Tuberculosis prevention and care in Korea: Evolution of policy and practice.

Tuberculosis (TB) in Korea remains a serious health problem with an estimated 77 per 100,000 incidence rate for 2016. This makes Korea as the only OECD country with high incidence of TB. The government has increased budgets and strengthened patient management policies since 2011. The management of latent tuberculosis was added to the response with strengthened and extensive contact investigations in the five-year tuberculosis control plan (2013-2017) and implementation was established in 2013. Due to these efforts Korea has achieved an average 5.2% reduction annually in tuberculosis incidence rate between 2011 and 2016. To further expedite the reduction of the TB burden the government has introduced additional measures including mandatory screening of latent tuberculosis infection for community workers in congregate settings including daycare centers for children, kindergarten, and teachers in schools and health care workers in clinics and hospitals to solve the problems identified through contact investigations in 2017. Providing high quality free diagnosis and treatment of active TB including for multidrug resistant TB combined with active contact investigations is the mainstay of the current programmatic response in Korea. However, the limitation of existing tools for LTBI pose challenge including absence of best mechanism for effective communication with professionals and the public, the need for at least 3 months of treatment and the risk of side effects. Developing effective tools will help to overcome these challenges.

Tuberculosis Notification Completeness and Timeliness in the Republic of Korea During 2012-2014.

OBJECTIVES: Completeness and timeliness are key attributes of accurate disease surveillance. This study aimed to evaluate the completeness and timeliness of tuberculosis (TB) notification in the Republic of Korea, by comparing notification data from the Korean National Tuberculosis Surveillance System and reimbursement data from the National Health Insurance. METHODS: We evaluated reimbursement data from 103,075 cases (2012-2014) and surveillance data from 215,055 cases (2011-2015); cases were matched using Resident Registration Numbers. Completeness was evaluated using notifications that were reported within 365 days of the corresponding insurance claim. Timeliness was evaluated using the delay between starting TB treatment and the corresponding notification. Multivariate logistic regression analysis was used to analyze factors that affected completeness (e.g., sex, age, institution type, and nationality). RESULTS: The completeness values were 90.0% in 2012 (33,094/36,775), 93.0% in 2013 (31,445/33,803), and 94.0% in 2014 (30,537/32,497). The rates of notification within 7 days of the corresponding claim were 81.6% in 2012 (27,323/33,489), 79.8% in 2013 (25,469/31,905), and 80.4% in 2014 (24,891/30,978). Increases over time were observed in the sex-, age-, institution type-, and nationality-specific analyses. Multivariate analyses revealed that completeness was affected by institution type [hospitals: odds ratio (OR) = 1.82, p < 0.001; general hospitals: OR = 4.18, p < 0.001] and nationality (native Korean status: OR = 1.48, p < 0.001). CONCLUSION: Notification completeness exhibited a 4.0% increase during 2012-2014 in Korea, and institution type and nationality significantly affected the completeness of TB notifications.

Synthesis of TiO2 nanorod-decorated graphene sheets and their highly efficient photocatalytic activities under visible-light irradiation.

The titanium dioxide (TiO(2)) nanorod-decorated graphene sheets photocatalysts with different TiO(2) nanorods population have been synthesized by a simple non-hydrolytic sol-gel approach. Electron microscopy and X-ray diffraction analysis indicated that the TiO(2) nanorods are well-dispersed and successfully anchored on the graphene sheet surface through the formation of covalent bonds between Ti and C atoms. The photocatalytic activities are evaluated in terms of the efficiencies of photodecomposition and adsorption of methylene blue (MB) in aqueous solution under visible-light irradiation. The as-synthesized TiO(2) nanorod-decorated graphene sheets showed unprecedented photodecomposition efficiency compared to the pristine TiO(2) nanorods and the commercial TiO(2) (P-25, Degussa) under visible-light. It is believed that this predominant photocatalytic activity is due to the synergistic contribution of both a retarded charge recombination rate caused by a high electronic mobility of graphene and an increased surface area originated from nanometer-sized TiO(2) nanorods. Furthermore, photoelectrochemical study is performed to give deep insights into the primary roles of graphene that determines the photocatalytic activity.

Aqueous synthesis of silver nanoparticle embedded cationic polymer nanofibers and their antibacterial activity.

This paper describes the one-pot, aqueous synthesis of cationic polymer nanofibers with embedded silver nanoparticles. Poly[2-(tert-butylaminoethyl) methacrylate] (PTBAM) was used as a cationic polymer substrate to reinforce the antimicrobial activity of the embedded silver nanoparticles. Electron microscope analyses revealed that the as-synthesized nanofibers had diameters of approximately 40 nm and lengths up to about 10 µm. Additionally, silver nanoparticles of approximately 8 nm in diameter were finely embedded into the prepared nanofibers. The embedded silver nanoparticles had a lower tendency to agglomerate than colloidal silver nanoparticles of comparable size. In addition, the nanofibers with embedded silver nanoparticles exhibited excellent antibacterial performance against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus. Interestingly, the prepared nanofibers exhibited enhanced bactericidal performance compared with the silver-embedded poly(methyl methacrylate) (PMMA) nanofibers, presumably because of the antibacterial properties of the PTBAM substrate.

A strategy for fabricating single layer graphene sheets based on a layer-by-layer self-assembly.

A novel approach to synthesize graphene nanosheet is explored on the basis of the layer-by-layer (LbL) self-assembly of polyallylamine (PAA) and poly(styrene-sulfonate) (PSS) multi-layer with a metallic dopant.

[Health pattern of elderly according to age group who living alone in an urban area].

PURPOSE: This study was conducted to identify the differences of health patterns; health-related characteristics, health behaviors, health problems, and self-care levels of elderly, living alone in an urban area according to age group. METHOD: The study design was a descriptive survey and the subjects were 1,800 elderly consisting of 937 young old, 704 middle old, and 159 old old. Data was collected from May to July 2003 using the structured questionnaire and analyzed by descriptive statistics, chi(2)-test, Fisher's exact probability test, ANOVA and Scheffe test using SPSS/PC. RESULT: The health related characteristics which involved body mass index, mental status, use of assistant devices, perceived health, concern of health, and social support were different among the groups and more aggravated by aging. Health behaviors and health problems were also significantly aggravated in the old old group. The self-care levels measured by ADL, physical activity, and self-care ability scores were also significantly decreased in the old old group. CONCLUSION: For the level of health status, health behaviors and self-care ability were significantly decreased by aging, health care services for the elderly should be planned considering the difference in the health pattern by age group.

[Nurses' image perceived by academic and vocational high school teachers in Korea].

PURPOSE: The purpose of this study was to identify nurses' image and its related factors to make nurses' image among academic and vocational high school teachers in Korea. METHOD: Study samples were composed of 470 teachers who were from 12 high schools in G and J city located in southwestern part of Korea. Data were collected from August 26 to October 4, 2002. The internal consistency of the total scale was Cronbach's a =.940. RESULT: In order to make nurses' image, 76.4% of respondents were influenced by the experience of their hospitalization in visiting hospitals. The mean score of nurses' image in general was 3.19+/-0.55; in four subcategories, 3.46+/-0.60 for professional image, 3.28+/-0.69 for traditional image, 2.93+/-0.70 for social image, and 2.91+/-0.64 for vision of nursing career. The mean score of nurses' image in general was more positive significantly in the 50's age group (F=6.43, p=.002) and in male groups (t=2.92, p=.002). CONCLUSION: On the basis of these findings, nursing professionals need to improve their working conditions, aspiration in job, and autonomy of nurses in their practice fields, monitor the mass media and other publishing materials continuously, and share the appropriate information on nursing profession to the school teachers and the public.

[Comparison of nursing activities reflected in nursing notes and in-depth interviews of nurses in an acute hospital].

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.