• 한국식품영양과학회지
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• 제46권8호
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• pp.997-1011
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• 2017

본 연구는 양적 질적 조사를 통해 기존 개발된 '서울시 영유아 공공급식 식품영양관리기준-어린이집'의 적용 가능성을 평가하여 향후 확대 적용을 위한 토대를 마련하고자 실시하였다. 기 개발된 서울시 공공급식 식품영양관리기준의 문항별 이해도, 적용도, 어린이집 건강급식 실천력을 향상시키기 위한 평가 문항으로서의 적합도를 평가하기 위해 2015년 11월 서울시를 통해 서울시에 소재하는 어린이집, 유치원, 지역아동센터 총 82개소에 이메일로 설문 조사하였다. 또한, 서울시 관내 공공급식을 하는 어린이집, 유치원 원장 및 육아지원센터 영양사와의 포커스 그룹 인터뷰를 통해 각 기준의 적절성을 최종 검토하여 본 기준을 확대 적용하기 위한 수정안을 도출하였다. 기 개발된 서울시 공공급식 식품영양관리기준의 설문조사 결과(n=82), 조사 항목에 대한 이해도 86.9%, 적용도 80.7%, 어린이집 건강급식 실천력을 향상시키기 위한 평가 문항으로서의 적합도가 82.6%로 도출되었다. 포커스 그룹 인터뷰를 통해 기준의 적용 가능성을 질적 평가한 결과, 확대 적용을 위해서 식자재 공급업체용 가이드라인의 필요성, 항목의 근거와 목적의 합치성, 맥락적 상황고려 및 서울시 차원의 기반 구축의 필요성 등 수정을 위한 4가지 요인이 도출되었다. 따라서 기준의 확대 적용을 위해 공공급식 식품영양관리기준안의 가이드라인을 영유아 공공급식 제공 기관용으로 제시하되 일부 가이드라인은 식자재 공급업체가 필수나 권고로 제공해야 할 사항으로 구분하여 별도의 가이드라인을 개발하였다. '서울시 공공급식 식품영양관리기준'의 적용 가능성 평가를 통해 기준이 확대적용 될 수 있도록 가이드라인 수정 및 보완을 통해 공공급식을 이용하는 영유아의 건강 증진 및 지속할 수 있는 환경 유지에 기여할 수 있음을 제시하였다. 또한, 서울시의 지속적인 검토로 급식관리자 전용 식품영양성분 관리 및 발주 통합 프로그램 도입 등을 위한 후속 연구가 필요하다고 생각한다.

• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.268-275
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• 2020

Background: It is not evident that the attributable risk of smoking on mortality in Korea has decreased. We investigated the impact of smoking on all-cause mortality and estimated the attributable risk of smoking in Korean adults. Methods: Those aged ≥20 years with smoking history in the Korean National Health and Nutrition Examination Surveys (KNHANES) 2007-2015 were enrolled. We categorized the participants into three groups as follows: never smoker, <20 pack-years (PY) smokers, and ≥20 PY smokers. We applied inverse probability weighting using propensity scores to control various confounders between the groups. All-cause mortality risks were compared between the groups using the Kaplan-Meier log-rank test. The effects of smoking-attributable risks (ARs) on mortality were also calculated. Results: A total of 50,458 participants were included. Among them, 19,334 (38.3%) were smokers and 31,124 (61.7%) were never smokers. Those with a smoking history of 20 PY or more (≥20 PY smokers), those with a smoking history of less than 20 PY (<20 PY smokers), and never smokers were 18.1%, 20.2%, and 61.7%, respectively, of the study population. Smokers had a higher risk of all-cause mortality compared to never smokers (log-rank test p<0.01). The ARs of smoking were 21.8% (95% confidence interval [CI], 5.7%-37.9%) and 9.0% (95% CI, 6.1%-12.0%) in males and females, respectively. ARs decreased from 24.2% to 19.5% in males and from 9.5% to 4.1% in females between 2007-2010 and 2011-2015. Conclusion: Our study using KNHANES IV-VI data demonstrated that smoking increased the risk of all-cause mortality in a dose-response manner and the ARs of smoking on mortality were 21.8% in males and 9.0% in females during 2007-2015. This suggests that the ARs of smoking on mortality have decreased since around 2010.

• 의학교육논단
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• 제24권2호
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• pp.79-92
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• 2022

With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor's awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor's competency framework from the patient's perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011-2020), domestic newspaper articles (2016-2020), and domestic social networking service data (2016-2020) related to doctor's competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor's competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists. Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor's competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.30-36
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• 2023

Background Most children with facial lacerations require sedation for primary sutures. However, sedation guidelines for invasive treatment are lacking. This study evaluated the current status of the sedation methods used for pediatric facial laceration repair in Korea. Methods We surveyed one resident in each included plastic surgery training hospital using face-to-face interviews or e-mail correspondence. The health care center types (secondary or tertiary hospitals), sedation drug types, usage, and dosage, procedure sequence, monitoring methods, drug effects, adverse events, and operator and guardian satisfaction were investigated. Results We included 45/67 hospitals (67%) that used a single drug, ketamine in 31 hospitals and chloral hydrate in 14 hospitals. All health care center used similar sedatives. The most used drug administered was 5 mg/kg intramuscular ketamine (10 hospitals; 32%). The most common chloral hydrate administration approach was oral 50 mg/kg (seven hospitals; 50%). Twenty-two hospitals (71%) using ketamine followed this sequence: administration of sedatives, local anesthesia, primary repair, and imaging work-up. The most common sequence used for chloral hydrate (eight hospitals; 57%) was local anesthesia, administration of sedatives, imaging work-up, and primary repair. All hospitals that used ketamine and seven (50%) of those using chloral hydrate monitored oxygen saturation. Median operator satisfaction differed significantly between ketamine and chloral hydrate (4.0 [interquartile range, 4.0-4.0] vs. 3.0 [interquartile range, 3.0-4.0]; p <0.001). Conclusion The hospitals used various procedural sedation methods for children with facial lacerations. Guidelines that consider the patient's condition and drug characteristics are needed for safe and effective sedation.

• 한국의료질향상학회지
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• 제30권1호
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• pp.88-104
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• 2024

Purpose: This study explored the suitability of interventions for medication interruption and intervention preferences. Methods: Two rounds of Delphi surveys were conducted with 18 expert panels comprising staff (or charge) nurses, nursing managers, and Quality Improvement (QI) team nurses working in a tertiary general hospital. For 47 situations involving the location of interruption, medication step, and source of interruption, the suitability of three interventions (no-interruption zone, medication safety vest, and education) was evaluated using a 5-point scale. Results: A total of 51 interventions for each situation were found appropriate by satisfying the degree of convergence and consensus. Patients or caregivers, peer nurses, doctors, telephones, and call bells were sources of interruption and were identified as appropriate for the application of interventions. 'Responding to requests and inquiries' by patients or caregivers showed high overall suitability. The nurses' preferred color for the intervention design (no-interruption zone, medication safety vest) is blue text on a yellow background. The priority groups for education related to medication interruptions were patients or caregivers, nurses, and non-nursing staff, in that order. Conclusion: Effective implementation of tailored intervention strategies that consider the specific characteristics of medication interruptions is crucial for mitigating interruptions and enhancing patient safety. Comprehensive educational programs aimed at reducing medication interruptions by improving awareness are necessary. Moreover, future research should evaluate these strategies in clinical settings to ensure their effectiveness in enhancing patient safety.

• 대한한방소아과학회지
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• 제25권1호
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• pp.90-110
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• 2011

Objectives: The purpose of this study is to examine the parental recognition and utilizing patterns of oriental medical care in children who live in Seong-Dong district. Methods 802 day-care center children's parents participated in the survey on recognition and utilizing patterns of oriental medical care, and 702 of the surveys were analyzed. Results: 1. 38.33% has received previous oriental medical treatments and most were received at the children's age under 12-24 months. Majority of the treatments took place in the clinical settings. By recommendation, some also received their treatment at the medical centers. One of the reasons why they receive oriental medical treatments was that they prefer to balance their treatment with the orental medical treatments along with the western's. 2. 53.85% of those who received oriental medical treatments were satisfied with their treatments. The effective treatment results were the major reason for the satisfaction. 3. 49.56% of those who had oriental medical treatments chose specific oriental medical facilities for the children's ailment. Most specific oriental medical facilities were local oriental medical clinics. Reputation fame were the main reason in choosing the clinics. 4. In 2009, 55.26% had received care in the specific oriental medical clinics for the diseases, such as respiratory symptoms, systemic symptoms, gastrointestinal symptoms, skin problems, neurological and psychiatric disease for infants, and respiratory symptoms, gastrointestinal symptoms, systemic symptoms, skin problems, neurological and psychiatric symptoms, urinary symptoms and musculoskeletal symptoms for toddlers. 5. The average duration of herbal treatment were 7-14 days, preferably 4-6 days, and preferred number of medical visits were once a week on Saturdays and preferred day for night cares were on Friday nights. Average treatment fee per treatment was less than 10,000 won which coincided with the preferred treatment fee per visit. 6. The very first medical institutions chosen by parents once their children are ill are the following; Western medical institutions, western medical clinics, pharmacies, oriental medical clinics, health centers, and lastly, oriental medical institutions. The major concerns in receiving oriental medical cares include pesticides in herbs and hazardous substances in heavy metals. Preferred form of oriental medicine was decoction, the negative feedback of oriental medicine was mostly due to the bitter taste of the oriental herbal decoctions. Preferred frequency of intake was twice a day with less than 10cc~20cc per single intake. Conclusions: Taken all together, we conclude that the growing recognition of Oriental Pediatric medicine is needed among parents.

• 한국의료질향상학회지
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• 제25권1호
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• pp.43-51
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• 2019

Purpose: The time lag between the decision to initiate continuous renal replacement therapy (CRRT) and its actual initiation remains a major barrier in our intensive care units. We developed a CRRT pop-up chart on EMR for managing CRRT machines. Methods: This study measured time interval between the decision to prepare the CRRT machine and the actual use of the machine before and after using a CRRT pop-up chart. This study conducted a questionnaire of the medical staff to assess the changes in the quality of CRRT preparation. Results: A total of 95 patients on CRRT is analyzed. The time to find an available CRRT machine is decreased by 24.6%. The time to move a CRRT machine to the patient's bedside is decreased by 55.8%. Medical surveys of 44 nurses gave the following results. 1) The time to apprehend machines for 1 to 3 minutes is improved from 29.5% to 81.8%, and the time to apprehend machines over 3 minutes is decreased from 70.5% to 18.2%. 2) The number (6-all) of known machine locations is improved from 22.7% to 63.4%. 3) Interruption of a nurse's work due to telephone calls asking for the possession of movable CRRT equipment also is improved. Scores of 1-4 are improved from 15.9% to 41%. Scores of 5-7 are reduced from 52% to 15.9%. Conclusions: CRRT pop-up chart is shortened the time lag of CRRT machine preparation, reduced the nurse's phone workload and helped to improve the quality of CRRT care.

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.513-520
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• 2000

Objectives : To estimate the prevalence of hypertension, rates of awareness, treatment modalities, and control of hypertension, and also to identify factors in rural Korea that are related to these aspects of hypertension. Methods : A cross-sectional survey, including blood pressure(BP) measurements and interviews, investigating the variables in the health belief model was peformed from August to November, 1999 on 1,426 (79.4%) study subjects out of 1,797 registered residents over 30 years old in Ibansong-Myun, Chinju City. A second survey was peformed from January to March, 2000 on 376 (80.0%) subjects out of 470 hypertensive (or suspected hypertensive) subjects found in the first survey. Two BP readings were taken in each survey using a standard mercury sphygmomanometer. Hypertension was defined as either a BP reading $\geq$ 140/90 mmHg in both surveys, or as subjects on oral hypertensive medication. Results : Estimated hypertension prevalence was 24.9% for men, and 30.4% for women. Rates of hypertension awareness, treatment (the regular use of oral hypertensives), and control (reduction of BP to <140/90 mmHg) were 52.5%, 34.4%, and 12.9%, respectively. The factors related to lower hypertension awareness in the logistic regression analysis were male gender, farming occupation, and higher perceived barrier to medical treatment (those for whom visiting health professionals is a burden). Conclusions : To improve the low awareness, treatment, and control of hypertension, a more active and out-reaching hypertension control program, including routine BP measurements for every visitor to primary care facilities, is needed in rural Korea.

• 한국치위생학회지
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• 제19권3호
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• pp.421-436
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• 2019

Objectives: The purpose of this study was to compare the dental treatment needs of workers depending on their shifts and working patterns. Methods: Only workers aged 15 or older according to the $6^{th}$ Korea National Health and Nutrition Examination Survey (2013-2015) were considered eligible. A total of 9,092 people who responded to health surveys and completed oral examinations and interviews were selected for the study. Statistical analysis was carried out by the complex samples general linear model. Results: As the daytime workers' age increased, the requirement for restorative treatment decreased. In contrast, the requirement for tooth extraction caused by dental caries and periodontal disease increased. As the evening shift workers' age increased, the requirement for restorative treatment decreased. In the case of shift workers, the requirement for restorative treatment was lowest in those aged 50-64 years and highest in those aged 30-49 years. In the case of smokers; the daytime workers required a higher amount of restorative treatment, pulpal treatment, and tooth extraction due to dental caries and periodontal disease; the night shift workers required a higher amount of restorative treatment; and the shift workers required a higher amount of tooth extraction caused by periodontal disease. The results of comparing the dental treatment needs depending on working patterns were: the need for restorative treatment was higher in night shift workers (0.377) than in shift workers (0.245); the requirement for pulpal and restorative treatment was higher in daytime workers (0.055) than in night shift workers (0.010); requirement for tooth extraction due to periodontal disease was higher in night shift workers (0.060) than in evening shift workers (0.012). Conclusions: There are differences in dental treatment needs depending on the workers' working patterns. Collective oral health care is needed at workplaces to promote the workers' oral health.

• Tuberculosis and Respiratory Diseases
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• 제71권5호
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• pp.328-334
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world and is the only major disease that is continuing to increase in both prevalence and mortality. The second Korean National Health and Nutrition Survey revealed that the prevalence of COPD in Korean subjects aged ${\geq}45$ years was 17.2% in 2001. Further surveys on the prevalence of COPD were not available until 2007. Here, we report the prevalence of spirometrically detected COPD in Korea, using data from the fourth Korean National Health and Nutrition Survey (KNHANES IV) which was conducted in 2007~2009. Methods: Based on the Korean Statistical Office census that used nationwide stratified random sampling, 10,523 subjects aged ${\geq}40$ years underwent spirometry. Place of residence, levels of education, income, and smoking status, as well as other results from a COPD survey questionnaire were also assessed. Results: The prevalence of COPD (defined as forced expiratory volume in 1 sec/forced vital capacity <0.7 in subjects aged ${\geq}40$ years) was 12.9% (men, 18.7%; women, 7.5%). In total, 96.5% of patients with COPD had mild-to-moderate disease; only 2.5% had been diagnosed by physicians, and only 1.7% had been treated. The independent risk factors for COPD were smoking, advanced age, and male gender. Conclusion: The prevalence of COPD was 12.9% in the KNHANES IV data. Most patients with COPD were undiagnosed and untreated. Based on these results, a strategy for early COPD intervention is warranted in high risk subjects.