• Title/Summary/Keyword: 환아 가족

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Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

Developmental Plans and Research on Private Security in Korea (한국 민간경비 실태 및 발전방안)

  • Kim, Tea-Hwan;Park, Ok-Cheol
    • Korean Security Journal
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    • no.9
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    • pp.69-98
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    • 2005
  • The security industry for civilians (Private Security), was first introduced to Korea via the US army's security system in the early 1960's. Shortly after then, official police laws were enforced in 1973, and private security finally started to develop with the passing of the 'service security industry' law in 1976. Korea's Private Security industry grew rapidly in the 1980's with the support of foreign funds and products, and now there are thought to be approximately 2000 private security enterprises currently running in Korea. However, nowadays the majority of these enterprises are experiencing difficulties such as lack of funds, insufficient management, and lack of control over employees, as a result, it seems difficult for some enterprises to avoid the low production output and bankruptcy. As a result of this these enterprises often settle these matters illegally, such as excessive dumping or avoiding problems by hiring inappropriate employees who don't have the right skills or qualifications for the jobs. The main problem with the establishment of this kind of security service is that it is so easy to make inroads into this private service market. All these hindering factors inhibit the market growth and impede qualitative development. Based on these main reasons, I researched this area, and will analyze and criticize the present condition of Korea's private security. I will present a possible development plan for the private security of Korea by referring to cases from the US and Japan. My method of researching was to investigate any related documentary records and articles and to interview people for necessary evidence. The theoretical study, involves investigation books and dissertations which are published from inside and outside of the country, and studying the complete collection of laws and regulations, internet data, various study reports, and the documentary records and the statistical data of many institutions such as the National Police Office, judicial training institute, and the enterprises of private security. Also, in addition, the contents of professionals who are in charge of practical affairs on the spot in order to overcomes the critical points of documentary records when investigating dissertation. I tried to get a firm grasp of the problems and difficulties which people in these work enterprises experience, this I thought would be most effective by interviewing the workers, for example: how they feel in the work places and what are the elements which inpede development? And I also interviewed policemen who are in charge of supervising the private escort enterprises, in an effort to figure out the problems and differences in opinion between domestic private security service and the police. From this investigation and research I will try to pin point the major problems of the private security and present a developmental plan. Firstly-Companies should unify the private police law and private security service law. Secondly-It is essential to introduce the 'specialty certificate' system for the quality improvement of private security service. Thirdly-must open up a new private security market by improving old system. Fourth-must build up the competitive power of the security service enterprises which is based on an efficient management. Fifth-needs special marketing strategy to hold customers Sixth-needs positive research based on theoretical studies. Seventh-needs the consistent and even training according to effective market demand. Eighth-Must maintain interrelationship with the police department. Ninth-must reinforce the system of Korean private security service association. Tenth-must establish private security laboratory. Based on these suggestions there should be improvement of private security service.

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The relationship between Gly71Arg and TATA box polymorphism of GT1A1 gene and prolonged hyperbilirubinemia of breast milk feeding infant in Korean (지속성 고빌리루빈혈증과 연관된 모유 황달에서 UGT1A1(Gly71Arg, TATA box) 다형성에 대한 연구)

  • Lee, Jae Myoung;Han, Young Ji;Kim, Ji Sook;Kim, Eun Ryoung
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.150-155
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    • 2008
  • Purpose : It has been known that breast milk cause prolonged unconjugated hyperbilirubinemia. UGT1A1 is a important gene of uridine diphosphate glucuronosyltransferase (UGT) which has a major role of bilirubin metabolism. These findings suggest that there is a relationship between UGT1A1 gene mutation and prolonged jaundice of breast feeding infant. The aim of study was to investigate whether a polymorphism of the UGT1A1 gene exist in prolonged hyperbilirubinemia of breast milk feeding Korean infant. Methods : The genomic DNA was isolated from 50 full term Korean neonates, who had greater than a 10 mg/dL of serem bilirubin after 2 weeks of birth with no significant cause, and the other genomic DNA was isolated from 162 full term Korean neonates of the control population. Both group fed breast milk. We performed direct sequencing of TATA box and Gly71Arg polymorphism of the UGT1A1 gene. Results : Two of the 50 neonates with hyperbilirubinemia had AA polymorphism, and 40 had GA polymorphism. Five of the 129 neonates of the control group had AA polymorphism, and 4 had GA polymorphism. The allele frequency of G>A polymorphism in the hyperbilirubinemia group was 44.0%; it was significantly higher than 5.4% of the control group. TATA box polymorpism was not different both group significantly. Conclusion : Our result indicated that Gly71Arg polymorphism is associated with the prolonged hyperbilirubinemia of breast milk-feeding infant in Korean, while TATA box polymorphism is not associated with the prolonged hyperbilirubinemia of breast milk-feeding infant in Korean.

Clinacal investigation of child sexual abuse (소아 성폭력에 관한 임상적 고찰)

  • Lee, Hyun Joo;Han, Hye Jung;Kim, Ji Hee;Lee, Hye Sun;Lee, In Sil
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.20-27
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    • 2007
  • Purpose : Child sexual abuse is a significant and serious problem that affects public health and society. Pediatricians are responsible for preventing and detecting sexual abuse of children. The aim of this study was to examine clinical findings of child sexual abuse. Methods : The authors retrospectively studied 292 patients between the ages of 0 and 18 who were referred for evaluation of sexual abuse to the Emergency Department of the National Police Hospital from Oct 1, 2001 to May 5, 2005. Results : Sixty three (21.6 percent) of sexual abuse victims were younger than 6 years of age; 89 (30.5 percent) were 6-12 years of age; and 104 (47.9 percent) were 12-18 years of age. Attack time was the most common between noon and 6 pm. Victims were attacked in their home or nearby (51.4 percent). One hundred fifty six (53.6 percent) offenders were accquaitances, thirty nine (13.4 percent) of whom were family members. The disclosure of attack by parents with abnormal physical symptoms was more common in younger children than in adolescence. Eighty nine (30.5 percent) victims had no specific physical findings, 51 percent had injury to the hymen, 37.3% had injury to external genitalia, and 4 percent had anal injury. One case of gonorrhea and thirteen cases of chlamydia were found. Sperm was found in 19 cases and acid phosphatase was positive in 28 cases. The absence of physical findings and laboratory findings was more common in younger children than in those in adolescence. The time interval from attacks to hospital visits had a significant negative correlation with age. Conclusion : For younger victims, the time interval from attack to hospital visitis was more prolonged. Victims may have no physical evidence of sexual abuse. Therefore, a careful history should be obtained and a through physical examination should be performed. Pediatricians must play a leading role in evaluation and treatment of sexually abused children, considering children,s growth and development. Coordination with other professionals is necessary to provide consultation, medical treatment, and legal assistance for the sexually abused children and families.

The Demand for Home Nursing Care of Hospital Inpatients in Brain-Spine and Musculoskeletal Diseases (종합병원의 뇌.척수.근골격계 입원환자의 가정간호요구)

  • Kim, Sang-Soon;Kim, Gui-Jae
    • Journal of Home Health Care Nursing
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    • v.1
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    • pp.57-70
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    • 1993
  • This study was carried out to investigate agreement, content and demand for home nursing care of hospital inpatients in brain, spain and musculoskeletal diseases .The data was collected by interviewing with 242 patients who were hospitalized in university hospital on Taegu, from September 6,60 October 9, 1993. Of 242 patients, 66.1% agreed to home nusing care system and rate of agreement was highest between 30 years to 49 years of age as 75.5%, in middle urban area residents as 75.9% and was lowest in medicaid as 40.0% in general chareacteristics. The rate of agreement according to type of diagnosis was highest inpatients with spinal diseases as 75.6% according to functional status was the highest in patients who had daily living activity freely as 69.4% according to prognosis in patients at terminal stage as 80.0% and the rate of agreement to home nursing care of patients who wanted early discharege was 73.9%. The first-ranking reasom of agreement to home nursing care was asking for continuous relationship with doctor as 37.3% and there was statistically significant difference in reasons of agreement to home nursing care according to functional status of patients. The first-ranking reason of eary discharge among patients who wanted early discharge(74.8%) was because of long time stay in hospital. Among 23 items of nursing activity that patient wanted, the first-ranking item was recovery promotion, prevention of complication, education and counseling for health as 76.4%, drug management was 2nd-ranking item as 62.1% and the third was regular checking of vital signs as 55.9%. The lowest item of demand for home unring care was hospice care(3.9%) and airway keep(9.1%).

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The Comparative Study of Dietary Habits according to the Alcohol Drinking among University Students (음주 여부에 따른 남녀 대학생의 식습관 비교 연구)

  • Kang, Ji-Eun;Choi, Han-Seok;Choi, Ji-Ho;Jung, Seok-Tae;Yeo, Su-Hwan;Kim, Mi-Hyang
    • Journal of the East Asian Society of Dietary Life
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    • v.23 no.6
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    • pp.681-689
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    • 2013
  • The purpose of this study was to investigate the effect of alcoholic drinking on the dietary habits among university students. The data was collected from 355 students (male : 188, female : 167) living in Busan. The questionnaire composed of general information, person with the lunch meal time, skipping meal, meal type place overeating, snacking eating out, food intake pattern. For statistics analysis, SPSSWIN 12.0 was used. The results were summarized as follows. First, the rates of alcohol drinking in male and female students were 94.1% and 93.4% respectively and the rate of under 19 years old's drinking were 94.4%. Second, in the appearance of drinking, the difference in dietary habits wasn't shown to be significant. However in term of dinner, few female students sometimes haven't dinner (p<0.01). And female group showed frequently eating out (p<0.05) and overeating more than male group(p<0.001). Third, the alcohol drinking group and non-alcohol drinking group showed significantly similar consumption frequency of cereal, meat products, fruits vegetable, oil sugars. But the intakes of milk and dairy products in male students were significantly higher than in female students (p<0.001). These results indicated that more attention should be taken to university students, having habits of skipping meal, alcohol drinking and low intake for nutrition knowledge or attitude so as to improve their health.

A Follow-up Survey of Mothers' Antenatal Breast-feeding Plans (임신시 모유 수유 계획의 실천에 대한 추적 관찰)

  • Kim, Hae Soon;Seo, Jeong Wan;Kim, Yong Joo;Lee, Kee Hyoung;Kim, Jae Young;Ko, Jae Sung;Bae, Sun Hwan;Park, Hye Sook
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.635-641
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    • 2003
  • Purpose : To investigate the success rate and factors that influence breast-feeding among women having antenatal breast-feeding plans. Methods : Questionnaires included items on success in breast-feeding, reasons for failure and perinatal factors. It was done by telephone calls to 152 randomly selected women having antenatal breast-feeding plans at 4 months after delivery. The questionnaires were analysed by bivariate ${\chi}^2$-analysis. Results : The breast-feeding rate for the first four months among women having antenatal breast-feeding plans was 37.5%. The major reason for breast-feeding failure was insufficient amount of breast milk(66.3%). The breast-feeding rate was 2.3(95% CI 1.15-4.62) times higher in women having antenatal breast-feeding plans for longer than 4 months(P<0.05), but maternal age, breast-feeding for previous baby, person advocating breast-feeding, and family size were not significant factors of success in breast-feeding. The breast-feeding rate of graduates of college was 0.43(95% CI 0.21-0.86) times lower than that of graduates of high school. The breast-feeding rate of employed mothers was 0.37(95% CI 0.17-0.83) times lower than that of housewives(P<0.05). Maternal disease, smoking, alcohol drinking, and understanding and knowledge about breast-feeding were not significant determinant factors of success in breast-feeding. Breast-feeding rate of infant born at local obstetric clinics was 3.97(95% CI 11-14.23) times higher than that of infant at general hospital(P<0.05). Conclusion : To increase the breast-feeding, medical personnel should educate mothers on problems during breast-feeding. Hospital polices that facilitate breast-feeding such as rooming-in must be promoted. For employed mothers, strategies for breast-feeding within companies must be encouraged.

Assessment of modifiable lifestyle factors for obese children and adolescents through questionnaires (소아청소년 비만상담에서 설문지를 이용한 중재 가능한 행동요인 탐색)

  • Seo, Jeong Wan;Jung, Ji A;Park, Hye Sook;Ko, Jae Sung;Kim, Yong Joo;Kim, Jae Young;Ryoo, Eell;Bae, Sun Hwan;Sim, Jae Geon;Yang, Hye Ran;Choe, Byung Ho;Cho, Ky Young
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.576-583
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    • 2008
  • Purpose : The identification of specific behaviors conducive to overeating or inactivity is the cornerstone of obesity management. The Committee on Nutrition of the Korean Pediatric Society developed parent and self-reporting questionnaires about eating behavior and physical activity in 2006. The aim of this study was to evaluate the usefulness of the questionnaires in assessing modifiable lifestyle factors related to obesity. Methods : A retrospective chart review was performed for 177 children (6-11 years old) and 134 adolescents (12-16 years old) from 10 hospitals between May 2006 and January 2007 who had completed parent or self-reporting questionnaires. Cases were divided into normal and overweight groups at or above the age-gender-specific 85th percentile based on 2007 Korean national growth charts. Results : Compared to children, the adolescents tended to have a significantly more sedentary lifestvle and inappropriate dietary behaviors significantly (P<.05). Overweight mothers were significantly associated with overweight children and adolescents (P<.05). Being overweight was significantly associated with a family history of adult diseases for children and adolescents (P<.05). Inappropriate eating behaviors (strong appetite, eating fast, eating until they were full, binge eating, favoring greasy foods) were associated with being overweight in children and adolescents. Sedentary activity such as TV viewing and using a computer were significantly associated with overweight in children and adolescents (P<.05). Conclusion : Intervention to modify obesity-related lifestyle factors is needed before adolescence. These questionnaires are useful in identifying modifiable lifestyle factors and in individual counseling for overweight children and adolescents in pediatric clinics.

Long-term Clinical Outcomes after Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction-on the basis of 65 Years (급성 심근경색증 환자에서 일차적 관상동맥 중재술 후 장기적 임상 경과-65세를 기준으로)

  • Lee, Han-Ol;Jang, Seong-Joo;Kim, In-Soo;Han, Jae-Bok;Park, Soo-Hwan;Kim, Jeong-Hun;Jang, Young-Ill
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.251-261
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    • 2014
  • Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term outcome, compared with thrombolytic therapy in patients with acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients.1,974 patients (Group I: n=1,018, $age{\geq}65years$, $73.8{\pm}5.99years$; Group II: n=956, age<65years, $52.8{\pm}7.96years$) who underwent primary PCI for AMI at Chonnam National University Hospital between 2006 and 2010 were analyzed according to their clinical, angiographic characteristics for hospital and one-year survival. Group I had a higher percentage of women, diabetes mellitus, hypertension, multi-vessel disease and lower prevalence of current smoking, hyperlipidemia, familial history than Group II. Culprit lesions were at the left anterior descending artery, left circumflex artery, right coronary artery and left main artery in 42.8% vs. 45.0%, 34.1% vs. 29.6%, 14.6% vs 14.6, 2.7% vs. 1.6%, respectively (p=0.007). Stent diameter was smaller in group I ($3.17{\pm}0.39$ vs. $3.29{\pm}0.42mm$, p=0.001). In-hospital mortality was higher in group I (8.4 vs. 1.9%, p<0.001). There were significant differences in the rates of major adverse cardiac events between the two groups during one-year clinical follow-up (20.1 vs.14.0%, p<0.001). On multiple logistic regression analysis, systolic blood pressure<100mmHg, serum $creatinine{\geq}1.3mg/dL$, Killip class> I, multivessel disease, left ventricular ejection fraction <40% and cerebro vascular disease were independent predictors of one-year motality in patients over 65 years after PCI.

Patient Distribution and Hospital Admission Costs in Neonatal Intensive Care Units: Collective Study of 7 Hospitals in Korea during 2006 (2006년도 전국 7개 병원 신생아중환자실 입원 현황 및 입원비용 분석)

  • Bae, Chong-Woo;Kim, Ki-Soo;Kim, Byeong-Il;Shin, Son-Moon;Lee, Sang-Lak;Lim, Baek-Keun;Choi, Young-Youn
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.25-35
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    • 2009
  • Purpose: The characteristics of hospitalized patients in neonatal intensive care units (NICUs), including hospitalization costs (HC) and National Health Insurance (NHI) status were studied. Methods: We gathered the following data from 7 hospitals in Korea during 2006: the distribution of patients according to birth weight (BW), and the duration of the hospital stay according to BW and He. Results: The patients who were admitted to the NICU consisted of high-risk neonates, including low birth weight or premature neonates, which comprised 50% of all neonates admitted to the NICU. The duration of hospitalization was 75-90 days for neonates with BW <1,000 g, 45-60 days for neonates with BW between 1,000 and 1,499 g, and approximately 15 days for neonates with BW between 2,000 and 2,499 g. The portion of the HC covered by the NHI was 77.1%, 22.9% of the total HC was not covered by the NHI (19.5% was included in the list, but not covered by the NHI and 3.4% was not listed, but covered by the NHI). The average total HC per person was 4,360,000 won, and the HC covered and not covered by the NHI were 3,677,000 won and 1,007,000 won, respectively. The mean HC were as follows; 35,000,000 won for a BW <500 g, 18,000,000 won for a BW between 500 and 999 g, 16,000,000 won for a BW between 1,000 and 1,499 g, and 4,200,000 won for a BW between 1,500 and 1,999 g. Conclusion: Not only premature, but also ill neonates were under the care of the NICU. The HC increased as the BW decreased and the hospitalization period increased. The proportion of the patient's financial burden is >25% of the total He. For this matter, additional NHI is needed.