Observation of the current Korean medical education and training system shows that certain negative traits of unchangeable solidification engraft themselves so deeply into the overarching system that they are now hampering the state of the national health welfare. Focusing only on undergraduate medical education, we can point out some glaring side-effects that should be of concern to any stakeholder. For instance, a graduate can legally begin his career as an independent practitioner immediately after passing the licensing exam and return to the old stuck school-year system of 2-year-premedical and 4-year-medical programs where outcome-based and integrated curricula are incomplete and unsatisfactory. In terms of learning opportunities, the balance between patient care and public health, as well as that between in-hospital highly specialized practice and community-based general practice, has worsened. Every stakeholder should be aware of these considerations in order to obtain the insight to forge a new direction. Moreover, our medical schools must prepare our students to take on the global roles of patient care within the Fourth Industrial Revolution, health advocacy for the imminent super-aged society, and education and research in the bio-health industry, by building and applying the concept of academic medicine. We will need to invest more resources, including educational specialists, into the current undergraduate medical education system in order to produce proper outcomes, smart curriculum, innovative methods of teaching and learning, and valid and reliable monitoring and evaluation. The improved quality of undergraduate medical education is the starting point for the success of the national system for public health and medical care as a whole, and therefore its urgency and significance should be emphasized to the public. The medical society should go beyond fixing what is broken and usher in a new era of cooperation and collaboration that invites other health professionals, governmental partners, law-makers, opinion leaders, and the general public in its steps toward the future.

• Journal of Korean society of Dental Hygiene
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• v.15 no.1
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• pp.73-79
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• 2015

Objectives: The purpose of this study was to investigate the factors influencing on the denture satisfaction in the low income elderly people. Methods: The subjects were 143 elderly people from 60 to 75 years old wearing dentures and receiving consistent follow-up in the public health center in Busan. A self-reported questionnaire was filled out by the elderly people from February 1 to March 1, 2013. The questionnaire consisted of denture satisfaction, social variables, and psychological variables. Data were analyzed by ANOVA and multiple regression analysis using SPSS 18.0. The sociodemographic characteristics included gender, age, and chronic diseases. The recognition of oral health included pronunciation, denture maintenance, mastication ability, and education for denture care. The questionnaire was measured by Likert 5 scale. Results: Gender, chronic disease, denture care instructions, and the self-preception of the oral health after denture treatment were closely correlated with denture satisfaction(p<0.001). Age and the number of repairs were very important factor to denture satisfaction(p<0.05). Elderly women were more satisfied with denture than men and those who had no chronic diseases tended to be more satisfied with denture. Those who received oral care instructions were more satisfied with the denture than those who did not. The younger age group and no repairing prosthetic group tended to be more satisfied with the denture. Conclusions: It is important to provide the denture management services to the low income elderly when they demand the services. The national dental health policy must be focused on connection of the elderly people denture services with the public health center.