• Journal of mucopolysaccharidosis and rare diseases
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• 제4권1호
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• pp.7-10
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• 2018

Rare diseases are life threatening or chronically debilitating diseases with a low prevalence (less than 2,000 people in a population), which includes lysosomal storage diseases. These diseases are often seen as unimportant especially in developing countries, such as Indonesia, due to small number of patients. National Rare Disease Center in Indonesia was pioneered almost 20 years ago and officially established in 2017 by the Indonesian Minister of Health. Lysosomal storage disease become the most commonly found inborn errors of metabolism (IEM) in Indonesia due to easily accessible diagnostic facilities. Currently there are 7 patients receiving ERT in this mixed-donation scheme, one patient with Gaucher disease and 6 patients with MPS type II. Few challenges for ERT in Indonesia include importation through special access scheme, preparation of ERT infusion in intensive care settting, and cost of treatment. Even with limited resources, healthcare professionals in Indonesia have been giving the best care possible for rare disease patients, especially to provide diagnostic facilities through collaboration and treatment options for treatable rare diseases. Improvements in care for rare disease patients are still needed.

• 농촌의학ㆍ지역보건
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• 제28권1호
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• pp.39-51
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• 2003

본 연구는 2002년 5월부터 9월까지 5개월간 경상남도 일개 군 보건소 한방진료실에 내소한 재진 환자를 대상으로 한방진료실 직원이 직접 설문지를 통한 일대일 면접 조사를 실시하였고, 면접 조사를 꺼리는 대상자에 대해서는 자기기입식 방법으로 자료를 수집하여 한방의료 이용 실태와 주민들의 이해도와 만족도를 파악하고 한방진료실을 한방의료서비스 부족지역으로 확대 설치하는 것에 대한 의견을 수렴하는데 그 목적을 두었다. 총 조사 대상자는 163명이었으며 본 연구의 결과를 요약하면 다음과 같다. 첫째, 보건소 한방진료실을 이용하는 주된 대상은 61세 이상이 전체의 65.0%로 과반수 이상을 차지하고 있으며 대상자의 13.5%만이 자신의 건강상태가 좋다고 인지하고 있었다. 둘째, 보건소 한방진료실의 치료법에 대한 사전인식 분석 결과 보건소 한방진료실에서 시행하는 치료법에 대해 올바르게 인식하는 비율은 54.0%로 나타났으며, 특히 침 시술의 경우에는 조사 대상자 모두가 보건소 한방진료실에서 시술한다는 것으로 인식하고 있었다. 셋째, 보건소 한방진료실 이용행태에 관한 분석 결과로는 한의학적인 치료를 받고 싶어서 한방진료실을 찾은 경우가 66.9%로 가장 많았으며 집에서 보건소까지의 소요시간이 1시간에서 2시간 사이까지 많은 시간이 걸린다고 응답한 사람도 9.2%나 되었다. 넷째, 보건소 한방진료실 이용자의 한방보건의료에 대한 요구도를 조사한 결과 이동진료, 금연프로그램, 거동불능자 방문 프로그램 순으로 한방지역보건사업에 대한 요구률이 높았으며 다른 면지역으로의 한방진료실 확대 설치에 대한 요구도 조사에서는 조사 대상자의 73.7%가 한방진료실 확대 설치가 필요하다고 응답하였다. 다섯째, 한방진료실 확대설치 요구도는 학력이 높은 집단, 집과 보건소와의 거리가 멀다고 생각하는 대상자, 치료비에 대한 만족도가 높은 집단에서 높은 것으로 나타났다. 이상의 결과를 볼 때 농촌지역의 한방진료서비스에 대한 이용도가 높은 것으로 나타났으며 도시지역에 비하여 한방의료자원의 분포가 낙후되어 있는 농촌지역 실정으로 보건소에 한방진료실을 설치하여 시행한 한방진료서비스에 대한 이용자들의 만족도 또한 매우 높다는 것을 파악할 수 있었다. 이러한 주민들의 높은 한방진료서비스에 대한 요구에 부응하기 위해 한방지역보건사업을 합리적으로 실시하고 한방진료실이 설치되어 있지 않은 면지역 보건지소로의 적극적인 확대설치가 적극 검토되어야 할 것이다.

• Pediatric Infection and Vaccine
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• 제5권1호
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• pp.143-146
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• 1998

Syphilis is a systemic communicable disease caused by the motile spirochete, Treponema pallidum, which is only a natural pathogen for human. The distribution and trends of syphilis are influenced by biologic factors, sexual behaviors, biomedical technology, availability of and access to health care, public health efforts, changes in population dynamics, and sociocultural factors. Although sexual contact is the main route of transmission, Treponema pallidum may also be infected through direct contact with syphilitic lesions, blood transfusion, ingestion of menstrual blood or vaginal secretions, or transplacental transmissions. In extremely unusual circumstances, infection by means of contact with a skin lesion and human bite have been reported. We experienced a case of syphilis which is thought to be infected by the abnormal imposition of hands on a child, which caused unnecessary erosive trauma with fingernails.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2014년도 춘계학술대회
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• pp.884-885
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• 2014

The use of Radio Frequency Identification technology (RFID) in medical context enables not only drug identification, but also a rapid and precise identification of patients, physicians, nurses or any other health care related staffs. The combination of RFID tag identification with structured and secured Internet of Things (IoT) solutions enables ubiquitous and easy access to medical related records, while providing control and security to all interactions. This paper surveyed a basic security architecture, easily deployable on mobile platforms, which would allow to establish and manage a medication prescription service in mobility context making use of electronic personal health records.

• 보건교육건강증진학회지
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• 제27권5호
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• pp.51-61
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• 2010

목적: 본 연구는 요양보호사 교육 수료생들을 대상으로 요양보호사의 업무 인지와 요양보호서비스 대상자 인지 정도를 예측변인들을 통해 검증함으로써 요양보호사가 인지하는 직업의 전문성 정도를 파악하는 것을 연구목적으로 한다. 방법: 응답자가 직접 기입하는 '자기기입식질문지법'을 이용하였고 불성실 응답 및 다문항 미기재 설문지를 제외한 총 2백83부를 분석에 사용하였다. 관련요소들의 기술적 통계를 통해 요양보호사 업무에 대한 인지 정도 및 서비스 대상자의 특성에 대한 인지 정도를 살펴보았다. 그리고 위 두 변수와 관련 요소들간의 상관관계를 알아보고, 어떠한 요소가 요양보호사 업무에 대한 인지 정도 및 서비스 대상자의 특성에 영향력을 갖는지 알아보기 위하여 다단계회귀분석을 실시하였다. 결과: 요양보호사 업무 인지에 관한 단계적 회귀분석에서 요양보호사는 전문직업이다(${\beta}$=.300)와 업무 특성에 관한 지식을 갖고 있다(${\beta}$=.254)가 유의미하게 나타났다. 또한 요양보호서비스 대상자 특성에 관한 단계적 회귀분석 결과로 가족들의 지지(${\beta}$=.187)와 요양보호사 업무인지 정도(${\beta}$=.509)가 유의미한 변인으로 밝혀졌다. 결론: 이상의 결과를 통해 본 연구에서 제기한 요양보호사 업무에 대한 인지정도 및 서비스 대상자 특성에 영향력을 갖는지에 대한 연구결과를 제시하였다.

• 대한예방한의학회지
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• 제18권3호
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• pp.11-21
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• 2014

The rapid development and distribution of information communication industry facilitates the changes of hospital administration, introducing EMR(Electronic Medical Record) instead of paper-based medical record in the medical field. The developed countries such as U.S. have established EMR system after in the middle of 1970s because the primary advantages of EMR is to store and handle vast amounts of records efficiently and increase the quality of health care. Most of health organizations in Korea also apply medical record system to their administration. As the result, they have accomplished a scientific administration system through the use of medical record to handle a variety of patient's information including patient's confidentiality and privacy such as family history, social status, income level, and so on. However, access to and the misuse of EMR causes illegal infringement of patient's information and finally it becomes a very serious medical issue. Potential leakage and misuse of records may seriously infringe patient's privacy rights. In this respect, the related agencies in the public and private sector have been making efforts to prevent patient's records leakages. Especially, the revision bill of Medical Law in 2002 establishes the ways on the security and standards of electronic records. However, it does not provide the proper guidelines which is applied to the rapid changes of the medical environment. One of the most priorities in the hospital administration is the production and maintenance of an accurate medical records fulfilled by medical recorders. Therefore, it is very important for health care providers to hire ethical-based medical recorders. But, unfortunately most of hospitals overlook the importance of their roles. All parts including government, physician and patient must have more concerns on the problems related to EMR. Therefore, this study aims to propose the proper ways to resolve the problems coming from EMR.

• Perspectives in Nursing Science
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• 제4권1호
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• pp.19-25
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• 2007

Systems and processes to provide clinical education to students of nursing have been established between universities and health facilities in all countries where nurse education is tertiary based. However, systems and processes to link nurse researchers based in universities to their clinical colleagues are less well developed. When collaborations are established they are frequently based on personal networks, and while the rhetoric of the organizations encourages these collaborations, they are largely unrecognised by senior administrators in health facilities. The research is frequently "invisible" and the clinician researchers usually do not have access to appropriate infrastructure and other resources that are required to support large projects that have the potential to change practice across organisations. This situation influences the focus and scope of nursing research and limits opportunities for clinicians to be engaged in the generation of professional knowledge. The University of Western Sydney (UWS) has taken a strategic approach to the development of collaborations for research and has linked with health services in Western Sydney to establish and maintain research centres and adjunct appointments. The partner organisations jointly fund the infrastructure of the centres which include a Professor, research assistant position(s) and administrative staff. Five Professors of Nursing have been appointed to positions in one of three nursing research centres. This paper describes the approach established by the School of Nursing at UWS to build collaborations with clinical areas to promote research. This approach could be adopted or adapted by other facilities.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4289-4294
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• 2012

While the incidence of breast cancer (BC) has been relatively low in Asian countries, it has been rising rapidly in Taiwan. Within the last decade, it has replaced cervical cancer as the most diagnosed cancer site for women. Nevertheless, there is a paucity of studies reporting the attitudes and practices of breast cancer screening among Chinese women. The aim of this study is to assess Taiwanese women's knowledge of and attitudes toward BC screening and to identify potential factors that may influence screening behavior. The study population consisted of a sample of 434 Taiwanese women aged 40 and older. Despite access to universal health care for Taiwanese women and the fact that a majority of the women had heard of the breast cancer screening (mammogram, clinical breast exams, etc.), the actual utilization of these screening modalities was relatively low. In the current study, the majority of women had never had mammograms or ultrasound in the past 5 years. The number one most reported barriers were "no time," "forgetfulness," "too cumbersome," and "laziness," followed by the perception of no need to get screened. In addition, the results revealed several areas of misconceptions or incorrect information perceived by study participants. Based on the results from the regression analysis, significant predictors of obtaining repeated screening modalities included age, coverage for screening, barriers, self-efficacy, intention, family/friends diagnosed with breast cancer. The findings from the current study provide the potential to build evidence-based programs to effectively plan and implement policies in order to raise awareness in breast cancer and promote BC screening in order to optimize health outcomes for women affected by this disease.

• 의학교육논단
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• 제21권3호
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• pp.127-136
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• 2019

Medical schools have been working to produce competent doctors and improve the quality of care by introducing and implementing new curricula and innovative teaching and learning methods. Despite these efforts, health disparities within and between countries still exist. To close these gaps, medical schools must identify the priorities of the community, region, and/or nation and conduct education, research, and service that reflect them-the core foundation of the social accountability of medical schools. Many medical schools and networks around the world have tried to achieve social accountability, but this needs more attention in Korea. This study will review the literature in aims to improve understanding and promote the implementation of the social accountability of medical schools. Most medical schools that practice the principles of social accountability focus primarily on the medically underserved in their communities or those who have limited access to health services, and have built collaborative partnerships with stakeholders to meet the needs of society. In addition, in order to implement social accountability effectively and efficiently, medical schools have developed strategies and various evaluation frameworks appropriate to the context of each school. To have more socially accountable medical schools, it is necessary to clarify the concept of social accountability and to establish a system that can evaluate the impacts. Medical schools exist to alleviate suffering and promote health, and this can be accomplished through social accountability.

• 한국지역지리학회지
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• 제17권5호
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• pp.617-637
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• 2011

본 연구는 충청북도의 사례를 통해서 온라인 협진의 지리적 특성과 환자의 온라인 협진에 대한 결정 요인에 대해서 알아보는 것을 목적으로 하고 있다. 2009년 7월부터 9월까지 심층 인터뷰에 기반한 정성적 기법을 이용하였고, 충청북도에 거주하는 환자 20명을 대상으로 하였다. 이 연구에 의하면 대부분의 환자는 1차적으로 의료 문제가 해결되지 않을 경우, 온라인 협진의 본래 취지와 달리 충청북도 내에서 그것을 해결하는 것이 아니라, 경기 의료권에 위치한 의료 기관으로 방문하는 경향을 보였다. 이와 더불어, 환자의 의무 기록 또한 온라인 시스템을 통해 이들 병원에 전달되어, 온라인 협진의 공간상 네트워크는 경기 의료권으로 집중하게 된다. 이러한 주요 원인은 의료 서비스에 대한 질 혹은 수준에 대한 고려, 개인적인 이해 관계와 신뢰성, 좋은 접근성 등에 기인하는 것으로 밝혀졌다. 이에 반해, 온라인 협진 시스템의 편리성, 유효성 등과 같은 온라인 협진의 기술적 가치나 온라인 협진의 본래적인 목적인 지역의료 향상과 같은 요인은 크게 영향을 미치지 않는 것으로 밝혀졌다. 따라서 우리나라 원격진료의 결정 요인은 환자 개인에 의해서 결정이 되는 바가 크고, 아직 개개인의 인식이 지역 의료 시스템과 크게 밀착되지 않는 형태를 보이기 때문에 경기 의료권으로 원격진료의 선택이 집중된 공간 특성을 보이고 있다고 할 수 있다. 특히, 이는 기존의 의료 제도 및 환자의 행태가 온라인 상에서의 의료 활동에도 그대로 투영되기 때문인데, 가장 이상적인 원격진료의 지리적 담론인 지역화를 실현하기 위해서는 근본적인 지역의 의료 서비스 구조의 개선이 필요할 것으로 보인다.