As the rapid growth of internet users, the implementation of e-commerce and e-community are becoming popular also in health fields. Especially, the marketing strategy through joint purchasing for health services such as lasik, plastic surgery, etc. has increasingly been an important issue in clinics and health portals. Therefore, this study purposes to investigate the current status of joint purchasing for health services and estimate the demand on them. Since the university students use an internet most frequently and tend to purchase the goods and services actively through it, the intention for health services were targeted to university students. Only 29% of respondents acknowledged the joint purchasing system for health services. And the purchasing intention was higher in the university students who experienced the joint purchasing for general goods than those who did not experience. Non-surgery items such as stress clinic, dental scaling showed higher intention. Meanwhile when respondents purchase the health services through an internet, they consider the reliability of quality for health services at most. Considering this, if the legal regulations and ethical standards for reliable health services are systematically prepared, positive attitudes and behavioral intention on joint purchasing for health services will be increased and the market of joint purchasing will be enlarged.
Surveys and Questionnaires ; Dental Clinics ; Group Purchasing* ; Health Services* ; Humans ; Intention ; Internet ; Joints* ; Keratomileusis, Laser In Situ ; Marketing ; Public Opinion* ; Social Control, Formal ; Surgery, Plastic

PURPOSE: This study evaluated the dietary quality of lunches consumed through home meals, institutional meals, and eating-out at restaurants in Chinese adults.METHODS: The total of 3,708 people (aged 20 ~ 64) were selected from the data of the 2011 China Health and Nutrition Survey and divided into three groups: the home (HM, 2,845 people), institutional (IM, 579 people), and eating-out (EO, 284 people) meal groups. Dietary intakes of eight food groups, the frequency of eating certain foods, food group intake pattern, dietary diversity and the variety score of lunches were analyzed.RESULTS: The meat intake of IM and EO were higher than that of HM (p < 0.05), and the vegetable intake was the highest in HM, followed by IM and EO (p < 0.05). The intake of fruit and milk · dairy products were extremely low in all the groups. Compared with 1/3 daily recommended intake, the meat intake was above the standard in all the groups and the vegetable intake was insufficient only in EO. The most frequently consumed food in all the groups was rice, followed by pork. The relatively desirable food group pattern, “grain + meat + vegetable”, was highest in IM (66.0%) and lowest in EO (48.2%). The “grain + vegetable” pattern in HM and the “grain + meat” pattern in EO were relatively higher than that in the other groups. The dietary diversity score (p < 0.001) and dietary variety score (p < 0.001) were significantly higher in IM than that in the HM or EO.CONCLUSION: The lunches of Chinese adults had common problems in excess meat intake and a severe lack of fruit and milk · dairy products. Even institutional meals were not ideal as single meals for Chinese adults, although they were better in food diversity. Customized dietary educational programs based on balanced meal plans need to be established, especially for those Chinese people having lunch at home or eating out. In addition, a systematic food service program should be developed and firmly implemented.
Adult ; Asian Continental Ancestry Group ; China ; Dairy Products ; Eating ; Food Services ; Fruit ; Humans ; Lunch ; Meals ; Meat ; Milk ; Nutrition Surveys ; Recommended Dietary Allowances ; Red Meat ; Restaurants ; Vegetables

BACKGROUND: Although the incidence of tuberculosis (TB) is decreasing, cases of multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB continue to increase. As conventional phenotype drug susceptibility testing (pDST) takes six to eight weeks, molecular assays are widely used to determine drug resistance. we developed QuantaMatrix Multiplexed Assay Platform (QMAP) MDR/XDR assay (QuantaMatrix Inc., Seoul, Korea) that can simultaneously detect mutations related to both first- and second-line drug resistance (rifampin, isoniazid, ethambutol, fluoroquinolones, second-line injectable drugs, and streptomycin). METHODS: We used 190 clinical Mycobacterium tuberculosis (MTB) strains isolated from Myanmar, compared QMAP and pDST results, and determined concordance rates. Additionally, we performed sequence analyses for discordant results. RESULTS: QMAP results were 87.9% (167/190) concordant with pDST results. In the 23 isolates with discordant results, the QMAP and DNA sequencing results completely matched. CONCLUSIONS The QMAP MDR/XDR assay can detect all known DNA mutations associated with drug resistance for both MDR- and XDR-MTB strains. It can be used for molecular diagnosis of MDR- and XDR-TB to rapidly initiate appropriate anti-TB drug therapy.

BACKGROUND: To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. MATERIAL AND METHOD: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively. The mean age of these patients was 61.2+/-8.5 (range: 30~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. RESULT: The mean number of distal anastomoses was 3.1+/-0.9 (range: 2~6), the mean duration of hospital stay was 8.4+/-4.5 days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean 4.1+/-0.8/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. CONCLUSION: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.
Angiography ; Aortic Valve ; Cardiac Output, Low ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Emergencies ; Heart Arrest ; Hemorrhage ; Humans ; Infarction ; Ischemic Attack, Transient ; Length of Stay ; Male ; Mammary Arteries* ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Risk Factors ; Transplants ; Vascular Patency ; Wound Infection

PURPOSE: The purpose of this study was to examine validity and reliability of Webel and colleagues' HIV Self-Management Scale when used with a Korean sample. METHODS: The original 20-item HIV Self-Management Scale was translated into Korean using translation and back-translation. Nine HIV nurse experts tested content validity. Principal component analysis (PCA) and confirmatory factor analysis (CFA) of data from 203 patients was used to test construct validity. Concurrent validity was evaluated using correlation with patients' self-rating as a "smart patient" measured using a visual analogue scale. Internal consistency was tested by Cronbach's alpha coefficients. RESULTS: All items were rated as having satisfactory content validity. Based on PCA and consideration of conceptual meaning, a three-factor solution was selected, explaining 48.76% of the variance. CFA demonstrated the adequacy of the three-domain structure of the construct HIV self-management: daily self-management health practices, social support and HIV self-management, and chronic nature of HIV self-management. Goodness-of-fit indices showed an acceptable fit overall with the full model (chi2/ df(164)=1.66, RMSEA=0.06, SRMR=0.05, TLI=0.91, and CFI=0.92). The Korean version of the HIV Self-Management Scale (KHSMS) was significantly correlated with patients' self-rated smart patient (r=.41). The subscale Cronbach's alpha coefficients ranged from .78 to .81; alpha for the total scale was .89. CONCLUSION: The KHSMS provides a valid and reliable measure of self-management in Korean patients with HIV. Continued psychometric testing is recommended to provide further evidence of validity with this population.
Adult ; Female ; HIV Infections/*psychology ; Humans ; Male ; Middle Aged ; Principal Component Analysis ; Program Evaluation ; Psychometrics ; Republic of Korea ; *Self Care ; Surveys and Questionnaires ; Translating ; Young Adult

PURPOSE: The purpose of this research was to assess the methodological quality of non-randomized studies published in the Journal of Korean Fundamentals of Nursing. METHODS: A search of non-randomized studies assessing intervention effects was conducted among all articles published in the Journal of Korean Fundamentals of Nursing between 2011 and 2013. Articles were assessed for quality using the Methodological Index for Non Randomized Studies (MINORS). For each index item, the frequency and percentage of articles meeting the criteria were calculated, along with mean scores by research method, publication year, and research topic. RESULTS: A total of 22 studies were included. The mean score for studies without control groups was 11.75 (range 0-16), and for those with control groups, 19.27 (range 0-24). Results show that improvement is needed on several items: "endpoints appropriate to the aim of the study," "unbiased assessment of the study endpoint," "follow-up period appropriate to the aim of the study," "loss to follow up less than 5%," and "contemporary groups." CONCLUSION: Although the quality of articles published in the Journal of Korean Fundamentals of Nursing has consistently increased, more emphasis should be placed on using rigorous research methods.
Follow-Up Studies ; Clinical Trial ; Nursing* ; Publications

PURPOSE: The purpose of this study was to provide a basis for improvement and enhancement of nursing education by investigating learning outcomes that apply to fundamentals of nursing and teaching methods used in classes. METHODS: Data were collected from 111 professors of fundamentals of nursing who responded to the self-report questionnaire. Data were analyzed using chi-square test. RESULTS: For learning outcomes in fundamentals of nursing the most frequent number of outcomes was two (35.2%), or three (32.4%). For learning outcomes in fundamentals of nursing practicum, the most frequent number of outcomes was two (32.4%), or three (31.6%). In fundamental nursing classes, teaching methods used most frequently were lectures (98.2%) and videos (60.4%), and in practice classes, demonstration (98.2) and open laboratory (90.9%). Constructivist teaching methods that were utilized in fundamental nursing were team-based learning (19.8%) and case-based learning (19.8%), and for practice classes, objective structured clinical examination (29.7%). In the cross analysis, 28.8% of the nursing professor used the constructivist teaching methods in fundamental nursing and in practice classes. CONCLUSION: There is a need to continue to improve teaching methods for new nurse-educators and professors and to discuss learning outcomes of fundamental nursing.
Education ; Education, Nursing ; Learning* ; Lectures ; Nursing* ; Teaching*

Objective: To evaluate the clinical utility of ultrafast dynamic contrast-enhanced (DCE)-MRI compared to conventional DCEMRIby studying lesion conspicuity and size according to the level of background parenchymal enhancement (BPE). Materials and Methods: This study included 360 women (median age, 54 years; range, 26–82 years) with 361 who had undergonebreast MRI, including both ultrafast and conventional DCE-MRI before surgery, between January and December 2017. Conspicuitywas evaluated using a five-point score. Size was measured as the single maximal diameter. The Wilcoxon signed-rank test wasused to compare median conspicuity score. To identify factors associated with conspicuity, multivariable logistic regressionwas performed. Absolute agreement between size at MRI and histopathologic examination was assessed using the intraclasscorrelation coefficient (ICC). Results: The median conspicuity scores were 5 at both scans, but the interquartile ranges were significantly different (5-5 atultrafast vs. 4-5 at conventional, p < 0.001). Premenopausal status (odds ratio [OR] = 2.2, p = 0.048), non-mass enhancement(OR = 4.1, p = 0.001), moderate to marked BPE (OR = 7.5, p < 0.001), and shorter time to enhancement (OR = 0.9, p =0.043) were independently associated with better conspicuity at ultrafast scans. Tumor size agreement between MRI andhistopathologic examination was similar for both scans (ICC = 0.66 for ultrafast vs. 0.63 for conventional). Conclusion Ultrafast DCE-MRI could improve lesion conspicuity compared to conventional DCE-MRI, especially in womenwith premenopausal status, non-mass enhancement, moderate to marked BPE or short time to enhancement.

Pacemaker lead-related infective endocarditis is an uncommon, but serious complication. We report a case of a 45-year-old man who had symptom of intermittent high fever and rupture of sinus Valsalva that developed after a redo aortic valve replacement and transvenous permanent pacemaker implantation. Positive blood cultures of streptococcus viridans and transesophageal echocardiography showing a large mobile vegetation on pacemaker lead and tricuspid valve lead to the diagnosis of pacemaker lead-related infective endocarditis. Initial antibiotic therapy followed by surgical extraction of the pacemaker lead and wide debridement of infective tissues including multiple vegetations was required. Postoperative antibiotic therapy was continued for 4 weeks. The postoperative course has been uneventful. The patient is totally asymptomatic and is doing well up to now.
Aortic Valve* ; Debridement ; Diagnosis ; Echocardiography, Transesophageal ; Endocarditis* ; Fever ; Humans ; Middle Aged ; Rupture* ; Tricuspid Valve ; Viridans Streptococci

At least 88 percents of ventricular aneurysms result from anterior infarction, while the remainder follow inferior infarction. Posterior infarction that produce a distinct left ventricular aneurysm is unusual. We report two operative cases of postinfarction posterobasal left ventricular aneurysms, one with a true aneurysm and the other with a false one.
Aneurysm* ; Infarction ; Myocardial Infarction