Background: & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.

Background: & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.

BACKGROUND: Physical activity (PA) is critical for maintaining the health and well-being of older people in community and also institutional settings. The purpose of this study was to examine the current status of PA and related individual and organizational factors among older nursing home residents with and without dementia. METHODS: This is a secondary data analysis study of a nationwide survey of 92 long-term care facilities in Korea, and the study sample includes older residents with dementia (n=753) and without dementia (n=480). The level of PA was measured by PA time and whether or not residents had an outdoor activity over the past 3 days. Multi-variate, multi-level analyses were conducted. RESULTS: More than half of the sample in both groups had no or less than 1 hour of PA. About one out of four older people in our sample had no outdoor activity over the past 3 days regardless of whether or not they had dementia. Among the people without dementia, several individual-level factors were associated with PA, including dependency for activities of daily living, social activity participation, and caregivers' belief in the functional improvement of residents. Unlike the non-dementia group, individual- and organizationallevel factors including staffing level and having the relevant equipment for PA were associated with PA among those with dementia. CONCLUSION: Study findings provide evidence on the lack of PA among older nursing home residents, and the importance of institutional capacity with regard to human resources and physical equipment for promoting PA among people with dementia, in particular. Policies and supports are needed to promote the implementation of healthy aging programs including PA for older nursing home residents. Such programs should be person-centered with consideration to the physical and cognitive status of individual residents.
Activities of Daily Living ; Aging ; Dementia ; Humans ; Korea ; Long-Term Care ; Motor Activity ; Nursing Homes ; Nursing ; Statistics as Topic

Neuromyelitis optica spectrum disorders (NMOSD) is a demyelinating syndrome of the central nervous system. This case report describes a 31-year-old woman whose electromyography revealed radiculopathy in the left L5-S1 spinal segment without anatomical abnormalities on lumbosacral magnetic resonance imaging (MRI). She was diagnosed with NMOSD based on gadolinium contrast whole spine and brain MRI and anti-aquaporin-4 antibody findings. Her peripheral nervous system might have been damaged during the early course of NMOSD. Therefore, it is necessary to consider NMOSD for patients who have radiculopathy in electromyography if lumbosacral MRI shows no abnormalities.
Adult ; Brain ; Central Nervous System ; Electromyography ; Female ; Gadolinium ; Humans ; Magnetic Resonance Imaging ; Neuromyelitis Optica* ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Radiculopathy* ; Spine

Cancer is a disease which has the huge burden in worldwide, and cancer is the number one cause of death in Korea. At this point, the new framework for cancer monitoring index is required for regional cancer monitoring. Especially, cancer survivors are the important target which is rapidly increasing recently, also cancer survivor’s quality of care should be considered in the cancer monitoring index framework. To develop the Multidimensional Cancer Monitoring Index considering cancer survivor’s quality of care, we took into account cancer continuum which including prevention, detection, diagnosis, treatment, survivorship, assessment of quality of care and monitoring cancer patient, and end-of life care for stage. For target, components of health care delivery system such as patient, family, provider, payer, and policy maker are included. Also, Donabedian model which is a framework for examining health services and evaluating quality of health care such as structure, process, and outcome is applied to contents. This new cancer monitoring framework which includes multidimensional components could help to develop regional cancer monitoring index, and to make national cancer management and prevention policy in the future.

PURPOSE: Feedback in medical education is as important as developing the curriculum and choosing the right method of instruction. This study measured three overarching areas: student satisfaction rates with academic feedback, the type and helpfulness of the feedback, and the types of feedback that students want. METHODS: In December 2013, 166 students answered a student survey that consisted of 26 items. The survey asked questions on their experiences with the overall feedback that was given the previous semester, the satisfaction rate, the type of feedback that was received, the helpfulness of the feedback, and the types of feedback that were desired after examinations and learning tasks. RESULTS: Overall, 35% of the students were satisfied with the feedback that they received in the previous semester. Students wanted more systematic (61.4%) and timely feedback (30.1%). The types of feedback that were most desired were "written comment feedback from the teacher" (51.8%) for learning tasks and "item difficulty, percentile ranks feedback" for examinations (62.0%). CONCLUSION: Students found the current feedback to be helpful, but the lack of feedback that students desired indicates that we must provide more systematic feedback in a more timely manner.
Curriculum ; Education, Medical ; Humans ; Learning ; Students, Medical*

PURPOSE: Maintaining body temperature is a key vital function of human beings, but little is known about how body temperature of high-risk infants is sustained during early life after birth. The aim of this study was to describe hypothermia in high-risk infants during their first week of life and examine demographic, environmental, and clinical attributors of hypothermia. METHODS: A retrospective longitudinal study was done from January 1, 2013 to December 31, 2015. Medical records of 570 high-risk infants hospitalized at Neonatal Intensive Care Units (NICU) of a university affiliated hospital were examined. Body temperature and related factors were assessed for seven days after birth. RESULTS: A total of 336 events of hypothermia (212 mild and 124 moderate) occurred in 280 neonates (49.1%) and most events (84.5%) occurred within 24 hours after birth. Logistic regression analysis revealed that phototherapy (aOR=0.28, 95% CI=0.10-0.78), Apgar score at 5 minute (aOR=2.20, 95% CI=1.17-4.12), and intra-uterine growth retardation or small for gestational age (aOR=3.58, 95% CI=1.69-7.58) were statistically significant contributors to hypothermia. CONCLUSION: Findings indicate that high-risk infants are at risk for hypothermia even when in the NICU. More advanced nursing interventions are necessary to prevent hypothermia of high-risk infants.
Apgar Score ; Body Temperature ; Gestational Age ; Humans ; Hypothermia* ; Infant* ; Infant, Newborn ; Intensive Care Units, Neonatal ; Logistic Models ; Longitudinal Studies ; Medical Records ; Nursing ; Parturition ; Phototherapy ; Retrospective Studies

PURPOSE: This study examined two overarching topics: to what extent do faculties acknowledge class readiness, execution of lessons, and evaluation of the session; and what core content should be strengthened in a medical school faculty development program? METHODS: In November 2012, 37 faculties completed a detailed survey on the needs of medical school faculty development programs. The 14-item survey assessed the importance, operational frequency, difficulty in accomplishment, class readiness, execution of teaching, and evaluation of the session. RESULTS: Faculties were aware of the importance of class readiness, execution of teaching, and evaluation of the session but had a low level of accomplishment with regard to execution of the instruction and evaluation of the session. Four subitems of session evaluation were considered very important but showed low operational frequency, high difficulty in accomplishment, and low accomplishment ability. The successful discussion class item had the lowest operational frequency and accomplishment ability. The core contents that should be strengthened in medical school faculty development programs are diagnose students' class readiness (prior knowledge) (35.5%) and providing class session with suitable level/content (32.3%). CONCLUSION: Before designing faculty development programs, a needs assessment is useful in providing more tailored content for the faculty.
Needs Assessment ; Schools, Medical

OBJECTIVE: To investigate the prevalence, risk factors of overactive bladder (OAB) and the factors affecting the severity of OAB symptoms. METHODS: A total 822 interviews with women aged 18–80 years who visited public health centers were conducted between April 2014 and April 2015. The questionnaire was composed of 16 questions about urinary symptoms, 14 questions about self-treatment and the use of complementary and alternative medicine, and 21 questions about socio-demographic characteristics. The diagnostic criterion for OAB is a total OAB symptom score of 3 and more, with an urgency score of 2 or more. To know the risk factors and factors affecting the severity of OAB, the multivariate logistic regression analysis was performed. RESULTS: One hundred fifty-seven participants (19.3%) were diagnosed with OAB, of whom 10.7%, 8.1%, and 0.7% had mild, moderate, and severe OAB symptoms, respectively. In addition, the prevalence of OAB increased with age. Among all the participants, 39.1% had stress incontinence, among them 32.7% had OAB as well. The significant risk factors of OAB were identified as age, current smoking, hyperlipidemia, cardiovascular and renal disease, whereas, the factors affecting the severity of OAB were age, current smoking, and hyperlipidemia. CONCLUSION: Those who have risk factors and factors affecting severity of OAB should be educated to increase OAB awareness and act of urinary health promotion.
Complementary Therapies ; Epidemiology ; Female ; Health Promotion ; Humans ; Hyperlipidemias ; Logistic Models ; Prevalence ; Public Health* ; Risk Factors* ; Smoke ; Smoking ; Urinary Bladder, Overactive*

PURPOSE: The 2017 international consensus guidelines (ICG) for intraductal papillary mucinous neoplasm (IPMN) of the pancreas were recently released. Important changes included the addition of worrisome features such as elevated serum CA 19-9 and rapid cyst growth (>5 mm over 2 years). We aimed to clinically validate the 2017 ICG and compare the diagnostic performance between the 2017 and 2012 ICG. METHODS: This was a retrospective cohort study. During January 2000–January 2017, patients who underwent complete surgical resection and had pathologic confirmation of branch-duct or mixed-type IPMN were included. To evaluate diagnostic performance, the areas under the receiver operating curves (AUCs) were evaluated. RESULTS: A total of 448 patients were included. The presence of mural nodule (hazard ratio [HR], 9.12; 95% confidence interval [CI], 4.60–18.09; P = 0.001), main pancreatic duct dilatation (>5 mm) (HR, 5.32; 95% CI, 2.67–10.60; P = 0.001), thickened cystic wall (HR, 3.40; 95% CI, 1.51–7.63; P = 0.003), and elevated CA 19-9 level (>37 unit/mL) (HR, 5.25; 95% CI, 2.05–13.42; P = 0.001) were significantly associated with malignant IPMN. Malignant lesions showed a cyst growth rate >5 mm over 2 years more frequently than benign lesions (60.9% vs. 29.7%, P = 0.012). The AUC was higher for the 2017 ICG than the 2012 ICG (0.784 vs. 0.746). CONCLUSION: The new 2017 ICG for IPMN is clinically valid, with a superior diagnostic performance to the 2012 ICG. The inclusion of elevated serum CA 19-9 level and cyst growth rate to the 2017 ICG is appropriate.
Area Under Curve ; Carcinoma, Pancreatic Ductal ; Cohort Studies ; Consensus ; Dilatation ; Humans ; Mucins ; Pancreas ; Pancreatic Ducts ; Retrospective Studies