BACKGROUND: A kids café is a popular indoor playground in Korea that combines a playground for young children and a café for their caregivers. There have been no national reports about kids café-related injuries in Korea. This study investigated kids café-related injuries in Korea registered in a multicenter injury surveillance database and analyzed the risk factors for significant kids café-related injuries.METHODS: A multicenter cross-sectional study was performed using the Emergency Department-based Injury In-depth Surveillance registry in Korea between 2011 and 2016. Significant injury was defined as an injury requiring hospitalization or surgery. A multivariable logistic regression model was used to obtain the adjusted odds ratios (aORs) for factors associated with significant kids café-related injuries.RESULTS: Among 1,537,617 injured patients, we extracted 891 patients who were injured in kids cafés. Of these, 46 (5.2%) were admitted, and 39 (4.4%) underwent surgery. The most common injured anatomical site, injury type, and mechanism were lower extremity (28.2%), superficial injury (27.2%), and slip (27.1%), respectively. Among injury-inducing factors, significant injuries were most commonly caused by a trampoline (28.1%), and rock climbing equipment was the only risk factor in a kids café that led to significant injury after adjusting for age, sex, injury mechanism, and injured anatomical sites (aOR, 14.94; 95% confidence interval, 1.51–147.72).CONCLUSION: The rock climbing equipment in a kids café can cause serious injury to children. Establishing safety regulations for rock climbing equipment in kids cafés may have the greatest impact in reducing significant injuries requiring hospitalization or surgery.
Caregivers ; Child ; Cross-Sectional Studies ; Emergencies ; Hospitalization ; Humans ; Korea ; Logistic Models ; Lower Extremity ; Odds Ratio ; Play and Playthings ; Risk Factors ; Social Control, Formal ; Wounds and Injuries

One person dies every six seconds from a smoking-related disease and this problem is likely to worsen. While many people try to quit smoking on their own or with using medicinal products, many of them fail. There is an ongoing debate within the public health community about e-cigarettes on whether they have a potential role in smoking cessation, whether their use can reduce harm for individual users, whether the widespread use of these devices has the potential to reduce or increase population-level harm, and how best to regulate e-cigarette use to minimize both individual and population-level harm. Although the long-term effects of e-cigarette use among smokers and non-smokers are not known, nicotine aerosol produced from a solution, rather than from burning tobacco, releases fewer harmful substances than cigarette smoke does. Some experts advocate wider availability and softer regulations regarding e-cigarette use and perceive them as having the potential to help smokers quit or switch to a harm-reducing means of consuming nicotine. Based on scientific evidence on e-cigarettes, this article explores its pros and cons to public health in order to guide practice, policy, and regulation through reviews of debate articles. ‘Quit or die’ is no longer the only option for those who cannot quit. Safer nicotine products offer another way. There is substantial international and independent evidence that these products are safer than cigarettes.
Burns ; Electronic Cigarettes ; Harm Reduction ; Humans ; Nicotine ; Public Health ; Smoke ; Smoking ; Smoking Cessation ; Social Control, Formal ; Tobacco ; Tobacco Products

The term new tobacco products (NTPs) refers to the new alternatives to conventional cigarettes. There are several kinds of NTPs in South Korea. The present study discusses the most widely used NTPs namely electronic cigarette (ECs) and heated tobacco products (HTPs). The aims of this study are to evaluate the risk related to the use of ECs and HTPs, introduce policy examples across different countries of management of this issue, and finally, present some policy implications of the problem and our response strategies. Since the advent of ECs, there has been a lot of debate about its risk. Some studies have reported that ECs are less harmful than conventional cigarettes and that they are effective in aiding smoking cessation. Nevertheless, the efficacy of ECs in smoking cessation and its potential health risks are still unclear. However, the obvious fact is that it is not harmless. Regulations on ECs differ from country to country. In many countries, they are strictly regulated as tobacco or toxic substances; however, in the United Kingdom, the use of ECs are included as part of their smoking cessation policy, and in Japan, they are treated as a form of medication. On the other hand, HTPs are the most recently introduced NTPs and they have attained sensational popularity because of the wrongly held belief that they are less harmful to health. So, what about our policy response to these two tobacco products? The research on ECs requires more systematic statistical monitoring, such as monitoring the ratio of dual-users. Further, the new EC smokers should be identified taking into account that the arguments for the use of ECs often emphasize smoking cessation or less risks to health, the government should further strengthen its policy to prevent those claims. The HTPs market experienced a very sharp growth and continues to grow because the government policy is too passive. Taking this as a lesson, it is necessary to approach NTPs, such as HTPs, proactively and increase their contribution to the National Health Promotion Fund by imposing greater taxes on them. Finally, considering the likelihood of NTPs being promoted as a less harmful tobacco product, it is essential to strictly regulate tobacco companies' publicity from the very beginning to ensure that potential consumer s are not mislead.
Electronic Cigarettes ; Financial Management ; Great Britain ; Hand ; Health Promotion ; Hot Temperature ; Japan ; Korea ; Smoking Cessation ; Social Control, Formal ; Taxes ; Tobacco Products ; Tobacco

BACKGROUND: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. METHODS: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. RESULTS: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. CONCLUSION: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.
Asian Continental Ancestry Group ; Decision Making ; Delivery of Health Care ; Global Health ; Health Expenditures ; Health Policy ; Humans ; Infant ; Infant Mortality ; Kazakhstan ; Kyrgyzstan ; Life Expectancy ; Mortality ; Primary Health Care ; Public Health ; Social Control, Formal ; United Nations ; Uzbekistan ; World Health Organization

Medulloblastoma is considered one of the most threatening malignant brain tumors with an extremely high mortality rate in children. In the medulloblastoma, there are several genes and mutations found to work in an unregulated manner that works together to push the cells into a cancerous state. With the discovery of non-coding RNAs such as microRNAs (miRNAs), it has been shown that a different layer of gene regulations may be disrupted which would cause cancer. This fact led scientists to put their focus on the role of miRNAs in cancer. A mature miRNA contains a seed sequence which gives the miRNA to identify and attach to the interest mRNA; this attachment may lead degradation of mRNA or suppress of translation of the mRNA. The expression of miRNAs in medulloblastoma shows that some of these non-coding RNAs are overexpressed (OncomiRs) which help cells to proliferate and keep their stemness features. On the other hand, there are other forms of these miRNAs which normally inhibit cell proliferation and promote cell differentiation (tumor suppressor). These are down-regulated during cancer progression. In this systematic review, we attempted to gather several important studies on miRNAs’ role in medulloblastoma tumors and the importance of these non-coding RNAs in the future study of cancer.
Brain Neoplasms ; Cell Differentiation ; Cell Proliferation ; Child ; Genes, Tumor Suppressor ; Hand ; Humans ; Medulloblastoma ; MicroRNAs ; Mortality ; Oncogenes ; RNA, Messenger ; RNA, Untranslated ; Social Control, Formal

Enteral nutrition (EN) formulas are foods that are used to improve the nutritional status of patients and these foods' safety and quality must be ensured. Therefore, EN formulas in other countries are managed differently from that of general foods. We investigated the direction of development of the relevant laws regulations and guidelines pertaining to EN formulas and we compared these laws regulations and guidelines from different countries, including Korea. The United States and Europe manage EN formulas as foods, but they are managed differently compared to general foods because of separate laws or programs pertaining to EN foods. In addition, the use of the formulas does not necessarily require a prescription, but when used by prescription, then medical insurance covers them. In Japan, there are two types of EN formulas, food and drug, and there are differences for their management and insurance coverage. In the case of Korea, EN formulas are classified as food and drug, and different management and insurance are applied in each case, which inhibits their systematic management and industrial development. Integration of a management system and establishment of a legal foundation is necessary for the systematic management and development of EN formula in Korea.
Enteral Nutrition ; Europe ; Humans ; Industrial Development ; Insurance ; Insurance Coverage ; Japan ; Jurisprudence ; Korea ; Nutritional Status ; Prescriptions ; Social Control, Formal ; United States

BACKGROUND: Medical device adverse event reporting is an essential activity for mitigating device-related risks. Reporting of adverse events can be done by anyone like healthcare workers, patients, and others. However, for an individual to determine the reporting, he or she should recognize the current situation as an adverse event. The objective of this report is to share observed individual differences in the perception of a medical device adverse event, which may affect the judgment and the reporting of adverse events. METHODS: We trained twenty-three participants from twelve Asia-Pacific Economic Cooperation (APEC) member economies about international guidelines for medical device vigilance. We developed and used six virtual cases and six questions. We divided participants into six groups and compared their opinions. We also surveyed the country's opinion to investigate the beginning point of ‘patient use’. The phases of ‘patient use’ are divided into: 1) inspecting, 2) preparing, and 3) applying medical device. RESULTS: As for the question on the beginning point of ‘patient use,’ 28.6%, 35.7%, and 35.7% of participants provided answers regarding the first, second, and third phases, respectively. In training for applying international guidelines to virtual cases, only one of the six questions reached a consensus between the two groups in all six virtual cases. For the other five questions, different judgments were given in at least two groups. CONCLUSION: From training courses using virtual cases, we found that there was no consensus on ‘patient use’ point of view of medical devices. There was a significant difference in applying definitions of adverse events written in guidelines regarding the medical device associated incidents. Our results point out that international harmonization effort is needed not only to harmonize differences in regulations between countries but also to overcome diversity in perspectives existing at the site of medical device use.
Consensus ; Delivery of Health Care ; Education ; Humans ; Individuality ; Judgment ; Social Control, Formal

We conducted this study to compare the awareness and attitude of Busan housewives about consuming marine products. The survey was conducted from April 10 to May 31, 2019 by using a questionnaire. The degree of preference of seafood was higher among individuals in their 40s than those in the other age groups. Among the women in their 30s, 40s, 50s and 70s, the reason for liking seafood was ‘taste’, and for those in their 60s it was ‘nutrition’. Overall the most common reason for disliking seafood was the ‘fishy smell (37.4%)’. Conception degree of nutritive value of seafood was higher among individuals in their 30s and 40s than that for those individuals in their 50s, 60s and 70s. As for the price of seafood, the wives over 40s thought seafood was more expensive than did those wives in their 30s. The younger the individuals were, the lower was the perceived degree of safety was 49.8% of the subjects reported that the main concern for purchase was ‘freshness’. The perceived degree of safety for imported seafood was better for the wives in their 60s and 70s than that for those wives in their 30s, 40s and 50s. The confidence level for local Korean seafood was higher for the wives in their 60s than that for the wives in their 50s. The degree of preference for seafood was moderate overall, except for Jellyfish. Age was positively correlated with conception for safety and dietary attitude (P<0.01), whereas age was negatively correlated with monthly food expenditure, nutrition knowledge and intake requirements (P<0.01). Preference for seafood was positively correlated with conception for safety (P<0.05), nutrition knowledge (P<0.05), dietary attitude (P<0.01), awareness for nutritive value (P<0.01) and intake requirements (P<0.01). Laws and regulations should be reinforced in order to promote eating more seafood and periodic research to determine the actual amount of consumed seafood and people's preferences should be conducted.
Busan ; Eating ; Female ; Fertilization ; Health Expenditures ; Humans ; Jurisprudence ; Nutritive Value ; Seafood ; Smell ; Social Control, Formal ; Spouses

Hospice and palliative care can help terminal patients and their family members to face the natural end of life more comfortably, by providing them with an environment to address psychosocial and spiritual problems, as well as physical symptoms. However, most patients and their caregivers have the misconception that hospice care means the withdrawal of all treatments. Many physicians also consider hospice care to be a form of terminal care after all treatments are finished. Laws regulating the withdrawal of life-prolonging treatment came into effect in Korea in 2018, and these regulations also apply to most terminal stages of benign diseases. The withdrawal of futile life-prolonging treatment is quite different from euthanasia or negligence. At the last stage of disease, treatment aimed at alleviating various symptoms can make critically ill patients more comfortable and thereby help them to die with dignity. Patients with a terminal illness should receive hospice and palliative care, instead of futile life-prolonging treatment. Therefore, education and training programs to promote a proper understanding of hospice and palliative care should be considered mandatory.
Caregivers ; Critical Illness ; Education ; Euthanasia ; Hospice Care ; Hospices ; Humans ; Jurisprudence ; Korea ; Malpractice ; Palliative Care ; Social Control, Formal ; Terminal Care ; Withholding Treatment

This study aimed to describe adverse effects or reactions by medical devices. There may be unexpected effects caused by medical devices that can often be harmful to the patient. This is defined as a medical device adverse event or adverse effect (MDAE). We should prevent the recurrence of MDAEs by reporting them to regulatory authorities and device manufacturers. This reporting requires that manufacturers check the manufacturing process and update the medical device. However, it is difficult for both patients and medical persons to recognize and report MDAEs because adverse effects can be ambiguous to them in many cases. In addition, many medical persons lack an understanding of the role of this reporting. In Korea, the Ministry of Health and Welfare enacted laws and regulations for MDAE reporting in 2005. However, the number of MDAEs reported was still very small. The Ministry of Food and Drug Safety started the Medical Device Safety Monitoring Center project in 2011, with the purpose of promoting MDAE reporting. Since the Medical Device Safety Monitoring Center project began, the number of reported MDAEs rapidly increased from 137 in 2010 to 6,078 in 2017. Medical persons and device manufacturers should be encouraged to voluntarily report MDAEs and provide useful information. Korea is an important member of the International Medical Device Regulators Forum and leader of the Asia-Pacific Economic Cooperation Regulatory Committee. There should be medical device vigilance with global cooperation.
Equipment and Supplies ; Equipment Safety ; Humans ; Jurisprudence ; Korea ; Mandatory Reporting ; Recurrence ; Safety Management ; Social Control, Formal