The number of disputes between physicians and patients caused by medical malpractice are showing a sharp increasing over the past several years. The disputes on medical malpractice may be resolved either in court or by direct negotiation between both sides concerned. There are no special acts relating to the civil or penal liability of the physicians in Korea. The medical disputes are decided merely through legal technicalities and without reference to actual medical practice. The current system which does not compensate injured patients adequately or equitably leads to taking a long time consuming for dispute resolution processes. The things make worsed, the problem is due to not being of insurance system or a proper funds for compensation. This research proposes a outline of new and comprehensive alternative for these problems and failure of conventional resolution of medical disputes. So far, we have learned lessons from the excperiencies of resolving medical malpractice disputes of Japan and the United States. The proposal first calls for an administrative arbitration and pretrial screening panels as a condition precedent to trial. The proposal also includes to facilitate with the funds for compensating the injured.
The face and the external nose define an individual's physical appearance. Nasal deformities can cause facial disfigurement along with unwanted psychological repercussions. Nasal deformities range in severity, with the most severe cases being indications for a rhinectomy, due to the complexity of the nasal defect. According to published literature, there is no consensus among otolaryngologists and plastic surgeons on which technique or flap use is preferred in terms of complications, aesthetic outcome, or patient satisfaction. The goal of this study is to provide a comprehensive analysis of published studies on nasal reconstruction following rhinectomy. Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines for writing systematic reviews, a systematic review was conducted. Four databases were searched using a search strategy. These articles were then imported into the COVIDENCE software and went screening and thorough article review. After screening 2,237 articles, 23 studies were then extracted for data collection analysis. We collected data from 12 case series, 4 case studies, 1 prospective case series, and 4 retrospective chart review studies. The most commonly reported flaps were forehead flaps, superior extended nasal myocutaneous island, forearm free flaps, anterolateral thigh (ALT) free flap, medial femoral condyle free flap (n = 8), and zygomaticus implants (n = 6), and retained nasal prosthesis. Although not specifically indicated by a certain number, the most common indication for the rhinectomy was malignancy, followed by traumas, postsurgical complications, radionecrosis, and congenital nasal malformations.
Cervical cancer (CaCx) is the second most fatal cancer contributing to 14% of cancers in Indian females, which account for 25.4% and 26.5% of the global burden of CaCx prevalence and mortality, respectively. Persistent infection with high-risk human papilloma virus (HPV- strains 16 and 18) is the most important risk factor for precursors of invasive CaCx. Comprehensive prevention strategies for CaCx should include screening and HPV vaccination. Three screening modalities for CaCx are cytology, visual inspection with acetic acid, and HPV testing. There is no Indian national policy on CaCx prevention, and screening of asymptomatic females against CaCx is practically non-existent. HPV vaccines can make a major breakthrough in the control of CaCx in India which has high disease load and no organized screening program. Despite the Indian Government's effort to introduce HPV vaccination in the National Immunization Program and bring down vaccine cost, challenges to implementing vaccination in India are strong such as: inadequate epidemiological evidence for disease prioritization, duration of vaccine use, parental attitudes, and vaccine acceptance. This paper reviews the current epidemiology of CaCx and HPV in India, and the current status of HPV vaccination in the country. This article stresses the need for more research in the Indian context, to evaluate interventions for CaCx and assess their applicability, success, scalability and sustainability within the constraints of the Indian health care system.
Purpose: This study was to monitor the effects of forming desirable eating and exercise habits and change the blood lipid levels by developing and applying E-Mail educational programs for a hyperlipidemia health check-up. Method: The research design used a nonequivalent control group pre-post test. Ninety-nine subjects (Exp.=50, Cont.=49) were selected randomly and the male subjects agreed to a hyperlipidemia health check-up at a comprehensive medical screening center. This study verified validity and reliability through factor analysis on a life habit measurement tool. The data was analyzed with SPSS win 12.0 using an $X^2-test$, t-test, ANOVA and ANCOVA. Result: Eatingand exercise habit scores of the experimental group which were educated through E-Mails changed considerably more than that of the control group which was not educated. Total-cholesterol and LDL-cholesterol in the experimental group was considerably lower than that in the control group, but HDL-cholesterol increased considerably Triglycerides, however, didn't show change. Conclusion: An E-Mail educational program may be applied as a hyperlipldemia health check-up nursing intervention strategy.
This study evaluated the nutrient intake with increasing coffee consumption for 403 adults aged over 30 years in Korea. The 403 subjects were national health screening examinees, who visited Sahmyook Seoul Hospital's Comprehensive Check-up Center between 2017.11.01 and 2018.12.18. The subjects were asked to answer questionnaires covering a 24-hour recall fluid and dietary intake before the health examination. The research ethics council of Sahmyook University (2-7001793-AB-N-012019036HR) approved this study. Coffee consumption exceeding two servings daily was more likely in males, in those aged between 30 and 40 years, and in the smoking, drinking, non-exercise, non-breakfast groups compared to each counterpart. The correlation between the coffee consumption frequency and current nutrient density showed negative correlations in most micronutrients. The mean nutrient density decreased gradually with increasing coffee consumption (<1 serving daily, ${\leq}1{\sim}2$ servings daily, >2 servings daily) in the ANOVA analysis. Therefore, the progressive adverse health effects of excessive coffee consumption needs to be researched further, and a daily total caffeine limit should be suggested in education of the nation levels.
This study was performed to analyze health problems in older adults in a comprehensive manner, including usual living habits, nutritional status, and society psychological factors. Research was conducted by a structured questionnaire by interviews with a test group of 316 people over the age of 65 from April 2012 to August 2012. Elderly people's dietary intake was assessed using NSI (Nutrition Screening Initiative) by the 24-hour retrospective method, and elderly people's feeling of helplessness and sense of belonging were assessed using the measuring device. Material analysis, descriptive statistics, and regression analysis were performed using SPSS. Elderly people with increased age showed higher chances of being in the high-risk and undernourished group. Elderly with high NSI showed low intake of fat, protein, fibrin, vitamin C, E, $B_1$, $B_2$, Niacin, K, Fe, Zn, and Cu than those with low NSI. Findings from this comparative analysis indicate that elderly with better nutritional status showed a lower feeling of helplessness than those with poor nutritional status. Overall, elderly people consumed a b road variety of foods, and social emotional stability of elderly people increased at optimal dietary levels.
The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.
Kim, Young-Bok;Park, Chun-Man;Kim, Hyun-Hee;Han, Chang-Hyun
The Journal of Korean Society for School & Community Health Education
/
v.11
no.1
/
pp.79-91
/
2010
Objectives: This study was conducted to analyze health behavior and utilization of university health clinics by college and university students. Methods: There are 376 colleges and universities in Korea as of May 2007. Of them 243 (69.6%) run health clinics in their campuses. Twenty of them were selected and 1,754 students were surveyed by using self reporting questionnaires. The data collected were analyzed by SPSS ver. 12.0. Results: Out of 1,754 students 56.5% were in good health. Of the subjects 15.6% were cigarette smokers, 30% were non drinkers, 20.8% exercise regularly, 53.7% sleep for seven to eight hours a day, 48% had proper body weight (BMI) 20-25) and 20% had physical examination in the past two years. The scores of health practices were higher in male students than female students (P 0.05). Perception rates of university clinics were higher in female students than male students. (P 0.01). Many students have intention to use the clinics (P 0.01). On health promotion program 35.2% of the subjects used clinics for emergency service, 32.8% participated in drinking control program, 32.8% in smoking cessation program, 20.4% in immunization program and 19.2% in regular health screening program. Conclusions: Comprehensive data for health behavior and need of health promotion services by the students should be collected regularly in order to meet the needs of students and faculty members in higher education institutes. The university authorities should pay more attention on the activities of health clinics in order to promote health of the students.
Kim, Keon-Yeop;Jeon, So-Youn;Jeon, Man-Joong;Lee, Kwon-Ho;Lee, Sok-Goo;Kim, Dong-Jin;Kang, Eun-Jeong;Bae, Sang-Geun;Kim, Jin-Hee
Journal of Preventive Medicine and Public Health
/
v.45
no.4
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pp.267-275
/
2012
Objectives: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. Methods: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. Results: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. Conclusions: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.
Purpose: To examine the levels of physical activity (PA) and diet quality, socio-demographic and clinical correlates, and identify associations with health-related quality of life (HRQOL) among breast cancer survivors. Methods: The study used a cross-sectional study design. A total of 74 breast cancer survivors who had completed their primary cancer therapy were recruited from a comprehensive cancer center in Korea. Measurements used included the International Physical Activity Questionnaire, the Diet Quality Index, and the EORTC QLQ-C30. Results: Only twenty-six women (35.1%) met the American Cancer Society criteria of weekly PA, while most participants (93.2%) displayed good or excellent diet quality. Those less likely to meet the PA criteria were older women, women who had a lower economic level, and women not receiving anti-hormone therapy. However, there was no significant factor associated with diet quality. Women who met the criteria for PA displayed significantly better global QOL than women who did not meet the criteria. No significant differences were found in HRQOL between women who did and did not meet the diet quality criteria. Conclusion: Nurses should be aware of breast cancer survivors who are older and who have a low economic status when assessing and screening the level of PA to improve HRQOL.
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