Perceptions of primary care in Korea: a comparison of patient and physician focus group discussions

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Background: The primary care system in the Republic of Korea has weakened over the past decade and is now in poorer condition than the systems in other countries. However, little is known about how the two key players, patients and physicians, view the current status of primary care in Korea. This study aims to understand what problems they perceive in respect to the key components of primary care. Methods: We conducted two focus groups; one with six patients and the other with six physicians. We designed and modified the guidelines for each focus group discussion through repeated review and discussion among all authors and then we conducted the groups with a professional interviewer at Gallup Korea. After the focus groups we analyzed the verbatim transcriptions to identify specific meanings and potential implications. Results: From the study we identified that the patients and physicians did not have a correct understanding about the role of primary care. We also identified a significant discrepancy between their perception of primary care. In particular, the patient group perceived the quality of primary care to be poor and unsatisfactory while the physician group perceived the quality of primary care to be better in Korea than in other countries. Conclusions: The focus group discussions revealed that such discrepancies in perception have resulted from Koreas distorted healthcare delivery system, undifferentiated roles among healthcare organizations, patients freedom of choice in selecting healthcare providers and other institutional factors. There are several steps that should be taken to promote primary care in Korea. First, we should undertake efforts to improve the quality of primary care provided by physicians. Second, we should inform the general public about using clinics instead of hospitals for the treatment of simple or minor diseases. Third, we should introduce a new compensation scheme to compensate physicians for services related to health education, disease prevention, behavioral change and nutrition consultation. Finally, we should provide additional reimbursement so that primary care physicians can extend their office hours to better meet the needs of patients.Peer Reviewe

A simple and easy home-based pulmonary rehabilitation programme for patients with Chronic Lung Diseases

Background and Aim. To develop a simple and easy home-based pulmonary rehabilitation programme and investigate its effectiveness. Methods. Patients with stable chronic lung disease were divided into a rehabilitation group (n = 25) and a control group (n = 18). Rehabilitation consisted of education and 12 weeks of enforced aerobic and musclestrengthening exercises. Aerobic exercise training was performed mostly by walking based on the functional capacity of the patients assessed by the maximal incremental exercise test. Patients visited hospital every two weeks for evaluation and a new exercise regimen. Results. Five patients dropped out of the rehabilitation group but three were due to development of unrelated diseases, five controls did not co-operate in the second evaluation. After 12 weeks of rehabilitation, exercise capacity (maximum work load and VO2max), exercise endurance, 6-minute walking distance, and quality of life measured by the St. George Respiratory Questionnaire had significantly improved in the rehabilitation group but not in the controls. At a follow-up evaluation one year after the rehabilitation, some exercise parameters were still significantly higher than baseline in the rehabilitation group. Conclusions. We developed a simple home-based pulmonary rehabilitation programme, which seems to be clinically feasible and effective

Zanthoxylum ailanthoides

Zanthoxylum ailanthoides (ZA) has been used as folk medicines in East Asian and recently reported to have several bioactivity; however, the studies of ZA on the regulation of triacylglycerol (TG) biosynthesis have not been elucidated yet. In this study, we examined whether the methanol extract of ZA (ZA-M) could reduce oleic acid- (OA-) induced intracellular lipid accumulation and confirmed its mode of action in HepG2 cells. ZA-M was shown to promote the phosphorylation of AMPK and its upstream LKB1, followed by reduction of lipogenic gene expressions. As a result, treatment of ZA-M blocked de novo TG biosynthesis and subsequently mitigated intracellular neutral lipid accumulation in HepG2 cells. ZA-M also inhibited OA-induced production of reactive oxygen species (ROS) and TNF-α, suggesting that ZA-M possess the anti-inflammatory feature in fatty acid over accumulated condition. Taken together, these results suggest that ZA-M attenuates OA-induced lipid accumulation and inflammation through the activation of LKB1/AMPK signaling pathway in HepG2 cells

Publishing SNP Genotypes of Human Embryonic Stem Cell Lines: Policy Statement of the International Stem Cell Forum Ethics Working Party

Novel methods and associated tools permitting individual identification in publicly accessible SNP databases have become a debatable issue. There is growing concern that current technical and ethical safeguards to protect the identities of donors could be insufficient. In the context of human embryonic stem cell research, there are no studies focusing on the probability that an hESC line donor could be identified by analyzing published SNP profiles and associated genotypic and phenotypic information. We present the International Stem Cell Forum (ISCF) Ethics Working Party’s Policy Statement on “Publishing SNP Genotypes of Human Embryonic Stem Cell Lines (hESC)”. The Statement prospectively addresses issues surrounding the publication of genotypic data and associated annotations of hESC lines in open access databases. It proposes a balanced approach between the goals of open science and data sharing with the respect for fundamental bioethical principles (autonomy, privacy, beneficence, justice and research merit and integrity)

Effect of Chongkukjang on histamine-induced skin wheal response: A randomized, double-blind, placebo-controlled trial

AbstractBackgroundStudies in animals have demonstrated the antiallergenic properties of Chongkukjang (CKJ), a traditional Korean food made by fermentation of soybean with Bacillus subtilis. CKJ might therefore be used as an ingredient in a functional food designed to suppress allergies. The purpose of this study was to investigate the effect of CKJ on histamine-induced skin wheal response in healthy participants.MethodsA randomized, double-blind, placebo-controlled trial was conducted. Sixty participants (48 women and 12 men) were randomly assigned to one of two groups: One group received 35 g CKJ daily for 12 weeks, and the other received a placebo at the same dosing frequency. A skin prick test with histamine (10 mg/mL) was conducted on the ventral forearm 10 cm from the elbow, and assessed 15 minutes later. Outcomes included measurement of efficacy [skin wheal response, immunoglobulin E (IgE), histamine, interferon-gamma, interleukin-4, eosinophil, and eosinophil cationic protein (ECP)], and safety (adverse events, laboratory test results, electrocardiogram, anthropometric values, and vital signs).ResultsFifty-five participants (28 in the CKJ group and 27 in the placebo group) completed the study. After 12 weeks of supplementation, participants in the CKJ group showed a significant reduction in histamine-induced skin wheal areas compared with placebo group (p < 0.05). At 12 weeks, the CKJ group showed a significant improvement in percentage change from baseline in histamine-induced wheal area, compared with the placebo group (p < 0.05). CKJ did not influence blood levels of IgE, histamine, interferon-gamma, interleukin-4, eosinophil, or ECP.ConclusionOral administration of CKJ for 12 weeks resulted in a reduction of the skin wheal response to histamine, with no apparent adverse effects. Trial registration: ClinicalTrials.gov: NCT01402141