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Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.248-329
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    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Successful Management and Operating System of a UNESCO World Heritage Site - A Case Study on the Wadi Al-Hitan of Egypt - (유네스코 세계자연유산의 성공적인 관리와 운영체계 - 『이집트 Wadi Al-Hitan』의 사례 -)

  • Lim, Jong Deock
    • Korean Journal of Heritage: History & Science
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    • v.44 no.1
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    • pp.106-121
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    • 2011
  • The number of World Natural Heritage Sites is smaller than that of World Cultural Heritage Sites. As of 2010, the total number of natural sites was 180, which is less than 1/3 of all cultural sites. The reason why the number of natural sites is smaller can be attributed to the evaluating criteria of OUV(outstanding universal value). Only 9 fossil related sites were designated as World Heritage Sites among 180 Natural Sites. This study compares their OUVs including the academic value and characteristics of the 9 World Heritage Sites to provide data and reference for KCDC(Korean Cretaceous Dinosaur Coast) to apply as a World Natural Heritage Site. This study was carried out to obtain information and data on the Wadi Al-Hitan of Egypt which was designated as a World Natural Heritage Site. The study includes field investigation for whale fossils, interviews of site paleontologists and staff, and inspections of facilities. Three factors can likely be attributed to its successful management and operating system. First, there is a system for comprehensive research and a monitoring plan. Secondly, experts have been recruited and hired and professional training for staff members has been done properly. Finally, the Wadi Al-Hitan has developed local resources with specialized techniques for conservation and construction design, which matched well with whale fossils and the environment at the site. The Wadi Al-Hitan put a master plan into practice and achieved goals for action plans. To designate a future World Natural Heritage Site in Korea, it is important to be recognized by international experts including IUCN specialists as the best in one's field with OUV. Full-time regular-status employees for a research position are necessary from the preparation stage for the UNESCO World Heritage Site. Local government and related organizations must do their best to control monitoring plans and to improve academic value after the UNESCO World Heritage Site designation. As we experienced during the designation process of Jeju Volcanic Island and Lava Tubes as the first Korean World Natural Heritage Site, participation by various scholars and specialists need to be in harmony with active endeavors from local governments and NGOs.

The Effect of Physical Health Status and Social Support on Depression and Quality of Life among the Elderly in G City (거제시 노인의 신체적 건강상태와 사회적 지지가 우울과 삶의 질에 미치는 영향)

  • Kim, Min-Ja;Oh, Mi-Jung;Lim, Jung-Hye;Chang, Koung-Oh
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.246-257
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    • 2018
  • The purpose of this study was to investigate the effects of physical health status and social support on depression and quality of life among the elderly in G City. This is a descriptive research study of 497 elderly residents in 45 senior citizen centers in G city; the data were collected from March 5 to 30, 2018. Data were analyzed using the IBM SPSS/win 24.0 program by t-test, ANOVA and multiple regression analysis. In physical health status, the chronic disease score was $1.35{\pm}0.91$, the functional status score was $1.80{\pm}4.45$, and the subjective health score was $3.14{\pm}1.13$. The average score for social support in the emotional network was $5.71{\pm}1.13$. In the sub-region of the social network, the score for frequency of contact with relatives was $2.92{\pm}1.31$, that for contact with friends was $3.18{\pm}0.98$, and that for social participation was $0.68{\pm}0.82$. In the multiple regression analysis of factors affecting depression and quality of life, the explanatory power of physical health status and quality of life was 45.5% and 21.1%, respectively. The explanatory power of depression based on social support and quality of life was 46.7% and 27.5%, respectively. This study indicates that physical health status and social support affect depression and quality of life. Therefore, programs should be developed to increase the physical health status and social support and thus improve the quality of life of the elderly in the community.

Case Study on Success and Innovation Activities of Women Entrepreneurs: Focusing on Startups (여성 창업가의 성공과 혁신활동에 대한 사례 연구 : 스타트업을 중심으로)

  • Hong, Jungim;Kim, Sunwoo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.1
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    • pp.55-69
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    • 2021
  • For the national economic development, the participation of women in the social and economic activities is crucial. The popularization of start-ups, digital transformation, and WEconomy trends have lowered the barriers to opportunities for women to start a business and provide an environment in which women can grow faster. This paper examines the significance and process of success of women entrepreneurs and the characteristics of innovation strategies and achievements by linking the recently changing business environment of a company, factors influencing the success of women entrepreneurship, and innovation activities. To this end, four companies' cases were analyzed in the fields of distribution/service and consumer products/services, which are areas of large investment among female startups. The result shows that women entrepreneurs recognize the meaning of success as creating and continuing to create a 'corporate value through establishing a trust relationship with customers' within the 'balance between personal life and work.' In terms of the business ecosystem, women entrepreneurs strive for 'business activities based on the win-win growth of consumers, producers and sellers' for success, and rather 'focus on the process with a problem-solving approach' rather than achieving performance-oriented goals. Also through excellent power of observation, flexibility, and execution power, women entrepreneurs conduct business by adapting to changing trends. In terms of innovation activities, the innovation strategy of women-led companies puts priority on 'creating the value customers want' and focuses on innovation in the 'customer-centric business model' rather than technological innovation. As such, women-led companies show several differentiated characteristics, which enable them to create corporate value and achieve sustainable growth. The barriers to challenges and opportunities for women to start a business have been lowered, and an ecosystem has been created for female startups to grow. But why are there still so few women entrepreneurs, and the answer to where we need to close these gaps is ultimately a close analysis and investigation of the field. We must present milestones for growth steps through the accumulation of case studies of women startups that have exited. In addition, women can stand as economic agents only when the policy targets are subdivided and specific approaches to child-rearing and childcare for women entrepreneurs must be taken. This paper expects to serve as basic data for follow-up studies and become the basis of research for women entrepreneurs to grow as economic agents.

Awareness of the Prevention of Work-Related Diseases among Farmers - Based on Qualitative Research Methods (농업인들의 업무상질환 예방에 대한 인식도 - 질적연구방법을 토대로)

  • Ae-Rim, Seo;Ji-Youn, Kim;Bokyoung, Kim;Gyeong-Ye, Lee;Ki-Soo, Park
    • Journal of agricultural medicine and community health
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    • v.47 no.4
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    • pp.211-219
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    • 2022
  • Objective: This study was conducted to investigate the awareness of work-related disease prevention of farmers. Method: As a research method, a qualitative focus group interview was conducted in 18 participants. Results: Prevention and management services for work-related diseases of farmers mostly are based on research from other fields and so are not highly effective because their content is not relevant to agricultural work. It has been suggested that such program designers be required to have some appropriate related knowledge, and that incentives and a certification system for participation in such education be established. To analyze work-related diseases of farmers, fields of prevention, diagnosis, treatment, and rehabilitation should be created. They demanded the designation of hospitals and the actualization of compensation for farmers' safety insurance. The work-related diseases to address were include musculoskeletal diseases, pesticide poisoning-related diseases (cardiovascular disease, respiratory disease), psychiatric diseases such as depression, and allergic diseases. However, this must have been the result of the harmful factors they felt during agricultural work. And for farmer patients diagnosed with work-related diseases, it was said to strengthen farmer safety insurance. Conclusion: In order to increase the safely and health effects of agricultural work, it is necessary to prevent and manage work-related diseases of farmers. Projects should be developed in consideration of cultural and economic barriers of farmers and the characteristics of the work.

Associations between maternal comprehensive feeding practices and dietary practices in preschool children (어머니의 종합적 식사지도와 유아의 식생활 실천과의 관계)

  • Cho, Myeongil;Kye, Seunghee
    • Journal of Nutrition and Health
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    • v.55 no.1
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    • pp.141-154
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    • 2022
  • Purpose: This study determined the relationships between maternal comprehensive feeding practices (CFP) and dietary practices of preschool children. Methods: Participants of the study were 227 mothers of children aged 3 to 5 years attending daycare centers and kindergartens in Seoul and Gyeonggi Province of Korea. The Comprehensive Feeding Practices Questionnaire was used to assess the maternal feeding practices. The Nutrition Quotient for Preschoolers (NQ-P) was measured to evaluate dietary practice and diet quality of children. Results: The balance of NQ-P for children was positively correlated with the modeling, restrictions for weight control, encouragement of balance and variety, pressure, and involvement among maternal CFP. Moderation of NQ-P was positively correlated with monitoring, modeling, teaching about nutrition, encouragement of balance and variety, environment, and involvement among maternal CFP. However, it was negatively correlated with emotion regulation, food as a reward, and child control in maternal CFP. Among maternal CFP, the environment of NQ-P was positively correlated with monitoring, modeling, teaching about nutrition, encouragement of balance and variety, environment, and involvement, and it was negatively correlated with emotion regulation. As a multiple regression analysis, maternal CFP that positively predicted balance of NQ-P indices were restricted for weight control, pressure, and involvement. Among maternal CFP, encouragement of balance and variety, and environment were positive predictors, while food as a reward, and child control were negative predictors for the moderation of NQ-P. Items of maternal CFP positively predicting environmental factors of NQ-P were monitoring and environment. Conclusion: Mothers are recommended to practice dietary guidance to their children, such as monitoring, modeling, teaching about nutritional information, recommendation of balance and diversity, healthy eating environment, and participation in meal plan and preparation, while they are advised not to conduct any adverse dietary guidance such as emotional control, compensation with food, child control, and food coercion.

Work & Life Balance and Conflict among Employees : Work-life Balance Effect that Reflects Work Characteristics (일·생활 균형과 구성원간 갈등관계 : 직장 내 업무 특성을 반영한 WLB 효과 중심으로)

  • Lee, Yang-pyo;Choi, Chang-bum
    • Journal of Venture Innovation
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    • v.7 no.1
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    • pp.183-200
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    • 2024
  • Recently, with the MZ generation's entry into society and the social participation of the female population, conflicts are occurring between workplace groups that value WLB and existing groups that emphasize collaboration due to differences in work orientation. Public institutions and companies that utilize work-life balance support systems show differences in job Commitment depending on the nature of the work and the activation of the support system. Accordingly, it is necessary to verify the effectiveness of the WLB support system actually operated by the company and present universally valid standards. The purpose of this study is, first, to verify the effectiveness of the support system for work-life balance and to find practical consensus amid changes in policies and perceptions of the working environment. Second, the influence of work-life balance level and job immersion according to work characteristics was analyzed to verify the mutual influence in order to establish standards for WLB operation that reflects work characteristics. For the study, a 2X2 matrix model was used to analyze the impact of work-life balance and work characteristics on job commitment, and four hypotheses were established. First, analysis of the job involvement level of conflict-type group members, second, analysis of the job involvement level of leading group members, third, analysis of the job involvement level of agreeable group members, and fourth, analysis of the job involvement level of cooperative group members. To conduct this study, an online survey was conducted targeting employees working in public institutions and large corporations. The survey was conducted for a total of 9 days from October 23 to 31, 2023, and 163 people responded, and the analysis was based on a valid sample of 152 people, excluding 11 copies that were insincere responses or gave up midway. As a result of the study's hypothesis testing, first, the conflict type group was found to have the lowest level of job engagement at 1.43. Second, the proactive group showed the highest level of job engagement at 4.54. Third, the conformity group showed a slightly lower level of job involvement at 2.58. Fourth, the cooperative group showed a slightly higher level of job involvement at 3.80. The academic implications of the study are that it subdivides employees' personalities into factors based on the level of work-life balance and nature of work. The practical implications of the study are that it analyzes the effectiveness of WLB support systems operated by public institutions and large corporations by grouping them.

Comparative Analysis of COVID-19 Pandemic Crisis Response Capacities by Countries (코로나19 팬데믹 위기 대응 역량의 국가별 비교분석)

  • Yoon Hyeon Lee
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.2
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    • pp.59-70
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    • 2024
  • Objectives: The purpose of this study is to analyze each country's infectious disease response capacities and, based on this, find areas for improvement in Korea's infectious disease management response. Methods: First, the capacity to respond to the COVID-19 infectious disease was analyzed by country using the SPAR scores of 96 countries around the world released by WHO in 2022. Second, we analyzed each country's specific COVID-19 quarantine performance using Our World in Data and the Global Health Security Index (GHSI). Results: First, the quarantine intensity index on January 24, 2021 was the highest in the Southeast Asia branch at 67.6, which had strong quarantine measures, and the lowest at 44.5 in the Africa branch. As of December 31, 2022, the quarantine intensity index in Europe was significantly lowered to 11.6. Second, the factor that influenced the SPAR indicator on the total number of patients per million population was national laboratory (C4), p=.027, and the factor that influenced the total number of deaths per million population was infection prevention and control (C9), p=.005., Risk Communication and Community Participation (C10) p=.040. The influential factor on GDP per capita was infection prevention and control (C9) p=.009, and the influential factor on GHSI was infection prevention and control (C9) p=.002. Conclusion: The research findings indicate that it was difficult to find a correlation between the SPAR, which is each country's self-assessment of their infectious disease capacities, and the number of COVID-19 cases or the intensity of pandemic responses. However, mortality rates, as well as factors such as the Global Health Security Index (GHSI) and national income, appear to be somewhat influenced. For future improvements in infectious disease management and response in our country, it is necessary to develop pandemic strategies that can reduce socio-economic costs based on more scientific and reliable data like JEE or GHSI, especially in preparation for potential unknown emerging infectious diseases. Based on this, proactive decision-making led by a control tower of experts and effective health communication are also required to respond to public health crises at a national level.

Structural Adjustment of Domestic Firms in the Era of Market Liberalization (시장개방(市場開放)과 국내기업(國內企業)의 구조조정(構造調整))

  • Seong, So-mi
    • KDI Journal of Economic Policy
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    • v.13 no.4
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    • pp.91-116
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    • 1991
  • Market liberalization progressing simultaneously with high and rapidly rising domestic wages has created an adverse business environment for domestic firms. Korean firms are losing their international competitiveness in comparison to firms from LDC(Less Developed Countries) in low-tech industries. In high-tech industries, domestic firms without government protection (which is impossible due to the liberalization policy and the current international status of the Korean economy) are in a disadvantaged position relative to firms from advanced countries. This paper examines the division of roles between the private sector and the government in order to achieve a successful structural adjustment, which has become the impending industrial policy issue caused by high domestic wages, on the one hand, and the opening of domestic markets, on the other. The micro foundation of the economy-wide structural adjustment is actually the restructuring of business portfolios at the firm level. The firm-level business restructuring means that firms in low-value-added businesses or with declining market niches establish new major businesses in higher value-added segments or growing market niches. The adjustment of the business structure at the firm level can only be accomplished by accumulating firm-specific managerial assets necessary to establish a new business structure. This can be done through learning-by-doing in the whole system of management, including research and development, manufacturing, and marketing. Therefore, the voluntary cooperation among the people in the company is essential for making the cost of the learning process lower than that at the competing companies. Hence, firms that attempt to restructure their major businesses need to induce corporate-wide participation through innovations in organization and management, encourage innovative corporate culture, and maintain cooperative labor unions. Policy discussions on structural adjustments usually regard firms as a black box behind a few macro variables. But in reality, firm activities are not flows of materials but relationships among human resources. The growth potential of companies are embodied in the human resources of the firm; the balance of interest among stockholders, managers, and workers of the company' brings the accumulation of the company's core competencies. Therefore, policymakers and economists shoud change their old concept of the firm as a technological black box which produces a marketable commodities. Firms should be regarded as coalitions of interest groups such as stockholders, managers, and workers. Consequently the discussion on the structural adjustment both at the macroeconomic level and the firm level should be based on this new paradigm of understanding firms. The government's role in reducing the cost of structural adjustment and supporting should the creation of new industries emphasize the following: First, government must promote the competition in domestic markets by revising laws related to antitrust policy, bankruptcy, and the promotion of small and medium-sized companies. General consensus on the limitations of government intervention and the merit of deregulation should be sought among policymakers and people in the business world. In the age of internationalization, nation-specific competitive advantages cannot be exclusively in favor of domestic firms. The international competitiveness of a domestic firm derives from the firm-specific core competencies which can be accumulated by internal investment and organization of the firm. Second, government must build up a solid infrastructure of production factors including capital, technology, manpower, and information. Structural adjustment often entails bankruptcies and partial waste of resources. However, it is desirable for the government not to try to sustain marginal businesses, but to support the diversification or restructuring of businesses by assisting in factor creation. Institutional support for venture businesses needs to be improved, especially in the financing system since many investment projects in venture businesses are highly risky, even though they are very promising. The proportion of low-value added production processes and declining industries should be reduced by promoting foreign direct investment and factory automation. Moreover, one cannot over-emphasize the importance of future-oriented labor policies to be based on the new paradigm of understanding firm activities. The old laws and instititutions related to labor unions need to be reformed. Third, government must improve the regimes related to money, banking, and the tax system to change business practices dependent on government protection or undesirable in view of the evolution of the Korean economy as a whole. To prevent rational business decisions from contradicting to the interest of the economy as a whole, government should influence the business environment, not the business itself.

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An Analysis on the Conditions for Successful Economic Sanctions on North Korea : Focusing on the Maritime Aspects of Economic Sanctions (대북경제제재의 효과성과 미래 발전 방향에 대한 고찰: 해상대북제재를 중심으로)

  • Kim, Sang-Hoon
    • Strategy21
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    • s.46
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    • pp.239-276
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    • 2020
  • The failure of early economic sanctions aimed at hurting the overall economies of targeted states called for a more sophisticated design of economic sanctions. This paved way for the advent of 'smart sanctions,' which target the supporters of the regime instead of the public mass. Despite controversies over the effectiveness of economic sanctions as a coercive tool to change the behavior of a targeted state, the transformation from 'comprehensive sanctions' to 'smart sanctions' is gaining the status of a legitimate method to impose punishment on states that do not conform to international norms, the nonproliferation of weapons of mass destruction in this particular context of the paper. The five permanent members of the United Nations Security Council proved that it can come to an accord on imposing economic sanctions over adopting resolutions on waging military war with targeted states. The North Korean nuclear issue has been the biggest security threat to countries in the region, even for China out of fear that further developments of nuclear weapons in North Korea might lead to a 'domino-effect,' leading to nuclear proliferation in the Northeast Asia region. Economic sanctions had been adopted by the UNSC as early as 2006 after the first North Korean nuclear test and has continually strengthened sanctions measures at each stage of North Korean weapons development. While dubious of the effectiveness of early sanctions on North Korea, recent sanctions that limit North Korea's exports of coal and imports of oil seem to have an impact on the regime, inducing Kim Jong-un to commit to peaceful talks since 2018. The purpose of this paper is to add a variable to the factors determining the success of economic sanctions on North Korea: preventing North Korea's evasion efforts by conducting illegal transshipments at sea. I first analyze the cause of recent success in the economic sanctions that led Kim Jong-un to engage in talks and add the maritime element to the argument. There are three conditions for the success of the sanctions regime, and they are: (1) smart sanctions, targeting commodities and support groups (elites) vital to regime survival., (2) China's faithful participation in the sanctions regime, and finally, (3) preventing North Korea's maritime evasion efforts.