Background/Aims: Although gastrointestinal endoscopy (GIE) is a major contributor to the carbon footprint of national healthcare, the amount of medical waste generated by GIE procedures is not reported in South Korea. This study aimed to measure the amount of medical waste generated from GIE procedures in South Korea. Methods: We conducted a 5-day audit of medical waste generated during GIEs at seven hospitals. During the study period, medical waste in the endoscopy examination rooms was measured twice daily and documented as mass (kg). To calculate the mean mass of disposable waste generated during one esophagogastroduodenoscopy (EGD) and one colonoscopy, the mean mass of medical waste generated from seven examinations was calculated. The mean mass of medical waste generated during GIEs was calculated by dividing the total mass of medical waste generated by the number of GIE procedures. Results: Overall, 3,922 endoscopies were performed and 4,558 kg of waste was generated. The mean weight of medical waste generated per endoscopy was 1.34 kg. Each EGD and colonoscopy generated a mean of 0.24 kg and 0.43 kg of disposable waste, respectively. Applying the mean waste estimates from this study to annual GIE procedures performed in South Korea in 2022 showed that the total medical waste produced from GIE was 13,704,453 kg. In addition, the total masses of medical waste produced during EGD and colonoscopy procedures were 819,766 kg and 2,889,478 kg, respectively. Conclusions Our quantitative measurement showed that a large amount of medical waste is generated from GIE procedures. However, further research is warranted to reduce medical waste generated during GIE, which is an urgent unmet need.

Background/Aims: Although gastrointestinal endoscopy (GIE) is a major contributor to the carbon footprint of national healthcare, the amount of medical waste generated by GIE procedures is not reported in South Korea. This study aimed to measure the amount of medical waste generated from GIE procedures in South Korea. Methods: We conducted a 5-day audit of medical waste generated during GIEs at seven hospitals. During the study period, medical waste in the endoscopy examination rooms was measured twice daily and documented as mass (kg). To calculate the mean mass of disposable waste generated during one esophagogastroduodenoscopy (EGD) and one colonoscopy, the mean mass of medical waste generated from seven examinations was calculated. The mean mass of medical waste generated during GIEs was calculated by dividing the total mass of medical waste generated by the number of GIE procedures. Results: Overall, 3,922 endoscopies were performed and 4,558 kg of waste was generated. The mean weight of medical waste generated per endoscopy was 1.34 kg. Each EGD and colonoscopy generated a mean of 0.24 kg and 0.43 kg of disposable waste, respectively. Applying the mean waste estimates from this study to annual GIE procedures performed in South Korea in 2022 showed that the total medical waste produced from GIE was 13,704,453 kg. In addition, the total masses of medical waste produced during EGD and colonoscopy procedures were 819,766 kg and 2,889,478 kg, respectively. Conclusions Our quantitative measurement showed that a large amount of medical waste is generated from GIE procedures. However, further research is warranted to reduce medical waste generated during GIE, which is an urgent unmet need.

Background/Aims: Although gastrointestinal endoscopy (GIE) is a major contributor to the carbon footprint of national healthcare, the amount of medical waste generated by GIE procedures is not reported in South Korea. This study aimed to measure the amount of medical waste generated from GIE procedures in South Korea. Methods: We conducted a 5-day audit of medical waste generated during GIEs at seven hospitals. During the study period, medical waste in the endoscopy examination rooms was measured twice daily and documented as mass (kg). To calculate the mean mass of disposable waste generated during one esophagogastroduodenoscopy (EGD) and one colonoscopy, the mean mass of medical waste generated from seven examinations was calculated. The mean mass of medical waste generated during GIEs was calculated by dividing the total mass of medical waste generated by the number of GIE procedures. Results: Overall, 3,922 endoscopies were performed and 4,558 kg of waste was generated. The mean weight of medical waste generated per endoscopy was 1.34 kg. Each EGD and colonoscopy generated a mean of 0.24 kg and 0.43 kg of disposable waste, respectively. Applying the mean waste estimates from this study to annual GIE procedures performed in South Korea in 2022 showed that the total medical waste produced from GIE was 13,704,453 kg. In addition, the total masses of medical waste produced during EGD and colonoscopy procedures were 819,766 kg and 2,889,478 kg, respectively. Conclusions Our quantitative measurement showed that a large amount of medical waste is generated from GIE procedures. However, further research is warranted to reduce medical waste generated during GIE, which is an urgent unmet need.

Background/Aims: Although gastrointestinal endoscopy (GIE) is a major contributor to the carbon footprint of national healthcare, the amount of medical waste generated by GIE procedures is not reported in South Korea. This study aimed to measure the amount of medical waste generated from GIE procedures in South Korea. Methods: We conducted a 5-day audit of medical waste generated during GIEs at seven hospitals. During the study period, medical waste in the endoscopy examination rooms was measured twice daily and documented as mass (kg). To calculate the mean mass of disposable waste generated during one esophagogastroduodenoscopy (EGD) and one colonoscopy, the mean mass of medical waste generated from seven examinations was calculated. The mean mass of medical waste generated during GIEs was calculated by dividing the total mass of medical waste generated by the number of GIE procedures. Results: Overall, 3,922 endoscopies were performed and 4,558 kg of waste was generated. The mean weight of medical waste generated per endoscopy was 1.34 kg. Each EGD and colonoscopy generated a mean of 0.24 kg and 0.43 kg of disposable waste, respectively. Applying the mean waste estimates from this study to annual GIE procedures performed in South Korea in 2022 showed that the total medical waste produced from GIE was 13,704,453 kg. In addition, the total masses of medical waste produced during EGD and colonoscopy procedures were 819,766 kg and 2,889,478 kg, respectively. Conclusions Our quantitative measurement showed that a large amount of medical waste is generated from GIE procedures. However, further research is warranted to reduce medical waste generated during GIE, which is an urgent unmet need.

Purpose: We aimed to assess the humoral response to and reactogenicity of coronavirus disease 2019 (COVID-19) vaccination according to the vaccine type and to analyze factors associated with immunogenicity in actively treated solid cancer patients (CPs). Materials and Methods: Prospective cohorts of CPs, undergoing anticancer treatment, and healthcare workers (HCWs) were established. The participants had no history of previous COVID-19 and received either mRNA-based or adenovirus vector–based (AdV) vaccines as the primary series. Blood samples were collected before the first vaccination and after 2 weeks for each dose vaccination. Spike-specific binding antibodies (bAbs) in all participants and neutralizing antibodies (nAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wild-type, Delta, and Omicron variants in CPs were analyzed and presented as the geometric mean titer. Results: Age-matched 20 HCWs and 118 CPs were included in the analysis. The bAb seroconversion rate and antibody concentrations after the first vaccination were significantly lower in CPs than in HCWs. After the third vaccination, antibody levels in CPs with a primary series of AdV were comparable to those in HCWs, but nAb titers against the Omicron variant did not quantitatively increase in CPs with AdV vaccine as the primary series. The incidence and severity of adverse reactions post-vaccination were similar between CPs and HCWs. Conclusion CPs displayed delayed humoral immune response after SARS-CoV-2 vaccination. The booster dose elicited comparable bAb concentrations between CPs and HCWs, regardless of the primary vaccine type. Neutralization against the Omicron variant was not robustly elicited following the booster dose in some CPs, implying the need for additional interventions to protect them from COVID-19.

Purpose: This study aims to verify whether the Reflective Practice Questionnaire (RPQ) developed by Priddis and Rogers is valid in the Korean context to identify the level of reflection of medical students in clinical practice. Methods: A total of 202 third- and fourth-year medical students from seven universities participated in the study. After receiving approval for use from the authors, a survey was conducted on the students through an adaptation process. The original scale consists of 10 factors with 40 items. The Self-efficacy in Clinical Performance Scale (SECP), Korean Self-reflection and Insight Scale (K-SRIS), and Reflection-in-Learning Scale (RinLS) were used to validate the scale. Exploratory factor, confirmatory factor, correlation, and reliability analyses were used for data analysis. Results: As a result of exploratory factor analysis, 10 subfactors were extracted (Kaiser-Meyer-Olkin=0.856, Bartlett’s test: χ 2 =5,044.337, degrees of freedom=780, p<0.001). Among the 40 items, one that showed a high overlapping load for other factors was excluded. As a result of confirmatory factor analysis, the 10-factor structure model was found suitable (χ 2 =1.980, comparative fit index=0.859, Tucker-Lewis index=0.841, root mean square error of approximation=0.070). As a result of the criterion validity test, most of the subfactors of the Korean version of the RPQ (K-RPQ) showed a positive correlation with K-SRIS, RinLS, and SECP. The reliability of 10 subfactors was satisfactory, ranging from 0.666 to 0.919. Conclusion The K-RPQ was confirmed to be a reliable and valid tool to evaluate the level of reflection among Korean medical students in clinical clerkship. This scale can be used as a tool to provide feedback on each student’s level of reflection in clinical clerkship.

We aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on admissions of patients with acute myocardial infarction, stroke, and severe trauma, and their excess mortality in emergency departments (EDs) in South Korea using registry data from the National Emergency Department Information System (NEDIS) for patients attending EDs of regional and local emergency medical centers. During the outbreak period of 2020, there were 350,698 ED visits, which was lower than the total in 2019 (392,627 visits).Multiple logistic regression revealed that, compared with 2019, there was significantly higher ED mortality rate during the COVID-19 outbreak in 2020 (adjusted odds ratio, 1.10;95% confidence interval, 1.07–1.13). This finding implies that during the early outbreak period, people might have avoided seeking medical care even for acute and life-threatening conditions, or transfer times at the scene to the hospital arrival were delayed, or treatment for the patients in EDs were delayed.

Chronic constipation is one of the most common digestive diseases encountered in clinical practice. Constipation manifests as a variety of symptoms, such as infrequent bowel movements, hard stools, feeling of incomplete evacuation, straining at defecation, a sense of anorectal blockage during defecation, and use of digital maneuvers to assist defecation. During the diagnosis of chronic constipation, the Bristol Stool Form Scale, colonoscopy, and a digital rectal examination are useful for objective symptom evaluation and differential diagnosis of secondary constipation. Physiological tests for functional constipation have complementary roles and are recommended for patients who have failed to respond to treatment with available laxatives and those who are strongly suspected of having a defecatory disorder. As new evidence on the diagnosis and management of functional constipation emerged, the need to revise the previous guideline was suggested. Therefore, these evidence-based guidelines have proposed recommendations developed using a systematic review and meta-analysis of the treatment options available for functional constipation. The benefits and cautions of new pharmacological agents (such as lubiprostone and linaclotide) and conventional laxatives have been described through a meta-analysis. The guidelines consist of 34 recommendations, including 3 concerning the definition and epidemiology of functional constipation, 9 regarding diagnoses, and 22 regarding managements. Clinicians (including primary physicians, general health professionals, medical students, residents, and other healthcare professionals) and patients can refer to these guidelines to make informed decisions regarding the management of functional constipation.

Background: The purpose of this study was to identify the connection between handwashing and toothbrushing, focusing on eating habits, and to verify whether eating habits can be used as an action cue for forming health habits. Methods: This was a cross-sectional study using secondary data from the 2019 community health survey. The participants included 229,099 adults aged 19 years or older, representative of the South Korean people. We employed two dependent variables: one was washing hands, and the other was brushing teeth. Eating habits was a major independent variable. Socioeconomic variables, such as age, gender, income, occupation, economic activity, education, and residence were adjusted as confounders. Multivariate logistic regression was performed to calculate adjusted odds ratio and 95% confidence intervals. Results: Most of the participants had good health behaviors: those who wash their hands and brush their teeth were each approximately 80%. Our finding indicated that brushing teeth and washing hands can be connected with eating habits. After adjusting for confounders, it was found that people who wash their hands before meals (compared to those who did not wash their hands before meals) had a higher toothbrushing rate after meals (i.e., socioeconomic status) (Adjusted Odds Ratio: 2.0, Confidence Intervals: 1.9 to 2.1). Conclusion Those who practice either washing hands before meals or brushing teeth after meals were found to have a connection between washing hands and brushing teeth based on the results of practicing other health behaviors. This implies that eating habits can be connected as a behavior cue to promote health habits, such as washing hands before meals and brushing teeth after meals.

Purpose: This study aimed to identify the effect of warm scarf on xerostomia and sore throat in postoperative colon cancer patients. Methods: A total of 40 participants with colon cancer who underwent colon cancer operation over 2hours were included from C University hospital in Seoul. The number of experimental group and control group is each 20 calculated by G*Power, and they were assigned by using nonequivalent control group no-synchronized design. In the experimental group, a warm scarf was applied to the neck for 120 minutes from entering the recovery room after the colorectal cancer surgery was completed. In the experimental group and the control group, xerostomia and sore throat were measured twice at 60-minute intervals. The degree of xerostomia was measured through the degree of wetness of the absorbent paper in mm, and the degree of sore throat was measured through the NRS (Numeral Rating Scale). Data were collected using self-administered questionnaires from August 2018 to September 2020 and were analyzed using IBM SPSS/WIN 21.0 Descriptive statistics, x2 test, Fisher's exact test, t-test were used to determine the participant's characteristics. The effect of warm scarf on xerostomia and sore throat were separately estimated by Repeated Measures ANOVA. Results: The experimental group showed significant decrease of xerostomia and sore throat as time goes (p<.001). Conclusion Results indicate that warm scarf on xerostomia and sore throat in postoperative colon cancer patients is helpful method for relieving side effect of tracheal intubation.