• Korean Journal of Health Education and Promotion
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• v.35 no.5
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• pp.1-16
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• 2018

Objectives: This study aimed to examine systems behavior of urban walking by analyzing a dynamic structure in Seoul, South Korea. Methods: As a systems thinking approach to urban walking and health promotion, we developed a Casual Loop Diagram based on literature review and expert consultation. The reviewed literature included: 1) qualitative studies that explores the experiences of urban walkers in Seoul; 2) a systematic review study on the built environmental factors related to walking; 3) policy research reports related to urban walking in Seoul. Results: The feedback structure for urban walking was related to the three urban environments (safety & walking environment, socioeconomic environment, and public transportation environment), and was characterized by a trade-off consisting of eight reinforcing loops and four balancing loops. Conclusions: The policies for a walkable city require multi-sectoral cooperation in order to change the causal loop structure related to the decline of walking. Therefore, it is necessary to establish legal and institutional conditions so that multi-sectoral and multidisciplinary approaches are possible.

• Journal of KIBIM
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• v.12 no.4
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• pp.116-127
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• 2022

Building Information Modeling, which was applied mainly in the construction sector, is expanding to the road sector, and the government recently recommends preparing individual application guidelines considering the characteristics of detailed fields such as railways, ports, and complexes through BIM implementation guidelines. Compared to general construction projects, a lot of the works such as signals, electricity, and power, and the railway BIM 2030 roadmap has been presented to apply BIM to railway construction projects that require business consultation and work environment review with various local governments, and pilot projects are in operation. Unlike a general building, in which the construction begins after the detailed design is completed, in the railway project, the detailed design of other works proceeds along with the roadbed construction. Because construction and design work together, railways need to coordinate detailed engineering interfaces such as trajectories, signals, and power, and the application of BIM in design interface coordination has the advantage of maximizing the effectiveness of pre-review. Overseas railway construction projects actively used BIM to adjust design interfaces and had a collaboration process to modify BIM models and create construction details from the revised models through regular meetings with suppliers. Therefore, this study aims to derive the factors necessary for establishing a BIM collaboration environment based on a survey of practitioners as a preliminary step for establishing the BIM collaboration process of the railway construction project.

• Anxiety and mood
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• v.19 no.2
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• pp.37-47
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• 2023

This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

• Health Policy and Management
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• v.25 no.3
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• pp.185-196
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• 2015

Background: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. Methods: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. Results: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. Conclusion: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.1
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• pp.1-7
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• 2021

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.87-92
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• 2014

Objectives : Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. Methods : Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. Results : Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. Conclusions : In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.77-83
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• 2016

Objectives The aim of this study is to investigate the possibility of making Korean Medicine-Western Medicine collaboration Critical Pathway for Acute Postoperative Pain after Back Surgery. Methods This preliminary Critical Pathway (CP) was composed of 9 Index of vertical axis (assesment, treatment, patient movements, consultation, diet, other, administration, examination, education) and 5 hospitalization periods of horizontal axis through a review of the literature and reference data of medical records. This preliminary CP's Content Validity Index (CVI) survey was carried out by 20 personnel of two different medical institutions from 06, June, 2016 to 15, June, 2016. All data were double-cross checked and analyzed. Results Of those questioned, there were 13 males and 7 females in age, 6 professors, 7 medical residents, 7 nurses in position of 20 personnel. According to the survey, among the 62 contents, 32 contents are above 80 percent agreements, 12 contents were between 70 to 80 percent and 18 contents below 70 percent agreements. Especially, Most contents in treatment index were below fixed validity. Overall Contents Validity in Index, Treatments (72.7%), Diet (100.0%), Other (100.0%), Administration (75.0%) and Examination (100.0%) were in high validity. On the other hands, Assessments (29.4%), Patient movements (0.0%), Consultation (30.0%) and Education (33.3%) were in low position. Conclusions This survey results can be evidence of possibility to develop New Korean Medicine-Western Medicine Collaboration Critical Pathway for Acute Postoperative Pain after Back Surgery.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.517-532
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• 2000

The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.

• Journal of the Korean Society of Marine Environment & Safety
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• v.20 no.2
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• pp.157-164
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• 2014

This paper suggested the improvement of marine environmental impact assessment of different types of project by analyzing the consultation on the coastal area utilization(133cases) of the coastal development project for 4years(2010-2013). According to the analysis results, the erosion protection project needs to precede the accurate analysis of erosion reasons, predict exactly possible problems and establish the systematic system to verify the effect of erosion protection by monitoring after projects. The construction projects of revetments and coastal roads have to require to sublate, examine the reliability in structures, give consideration to the problems of coastal erosion by increase of reflected waves. In addition, flooding protection projects have got to require to select the waves for evaluation items in conjunction with the effects of abnormal waves. furthermore, waterfront construction projects need to establish comprehensive and methodical space plans and reinforce the review to conserve the natural environment and conduct nature-friendly development. There are many problems inherently related to coastal development Project. To these problems, however, it is required to support the project on the side of the legislation and conduct additional studies reflecting the characteristics by sea areas and projects.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.20-26
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• 2022

Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.