BACKGROUND: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes, but more than half of the adults with diabetes in Korea are improperly controlling their glycemic levels. The purpose of this study is to identify the factors associated with poor glycemic control in type 2 diabetes patients. METHODS: This study analyzed 1,261 subjects ≥30 years old diagnosed with type 2 diabetes who participated in the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Poor glycemic control rates were defined as hemoglobin A1c (HbA1c) level ≥7%. To shed light on the causes of poor glycemic control, socio-demographics, diabetes severity, health status, and health behavior factors were adjusted and logistic regression was done. RESULTS: Of the total 1,261 patients, 53.0% of patients with type 2 diabetes had HbA1c ≥7%. After running a logistic regression model, the odds ratio of poor glycemic control was higher in high school graduates than elementary school graduates; in people living in Chungcheong and Jeolla/Jeju than those living in Seoul; in the group with diabetes for over 5 years had diabetes less than 5 years; in a group with insulin and oral hypoglycemic agent treatment than non-treatment; in a group with hypertriglyceridemia than without hypertriglyceridemia; and in the group with slept less than 6 hours slept 7-8 hours. CONCLUSION: We need a comprehensive public health policy to reduce the poor glycemic control rates in type 2 diabetes patients. We should recognize the education levels, duration of diabetes, diabetes treatment, hypertriglyceridemia, and sleep duration were associated with poor glycemic control.
Adult ; Diabetes Mellitus, Type 2* ; Education ; Health Behavior ; Humans ; Hypertriglyceridemia ; Insulin ; Korea* ; Logistic Models ; Nutrition Surveys* ; Odds Ratio ; Public Health ; Running ; Seoul

PURPOSE: The purpose of this study was to identify the current issues concerning a mutual recognition agreement (MRA) for nursing professionals, and to suggest policy alternatives in South Korea. METHODS: The study was conducted through a literature review. RESULTS: The nursing MRA was signed by the European Union, the Association of Southeast Asian Nations, Australia-New Zealand, India-Singapore, and the Caribbean Community. The United States and Japan have not concluded a nursing MRA with other countries, but they have lowered the entry barriers for foreign nurses from certain countries. In order to prepare for a nursing MRA with developed countries such as the United States, Canada and Australia, it is necessary to establish international standards for nursing and to build a verification system for the qualifications of foreign nurses. In addition, there is a need to establish an independent professional licensing authority that assumes responsibility for all the tasks regarding a nursing license. CONCLUSION The findings of this study can be used as basic data for the preparation of a nursing MRA, and can contribute to the establishment of policies for foreign nurses.

PURPOSE: This study was done to evaluate the adequacy of nurse staffing in integrated nursing care. METHODS: Statistical data on integrated nursing care from the National Health Insurance Corporation was used in this study. We extracted hospital data and patient data related to patient needs for nursing care. We analyzed the differences in patient needs by staffing level of each type of medical institution. RESULTS: Approximately 70% of medical institutions provided nursing care by the mid level of nurse staffing, which was 1:6, 1:10 and 1:12 in the tertiary hospital, general hospital and semi-hospital, respectively. The patients' characteristics were significantly different by hospital type. Especially, the distribution of the main diagnosis was completely different between the tertiary hospital and semi-hospital. In the tertiary hospital, the patient needs measured by severity and activities of daily living dependency were higher at higher staffing level than at lower staffing level. However, the nurse staffing was less relevant to the patient needs in the general hospital and semi-hospital. CONCLUSION: To provide high-quality nursing care, accurate workload forecasting is required at the start, and then the standard nurse staffing level can established based on workload forecasting.
Activities of Daily Living ; Diagnosis ; Forecasting ; Hospitals, General ; Humans ; National Health Programs ; Nursing Care ; Nursing ; Tertiary Care Centers

Radiocontrast media-induced acute severe thrombocytopenia is a very rare complication and potentially life-threatening. Here, we report the case of a 63-year-old male patient with severe acute thrombocytopenia following first exposure to intravenous non-ionic contrast media without immediate allergic reactions. His platelet count dropped from 107000/µL to 2000/µL after six hours of radiocontrast infusion. After administration of corticosteroid and transfusion of platelet concentrates, the platelet count returned gradually to normal within 5 days. To the best of our knowledge, non-ionic contrast media-induced isolated acute severe thrombocytopenia following no signs or symptoms of immediate allergic reaction has never been described.
Acute Disease ; Administration, Intravenous ; Contrast Media/administration & dosage ; Contrast Media/adverse effects ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Platelet Count ; Thrombocytopenia/etiology

PURPOSE: To evaluate the structural characteristics of a scientific network of radiation oncology society. MATERIALS AND METHODS: A total of 1,512 articles published from 1986 to April 2010 with the terms 'radiation oncology' or 'therapeutic radiology' were obtained in the KoreaMed database. The co-authors were analyzed according to their affiliation, and their relationship was used to build a matrix. With the matrix, centralization indices and the Key Player index were analyzed. We used UCINET 6.0 for the network analysis, Netdraw for determining a sociogram and Key Player 1.44 for the key player analysis. RESULTS: The centralization of the radiation oncology field decreased from 8.29% for the period from 1986~1990 to 1.84% from 2006~2010. However, when the Korean Journal of Medical Physics was excluded, centralization increased from 2.32% for the period from 2001~2005 to 3.80% from 2006~2010. This suggested that the communication in the clinical research field of radiation oncology is decreasing. In a node centralization analysis, Seoul National University was found to be the highest at 7.9%. Seoul National University showed the highest indices in the Outdegree (6.50%) and Indegree (8.54%), in addition to Betweenness (14.94%) and Eigenvector (135.234%). The Key Player analysis indicated that Inha University had the highest index at 0.491, but when the Korean Journal of Medical Physics was excluded, Yonsei University had the highest Key Player index at 0.584. CONCLUSION: The degree centrality in the network of radiation oncology decreased in the most recent period as more institutions are participating in network. However, the Betweenness centrality is still increasing, suggesting that the communications among research groups (clique) in radiation oncology is warranted.
Korea ; Radiation Oncology

PURPOSE: This study was done to identify issues surrounding comprehensive nursing care within the national health insurance, analyze results and problems within national health insurance and to suggest new policy directions for stability. METHODS: A literature search was performed using RISS, KISS, PUBMED databases. Eighteen studies were analyzed. RESULTS: For implementation of comprehensive nursing care, there was improvement in nursing and in facilities. By improvement of structure, this new system showed positive outcomes in term of patient satisfaction and indicators related to patient safety. However, issues related to overload, job stress and evaluation of the system remain. In order to establish this system, staffing levels for nurses and nurse aids need to be adjusted to appropriate levels that reflect requirements for nursing. In addition, range of work needs to be determined clearly. Lastly, regular and systematic evaluation is needed to provide safe quality services to patients and to prevent waste of financial resources. CONCLUSION: Comprehensive nursing care needs to be implemented in ways that patients can be provided with safe and high quality service. There is a need to resolve several issues to allow this new system to function.
Humans ; Job Satisfaction ; National Health Programs* ; Nursing Care ; Nursing Services* ; Nursing* ; Patient Safety ; Patient Satisfaction

OBJECTIVES: Little is yet known about the determinants of bone mineral density (BMD) in young adults. Thus, in this study, we aimed to determine the factors that have an impact on BMD in young men. METHODS: Questionnaires were sent out to 111 male medical students. Information on age, socio-economic status, medical history, lifestyle, physical activity during adolescence, school club participation, current physical activity, and dietary intake were collected by the survey. Height, weight, percent body fat and muscle mass were estimated by bioelectrical impedance, and BMD was obtained using calcaneal quantitative ultrasound. Using the Poisson regression model, prevalence ratios (PRs) were used to estimate the degree of association between risk factors and osteopenia. RESULTS: The height and current physical activity showed a correlation to the Osteoporosis Index. Among the categorized variables, past physical activity during adolescence (p=0.002) showed a positive effect on the bone mineral content. In the multivariate model, past physical activity (> or =1 time/wk) had a protective effect on osteopenia (PR, 0.37; 95% confidence interval [CI], 0.18 to 0.75) and present physical activity (1000 metabolic equivalent of task-min/wk) decreased the risk of osteopenia (PR, 0.64; 95% CI, 0.44 to 0.91). CONCLUSIONS: Past physical activity during adolescence is as important as physical activity in the present for BMD in young men.
Adult ; Body Mass Index ; *Bone Density ; Calcium, Dietary ; Humans ; Male ; *Motor Activity ; Questionnaires ; Risk Factors ; Smoking ; Socioeconomic Factors ; Students, Medical/psychology ; Young Adult

OBJECTIVES: This study examined how trends in the weekly frequencies of gastrointestinal infectious diseases changed before and during the coronavirus disease 2019 (COVID-19) pandemic in Korea, and compared them with the trends in the United States. METHODS: We compared the weekly frequencies of gastrointestinal infectious diseases (16 bacterial and 6 viral diseases) in Korea during weeks 5-52 before and after COVID-19. In addition, the weekly frequencies of 5 gastrointestinal infectious diseases in the United States (data from the Centers for Disease Control and Prevention) that overlapped with those in Korea were compared. RESULTS: The mean weekly number of total cases of gastrointestinal infectious diseases in Korea showed a significant decrease (from 522 before COVID-19 to 245 after COVID-19, p<0.01). Only bacterial gastrointestinal infectious diseases caused by Campylobacter increased significantly; other bacterial gastrointestinal infectious diseases showed either a decrease or no change. The incidence of all other viral diseases decreased. In the United States, the weekly numbers of Salmonella, Campylobacter, typhoid, shigellosis, and hepatitis A virus cases sharply decreased after the COVID-19 outbreak. The weekly case numbers of all viral diseases markedly decreased in both countries; however, bacterial gastrointestinal infectious diseases showed a different pattern. CONCLUSIONS The incidence of gastrointestinal infectious diseases decreased after the COVID-19 outbreak. In contrast, Campylobacter infections showed an increasing trend in Korea, but a decreasing trend in the United States. Further studies are needed to elucidate the different trends in bacterial and viral infectious diseases before and after non-pharmaceutical interventions and between different countries.

Bleeding into joint space is critical to develop hemophilic arthropathy. To reduce the frequency of bleeding in the ankle joint of children with hemophilic arthropathy, low dose external beam irradiation was performed for 37 patients. Among them, 35 patients followed-up for longer than 1 yr (median 87 months) were enrolled for analysis. The average number of bleedings per month was 3.6 during one year prior to radiation therapy. After radiation therapy, it was decreased to 2.1 during the first year, after then it was maintained in the range of 1.0 to 1.5 until the tenth year. The bleeding frequency was reduced to 42% at the first year and it was maintained in the range of 58% to 73% from the second to the tenth year. Especially the patients who had 3 or more bleedings per month, and who had MRI score more than 3 showed significant decreases. During the follow-up period, growth disturbances and secondary malignancies were not found. External beam radiotherapy can be considered for the hemophilic patients with surgical or isotope therapies are not amenable.
Adolescent ; *Ankle Joint/radiography ; Child ; Child, Preschool ; Hemarthrosis/etiology/*radiotherapy ; Hemophilia A/*complications ; Humans ; Male ; Prognosis

PURPOSE: This research aimed to analyze the patterns of co-authorship network among the Korean radiation oncologists and to identify attributing factors for the formation of networks. MATERIALS AND METHODS: A total of 1,447 articles including contents of 'Radiation Oncology' and 'Therapeutic Radiology' were searched from the KoreaMed database. The co-authorship was assorted by the author's full name, affiliation and specialties. UCINET 6.0 was used to figure out the author's network centrality and the cluster analysis, and KeyPlayer 1.44 program was used to get a result of key player index. Sociogram was analyzed with the Netdraw 2.090. The statistical comparison was performed by a t-test and ANOVA using SPSS 16.0 with p-value < 0.05 as the significant value. RESULTS: The number of articles written by a radiation oncologist as the first author was 1,025 out of 1,447. The pattern of co-authorship was classified into five groups. For articles of which the first author was a radiation oncologist, the number of single-author articles (type-A) was 81; single-institution articles (type-B) was 687; and multiple-author articles (type-C) was 257. For the articles which radiation oncologists participated in as a co-author, the number of single-institution articles (type-D) was 280 while multiple-institution articles (type-E) were 142. There were 8,895 authors from 1,366 co-authored articles, thus the average number of authors per article was 6.51. It was 5.73 for type-B, 6.44 for type-C, 7.90 for type-D, and 7.67 for type-E (p = 0.000) in the average number of authors per article. The number of authors for articles from the hospitals published more than 100 articles was 7.23 while form others was 5.94 (p = 0.005). Its number was 5.94 and 7.16 for the articles published before and after 2001 (p = 0.000). The articles written by a radiation oncologist as the first author had 5.92 authors while others for 7.82 (p = 0.025). Its number was 5.57 and 7.71 for the Journal of the Korean Society for Therapeutic Radiology and Oncology and others (p = 0.000), respectively. Among the analysis, a significant difference in the average number of author per article was indicated. The out-degree centrality of network among authors was 4.26% (2.03.7.09%) while in-degree centrality was 1.31% (0.53.2.84%). The three significant nodes were classified and listed as following: Choi, Eun Kyung for 1991-1995, Kim, Dae Young for 1998-2001, Park, Won and Lee, Sang Wook for 2003-2010. Choi, Eun Kyung and Kim, Dae Young appeared in two cases, and ranked as the highest degree in centrality. In the key player analysis, Choi, Eun Kyung and Lee, Sang Wook appeared in two cases, and ranked as the highest. From the cluster analysis, Sungkyunkwan University, Seoul National University and Yonsei University revealed as the three large clusters when Ulsan University, Chonnam National University, and Korea Institute of Radiological & Medical Science as the medium clusters. CONCLUSION: The Korean radiation oncologist's society shows a closed network with numerous relationships among the particular clusters, and the result indicates it is different from other institutions in the pattern of co-authorship formation of the major hospitals.
Korea ; Radiation Oncology