The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.
Counseling ; Fees and Charges ; Food Services ; Humans ; Licensure ; Medical Staff ; Surveys and Questionnaires

OBJECTIVE: As the accelerated development and use of Electronic Health Record have grown exponentially, the possible disclosure of patient healthcare information is increased. The purpose of this study is to examine the perception gap on disclosure of EHR information among the patient/guardian group, healthcare provider group, and administration group. METHODS: A questionnaire survey from a hospital located in Incheon City of Korea was conducted and over 200 responses were collected. Outcome measures include healthcare information protection, disclosure of unidentifiable information, possible losses from the disclosure of healthcare information, and the ownership of healthcare information. RESULTS: Regarding healthcare information protection, three groups have a general consensus over some issues. In contrast, the healthcare providers and the administration group have a higher consideration regarding possible losses resulting from the disclosure of healthcare information than the patient group. In addition, the healthcare provider group considered the ownership of healthcare information to belong to the hospital in contrast with the patients' view that the ownership and disclosure rights belong to the patient. CONCLUSION: These findings indicate that the high level of interest and concern that our results revealed, suggests that more attention should be directed toward designing and developing policy, organization and legislative systems.
Computer Security ; Consensus ; Delivery of Health Care* ; Disclosure ; Electronic Health Records* ; Health Personnel* ; Human Rights ; Humans ; Incheon ; Korea ; Outcome Assessment (Health Care) ; Ownership ; Privacy* ; Surveys and Questionnaires

Atopic dermatitis (AD) is a chronic, inflammatory cutaneous disease driven by immune dysregulation and skin barrier dysfunction. Currently, we are experiencing a new era of understanding of the pathogenesis of AD and, as a consequence, a new era of innovation in therapeutics, including small molecules and biologic therapy. In contrast to biologics, small molecules are similar to conventional pharmacologic chemical agents used as drugs and are generally prepared by chemical synthesis. Unlike biologics, these drugs often are taken orally or formulated for topical use. The purpose of this review is to summarize the efficacy and safety of the current topical and systemic new therapies in AD by reviewing recently published papers on therapies currently in phase 2 or 3 clinical trials. In this review, it is important to note the characteristics of the study population, the primary endpoints, and whether or not there was concomitant topical therapy allowed. These study design elements may significantly alter the results of studies and should be taken into account. Targeted therapy help push AD treatment into a new era of personalized medicine.

Atopic dermatitis (AD) is a chronic, inflammatory cutaneous disease driven by immune dysregulation and skin barrier dysfunction. We are currently experiencing a new era of understanding of the pathogenesis of AD and, as a consequence, a new era of innovation in therapeutics, including small molecules and biologic therapy. Recently, advances in translational research have challenged the traditional AD pathogenesis paradigm of AD being solely a Th2-dominant disease. Other immune pathways seem to play a role in the complex AD pathophysiology, although the clinical relevance of these additional immune pathway abnormalities is unclear. Type 1, type 22, and type 17 pathway activation (with related cytokines/chemokines) have been demonstrated in the skin and blood of AD patients. Type 2 (interleukin [IL]-4, IL-13), IL-31, and type 22 (IL-22) pathway cytokines are increased in AD acute lesions. IL-22 induces both an epidermal hyperplasia at the onset of acute AD and a marked increase in the terminal differentiation S100 genes.This understanding of pathogenesis corresponds to a historic increase in therapeutic development in AD. The extreme clinical heterogeneity and the chronic progression of AD establish the need for newer, safer, and more effective treatments, control the disease, and improve the quality of life of affected patients.

Background: This study examines the impact of sleep duration on the incidence of metabolic syndrome in Korean adults. Methods: A total of 11,721 participants (5,263 male 6,458 female) aged 19–64 years from the 8th Korea National Health and Nutrition Examination Survey were included. Sleep duration was categorized as less than 7 hours, 7 to less than 9 hours, and 9 or more hours. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel-III criteria. Chisquare tests and logistic regression analysis were conducted to assess associations. Results: The prevalence of metabolic syndrome was 28.4%, higher in male (34.4%) than female (23.6%). The average sleep duration was 6.79±1.75 hours. In male, sleeping less than 6 hours increased the risk of metabolic syndrome by 1.54 times (95% confidence interval [CI]: 1.30–1.82) and abdominal obesity by 1.51 times (95% CI: 1.29–1.77). In premenopausal female, sleep under 7 hours increased the risk of metabolic syndrome by 1.28 times (95% CI: 1.06–1.55) and abdominal obesity by 1.41 times (95% CI: 1.20–1.66). Conclusions Shorter sleep duration is linked to a higher risk of metabolic syndrome and abdominal obesity, highlighting the importance of adequate sleep for metabolic health.

Background: This study examines the impact of sleep duration on the incidence of metabolic syndrome in Korean adults. Methods: A total of 11,721 participants (5,263 male 6,458 female) aged 19–64 years from the 8th Korea National Health and Nutrition Examination Survey were included. Sleep duration was categorized as less than 7 hours, 7 to less than 9 hours, and 9 or more hours. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel-III criteria. Chisquare tests and logistic regression analysis were conducted to assess associations. Results: The prevalence of metabolic syndrome was 28.4%, higher in male (34.4%) than female (23.6%). The average sleep duration was 6.79±1.75 hours. In male, sleeping less than 6 hours increased the risk of metabolic syndrome by 1.54 times (95% confidence interval [CI]: 1.30–1.82) and abdominal obesity by 1.51 times (95% CI: 1.29–1.77). In premenopausal female, sleep under 7 hours increased the risk of metabolic syndrome by 1.28 times (95% CI: 1.06–1.55) and abdominal obesity by 1.41 times (95% CI: 1.20–1.66). Conclusions Shorter sleep duration is linked to a higher risk of metabolic syndrome and abdominal obesity, highlighting the importance of adequate sleep for metabolic health.

Background: This study examines the impact of sleep duration on the incidence of metabolic syndrome in Korean adults. Methods: A total of 11,721 participants (5,263 male 6,458 female) aged 19–64 years from the 8th Korea National Health and Nutrition Examination Survey were included. Sleep duration was categorized as less than 7 hours, 7 to less than 9 hours, and 9 or more hours. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel-III criteria. Chisquare tests and logistic regression analysis were conducted to assess associations. Results: The prevalence of metabolic syndrome was 28.4%, higher in male (34.4%) than female (23.6%). The average sleep duration was 6.79±1.75 hours. In male, sleeping less than 6 hours increased the risk of metabolic syndrome by 1.54 times (95% confidence interval [CI]: 1.30–1.82) and abdominal obesity by 1.51 times (95% CI: 1.29–1.77). In premenopausal female, sleep under 7 hours increased the risk of metabolic syndrome by 1.28 times (95% CI: 1.06–1.55) and abdominal obesity by 1.41 times (95% CI: 1.20–1.66). Conclusions Shorter sleep duration is linked to a higher risk of metabolic syndrome and abdominal obesity, highlighting the importance of adequate sleep for metabolic health.

Background: This study examines the impact of sleep duration on the incidence of metabolic syndrome in Korean adults. Methods: A total of 11,721 participants (5,263 male 6,458 female) aged 19–64 years from the 8th Korea National Health and Nutrition Examination Survey were included. Sleep duration was categorized as less than 7 hours, 7 to less than 9 hours, and 9 or more hours. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel-III criteria. Chisquare tests and logistic regression analysis were conducted to assess associations. Results: The prevalence of metabolic syndrome was 28.4%, higher in male (34.4%) than female (23.6%). The average sleep duration was 6.79±1.75 hours. In male, sleeping less than 6 hours increased the risk of metabolic syndrome by 1.54 times (95% confidence interval [CI]: 1.30–1.82) and abdominal obesity by 1.51 times (95% CI: 1.29–1.77). In premenopausal female, sleep under 7 hours increased the risk of metabolic syndrome by 1.28 times (95% CI: 1.06–1.55) and abdominal obesity by 1.41 times (95% CI: 1.20–1.66). Conclusions Shorter sleep duration is linked to a higher risk of metabolic syndrome and abdominal obesity, highlighting the importance of adequate sleep for metabolic health.

More than 6,000 rare disorders including genetic diseases have been reported. Of them, 1,500 diseases (1,211 for clinical diagnosis and 289 for research only) are technically possible for genetic testing. In Korea, since 2005, only 63 genetic diseases is permitted for prenatal genetic testing by the "Bioethics and Biosafety Law". The article 25 in the law prescribes 63 genetic diseases without clear indication for its selection and inclusion criteria. In EU, USA, and other foreign countries, however, there is no provision in the statute on prenatal genetic testing; it is not restricted by a law. Recently, a woman (Mrs. L, 38y) who is a carrier for Menkes disease made an appeal to a government for an amendment of the "Bioethics and Biosafety Law" prohibiting the prenatal diagnosis of her pregnancy at risk for Menkes disease. Menkes disease (MNK) is an X-linked recessive disorder characterized by neurodegeneration, connective tissue defects and hair abnormalities, and no effective treatment is available yet. The prevalence rate of MNK is one in about 250,000 live births. Menkes syndrome patients fail to absorb copper from the gastrointestinal tract in quantities adequate for meeting nutritional needs. These needs seem particularly acute during the initial 12 month of life, when the velocity of brain growth and motor neurodevelopment. Most of pts. die around 3yrs. of age. Mrs. L had a boy with Menkes disease who died at 2y.o. in 2001. Subsequent pregnancy in 2003, she was able to have prenatal genetic testing for mutation of the Menkes (ATP7A) gene and delivered a healthy baby boy. Now, She is pregnant again and wants to have prenatal diagnosis. however, this time, she was not allowed to have any more because Menkes disease is not included in 63 genetic diseases permitted by the law for prenatal genetic testing, in spite of the fact that she is a Menkes disease carrier and her pregnancy is at risk to have an affected baby. This case shows the practical problem of the legal restriction for prenatal genetic testing in Korea. In this study, we report a arguable case and discuss the controversial issues in the legal restriction for prenatal genetic testing in Korea.
Brain ; Connective Tissue ; Copper ; Diagnosis ; Female ; Gastrointestinal Tract ; Genetic Testing* ; Hair ; Humans ; Jurisprudence ; Korea* ; Live Birth ; Male ; Menkes Kinky Hair Syndrome ; Pregnancy ; Prenatal Diagnosis ; Prevalence

PURPOSE: The necessity of professional non-MD genetic counselor has been recently emphasized in a medical field. By conducting a national survey on the demands for generic counseling and professional non-MD generic counselor, we can make a long-term master plan to execute the educational program for professional genetic counselors and indeed promote genetic counseling in Korean health care service in a systemic manner. METHODS: The survey has been conducted from September 3rd to October 4th of 2007 in a way of e-mail, telephone interview, fax, and direct contacts. It's targets were senior researchers and professors in medical and non-medical institutions, policy makers, research institutions or foundations. The survey questions consist of 16 questionnaires. RESULTS: As a result of survey, 102 of 650 people responded. 80% of respondents indicated that genetic counseling is needed as a health care service and 34% among them considered it as "the most needed". In addition, 77% of the respondents showed that, it is necessary to have a professional non-MD genetic counselor with a master degree or higher in the field of medical genetics and among them 29% thought it as "the most necessary". A 77% of respondents considered that the cost of genetic counseling should be covered by health insurance and among them, 29% answered "strongly agreed". A 56% of respondents chose the answer of "They have a plan to hire the professional non-MD genetic counselor" in their institution, and among them 71% selected "within 5 years" in terms of when to hire. Also, they tend to expect the role of the professional non-MD genetic counselor to be not only "genetic counselor" (60%), but also "researcher" (42%), "educator" (18%) and "clinical laboratory coordinator" (19%). CONCLUSION: The 102 of 650 people responded to the survey. Based upon the nationwide survey over the needs on genetic counseling in health care service and demands on the professional non-MD genetic counselor, systematic educational program for the genetic counseling, with reimbursement coverage for counseling service by health insurance should be emphasized in development of a master plan.
Administrative Personnel ; Counseling* ; Surveys and Questionnaires ; Delivery of Health Care ; Electronic Mail ; Foundations ; Genetic Counseling* ; Genetics, Medical ; Humans ; Insurance, Health ; Interviews as Topic