• Health Policy and Management
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• v.25 no.3
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• pp.149-151
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• 2015

United Nations (UN) adopted 17 global sustainable development agenda to the year 2030 in the 68th general assembly on september, 2015. The global agendas and goals are important for 3 reasons: (1) to adopt the international standard for determining the health status; (2) to identify areas in need of attention; and (3) to advance international cooperation regarding health issues. In the area of infectious diseases, our goals include the eradication of human immunodeficiency virus infection and acquired immune deficiency syndrome, tuberculosis, and malaria as well as a substantial reduction of hepatitis by the year 2030. In the area of non-communicable diseases, our goal is to reduce premature mortality (${\leq}70years$) at least 30% by the year 2030. Preventive activities such as smoking cessation, alcohol abstinence, nutritional measures, and physical activities, should also be promoted intensively nationwide. It is also necessary to establish stringent policies for control hypertension, diabetes, obesity, and hypercholesterolemia. Additionally, environmental health, injury by traffic accident, mental health, and drug and alcohol abuse are important health policies. Furthermore, in the area of international health and cooperation, maternal and child health remain important areas of support for underdeveloped countries. Education and training towards the empowerment of health professionals in underdeveloped countries is also an important issue. The global agenda prioritize resources(manpower and budget) allocation of international organizations such as UN, World Health Organization, United Nations Development Programme, and World Bank. The global agenda also sets the contribution levels of Official Developmental Assistance donor countries. Health professionals such as professors and researchers will have to turn their attention to areas of vital international importance, and play an important role in implementation strategies and futhermore guiding global agenda.

• Neonatal Medicine
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• v.28 no.3
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• pp.133-138
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• 2021

Osteopetrosis refers to a group of genetic skeletal disorders characterized by osteosclerosis and fragile bones. Osteopetrosis can be classified into autosomal dominant, autosomal recessive, or X-linked forms, which might differ in clinical characteristics and disease severity. Autosomal recessive osteopetrosis, also known as malignant osteopetrosis, has an earlier onset, more serious clinical symptoms, and is usually fatal. We encountered a 1-day-old girl who was born full-term via vaginal delivery, which was complicated by meconium-stained amniotic fluid, cephalo-pelvic disproportion, and nuchal cord. Routine neonatal care was provided, in addition to blood tests and chest radiography to screen for sepsis, as well as skull radiography to rule out head injuries. Initial blood tests revealed hypocalcemia, which persisted on follow-up tests the next day. Radiographic examinations revealed diffusely increased bone density and a "space alien" appearance of the skull. Based on radiographic and laboratory findings, the infantile form of osteopetrosis was suspected and genetic testing for identification of the responsible gene. Eventually, a heterozygous mutation of the T cell immune regulator 1, ATPase H+ transporting V0 subunit a3 (TCIRG1) gene (c.292C>T) was identified, making this the first reported case of neonatal-onset malignant osteopetrosis with TCIRG1 mutation in South Korea. Early-onset hypocalcemia is common and usually results from prematurity, fetal growth restriction, maternal diabetes, perinatal asphyxia, and physiologic hypoparathyroidism. However, if hypocalcemia persists, we recommend considering 'infantile of osteopetrosis' as a rare cause of neonatal hypocalcemia and performing radiographic examinations to establish the diagnosis.

• Neonatal Medicine
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• v.18 no.2
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• pp.197-203
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• 2011

Purpose: The purpose of this study is to compare perinatal outcomes between in vitro fertilization (IVF) twins and naturally conceived twins born to women aged 35 years or older and to provide basic information for taking care of IVF twins born to women aged 35 years or older. Methods: We reviewed the records of perinatal and neonatal outcomes in 288 IVF twins and 220 naturally conceived twins born to women aged 35 years or older between January 2001 and December 2010 at CHA Bundang Medical Center. Results: No difference was observed in the maternal ages of mothers giving birth to IVF twins and those giving birth to naturally conceived twins. Gestational ages and birth weights of IVF twins were not different from those of naturally conceived twins. Various perinatal outcomes, including gestational diabetes mellitus, pregnancy-induced hypertension, placenta previa, premature amniotic membrane rupture, and need for a Cesarean section did not differ between the 2 groups. However, the 1-min and 5-min Apgar scores (P=0.019 and P=0.045, respectively) were different between the 2 groups. The incidence of early-onset sepsis was lower in the IVF twins than in the naturally conceived twins (P=0.02). However, the 2 groups did not show any difference in the incidence of respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, and other congenital anomalies. Conclusion: The perinatal outcomes in IVF twins born to women aged 35 years or older were not significantly different from those of naturally conceived twins.

• Development and Reproduction
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• v.10 no.3
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• pp.185-192
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• 2006

It is known that maternal diabetes induces a premature delivery and a congenital malformation. Although it was suggested that hyperglycemia is a main cause, little has been known. The effects of subtotal pancreactomized animal as a diabetic model on the embryo and the offspring were investigated. 1) Although survival rate of offsprings from the 90% pancreactomized female was lower than that of control, body weight of the survived offsprings was similar to that of control until 6 weeks after birth. When the liver was investigated, abnormal tissue was observed in both female and male offsprings from the pancreactomized mother. The level of major urinary protein(MUP) that is synthesized in the liver and secrets into urine was decreased in both female and male, supporting the liver abnormality. 2) In the pancreactomized female, size of the Langhan's island was increased and the liver also was observed abnormal. However, blood glucose level of the pancreactomized mother was not different from that of control. The low body weight and survival rate of offsprings from the $inhibin-{\alpha}$ overexpressed mice was very similar to those of the offsprings from diabetic mother. Thus when the mother itself was investigated after DNA injection, blood glucose level in the $inhibin-{\alpha}$ overexpressed mice was not different from that of control although size of the Langhan's island was decreased. Taken together, subtotal pancreactomy affected the offspring and embryo and influenced deeply the mother itself. However glucose level of the mother was not changed during investigation. It suggested that the relationship between the diabetic mother and embryo through offspring is very complex.

• Journal of the Korea Convergence Society
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• v.1 no.1
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• pp.83-91
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• 2010

In accordance with the analysis results on the questionnaires, in the awareness of employees on a public health center, the answer "I can make every endeavor for the success of public health center organization" showed the highest score as $4.07{\pm}0.75$. The awareness on the organization where a subject was included was higher than the average out of a 7 points. It showed the subjects were sincere to the missions and duties of the organizations where they were included. For the awareness on the work environment, the subjects who considered that their workplace was comfortable were higher than the average. The duties which the subjects recognized as the necessary duties among health businesses include health behavior improvement project, disease control project, customized visiting health care project, maternal and child health care, family health care and infectious disease control project. The duties which were considered as unnecessary among health care projects were general care functions, administrative businesses including issuance of certificates and various kinds of civil application processing. The projects which were considered to be reinforced or implemented in the future were health care project for the old, patients registration and care project including hypertension and diabetes and health promotion project in that order.

• Journal of Preventive Medicine and Public Health
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• v.6 no.1
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• pp.101-117
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• 1973

Socio-medical survey was carried out on six hundred and thirty Korean households in the cities of Tokyo, Osaka, Kyoto, and Nagoya in Japan from Nov. 1972 to Dec. 1972, and following results were obtained. 1. Age distribution of households showed the highest occurence in the group of 40 to 49 years of age in the both sexes. Families with five members showed highest occurence, and the average number of familial members was 5.7 persons per one household. 2. More than half of the householders were some independent enterprisers rather than to be the employees and most of the household had one familial member engaged in more or less liberal profession. 3. 19.4% of households moved into these cities from 1941 to 1945. 4. 40.5% of all the households had their own houses. The possession rate of one's own house was higher in the households which had long period of residence in Japan. 5. 83.5% of all households had various medical insurances. And the 6.2% of the household which had no insurance stated that the reason for not being affiliated was 'because to be the foreigner'. Household of shorter dwelling period had less tendency to be affiliated to the various insurances. 6. In 41.3% of all the households, average medical expenditure amounted to 1000-5000 Yen per month. And only 25.6% of household stated that they do not worry about the medical expenditure for the futures. 7. 66.3% of households were consulting to medical doctors for their sickness, such as toothache, severe coughing, profuse sputum, children's fever and stomach pain etc. 8. 59.4% of households were using the facilities of health center services. The health center service was used mainly for individual health service rather than the environmental aspect. And 19.8% of households were not aware of health center activities. 9. It was found that 23.5% of households received the screening test of the tuberculosis and adult diseases. Especially, the rate of screening test of the adult diseases showed as following ; stomach cancer, 8.9% ; hypertension, 7.9% ; diabetes mellitus, 2.1% ; and uterus cancer, 1.6%. 10. Birth control was carried out in 17.3% of households but not in 52.5%. The chief reason of birth control was 'because of poor maternal health' (40.0%) or 'should not be done' (5.4%). 11. Most of them are obtaining the knowledges and informations on family plannings. public nuisance problems and nutritions etc. by means of the mass communications, while those no preventing diseases and the environmental hygiene through the administrative organizations.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.3
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• pp.53-66
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• 1996

Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.427-440
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• 2000

A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

• Journal of Yeungnam Medical Science
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• v.12 no.2
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• pp.347-365
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• 1995

A survey was conducted to study perception and attitudes of health workers towards health center's activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predominantly female(62.3%); had college education(60.3%); and held medical and nursing positions(39.6%), technicians(30.6%) and public health/administrative positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker(47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Tb control, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; personnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive perceptions, particularly to those areas as further training needs and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.