Vaccines require higher safety standards than most other medicinal products because they are given to healthy individuals, including infants, children, and elderly. Despite various activities by national agencies, public concern about vaccine safety often arises. Post-marketing activities for vaccine safety can be broadly classified into passive and active surveillances. Many countries as well as Korea operate passive vaccine safety surveillance systems that report adverse events related to vaccines. However, the active surveillance systems operate only in several countries, such as the United States of America (USA), Europe, Canada and Australia. In the US, Vaccine Safety Datalink (VSD) and Post-Licensure Rapid Immunization Safety Monitoring (PRISM) were developed in 1990 and 2009 respectively for monitoring vaccine actively. In the case of Europe, the Vaccine Adverse Event Surveillance and Communication (VAESCO) consortium was launched in 2008. After the end of VAESCO, the Accelerated Development of VAccine beNefit-risk Collaboration in Europe (ADVANCE) was organized to establish a vaccine benefit-risk monitoring framework in 2013. Canada has been operating a vaccine active monitoring system known as the Canadian Immunization Monitoring Program, ACTive (IMPACT) since 1991. The objective of this review was to describe and compare background, databases, and analysis systems of various vaccine active surveillance systems in the US, Europe, and Canada. We described the examples of studies on the safety of influenza A (H1N1) vaccines carried out in each system. This review could help provide directions for the future development of the ideal active vaccine safety surveillance system in Korea.

Objectives: The purpose of this study is to provide availability of laboratory results in differential diagnosis of iron deficiency anemia (IDA) and anemia of chronic disease (ACD). Methods: This study was based on a systematic review of related to iron metabolism, IDA and ACD. We searched the published articles from 1992 to 2019 in Earticle, KISS, NDSL, RISS, DBpia and PubMed. Results: IDA accounts for more than 50% of all anemia patients, followed by ACD. Differential diagnosis is needed between IDA and ACD, which usually shows microcytic, hypochromic anemia. The standard for differential diagnosis is the bone marrow iron stain. However, bone marrow study is invasive, expensive so that it cannot be routinely performed. Consequently, the measurement of serum ferritin is the first level test for differential diagnosis. Serum ferritin level is good indicators of storage iron; decreased levels in IDA and normal to increased levels in ACD. However, serum ferritin level may increase irrespective of iron stores in cases of chronic disease. Therefore, it is difficult to diagnose IDA coexisting with ACD. Another available biomarker is soluble transferrin receptor (sTfR). The sTfR level is not affected by chronic disease; it is elevated in IDA but not in ACD. Additionally, the sTfR/log ferritin index is suggested as a good biomarker for identifying coexisting IDA and CAD. Conclusions: This review introduces the etiology and differential diagnosis of IDA and ACD based on an understanding of iron metabolism. Understanding the interrelationship of the various laboratory results may be helpful in the accurate diagnosis and treatment of IDA and ACD.

Objectives: Professional identity, which is a subjective evaluation of self-determination, has been studied as an important factor in determining job satisfaction. Organizational commitment can be expected to play an important role in the relationship between professional identity and job satisfaction. The study was aimed to examine mediating effect of organizational commitment of physician assistants in the relationship between professional identity and job satisfaction. Methods: The participants of this study were 124 nurses who agreed to participate in the study among physician assistants working at two university hospitals located in B metropolitan city and Y city. The measurement tools included a questionnaire on professional identity, organizational commitment, and job satisfaction. Descriptive statistics, t-test, ANOVA, Kruskal-Wallis test, partial correlation coefficients, and multiple regression were used to analyze results. Results: The mean score of professional identity was 3.36±0.42, organizational commitment was 3.28±0.54, and job satisfaction was 3.12±0.38. There were significant positive partial correlations between professional identity and organizational commitment (r=0.56, p<0.001), professional identity and job satisfaction (r=0.65, p<0.001), and organizational commitment and job satisfaction (r=0.61, p<0.001). Organizational commitment was a mediator between professional identity and job satisfaction. Conclusions: Based on this study, organizational commitment promotion strategies to improve job satisfaction are needed. These results will contribute to development of education program of a physician assistant and promotion of quality of medical services.

Objectives: This study examined to identify the factors influencing on patients' satisfaction with treatment outcome and willingness to recommend hospital to others. Methods: Data from the 2017 National Patient Experience Survey were used for the analysis. Logistic regression analysis was conducted to explore the factors such as sociodemographic, health related factors and perceived quality of healthcare services which patience had experienced. The influence of patients' satisfaction on willingness to recommend hospital was analyzed using logistic analysis. Results: Of the 7,488 patients experiencing outpatient services, 6,676 (89.2%) and 6,383 (85.2%) respondents showed satisfied with treatment outcome and willingness to recommend hospital, respectively. Those who experienced involvement in care decision, ample opportunities to questions, enough time to talk and being treated with respect by physician were more likely to satisfy with treatment outcome. Even after controlling for their socio-demographic and health related factors, outpatients with better quality of healthcare services were more likely to show higher satisfaction and willingness to recommend hospital. Conclusions: The result revealed that experiences of positive physician-patient relationship and better hospital facility and effective administrative service affected the patients' satisfaction with treatment outcome and willingness to recommend hospital. To improve patients' satisfaction of health care uses, it is necessary to improve non-medical service as well as patient-health care provider interaction from the patients' perspectives.

Objectives: The purpose of this study was to identify the relationship of self-efficacy, organizational commitment, organizational citizenship behavior, and satisfaction of clinical practice and investigate the influencing factors on satisfaction of clinical practice in nursing college students. Methods: Participants were in 3rd and 4th grade of nursing students with clinical experiences. Data were gathered from December 3, 2018 to December 7, 2018. Data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe test, Person's correlation coefficients, multipel regression using SPSS 22.0 program. Results: The significant influencing factors of satisfaction of clinical practice were religion β=0.14 (p=0.008), major satisfaction β=0.12 (p=0.035), organizational commitment β=0.38 (p<0.001) and organizational citizenship behavior β=0.29 (p<0.001). These factors explained 43% of the variance (R2=0.43, p< 0.001). Conclusions: This study showed that organizational commitment and organizational citizenship behavior were influencing factors on satisfaction of clinical practice and it is necessary to develop various strategies to improve organizational commitment and organizational citizenship behavior in nursing college students.

Objectives: The purpose of this study is to analyze whether emotional labor experienced by nurses in their work affects turnover intention through job engagement. Methods: Data were collected by a self-entry method using structured questionnaire for 243 nurses who worked at hospitals in Busan. Structural equation and moderating regression model were applied for the analysis. Results: Firstly, in emotional labor, which is an independent variable, emotional disharmony had a negative (-) effect on job engagement and a positive (+) influence on turnover intention. Secondly, it was found that job engagement, which is a mediating variable, had a negative (-) influence on turnover intention. Third, job engagement had partially mediating effect on causal relation between emotional disharmony (which is a subordinate variable of emotional labor) and turnover intention. Conclusions: Based on the results of this study, it is suggested that preparation of a scheme to raise job enthusiasm and lower intention to change jobs is required by recognizing emotional disharmony experienced by nurses and paying continuous attention to their work environment.

Objectives: The purpose of this study was to examine the degree of satisfaction of ordinary residents with each healthcare project and determine the extent of satisfaction of local residents by level of awareness towards each healthcare project so as to increase satisfaction of local residents with healthcare projects ultimately. Methods: The subjects of this study were 212 ordinary residents in Chungcheongbuk-do. For the analyses of simple data, the SPSS 25.0 statistics package was used to analyze the data from June 03 to 24, 2019. To determine the difference in demographic characteristics, frequency analysis, independent sample t-test and ANOVA were used. Results: First, a significant difference was observed in the satisfaction with healthcare projects by, education level, and occupation. By education level, the satisfaction increased as the education level was lower. Second, overall average score of awareness by item of health improvement projects was 3.0 points or lower. Third, overall average score of awareness by item of health management projects was 3.0 points or lower. Fourth, overall average score of awareness by item of projects for pregnant women, infants and toddlers and infectious disease prevention projects was 3.0 points or lower. Fifth, overall average score of awareness by item of medical cost support and vaccination projects was 3.0 points or lower. Conclusions: Based on overall consideration of the results, the awareness towards healthcare projects was found to be very low. Those results were considered attributable to the lack of promotion of healthcare projects led by public health centers.

Objectives: The purpose of this study was to determine association between participation degree and any changes in health behaviors in the Gyeongsangbuk-do Health Saemaeul Program, a community-based health promotion project. Methods: The study used surveys of the Gyeongsangbuk-do Health Saemaeul Program, in 2016, 2018 and data from KOSIS. Results: The multi-level linear regression analysis was completed with a total health behavior improvement score based on the six types of health behavior changes. People with temporal participation showed a higher total health behavior improvement score than the non-participants. Females showed a higher total health behavior improvement score than males and people with any chronic diseases showed a higher total health behavior improvement score than those without. None of the community-related variables showed any statistical significances. The results of the stratified analysis according to individual and community-related variables revealed that a group with the following community-related characteristics were more likely to have a higher total health behavior improvement score according to the participation degree; (1) a higher proportion of vulnerable subjects, (2) a higher financial self-reliance, and (3) a higher participation degree with willingness. No statistical significance was revealed with the individual characteristics. Conclusions: In order to enhance health status of its residents in a community-level, designing an integrated health promotion program in considering the community characteristics would be more effective. In order to improve the quality of the Gyeongsangbuk-do Saemaeul Health Program and to expand its effects, an establishment of strategic plans is required at the level of selecting the target community.

Objectives: The purpose of this study was to investigate the factor contributing to loneliness of children in lower income class and to examine the relationship of the variables. Methods: The participants were 178 children in lower income class. Data were collected from April to May, 2018 by taking a self reported survey and analyzed using descriptive statistics of a mean±SD, Pearson's correlation coefficient, and hierarchical regression analysis with SPSS 25.0 program. Results: The mean score of loneliness was 37.02±8.05 out of a 3 point scale, slightly lower the half. There were negative correlations between loneliness and allowance per month, double income couple, perceived atmosphere, and both parents' supervision and positive correlation between loneliness and both parents' abuse and neglect. Variables such as allowance, double income, mother's supervision and abuse explained 36.8% of children's loneliness. Conclusions: There is a need to develop parental educational programs to evaluate the parenting attitude for decreasing the level of children's loneliness.

Objectives: The purpose of this study was to examine effects of individual career plan program (ICPP) on career decision-making self-efficacy, career decision level and career resilience in nursing students. Methods: A quasi-experimental study with non-equivalent control group posttest only design was used. Students were allocated to the experimental group (n=169) and control group (n=68). The experimental group required to fulfil course credit of ICPP template above sixty scores in the academic year 2013-2016. Collected data were analyzed using Chi-squire test and independent t-test. Results: Total mean scores of career decision-making self-efficacy, career decision level and career resilience for experimental group were significantly higher than control group. Conclusions: The ICPP is effective in empowering nursing students' career decision-making self-efficacy, career decision level and career resilience. The findings suggest a need to explore the prolonged effect of ICPP after entering professional nursing career.