Background: This study aimed to identify the factors affecting the successful operation of electr... more Background: This study aimed to identify the factors affecting the successful operation of electronic health records (EHRs) during the initial pilot implementation period from 2015 to 2017. The EHR system in Timor-Leste was first launched in 2015 after the VI Constitutional Government introduced the "Saúde na Familia" initiative. In January 2019, the system was discontinued after being disrupted by a political impasse between 2017 and 2018. The new Minister of Health reactivated the adoption of the EHR system as of August 2020. Methods: This study included a cross-sectional survey. The questionnaire covered benefits, barriers, and satisfaction categories along with sociodemographic variables. Results: Statistically significant differences between age groups were noted for the benefits, perceived barriers (such as the ability to use computers), and overall satisfaction of the EHR system. The slope of the benefit category (β = 0.497, t = 11.361) was a statistically significant predictor of satisfaction with EHR system implementation. However, the slope of the barrier category had a negative statistical significance for satisfaction (β = −0.086, t = −1.794). Satisfaction with the EHR system was influenced by its perceived benefit and reduced perceived barriers due to individuals' utilization of the information and communication technology system. Conclusion: Continuous political commitment to health policy, financial support, friendly end-user applications, improved quality of Internet service, and a positive attitude toward the system were crucial for its successful implementation.
Background: Immunization plays a vital role in the lives of children in the protection against in... more Background: Immunization plays a vital role in the lives of children in the protection against infectious diseases such as measles, polio, tuberculosis, hepatitis B, and diphtheria. Under the National Health Mission in the Lao People's Democratic Republic (Lao PDR), there are different programs and facilities for newborn and child health. However, despite these schemes and programs, the immunization coverage rate in the rural areas of Lao PDR is considerably low as compared to that in urban areas. We conducted a critical review of the various factors, schemes, and research currently being conducted on child immunization. Methods: A retrospective secondary data analysis was performed. Secondary data on childhood immunization coverage in 2018 was collected from the Directorate General of Health Prevention of the Ministry of Health, Lao PDR. Results: The coverage of immunization in the rural areas increased by only 1%, from 55% in 2018 to 56% in 2019, whereas that in urban areas increased significantly by 22%, from 71% in 2018 to 93% in 2019 because the Expanded Program Immunization Department in urban areas has improved its performance at health centers and ensures that vaccines are available with proper storage and maintenance of the cold chain. Conclusion: Although impressive gains have been made in reducing infant mortality and increasing immunization coverage in the Lao PDR, inequalities persist in rural areas. International organizations and governments of the Lao PDR each have important roles in supporting not only vaccine purchases but also infrastructure efforts and supervision that can achieve and sustain national immunization goals. The immunization policy must be national in scope. Additionally, it must be flexible enough to respond to special circumstances that occur in urban and remote areas.
International Journal of Environmental Research and Public Health, May 5, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Cholera remains a significant public health problem among the vulnerable populations living in ma... more Cholera remains a significant public health problem among the vulnerable populations living in many resource-limited settings with poor access to safe and clean water and hygiene practice. Around 2.86 million cholera cases and 95,000 deaths are estimated to occur in endemic countries. In Ethiopia, cholera has been one of the major epidemic diseases since 1634 when the first cholera outbreak was recorded in-country. Several cholera epidemics occurred with recent outbreaks in 2019–2021. Cholera has been often reported as acute watery diarrhea due to limited diagnostic capacity in remote areas in Ethiopia and sensitivities around cholera outbreaks. The government of Ethiopia has been executing several phases of multi-year health sector development plan in the past decades and has recently developed a national cholera control plan. Here, we aim to present the existing cholera control guidelines and health system in Ethiopia, including case detection and reporting, outbreak declaration, ...
This paper proposed an effective model for improving global health nursing competence among under... more This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre-and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed.
To determine the efficacy of isoniazid 300 mg daily for 6 months in the prevention of tuberculosi... more To determine the efficacy of isoniazid 300 mg daily for 6 months in the prevention of tuberculosis in HIV-1-infected adults and to determine whether tuberculosis preventive therapy prolongs survival in HIV-1-infected adults. Design and setting: Randomized, double-blind, placebo-controlled trial in Nairobi, Kenya. Subjects: Six hundred and eighty-four HIV-1-infected adults. Main outcome measures: Development of tuberculosis and death. Results: Three hundred and forty-two subjects received isoniazid and 342 received placebo. The median CD4 lymphocyte counts at enrolment were 322 and 346 × 10 6 /l in the isoniazid and placebo groups, respectively. The overall median follow-up from enrolment was 1.83 years (range, 0-3.4 years). The incidence of tuberculosis in the isoniazid group was 4.29 per 100 person-years (PY) of observation [95% confidence interval (CI) 2.78-6.33] and 3.86 per 100 PY of observation (95% CI, 2.45-5.79) in the placebo group, giving an adjusted rate ratio for isoniazid versus placebo of 0.92 (95% CI, 0.49-1.71). The adjusted rate ratio for tuberculosis for isoniazid versus placebo for tuberculin skin test (TST)-positive subjects was 0.60 (95% CI, 0.23-1.60) and for the TST-negative subjects, 1.23 (95% CI, 0.55-2.76). The overall adjusted mortality rate ratio for isoniazid versus placebo was 1.18 (95% CI, 0.79-1.75). Stratifying by TST reactivity gave an adjusted mortality rate ratio in those who were TST-positive of 0.33 (95% CI, 0.09-1.23) and for TST-negative subjects, 1.39 (95% CI, 0.90-2.12). Conclusions: Overall there was no statistically significant protective effect of daily isoniazid for 6 months in the prevention of tuberculosis. In the TST-positive subjects, where reactivation is likely to be the more important pathogenetic mechanism, there was some protection and some reduction in mortality, although this was not statistically significant. The small number of individuals in this subgroup made the power to detect a statistically significant difference in this subgroup low. Other influences that may have diluted the efficacy of isoniazid include a high rate of transmission of new infection and rapid progression to disease or insufficient duration of isoniazid in subjects with relatively advanced immunosuppression. The rate of drug resistance observed in subjects who received isoniazid and subsequently developed tuberculosis was low.
It is necessary to increase global health and nursing competency for nursing major students to im... more It is necessary to increase global health and nursing competency for nursing major students to improve their understanding of people from various cultural backgrounds on a long-term basis. Living in the age of globalization makes professors teach their students to acquire more of these competencies. Further studies on global leadership ability are required and more well designed global nursing leadership programs for undergraduate students should be considered to increase global leadership ability. Moreover, community-partnership program with university should be considered to expose students for awareness of global health setting and to support them; they can live with them harmonized as a global citizen. Results
Transplantation is recognized as one of the greatest triumphs of modern medical science, but we a... more Transplantation is recognized as one of the greatest triumphs of modern medical science, but we are confronting the severe shortage of organs for transplantation. Xenotransplantation, the transplantation of nonhuman organs, tissues or cells into humans could be an alternative to fundamentally resolve this problem. Despite the potential benefit, xenotransplantation also gives us a potential risk, which are rejection and infection. The potential immunological rejection means the possibility of the human immune system to reject any foreign object. The rejection mechanism is very similar to that by which the body resists infection. The rejection of foreign object may endanger the life of the recipient. In xenotransplantation, immunosuppressive drugs can be clinically used to prevent the rejection of foreign object. However, these toxic drugs have side effects: the immune system loses its ability to successfully resist infections. The potential risk of infection means xenozoonosis that might result from xenotransplantation. For example, a pig virus, especially PERV might infect the human recipient, mutate and spread first to the close contacts of the recipient and then to the general population. This article primarily focuses on warning the risk of rejection and infection. This article also discusses clinicaltrials, informed consent and legal liability as legal aspects of xenotransplantation. Especially, an in-depth study is further required on legal implications and toxicology of xenotransplantation because the use of immunosuppressants for resolving immune rejection may bring lots of potential toxicologic problems. While clinical trials and informed consent are pretransplant prevention against the potential risk as preconditions for xenotransplantation, legal liability is posttransplant protection from it.
Introduction: Immunization is an effective preventive health intervention. In Cameroon, the Expan... more Introduction: Immunization is an effective preventive health intervention. In Cameroon, the Expanded Program on Immunization aims to vaccinate children under five years old for free, but vaccination coverage has consistently remained below the national target. Vaccines are distributed based on the target population size, factoring in wastage norms. However, vaccine wastage rates (VWR) may differ among various settings. Our study aimed to assess vaccine wastage for different site settings, seasonality, and vaccine types in comparison to vaccination coverage. As the government of Cameroon continuously seek to improve and vaccination coverage and vaccine wastage, an investigation into why vaccines are being wasted may provide solutions to minimize it occurrences.Methods: Retrospective data on immunization and vaccine wastage covering 2016 and 2017 in the Littoral Region, Cameroon, were collected. Health districts were classified as urban or rural, seasonality categorized as rainy or dr...
There are some new trends in judgments concerning medical malpractice. which include emphasis on ... more There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in ...
Purpose: This study aimed to analyze how a private high school in Seoul developed and executed a ... more Purpose: This study aimed to analyze how a private high school in Seoul developed and executed a “school disinfection strategy” to ensure the students' right to study in a safe environment, and also to analyze the lessons learned from this process. Methods: This was a case study of school health in a community-based school reopening during the COVID-19 pandemic. The study target was a 64-year-old private high school with 12 classes for each grade with a total of 1,100 students. Results: A “school disinfection strategy” was set up at individual and class environment levels to protect students from the risk of infection. In addition, school health activities were carried out with a “personal protection safety belt” and “community protection safety belt” for effective implementation. To ensure a safe educational environment for high school students and to ensure smooth execution of face-to-face classes (in-person teaching), the “prevention safety belt strategy” was introduced in ac...
Background: This study aimed to identify the factors affecting the successful operation of electr... more Background: This study aimed to identify the factors affecting the successful operation of electronic health records (EHRs) during the initial pilot implementation period from 2015 to 2017. The EHR system in Timor-Leste was first launched in 2015 after the VI Constitutional Government introduced the "Saúde na Familia" initiative. In January 2019, the system was discontinued after being disrupted by a political impasse between 2017 and 2018. The new Minister of Health reactivated the adoption of the EHR system as of August 2020. Methods: This study included a cross-sectional survey. The questionnaire covered benefits, barriers, and satisfaction categories along with sociodemographic variables. Results: Statistically significant differences between age groups were noted for the benefits, perceived barriers (such as the ability to use computers), and overall satisfaction of the EHR system. The slope of the benefit category (β = 0.497, t = 11.361) was a statistically significant predictor of satisfaction with EHR system implementation. However, the slope of the barrier category had a negative statistical significance for satisfaction (β = −0.086, t = −1.794). Satisfaction with the EHR system was influenced by its perceived benefit and reduced perceived barriers due to individuals' utilization of the information and communication technology system. Conclusion: Continuous political commitment to health policy, financial support, friendly end-user applications, improved quality of Internet service, and a positive attitude toward the system were crucial for its successful implementation.
Background: Immunization plays a vital role in the lives of children in the protection against in... more Background: Immunization plays a vital role in the lives of children in the protection against infectious diseases such as measles, polio, tuberculosis, hepatitis B, and diphtheria. Under the National Health Mission in the Lao People's Democratic Republic (Lao PDR), there are different programs and facilities for newborn and child health. However, despite these schemes and programs, the immunization coverage rate in the rural areas of Lao PDR is considerably low as compared to that in urban areas. We conducted a critical review of the various factors, schemes, and research currently being conducted on child immunization. Methods: A retrospective secondary data analysis was performed. Secondary data on childhood immunization coverage in 2018 was collected from the Directorate General of Health Prevention of the Ministry of Health, Lao PDR. Results: The coverage of immunization in the rural areas increased by only 1%, from 55% in 2018 to 56% in 2019, whereas that in urban areas increased significantly by 22%, from 71% in 2018 to 93% in 2019 because the Expanded Program Immunization Department in urban areas has improved its performance at health centers and ensures that vaccines are available with proper storage and maintenance of the cold chain. Conclusion: Although impressive gains have been made in reducing infant mortality and increasing immunization coverage in the Lao PDR, inequalities persist in rural areas. International organizations and governments of the Lao PDR each have important roles in supporting not only vaccine purchases but also infrastructure efforts and supervision that can achieve and sustain national immunization goals. The immunization policy must be national in scope. Additionally, it must be flexible enough to respond to special circumstances that occur in urban and remote areas.
International Journal of Environmental Research and Public Health, May 5, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Cholera remains a significant public health problem among the vulnerable populations living in ma... more Cholera remains a significant public health problem among the vulnerable populations living in many resource-limited settings with poor access to safe and clean water and hygiene practice. Around 2.86 million cholera cases and 95,000 deaths are estimated to occur in endemic countries. In Ethiopia, cholera has been one of the major epidemic diseases since 1634 when the first cholera outbreak was recorded in-country. Several cholera epidemics occurred with recent outbreaks in 2019–2021. Cholera has been often reported as acute watery diarrhea due to limited diagnostic capacity in remote areas in Ethiopia and sensitivities around cholera outbreaks. The government of Ethiopia has been executing several phases of multi-year health sector development plan in the past decades and has recently developed a national cholera control plan. Here, we aim to present the existing cholera control guidelines and health system in Ethiopia, including case detection and reporting, outbreak declaration, ...
This paper proposed an effective model for improving global health nursing competence among under... more This paper proposed an effective model for improving global health nursing competence among undergraduate students. A descriptive case study was conducted by evaluation of four implemented programs by the author. All programs were conducted with students majoring in nursing and healthcare, where the researcher was a program director, professor, or facilitator. These programs were analyzed in terms of students' needs assessment, program design, and implementation and evaluation factors. The concept and composition of global nursing competence, identified within previous studies, were deemed appropriate in all of our programs. Program composition varied from curricular to extracurricular domains. During the implementation phase, some of the programs included non-Korean students to improve cultural diversity and overcome language barriers. Qualitative and quantitative surveys were conducted to assess program efficacy. Data triangulation from students' reflective journals was examined. Additionally, students' awareness regarding changes within global health nursing, improved critical thinking, cultural understanding, and global leadership skills were investigated pre-and post-program implementation. The importance of identifying students' needs regarding global nursing competence when developing appropriate curricula is discussed.
To determine the efficacy of isoniazid 300 mg daily for 6 months in the prevention of tuberculosi... more To determine the efficacy of isoniazid 300 mg daily for 6 months in the prevention of tuberculosis in HIV-1-infected adults and to determine whether tuberculosis preventive therapy prolongs survival in HIV-1-infected adults. Design and setting: Randomized, double-blind, placebo-controlled trial in Nairobi, Kenya. Subjects: Six hundred and eighty-four HIV-1-infected adults. Main outcome measures: Development of tuberculosis and death. Results: Three hundred and forty-two subjects received isoniazid and 342 received placebo. The median CD4 lymphocyte counts at enrolment were 322 and 346 × 10 6 /l in the isoniazid and placebo groups, respectively. The overall median follow-up from enrolment was 1.83 years (range, 0-3.4 years). The incidence of tuberculosis in the isoniazid group was 4.29 per 100 person-years (PY) of observation [95% confidence interval (CI) 2.78-6.33] and 3.86 per 100 PY of observation (95% CI, 2.45-5.79) in the placebo group, giving an adjusted rate ratio for isoniazid versus placebo of 0.92 (95% CI, 0.49-1.71). The adjusted rate ratio for tuberculosis for isoniazid versus placebo for tuberculin skin test (TST)-positive subjects was 0.60 (95% CI, 0.23-1.60) and for the TST-negative subjects, 1.23 (95% CI, 0.55-2.76). The overall adjusted mortality rate ratio for isoniazid versus placebo was 1.18 (95% CI, 0.79-1.75). Stratifying by TST reactivity gave an adjusted mortality rate ratio in those who were TST-positive of 0.33 (95% CI, 0.09-1.23) and for TST-negative subjects, 1.39 (95% CI, 0.90-2.12). Conclusions: Overall there was no statistically significant protective effect of daily isoniazid for 6 months in the prevention of tuberculosis. In the TST-positive subjects, where reactivation is likely to be the more important pathogenetic mechanism, there was some protection and some reduction in mortality, although this was not statistically significant. The small number of individuals in this subgroup made the power to detect a statistically significant difference in this subgroup low. Other influences that may have diluted the efficacy of isoniazid include a high rate of transmission of new infection and rapid progression to disease or insufficient duration of isoniazid in subjects with relatively advanced immunosuppression. The rate of drug resistance observed in subjects who received isoniazid and subsequently developed tuberculosis was low.
It is necessary to increase global health and nursing competency for nursing major students to im... more It is necessary to increase global health and nursing competency for nursing major students to improve their understanding of people from various cultural backgrounds on a long-term basis. Living in the age of globalization makes professors teach their students to acquire more of these competencies. Further studies on global leadership ability are required and more well designed global nursing leadership programs for undergraduate students should be considered to increase global leadership ability. Moreover, community-partnership program with university should be considered to expose students for awareness of global health setting and to support them; they can live with them harmonized as a global citizen. Results
Transplantation is recognized as one of the greatest triumphs of modern medical science, but we a... more Transplantation is recognized as one of the greatest triumphs of modern medical science, but we are confronting the severe shortage of organs for transplantation. Xenotransplantation, the transplantation of nonhuman organs, tissues or cells into humans could be an alternative to fundamentally resolve this problem. Despite the potential benefit, xenotransplantation also gives us a potential risk, which are rejection and infection. The potential immunological rejection means the possibility of the human immune system to reject any foreign object. The rejection mechanism is very similar to that by which the body resists infection. The rejection of foreign object may endanger the life of the recipient. In xenotransplantation, immunosuppressive drugs can be clinically used to prevent the rejection of foreign object. However, these toxic drugs have side effects: the immune system loses its ability to successfully resist infections. The potential risk of infection means xenozoonosis that might result from xenotransplantation. For example, a pig virus, especially PERV might infect the human recipient, mutate and spread first to the close contacts of the recipient and then to the general population. This article primarily focuses on warning the risk of rejection and infection. This article also discusses clinicaltrials, informed consent and legal liability as legal aspects of xenotransplantation. Especially, an in-depth study is further required on legal implications and toxicology of xenotransplantation because the use of immunosuppressants for resolving immune rejection may bring lots of potential toxicologic problems. While clinical trials and informed consent are pretransplant prevention against the potential risk as preconditions for xenotransplantation, legal liability is posttransplant protection from it.
Introduction: Immunization is an effective preventive health intervention. In Cameroon, the Expan... more Introduction: Immunization is an effective preventive health intervention. In Cameroon, the Expanded Program on Immunization aims to vaccinate children under five years old for free, but vaccination coverage has consistently remained below the national target. Vaccines are distributed based on the target population size, factoring in wastage norms. However, vaccine wastage rates (VWR) may differ among various settings. Our study aimed to assess vaccine wastage for different site settings, seasonality, and vaccine types in comparison to vaccination coverage. As the government of Cameroon continuously seek to improve and vaccination coverage and vaccine wastage, an investigation into why vaccines are being wasted may provide solutions to minimize it occurrences.Methods: Retrospective data on immunization and vaccine wastage covering 2016 and 2017 in the Littoral Region, Cameroon, were collected. Health districts were classified as urban or rural, seasonality categorized as rainy or dr...
There are some new trends in judgments concerning medical malpractice. which include emphasis on ... more There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in ...
Purpose: This study aimed to analyze how a private high school in Seoul developed and executed a ... more Purpose: This study aimed to analyze how a private high school in Seoul developed and executed a “school disinfection strategy” to ensure the students' right to study in a safe environment, and also to analyze the lessons learned from this process. Methods: This was a case study of school health in a community-based school reopening during the COVID-19 pandemic. The study target was a 64-year-old private high school with 12 classes for each grade with a total of 1,100 students. Results: A “school disinfection strategy” was set up at individual and class environment levels to protect students from the risk of infection. In addition, school health activities were carried out with a “personal protection safety belt” and “community protection safety belt” for effective implementation. To ensure a safe educational environment for high school students and to ensure smooth execution of face-to-face classes (in-person teaching), the “prevention safety belt strategy” was introduced in ac...
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