• 제목/요약/키워드: Care system

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The propriety of Spatial Arrangement Condition of 119 Emergency Medical Service - Mainly Around H Town Area, Countrysid of Y city - (119지역대의 공간적 배치 현황의 적절성 -Y시 H면 지역을 중심으로-)

  • Yun, Jong-Geun;Choi, Kyu-Chul
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.374-380
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    • 2017
  • In this study, we analyzed the situation of the 119 emergency medical service zone of H town, countryside of Y city from January 1st, 2015 to December 31st, 2016 and then, on the basis of this analysis, we investigated the present condition of the patient-transportation service of the 119 emergency medical service to provide the basic data in order for patients to use the emergency medical service more efficiently. We analyzed the data with SPSS 21.0 using frequency analysis and, after positioning the virtual 119 emergency medical service, we analyzed the data of the transportation time and transportation distance by using GIS. The results of this study show that the use of the 119 emergency medical service for people over 65 years old represents approximately 57% of the total number of patients transported, The average distance and time of the real moving reaction are 6.41 km and 11.86 min, respectively. The distance and time from the pick-up location to the hospital are 18.24 km and 21.52 min, respectively. Given the present position of the 119 emergency medical service, the results of this analysis using GPS show that the (average) distance and time from the 119 emergency medical service to Jang * Ri town are 9.12 km and 12 min, and the (average) total distance and time to arrive at the hospital after the emergency medical service picks up the patient are 36.83 km and 62 min, respectively. In the case of the virtual emergency medical service, the total distance and time required to arrive at the hospital after the emergency medical service picks up the patient are 27.71km and 50min, respectively. The results of this study showed that the present position of the 119 emergency service does not provide the optimum distance and time from the patient's location to the hospital. Therefore, we consider that the repositioning of the 119 emergency medical center is necessary, in order to reduce the time required for the emergency medical service to move to the patient's location and then bring the patient to the hospital.

Effects of Nutrition Education Using a Ubiquitous Healthcare (u-Health) Service on Metabolic Syndrome in Male Workers (u-헬스 케어 (Ubiquitous Healthcare) 서비스를 이용한 영양교육이 직장 남성근로자의 대사증후군에 미치는 영향)

  • Park, Se-Yun;Yang, Yoon-Jung;Kim, Yu-Ri
    • Journal of Nutrition and Health
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    • v.44 no.3
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    • pp.231-242
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    • 2011
  • The objective of this study was to investigate the effects of nutrition education based on ubiquitous healthcare (u-health) service on changes in dietary habits, nutrition intake, and risk factors for metabolic syndrome in male workers. In total, 72 male office workers with at least three risk factors of the National Cholesterol Education Program-Adult Treatment Panel III were recruited as subjects. Anthropometric measurements and biochemical analyses were conducted on all subjects. Dietary habits and nutrient intake were determined by a questionnaire using the 24-hour dietary recall method before and after nutrition education. Subjects measured their body composition, blood pressure, and physical activity more than once per week during the 12 weeks using the u-health care equipment and sent these data to a central database system using a personal computer. Individual nutrition counseling was provided four times on the first, fourth, eight, and twelfth weeks. The results showed significant decreases in abdominal circumference, body fat (%), diastolic blood pressure, serum triglycerides, and serum total cholesterol during the 12 weeks. Subjects with more than 12 measurements showed significant reductions in abdominal circumference, body fat (%), serum triglyceride, and serum total cholesterol. Mean intake of dietary fiber, animal calcium, potassium, vitamin C, and folic acid after nutrition education were higher than those before nutrition education. Participants showed significant increases in the frequencies of consuming protein foods (meat, fish, eggs, beans, tofu, etc.) and vegetables. In conclusion, nutrition education through the u-health service resulted in positive effects on the risk factors for metabolic syndrome, nutrient intake, and dietary habits.

Current State of Vocational Rehabilitation Program for Individuals with Disabling Mental Illness in Korea (우리나라 정신장애인 직업재활 현황 조사연구)

  • Han, Myung Hun;Kim, Ji-Woong;Kim, Do Yoon;Park, Hye Sun;Park, Hanson;Hwang, Tae-Yeon;Seo, Yongjin;Kim, Seung-Jun;Im, Woo-Young;Lee, Sang Min
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.145-152
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    • 2017
  • Objectives : There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. Methods : We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. Results : Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was 'worries about being excluded from beneficiary of National Basic livelihood Protection Act'. Conclusions : Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.

Decreased White Matter Structural Connectivity in Psychotropic Drug-Naïve Adolescent Patients with First Onset Major Depressive Disorder (정신과적 투약력이 없는 초발 주요 우울장애 청소년 환아들에서의 백질 구조적 연결성 감소)

  • Suh, Eunsoo;Kim, Jihyun;Suh, Sangil;Park, Soyoung;Lee, Jeonho;Lee, Jongha;Kim, In-Seong;Lee, Moon-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.153-165
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    • 2017
  • Objectives : Recent neuroimaging studies focus on dysfunctions in connectivity between cognitive circuits and emotional circuits: anterior cingulate cortex that connects dorsolateral orbitofrontal cortex and prefrontal cortex to limbic system. Previous studies on pediatric depression using DTI have reported decreased neural connectivity in several brain regions, including the amygdala, anterior cingulate cortex, superior longitudinal fasciculus. We compared the neural connectivity of psychotropic drug naïve adolescent patients with a first onset of major depressive episode with healthy controls using DTI. Methods : Adolescent psychotropic drug naïve patients(n=26, 10 men, 16 women; age range, 13-18 years) who visited the Korea University Guro Hospital and were diagnosed with first onset major depressive disorder were registered. Healthy controls(n=27, 5 males, 22 females; age range, 12-17 years) were recruited. Psychiatric interviews, complete psychometrics including IQ and HAM-D, MRI including diffusion weighted image acquisition were conducted prior to antidepressant administration to the patients. Fractional anisotropy(FA), radial, mean, and axial diffusivity were estimated using DTI. FMRIB Software Library-Tract Based Spatial Statistics was used for statistical analysis. Results : We did not observe any significant difference in whole brain analysis. However, ROI analysis on right superior longitudinal fasciculus resulted in 3 clusters with significant decrease of FA in patients group. Conclusions : The patients with adolescent major depressive disorder showed statistically significant FA decrease in the DTI-based structure compared with healthy control. Therefore we suppose DTI can be used as a bio-marker in psychotropic drug-naïve adolescent patients with first onset major depressive disorder.

TEACHERS' PERCEPTIONS OF MENTAL HEALTH PROBLEMS IN STUDENTS AND PSYCHIATRIC CONSULTATIONS (학생들의 정신건강문제와 정신과 의뢰에 대한 교사의 인식도 조사)

  • Kwak, Young-Sook;Chun, Ja-Sung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.82-90
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    • 1998
  • This study is attempted to examine Korean teachers’ perceptions of mental health problems in students and their attitudes towards psychiatric consultations through a questionnaire survey. The results of this study are as follows. 1) Teachers thought that 5.3% of their students had mental health problems, 1.9% of students required psychiatric evaluation, and 1.2% of students were referred or recommended psychiatric evaluation by their teachers. 2) The most frequent mental health problems in students discovered by teachers were distractibility and inattention, lack of academic skills, and language difficulties in elementary schools;distractibility and inattention, conduct problems, and lack of academic skills in middle schools;and conduct problems, distractibility and inattention, physical symptoms, and substance abuse in high schools. 3) Teachers thought the mental health problems in students were caused by the family environment, psychological factors, the educational system, and a lack of mental health services. 4) Teachers desired smaller classes, improvement of the school environment, more time, regular mental health education, a special program for students with mental health problems, and the counseling staffs or consultants for the school mental health. 5) Teachers consulted with other teachers, the parents of the students, the counseling teachers, the health care teachers, the counseling institutes, the psychiatric clinics, and the principals in descending order to handle the hard case problems. The frequent reasons for failing in psychiatric consultations were the prejudice of parents against psychiatric services, the teachers’ sense of superiority in dealing with the problems of students, the prejudice of teachers themselves against psychiatric practice, and inaccessible professional consultation. 6) About 20.4% of teachers reported they had proposed psychiatric consultations or had recommended their students to receive psychiatric evaluations.

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An Evaluation of the Use of Statistical Methods in the Journal of Tuberculosis and Respiratory Diseases ([결핵 및 호흡기질환] 게재 논문의 통계적 기법 활용에 대한 평가)

  • Koh, Won-Jung;Lee, Seung-Joon;Kang, Min Jong;Lee, Hun Jae
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.168-179
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    • 2004
  • Background : The statistical analysis is an essential procedure ensuring that the results of researches are based on evidences rather than opinion. The purpose of this study is to evaluate which statistical techniques are used and whether these statistical methods are used appropriately or not in the journal of Tuberculosis and Respiratory Diseases. Materials and Methods : We reviewed 185 articles reported in the journal of Tuberculosis and Respiratory Diseases in 1999. We evaluated the validity of used statistical methods based upon the checklist that was developed on the basis of the guideline for statistical reporting in articles for medical journals by International Committee of Medical Journal Editors. Results : Among 185 articles, original articles and case reports were 110 (59.5%) and 61 (33.0%) respectively. In 112 articles excluding case reports and reviews, statistical techniques were used in 107 articles (95.5%). In 94 articles (83.9%) descriptive and inferential methods were used, while in 13 (11.6%) articles only descriptive methods were used. With the types of inferential statistical techniques, comparison of means was most commonly used (64/94, 68.1%), followed by contingency table (43/94, 45.7%) and correlation or regression (18/94, 19.1%). Among the articles in which descriptive methods were used, 83.2% (89/107) showed inappropriate central tendency and dispersion. In the articles in which inferential methods were used, improper methods were applied in 88.8% (79/89) and the most frequent misuse of statistical methods was inappropriate use of parametric methods (35/89, 39.3%). Only 14 articles (13.1%) were satisfactory in utilization of statistical methodology. Conclusion : Most of the statistical errors found in the journal were misuses of statistical methods related to basic statistics. This study suggests that researchers should be more careful when they describe and apply statistical methods and more extensive statistical refereeing system would be needed.

Private Income Transfers and Old-Age Income Security (사적소득이전과 노후소득보장)

  • Kim, Hisam
    • KDI Journal of Economic Policy
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    • v.30 no.1
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    • pp.71-130
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    • 2008
  • Using data from the Korean Labor & Income Panel Study (KLIPS), this study investigates private income transfers in Korea, where adult children have undertaken the most responsibility of supporting their elderly parents without well-established social safety net for the elderly. According to the KLIPS data, three out of five households provided some type of support for their aged parents and two out of five households of the elderly received financial support from their adult children on a regular base. However, the private income transfers in Korea are not enough to alleviate the impact of the fall in the earned income of those who retired and are approaching an age of needing financial assistance from external source. The monthly income of those at least the age of 75, even with the earning of their spouses, is below the staggering amount of 450,000 won, which indicates that the elderly in Korea are at high risk of poverty. In order to analyze microeconomic factors affecting the private income transfers to the elderly parents, the following three samples extracted from the KLIPS data are used: a sample of respondents of age 50 or older with detailed information on their financial status; a five-year household panel sample in which their unobserved family-specific and time-invariant characteristics can be controlled by the fixed-effects model; and a sample of the younger split-off household in which characteristics of both the elderly household and their adult children household can be controlled simultaneously. The results of estimating private income transfer models using these samples can be summarized as follows. First, the dominant motive lies on the children-to-parent altruistic relationship. Additionally, another is based on exchange motive, which is paid to the elderly parents who take care of their grandchildren. Second, the amount of private income transfers has negative correlation with the income of the elderly parents, while being positively correlated with the income of the adult children. However, its income elasticity is not that high. Third, the amount of private income transfers shows a pattern of reaching the highest level when the elderly parents are in the age of 75 years old, following a decreasing pattern thereafter. Fourth, public assistance, such as the National Basic Livelihood Security benefit, appears to crowd out private transfers. Private transfers have fared better than public transfers in alleviating elderly poverty, but the role of public transfers has been increasing rapidly since the welfare expansion after the financial crisis in the late 1990s, so that one of four elderly people depends on public transfers as their main income source in 2003. As of the same year, however, there existed and occupied 12% of the elderly households those who seemed eligible for the National Basic Livelihood benefit but did not receive any public assistance. To remove elderly poverty, government may need to improve welfare delivery system as well as to increase welfare budget for the poor. In the face of persistent elderly poverty and increasing demand for public support for the elderly, which will lead to increasing government debt, welfare policy needs targeting toward the neediest rather than expanding universal benefits that have less effect of income redistribution and heavier cost. Identifying every disadvantaged elderly in dire need for economic support and providing them with the basic livelihood security would be the most important and imminent responsibility that we all should assume to prepare for the growing aged population, and this also should accompany measures to utilize the elderly workforce with enough capability and strong will to work.

Spawning Behavior, Egg and Larvae Developments of Maroon Clownfish, Premnas biaculeatus (Maroon Clownfish, Premnas biaculeatus의 산란습성과 난 발생 및 자치어의 외부형태발달)

  • Kim, Jong-Su;Choi, Young-Ung;Rho, Sum;Yoon, Young-Seock;Jung, Min-Min;Song, Young-Bo;Lee, Chi-Hoon;Lee, Young-Don
    • Journal of Aquaculture
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    • v.20 no.2
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    • pp.96-105
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    • 2007
  • A pair of maroon clownfishes with an indonesian native, reared in recirculation culture system to develope its aquaculture techniques. Courtship, spawning behavior, egg developments and rearing of the maroon clownfish larvae were documented. The larval development were described with illustrative figures. The spawning was occurred 8 times between Feburary and August 2004. The gravid female spawned during 15:00-20:00. The male mainly took care of the eggs supplying oxygen by water currents using their pectoral fins, anal fin and mouth. The fertilized eggs were separative-adhesive and oval in shape, and $1.99{\pm}0.03\;mm$ in longer diameter and $0.88{\pm}0.03\;mm$ in shorter diameter. The fertilized eggs were in deep-orange color. Cleavage occurred in 30 minutes after fertilization, and the egg reached 2 cells stage in 1 hour 10 minutes after fertilization at $27.0^{\circ}{\pm}0.5^{\circ}C$. The embryo was formed in 23 hours 40 minutes after fertilization. Hatching began in between $120{\pm}2$ hours and $150{\pm}12$ hours after fertilization at $27.0^{\circ}C$ in the incubator. Total length (TL) of the newly hatched larvae was 3.22 mm with mouth and anus opened. Ten days after hatching, mean TL of the larvae were 6.21 mm with 28 dorsal fin rays, 17 anal fin rays and 28 caudal fin rays. Nineteen days after hatching, mean TL of the larvae were 9.34 mm. At this stage the larva had three white bands on the body, and they began to feed on commercial diet.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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Comprehensive Geriatric Assessment for Community Living Elderly in a Rural Area (일부 농촌지역 거주 노인들에 대한 포괄적 노인평가)

  • Rhee, Jung-Ae;Shin, Hee-Young;Chung, Eun-Kyung;Shin, Jun-Ho
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.21-31
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    • 2002
  • The aim of this study was to analyse and conduct the comprehensive geriatric assessment for the elderly in rural area. The subjects were 388 older people aged 65 years or older living in the community. Data for comprehensive assessment such as physical, mental, functional, social and environmental conditions were collected from January to February, 2001 through a person-to-person interview. Of the total 388 olders, 169(43.6%) were men and 219(56.4%) were women. Mean ages of men and women were $73.5{\pm}6.4$ and $74.0{\pm}6.2$ years respectively. Three common diseases of the elderly were arthralgia(51.6%), chronic back pain(33.2%) and hypertension(18.6%), and higher in women than in men. Impairment rate of vision, hearing and bowel or bladder control was 59.0%, 20.1%, and 28.4% respectively. But that of lover extremities 3.4%. In terms of cognitive function, short term memory loss was found in 33.7% of males and 44.7% of females. The percentage of fully independent in the six ADL items was 72.2% in men and 58.9% in women. In the social supportive system, 49.5% of the elderly were living with spouse, and 22.9% living alone, 26.3% having care giver. These results will provide basic data for the development of community-based health program, which gives appropriate health service for the elderly living in the community.

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