BACKGROUND/OBJECTIVES: In the Republic of Korea, “Healthy Restaurant for Sodium Reduction (HRSR)” project have been designated as one of the representative policies for sodium intake reduction. However, as of 2021, only 879 restaurants, less than 0.1% of all restaurants, had been designated. Therefore, to increase the participation of restaurants in this policy, it is necessary to examine the in-depth perception and experience of participants and non-participants in the HRSR.MATERIALS/METHODS: Two focus group discussions were conducted for HRSR project participants and non-participants. RESULTS: A total of 260 semantic units were derived from the 2 groups. The units were further classified into 5 upper categories and 11 subcategories. All the study participants knew the importance of low sodium intake, but they had little information on HRSR project.Various attempts have been made to encourage low sodium practice in restaurants, and the participants reported that the amount of salt used in their restaurants currently is reduced compared to that used in the past. However, they were worried about customers’ complaints about the low sodium in their diet and the insignificant beneficent associated with the policy, which makes restaurant owners reluctant to participate in this policy. All the participants agreed on the urgent need for the improvement of public awareness of low-sodium diets and for substantive government support for HRSR. CONCLUSION This study concluded that strategies such as more active publicity for the practice of sodium reduction in restaurants, identification of approaches to dispel the perception that low-salt diet is not tasty, and development of plans to increase the sale of food in of HRSR, are needed.

Quantitative and qualitative research explore various social phenomena using different methods. However, there has been a tendency to treat quantitative studies using complicated statistical techniques as more scientific and superior, whereas relatively few qualitative studies have been conducted in the medical and healthcare fields. This review aimed to provide a proper understanding of qualitative research. This review examined the characteristics of quantitative and qualitative research to help researchers select the appropriate qualitative research methodology. Qualitative research is applicable in following cases: (1) when an exploratory approach is required on a topic that is not well known, (2) when something cannot be explained fully with quantitative research, (3) when it is necessary to newly present a specific view on a research topic that is difficult to explain with existing views, (4) when it is inappropriate to present the rationale or theoretical proposition for designing hypotheses, as in quantitative research, and (5) when conducting research that requires detailed descriptive writing with literary expressions. Qualitative research is conducted in the following order: (1) selection of a research topic and question, (2) selection of a theoretical framework and methods, (3) literature analysis, (4) selection of the research participants and data collection methods, (5) data analysis and description of findings, and (6) research validation. This review can contribute to the more active use of qualitative research in healthcare, and the findings are expected to instill a proper understanding of qualitative research in researchers who review qualitative research reports and papers.

Background: A methodology for comprehensively and reasonably measuring the burden of disease due to adverse events has yet to be clearly established. In this study, a new and systematic method for measuring the burden of disease due to adverse events was tested by utilizing the results of a medical record review, which is commonly used as a gold standard. Methods: Using the characteristics of preventable adverse events identified in the 2019 Patient Safety Incidents Inquiry (PSII), conducted to monitor the level of patient safety in Korea accurately, the resulting disability-adjusted life years (DALYs) and economic costs were estimated. DALYs were calculated as the sum of the years lived with a disability for patients who suffered permanent disability, or more, due to preventable adverse events, and the years of life lost due to premature mortality was calculated for patients who died due to preventable adverse events. The economic cost was calculated using the main diagnostic codes of patients who suffered preventable adverse events, identified as prolonged hospitalization in PSII, and the average medical cost by disease category and age group. Results: Estimates of DALYs due to preventable adverse events were 1,114.4 DALYs per 100,000 population for the minimum standard and 1,658.5 DALYs per 100,000 population for the maximum standard. Compared to the 2015 Korea Burden of Disease results, the ranking of DALYs due to preventable adverse events was sixth for the minimum standard and third for the maximum standard. The annual medical cost of adverse events in 2016 was estimated to be approximately Korean Republic Won (KRW) 870 billion (700 million US dollars). Medical expenses due to preventable adverse events were calculated to be approximately KRW 150 billion (120 million US dollars) as a minimum standard and approximately KRW 300 billion (240 million US dollars) as a maximum standard. Conclusion If this more standard method of systematically calculating the disease burden due to adverse events is used, it will be possible to compare the size of the patient safety problem with that of other diseases. The results of this study indicate that we still need to pay more attention to the issue of patient safety.

Purpose: The aim of this study was to identify factors related to the vaccination intentions of nursing students before clinical practice. Methods: A descriptive correlational study design was used. The participants were 129 nursing students who were enrolled in one college of nursing in Seoul and were scheduled for clinical training. Data collection was conducted from February 28 to March 7, 2022. The data were analyzed using descriptive statistics, a t-test, ANOVA, Pearson’s correlation coefficient, and a latitudinal regression analysis using the IBM SPSS statistics version 26.0 program. Results: The intention to vaccinate showed a significant correlation with vaccination attitude (r=.72, p<.001), subjective norms (r=.68, p<.001), and perceived behavioral control (r=.63, p<.001). The influencing factors on three intent to vaccinate were vaccination attitude (β=.36 p<.001), subjective norms (β=.31, p<.001), and perceived behavioral control (β=.36, p<.001). The explanatory power of these variables was 69.6%. Conclusion The vaccination rate before the clinical training of nursing students was related to economic burden, a lack of time, and transportation problems that nursing college students experienced during the vaccination process. Therefore, administrative and financial support is needed for improving the vaccination rates of nursing students.

Long-term outcomes of live kidney donors remain controversial, although this information is crucial for selecting potential donors. Thus, this study compared the long-term risk of all-cause mortality between live kidney donors and healthy control. Methods: We performed a retrospective cohort study including donors from seven tertiary hospitals in South Korea. Persons who underwent voluntary health screening were included as controls. We created a matched control group considering age, sex, era, body mass index, baseline hypertension, diabetes, estimated glomerular filtration rate, and dipstick albuminuria. The study outcome was progression to end-stage kidney disease (ESKD), and all-cause mortality as identified in the linked claims database. Results: We screened 1,878 kidney donors and 78,115 health screening examinees from 2003 to 2016. After matching, 1,701 persons remained in each group. The median age of the matched study subjects was 44 years, and 46.6% were male. Among the study subjects, 2.7% and 16.6% had underlying diabetes and hypertension, respectively. There were no ESKD events in the matched donor and control groups. There were 24 (1.4%) and 12 mortality cases (0.7%) in the matched donor and control groups, respectively. In the age-sex adjusted model, the risk for all-cause mortality was significantly higher in the donor group than in the control group. However, the significance was not retained after socioeconomic status was included as a covariate (adjusted hazard ratio, 1.82; 95% confidence interval, 0.87–3.80). Conclusion: All-cause mortality was similar in live kidney donors and matched non-donor healthy controls with similar health status and socioeconomic status in the Korean population.

Background: Atopic dermatitis (AD) has been clarified that imbalance of bacterial and fungal communities in the skin and gut play key roles in immunologic dysfunction. Atopic keratoconjunctivitis (AKC), one of severe ophthalmic manifestation of AD, could be related with dysbiosis as same as AD. Objective: In this case-control study, the roles of conjunctival microbial communities in AKC were evaluated by a comparative analysis with healthy controls (HCs). Methods: 16S rRNA sequencing was used to construct libraries of compositional information for a total of 30 volunteers including 20 patients with AKC and 10 HCs. Results: In the results, variation in the conjunctival taxonomic composition was higher in patients with AKC than in the HC group. In an analysis of relative abundance at the genus level, some taxa significantly differed between groups, including Ralstonia, Staphylococcus, Pseudomonas, Proteus, Haemophilus, and Bifidobacterium(p＜0.05). Beta diversity was significantly higher in patients with AKC than in HCs (PERMANOVA, p=0.004). Conclusion The results indicated that the diversity and composition of the microbiome differs between patients with AKC and HCs.

Background: Considering the growing prevalence of Western lifestyles and related chronic diseases occurring in South Korea, this study aimed to explore the progression of metabolic risk factors in living kidney donors compared to a control group. Methods: This study enrolled living kidney donors from seven hospitals from 1982 to 2016. The controls were individuals that voluntarily received health check-ups from 1995 to 2016 that were matched with donors according to age, sex, diabetes status, baseline estimated glomerular filtration rate, and date of the medical record. Data on hyperuricemia, hypertension, hypercholesterolemia, and overweight/obesity were collected to determine metabolic risks. The proportion of individuals with three or more metabolic risk factors was evaluated. Logistic regressions with interaction terms between the medical record date and donor status were used to compare the trends in metabolic risks over time in the two groups. Results: A total of 2,018 living kidney donors and matched non-donors were included. The median age was 44.0 years (interquartile range, 34.0–51.0 years) and 54% were women. The living kidney donors showed a lower absolute prevalence for all metabolic risk factors, except for those that were overweight/obese, than the non-donors. The proportion of subjects that were overweight/obese was consistently higher over time in the donor group. The changes over time in the prevalence of each metabolic risk were not significantly different between groups, except for a lower prevalence of metabolic risk factors ≥ 3 in donors. Conclusion Over time, metabolic risks in living kidney donors are generally the same as in non-donors, except for a lower prevalence of metabolic risk factors ≥ 3 in donors.

Purpose: We quantitatively analyzed the therapeutic effects of intravitreal anti-vascular endothelial growth factor (anti-VEGF) and dexamethasone implants used to treat macular edema caused by retinal vein occlusion. Methods: Eighty-three patients with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO) with macular edema treated from February 2009 to August 2019 via anti-VEGF injections or dexamethasone implants were enrolled. The medical records of 83 eyes were retrospectively analyzed. Horizontal B-scan spectral domain optical coherence tomography images spanning the foveal center were obtained before treatment and 1 month later. These were analyzed with the aid of Image J software and the numbers of pixels corresponding to intraretinal and subretinal fluids calculated. Results: In patients with BRVO, the retinal fluid changes were identical 1 month after injection in both the anti-VEGF injection and the dexamethasone implant groups. For CRVO cases, the dexamethasone implant group exhibited a significantly higher loss of retinal fluid and thus a greater reduction in retinal edema than the anti-VEGF group. Linear regression analysis revealed that in BRVO cases poor final visual acuity was associated with a large amount of fluid at baseline and poor visual acuity 1 and 3 months after treatment. In CRVO cases, poor final visual acuity was associated with a large change in the intraretinal fluid level and poor visual acuity 3 months after treatment. Conclusions The extent of anatomical and visual acuity improvement did not differ between the anti-VEGF injection and the dexamethasone injection groups with BRVO. For CRVO patients, the short-term anatomical improvement was significantly greater in the latter group, but the extent of vision improvement was significantly higher in the former group.

Background: Medical professionals who experience patient safety incidents (PSIs) are vulnerable to emotional pain and other difficulties; such individuals are referred to as “second victims.” This study quantitatively examines the characteristics of physicians’ experiences of PSIs, along with the consequent difficulties and levels of post-traumatic stress disorder (PTSD), and post-traumatic embitterment disorder (PTED) regarding the events. Methods: An anonymous, self-report online survey was administered to physicians. This collected information regarding PSI characteristics (e.g., type, severity of harm) and impact (e.g., sleep disorder, consideration of career change), as well as participants' socio-demographic characteristics. Meanwhile, to quantitatively assess PSI impacts, PTSD and PTED scales were also administered. PSI characteristics and impacts were analyzed using frequency analysis, and the differing effects of indirect and direct PSI experience regarding consequent difficulties were analyzed using chi-square tests. Factors associated with PTSD and PTED scores were identified using linear regression. Results: Of 895 physicians, 24.6% and 24.0% experienced PSI-induced sleep disorder and eating disorder, respectively. Moreover, 38.9% reported being overly cautious in subsequent similar situations, and 12.6% had considered changing jobs or career. Sleep disorder was significantly more common among participants who directly experienced a PSI (32.8%) than among those with indirect experience (15.3%; P < 0.001). Linear regression showed that indirectly involved physicians had a lower mean PTSD score (by 8.44; 95% confidence interval, −12.28 to −4.60) than directly involved physicians. Conclusion This study found that many physicians experience PSI-induced physical symptoms and behavioral responses, and that the severity of these symptoms varies depending on the type of incident and degree of harm involved. Our findings can provoke more active discussion regarding programs for supporting second victims, and can also encourage the establishing of a system for addressing PSIs that have already occurred, such as through disclosure of PSIs.

Background: The coronavirus disease 2019 (COVID-19) pandemic is a major public health problem of international concern. It is important to estimate its impact of COVID-19 for health policy decision-making. We estimated the years of life lost (YLLs) due to COVID-19 in high-incidence countries. Methods: We collected the YLLs due to COVID-19 in 30 high-incidence countries as of April 13, 2020 and followed up as of July 14, 2020. Incidence and mortality were collected using each country's formal reports, articles, and other electronic sources. The life expectancy of Japanese females by age and the UN population data were used to calculate YLLs in total and per 100,000. Results: As of April 22, 2020, there were 1,699,574 YLLs due to COVID-19 in 30 high-incidence countries. On July 14, 2020, this increased to 4,072,325. Both on April 22 and July 14, the total YLLs due to COVID-19 was highest in the USA (April 22, 534,481 YLLs; July 14, 1,199,510 YLLs), and the YLLs per 100,000 population was highest in Belgium (April 22, 868.12 YLLs/100,000;July 14, 1,593.72 YLLs/100,000). YLLs due to COVID-19 were higher among males than among females and higher in those aged ≥ 60 years than in younger individuals. Belgium had the highest proportion of YLLs attributable to COVID-19 as a proportion of the total YLLs and the highest disability-adjusted life years per 100,000 population. Conclusion This study estimated YLLs due to COVID-19 in 30 countries. COVID-19 is a high burden in the USA and Belgium, among males and the elderly. The YLLs are very closely related with the incidence as well as the mortality. This highlights the importance of the early detection of incident case that minimizes severe acute respiratory syndrome coronavirus-2 fatality.