• Tuberculosis and Respiratory Diseases
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• v.70 no.3
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• pp.199-205
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• 2011

Social welfare services for respiratory-disabled persons in Korea are offered based on the respiratory impairment grade, which is determined by 3 clinical parameters; dyspnea, forced expiratory volume in 1 second ($FEV_1$), and arterial oxygen tension. This grading system has several limitations in the objective assessment of respiratory impairment. We reviewed several guidelines for the evaluation of respiratory impairment and relevant articles. Then, we discussed a new grading system with respiratory physicians. Both researchers and respiratory physicians agreed that pulmonary function tests are essential in assessing the severity of respiratory impairment, forced vital capacity (FVC), $FEV_1$ and single breath diffusing capacity ($DL_{co}$) are the primarily recommended tests. In addition, we agreed that arterial blood gas analysis should be reserved for selected patients. In conclusion, we propose a new respiratory impairment grading system utilizing a combination FVC, $FEV_1$ and $DL_{co}$ scores, with more social discussion included.

• Tuberculosis and Respiratory Diseases
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• v.67 no.2
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• pp.88-94
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• 2009

Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3${\pm}$13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56${\pm}$0.68 L/min at rest, 2.08${\pm}$0.91 L/min during exercise or 1.51${\pm}$0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18${\pm}$10.48% and 91.64${\pm}$7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85${\pm}$6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414${\pm}$15,618 won/month and 40,352${\pm}$36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.120-129
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• 2015

Objectives: Drug utilization review program in Korea has provided 'drug combinations to avoid (DCA)' alerts to physicians and pharmacists to prevent potential adverse drug events or inappropriate drug use. Seven hundred and six DCA pairs have been announced officially by the Ministry of Food and Drug Safety (MFDS) by March, 2015. Some DCA pairs could be grouped based on the drug interaction mechanism and its consequences. This study aimed to investigate the drug-drug interaction (DDI) pairs, which may be potential DCAs, generated by the drug class-drug class interaction method. Methods: Eleven additive/synergistic and one antagonistic drug class-drug class interaction groups were identified. By combining drugs of two interacting drug class groups, numerous DDI pairs were made. The status and severity of DDI pairs were examined using Lexicomp and Micromedex. Also, the DCA listing rate was calculated. Results: Among 258 DDI pairs generated by the drug class-drug class interaction method, only 142 pairs were identified as official DCA pairs by the MFDS. One hundred and four pairs were identified as potential DCA pairs to be listed. QT prolonging agents-QT prolonging agents, triptans-ergot alkaloids, tricyclic antidepressants-monoamine oxidase inhibitors, and dopamine agonists-dopamine antagonists were identified as drug class-drug class interaction groups which have less than 50 % DCA listing rate. Conclusion: To improve the clinicians' adaptability to DCA alerts, the list of DCA pairs needs to be continuously updated.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.512-520
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• 2016

Breast cancer is the most common malignancy in women, and lymphedema is one of the most common postoperative complications of breast surgery. Exercises are usually prescribed to prevent this occurrence. On the other hand, conflicting results regarding the effects and timing of such exercises have been reported. This study reviewed systematically the contemporary literature, peer-reviewed publications, and web sites of professional organizations that examined exercise for lymphedema prevention or therapy to determine the effects of exercise on lymphedema providing the best evidence for the treatment of patients. Exercise or training groups have strategies that appear to reduce the development of secondary lymphedema and altering its progression compared to the control group. Advances in cancer treatment, cancer and exercise research, and lymphedema management require physicians to have a basic understanding of the current evidence to provide the appropriate patient education and specialist referral.

• Journal of the Korea Convergence Society
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• v.10 no.4
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• pp.277-284
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• 2019

Purpose: The purpose of this study is to examine the relationships among job stress, resilience and turn over intention of new graduate nurses in general hospital. Methods: A descriptive regression design was used and the participants were 90 new graduate nurses from one general hospital in S city. Data analysis included t-test, ANOVA, pearson's correlation and multiple regression. Results: There were significant correlations between conflict with physicians(r=.17, p=.049), problem relating to supervisors(r=.18, p=.040), discrimination(r=.18, p=.041), resilience(r=-.21, p=.023) and turnover intention. The regression model explained approximately 24.5 % of turnover intention. Conclusion: The findings suggest that nursing leaders have to reduce job stress and to improve resilience of new graduate nurses.

• Safety and Health at Work
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• v.5 no.4
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• pp.191-197
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• 2014

Background: Disabling fatigue is common in the working age population. It is essential that occupational health (OH) professionals are up-to-date with the management of fatigue in order to reduce the impact of fatigue on workplace productivity. Our aim was to evaluate the impact of one-day workshops on OH professionals' knowledge of fatigue and chronic fatigue syndrome (CFS), and their confidence in diagnosing and managing these in a working population. Methods: Five interactive problem-based workshops were held in the United Kingdom. These workshops were developed and delivered by experts in the field. Questionnaires were self-administered immediately prior to, immediately after, and 4 months following each workshop. Questionnaires included measures of satisfaction, knowledge of fatigue and CFS, and confidence in diagnosing and managing fatigue. Open-ended questions were used to elicit feedback about the workshops. Results: General knowledge of fatigue increased significantly after training (with a 25% increase in the median score). Participants showed significantly higher levels of confidence in diagnosing and managing CFS (with a 62.5% increase in the median score), and high scores were maintained 4 months after the workshops. OH physicians scored higher on knowledge and confidence than nurses. Similarly, thematic analysis revealed that participants had increased knowledge and confidence after attending the workshops. Conclusion: Fatigue can lead to severe functional impairment with adverse workplace outcomes. One-day workshops can be effective in training OH professionals in how to diagnose and manage fatigue and CFS. Training may increase general knowledge of fatigue and confidence in fatigue management in an OH setting.

• Tuberculosis and Respiratory Diseases
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• v.64 no.2
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• pp.109-124
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• 2008

Background: The incidence of chronic obstructive pulmonary disease (COPD) is increasing and the disease is becoming an important cause of morbidity and mortality worldwide. It is important to implement evidence-based guidelines by primary care physicians (PCPs) to establish qualified management of COPD patients. The aim of this survey is to investigate the pattern of COPD management among PCPs and to apply it to the development of Korean COPD guidelines. Methods: A web-based questionnaire was prepared that consisted of 25 questions on the pattern of COPD management. A total of 217 PCPs participated in the survey from June 2006 to May 2007. Results: Many PCPs (61.8%) possessed a spirometer, but the application rate was relatively low (35.8%) and more than half of the COPD patients (57%) did not receive a diagnosis based on spirometry. Administration of oral medication was preferred than the administration of inhaled medication for both stable COPD and acutely exacerbated COPD. More than 90% of the PCPs endorsed educational measures to quit smoking and vaccinate against influenza. It was noted that 56.7% of the PCPs were aware of the GOLD guidelines, but only 7.3% tended to fully implement the recommendations of the guidelines in daily practice. Conclusion: The results of the survey indicate that despite the high awareness rate of the current COPD guidelines, deficits exist among the PCPs with respect to the diagnosis and treatment of COPD. The results of this survey should be applied for the development of new COPD guidelines in order to decrease the discrepancy between the guidelines and the daily practice of the PCPs.

• Journal of Korean Traditional Oncology
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• v.22 no.1
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• pp.23-35
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• 2017

Backgrounds: The demand of complementary and alternative medicine (CAM) including Korean Medicine (KM) is increasing worldwide. But cancer patients (CP) still have a difficulty in gathering CAM information or communicating with their doctors, and clinical status in cancer care is unclear in the field of KM in Korea especially. The aim of this study is to examine clinical status of KM for cancer symptom care by KM doctors in medical service institutions. Methods: Total forty nine KM doctors completed the site survey questionnaire. The questionnaire items were to list chief symptom complaints of CP treated with KM and effective KM therapies. Results: The majority of the respondents were general physicians without KM specialist board (67.4%) who have 10-20 years clinical experience with CP (55.1%). Primary cancer lesion, diagnostic status, and treatment period were not different in KM clinical service institutions. In chief symptom complaints of CP treated with KM, gastrointestinal (32.9%), musculoskeletal (19.9%), circulatory & respiratory (16.2%), psychiatric (14.1%), urinary (5.8%) symptoms were in turn. In effective KM therapies assessed by KM doctors, xerostomia (45.7%) and cancer-related fatigue (44.8%) were more effective with herbal treatments. Peripheral neuropathy (43.4%), depression, insomnia (38.2%), and cancer pain (31.9%) were preferred to treat using acupuncture. Conclusion: The CP treated with KM used evenly KM medical service institutions regardless of hospital size, and there will be further survey for CP treated KM in the future.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.74-87
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• 2017

Purposes: The purpose is to establish the direction of healthcare R&D through private nonprofit organization. Methodology: The data is divided into two groups: 12 physicians and pharmacists, and 16 persons including professors related to university donation, non-profit foundation executives. Each group was subjected to two Delphi surveys. To analyze the validity of the opinion, the content validity ratio and the consensus of experts were verified. Findings: Funding should be invested in 'development research' and 'application research'. The factors that hinder the donation culture are 'donation prevention system such as tax imposition system and rebate double penalty system', 'insufficient motivation of fund raising person', and 'lack of fund specializing specialist'. The fund raising strategy should be centered on a small number of large donors or a balance between large and small donors. The fund raising target should be effective to raise funds for corporate and individual donors. It is necessary to clarify the purpose of the social problem to be solved by the campaign strategy for promoting donation, to announce the validity of the trust and transparency of the institution, and to emphasize the social investment by the private sector. Practical Implications: It is necessary to present directions through private nonprofit organizations for the future development of healthcare R&D. The legal and institutional deficiencies of the domestic nonprofit organization fundraising infrastructure should be improved. In order to create a social investment climate, it is necessary to improve the awareness of donations and develop various donation programs for the private sector.

• Korean Medical Education Review
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• v.25 no.3
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• pp.198-211
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• 2023

Health systems science (HSS) is recognized as the third pillar of medical education. alongside basic and clinical sciences. Today's physicians must also be systems thinkers who are able to discern how social, economic, environmental, and technological forces influence clinical decision-making. This study aimed to propose strategies for structuring an HSS curriculum that is tailored to the Korean healthcare and medical education context. First, the authors of this study conducted a survey to identify the present curricular contents of HSS related education at Korean medical schools. Second, a needs assessment was performed to determine the necessity of HSS competencies, as well as the prerequisites for the seamless integration of HSS into the existing curriculum. Third, literature reviews on HSS education at 14 US medical schools and expert consultations was conducted. We would like to propose a set of strategic approaches, classified into two levels: comprehensive and partial restructuring of the current medical curriculum to incorporate HSS. The partial restructuring approach entails a gradual, incremental incorporation of HSS content, while maintaining the current curricular structure. In contrast, a complete overhaul of the curriculum may be ideal to build HSS as the third pillar of medical education, but its feasibility remains relatively limited. The partial reorganization approach, however, has the advantage of being highly feasible. Collaborative efforts between professors and students are imperative to collectively devise effective methods for the seamless integration of HSS into the existing curriculum.