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A Basic Study for the Introduction of Green Prescription and Establishment of Policy System in Korea - Through Comparative Analysis of U.K. and U.S. Cases - (국내 녹색처방 도입과 정책체계 수립을 위한 기초연구 - 영국과 미국 사례 비교 분석을 통해 -)

  • Kim, Hyo-Ju;Jung, Hae-Joon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.52 no.4
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    • pp.104-119
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    • 2024
  • The burden of medical expenses and the loss of social capital due to chronic diseases are becoming problems worldwide, and comprehensive and inclusive measures across various fields are required to prevent and manage their impacts. Social prescriptions have been shown to be effective in resolving the fundamental causes of health problems in patients with chronic diseases and in supporting existing treatments. In particular, green prescriptions that utilize the healing effects of nature and green spaces based on social prescriptions are being introduced in many countries overseas. Green prescription is the practice of a healthcare provider recommending activities in green spaces or experiences in the natural environment to patients for the prevention and management of chronic diseases. This study analyzed cases focusing on the policy system, the cases of the United Kingdom and the United States, which have introduced and operated green prescriptions under a national system. For this purpose, this study compared the background of green prescription introduction, related policies, and operation methods. Based on this, four implications were proposed to establish an effective plan for introducing green prescriptions in Korea. First, prior to establishing a policy for green prescriptions, interest in and research on green prescriptions are essential. Second, an implementation plan that fits the national health care system should be established, and policies should support the plan. Third, the introduction of green prescriptions from a long-term and gradual perspective is required. Fourth, comprehensive cooperation is required for the introduction and implementation of the green prescription system. This study can be used as basic data for discussion before introducing green prescriptions in Korea in the future.

A Preliminary Study on the Current Status and Health Effects of PM2.5 for Evaluating the Act on Air Quality Management Regions in Jeollabuk-do Province (대기관리권역법 시행효과 평가를 위한 전북지역 초미세먼지 현황 및 건강영향 사전연구)

  • Chang-Jin Ma;Nam-Jeong Jang;Gong-Unn Kang
    • Journal of Environmental Health Sciences
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    • v.50 no.4
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    • pp.282-290
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    • 2024
  • Background: In order to evaluate the national effort to improve air quality through the Act on Air Quality Management Regions, an investigation of the current status of air quality in respective regions and the health impact of air pollution should be undertaken. Objectives: This study is a preliminary study on the status of PM2.5 in the central region of South Korea and its health effects. It can be applied to the evaluation of the effectiveness of the Act on Air Quality Management Regions. Methods: Time series variation of PM2.5 concentrations in the air quality management region (hereafter referred to as AQMR) and in the non-AQMR area in the central region of South Korea were created. Odds ratios (OR) were calculated based on the survey results of whether the residents of Jeollabuk-do were feeling anxiety caused by air pollution by sex, region, and regional characteristics. Relative risk (RR) values of lung cancer deaths in each city in the AQMR for the central region of South Korea were calculated. Results: During the period from Dec. 2018 to Dec. 2021, the average concentration of PM2.5 was higher in the AQMR at 26.0 ㎍/m3 compared to 19.5 ㎍/m3 in the non-AQMR. The odds ratio (OR) calculated using data from the Jeonbuk Research Institute (2020) suggested that women were more uncomfortable or anxious about their lives due to air pollutants than were men. The OR evaluation results also showed that in terms of PM2.5 sensitivity, residents in the non-AQMR were relatively more sensitive than those in the AQMR. The relative risk (RR) was calculated to evaluate the relationship between health hazards (PM2.5) and diseases (lung cancer). As a result, for super-aged people over 80 years old, compared to the non-AQMR (Muju-gun and Jangsu-gun), the residents in the AQMR (Jeonju, Gunsan, and Iksan) have about twice the relative risk of lung cancer. Conclusions: It is necessary to make efforts to improve residents' health and extend their healthy lives through efforts to reduce air pollutants such as PM2.5 in areas specially selected as an AQMR.

The Effects of Shift Work Nurses' Job Stress, Job Involvement, and Goal Orientation on Work-Life Balance (교대근무간호사의 직무스트레스, 직무몰입, 목표지향성이 일과 삶의 균형에 미치는 영향)

  • Su Mi Choi;Nam Joo Je
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.5
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    • pp.29-39
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    • 2024
  • This study attempted to determine the effect of job stress, job involvement, and goal orientation on work-life balance for shift nurses. The subjects of the study were 128 shift nurses working at a hospital in city C of province G. Date were conducted from April 01 to April 15, 2024 using a Google questionnaire. The collected data were analyzed by correlation and multiple regression analysis. The total explanatory power was 28.0%. The results of this study showed significant differences in job stress(β=.405, p<.001), goal orientation(β=-265, p=.002), and job involvement(β=.174, p=.037) as factors affecting the work-life balance of shift nurses. Therefore, it is expected to have a positive impact on patient health by contributing to the improvement of the quality of nursing services by forming an organizational culture that avoids excessive goal setting and allows employees to concentrate on their work with appropriate stress management. This suggests that nurses are not only individuals but also professional medical practitioners, and that maintaining a healthy work-life balance is crucial for the country's human resources, which requires institutional support at the government level.

Effects of Job Stress, Self-Efficacy, and Mindfulness on Job Satisfaction according to MBTI Personality of Nurses (간호사의 MBTI 유형에 따른 직무스트레스, 자기효능감, 마음챙김이 직무만족도에 미치는 영향)

  • Kim Hyang Mi;Park Meera
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.5
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    • pp.173-180
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    • 2024
  • The purpose of this study was to investigate the effects of job stress, self-efficacy, and mindfulness on job satisfaction according to the MBTI type of nurses. The subjects of this study were 163 nurses working in medical institutions across the country, and data were collected from March 28 to April 20, 2024 through online (Google) questionnaires. MBTI preference indices were introvert type (I), sensory type (S), emotional type (F), and judgment type (J). In MBTI's four psychological function types, SF type was the most, SJ type was the most in MBTI's four psychological temperament types, and ISFJ type was the most in MBTI's 16 personality types. In this study, job satisfaction had a negative correlation with job stress, and self-efficacy and mindfulness had a positive correlation. As a result of this study, the factors affecting job satisfaction were job stress and self-efficacy, and the explanatory power was 43.6%. In order to improve the job satisfaction of nurses, it is necessary to develop stress management and self-efficacy enhancement programs and verify them.

Distribution Survey of Babesia and Assessment of Tick-borne Diseases in Jeju, Republic of Korea (Babesia의 제주 지역 내 분포 조사)

  • Jiro KIM;YoungMin YUN
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.3
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    • pp.189-197
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    • 2024
  • From March to November 2021, a study conducted in Jeju used the dry ice trap method to collect 17,855 ticks across six regions, examining their distribution and potential as disease vectors. The ticks were identified and categorized by species and growth stage. In addition, the study focused on Babesia, a disease transmitted by hard ticks. Of 17,641 ticks from which DNA had been extracted, 581 pools underwent polymerase chain reaction testing. Of these, 43 pools tested positive for Babesia, with the highest positivity found in Western Seogwipo (23 pools, 53.5%), followed by eastern Seogwipo and central Jeju. The peak times for positive results were April and July. This study highlights an increased risk of tick bites linked to the rising number of abandoned pets in Jeju, necessitating ongoing environmental management and monitoring. These findings provide fundamental data for formulating strategies to prevent and manage tick-borne diseases in Jeju. This involves reducing the disease incidence through targeted preventive measures and detailed epidemiological research. These results underscore the necessity for continued vigilance and proactive intervention to address the health challenges ticks pose in the region.

Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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A Study of Equipment Accuracy and Test Precision in Dual Energy X-ray Absorptiometry (골밀도검사의 올바른 질 관리에 따른 임상적용과 해석 -이중 에너지 방사선 흡수법을 중심으로-)

  • Dong, Kyung-Rae;Kim, Ho-Sung;Jung, Woon-Kwan
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.17-23
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    • 2008
  • Purpose : Because there is a difference depending on the environment as for an inspection equipment the important part of bone density scan and the precision/accuracy of a tester, the management of quality must be made systematically. The equipment failure caused by overload effect due to the aged equipment and the increase of a patient was made frequently. Thus, the replacement of equipment and additional purchases of new bonedensity equipment caused a compatibility problem in tracking patients. This study wants to know whether the clinical changes of patient's bonedensity can be accurately and precisely reflected when used it compatiblly like the existing equipment after equipment replacement and expansion. Materials and methods : Two equipments of GE Lunar Prodigy Advance(P1 and P2) and the Phantom HOLOGIC Spine Road(HSP) were used to measure equipment precision. Each device scans 20 times so that precision data was acquired from the phantom(Group 1). The precision of a tester was measured by shooting twice the same patient, every 15 members from each of the target equipment in 120 women(average age 48.78, 20-60 years old)(Group 2). In addition, the measurement of the precision of a tester and the cross-calibration data were made by scanning 20 times in each of the equipment using HSP, based on the data obtained from the management of quality using phantom(ASP) every morning (Group 3). The same patient was shot only once in one equipment alternately to make the measurement of the precision of a tester and the cross-calibration data in 120 women(average age 48.78, 20-60 years old)(Group 4). Results : It is steady equipment according to daily Q.C Data with $0.996\;g/cm^2$, change value(%CV) 0.08. The mean${\pm}$SD and a %CV price are ALP in Group 1(P1 : $1.064{\pm}0.002\;g/cm^2$, $%CV=0.190\;g/cm^2$, P2 : $1.061{\pm}0.003\;g/cm^2$, %CV=0.192). The mean${\pm}$SD and a %CV price are P1 : $1.187{\pm}0.002\;g/cm^2$, $%CV=0.164\;g/cm^2$, P2 : $1.198{\pm}0.002\;g/cm^2$, %CV=0.163 in Group 2. The average error${\pm}$2SD and %CV are P1 - (spine: $0.001{\pm}0.03\;g/cm^2$, %CV=0.94, Femur: $0.001{\pm}0.019\;g/cm^2$, %CV=0.96), P2 - (spine: $0.002{\pm}0.018\;g/cm^2$, %CV=0.55, Femur: $0.001{\pm}0.013\;g/cm^2$, %CV=0.48) in Group 3. The average error${\pm}2SD$, %CV, and r value was spine : $0.006{\pm}0.024\;g/cm^2$, %CV=0.86, r=0.995, Femur: $0{\pm}0.014\;g/cm^2$, %CV=0.54, r=0.998 in Group 4. Conclusion: Both LUNAR ASP CV% and HOLOGIC Spine Phantom are included in the normal range of error of ${\pm}2%$ defined in ISCD. BMD measurement keeps a relatively constant value, so showing excellent repeatability. The Phantom has homogeneous characteristics, but it has limitations to reflect the clinical part including variations in patient's body weight or body fat. As a result, it is believed that quality control using Phantom will be useful to check mis-calibration of the equipment used. A value measured a patient two times with one equipment, and that of double-crossed two equipment are all included within 2SD Value in the Bland - Altman Graph compared results of Group 3 with Group 4. The r value of 0.99 or higher in Linear regression analysis(Regression Analysis) indicated high precision and correlation. Therefore, it revealed that two compatible equipment did not affect in tracking the patients. Regular testing equipment and capabilities of a tester, then appropriate calibration will have to be achieved in order to calculate confidential BMD.

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Radioimmunoassay Reagent Survey and Evaluation (검사별 radioimmunoassay시약 조사 및 비교실험)

  • Kim, Ji-Na;An, Jae-seok;Jeon, Young-woo;Yoon, Sang-hyuk;Kim, Yoon-cheol
    • The Korean Journal of Nuclear Medicine Technology
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    • v.25 no.1
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    • pp.34-40
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    • 2021
  • Purpose If a new test is introduced or reagents are changed in the laboratory of a medical institution, the characteristics of the test should be analyzed according to the procedure and the assessment of reagents should be made. However, several necessary conditions must be met to perform all required comparative evaluations, first enough samples should be prepared for each test, and secondly, various reagents applicable to the comparative evaluations must be supplied. Even if enough comparative evaluations have been done, there is a limit to the fact that the data variation for the new reagent represents the overall patient data variation, The fact puts a burden on the laboratory to the change the reagent. Due to these various difficulties, reagent changes in the laboratory are limited. In order to introduce a competitive bid, the institute conducted a full investigation of Radioimmunoassay(RIA) reagents for each test and established the range of reagents available in the laboratory through comparative evaluations. We wanted to share this process. Materials and Methods There are 20 items of tests conducted in our laboratory except for consignment tests. For each test, RIA reagents that can be used were fully investigated with the reference to external quality control report. and the manuals for each reagent were obtained. Each reagent was checked for the manual to check the test method, Incubation time, sample volume needed for the test. After that, the primary selection was made according to whether it was available in this laboratory. The primary selected reagents were supplied with 2kits based on 100tests, and the data correlation test, sensitivity measurement, recovery rate measurement, and dilution test were conducted. The secondary selection was performed according to the results of the comparative evaluation. The reagents that passed the primary and secondary selections were submitted to the competitive bidding list. In the case of reagent is designated as a singular, we submitted a explanatory statement with the data obtained during the primary and secondary selection processes. Results Excluded from the primary selection was the case where TAT was expected to be delayed at the moment, and it was impossible to apply to our equipment due to the large volume of reagents used during the test. In the primary selection, there were five items which only one reagent was available.(squamous cell carcinoma Ag(SCC Ag), β-human chorionic gonadotropin(β-HCG), vitamin B12, folate, free testosterone), two reagents were available(CA19-9, CA125, CA72-4, ferritin, thyroglobulin antibody(TG Ab), microsomal antibody(Mic Ab), thyroid stimulating hormone-receptor-antibody(TSH-R-Ab), calcitonin), three reagents were available (triiodothyronine(T3), Tree T3, Free T4, TSH, intact parathyroid hormone(intact PTH)) and four reagents were available are carcinoembryonic antigen(CEA), TG. In the secondary selection, there were eight items which only one reagent was available.(ferritin, TG, CA19-9, SCC, β-HCG, vitaminB12, folate, free testosterone), two reagents were available(TG Ab, Mic Ab, TSH-R-Ab, CA125, CA72-4, intact PTH, calcitonin), three reagents were available(T3, Tree T3, Free T4, TSH, CEA). Reasons excluded from the secondary selection were the lack of reagent supply for comparative evaluations, the problems with data reproducibility, and the inability to accept data variations. The most problematic part of comparative evaluations was sample collection. It didn't matter if the number of samples requested was large and the capacity needed for the test was small. It was difficult to collect various concentration samples in the case of a small number of tests(100 cases per month or less), and it was difficult to conduct a recovery rate test in the case of a relatively large volume of samples required for a single test(more than 100 uL). In addition, the lack of dilution solution or standard zero material for sensitivity measurement or dilution tests was one of the problems. Conclusion Comparative evaluation for changing test reagents require appropriate preparation time to collect diverse and sufficient samples. In addition, setting the total sample volume and reagent volume range required for comparative evaluations, depending on the sample volume and reagent volume required for one test, will reduce the burden of sample collection and planning for each comparative evaluation.

Effect of combined exercise on metabolic bio-marker in overweight and obese children (복합운동이 과체중 및 비만 남자 초등학생의 대사적지표에 미치는 영향)

  • Kim, Hyun-Jun;Kim, Tae-Un;Lee, Sangyeoup;Shin, Goon-Soo;Kim, Young-Joo;Kim, Su-Yung
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.946-951
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    • 2006
  • Purpose : The purpose of this study was to demonstrate the effectiveness of combined exercise for 12 weeks on the adiponectin and obesity related variables in overweight and obese children. Methods : Eighteen children in 5th grade in a certain elementary school in Busan were recruited. They were all overweight or obese children(more than 85 percentile in body mass index). Nine children in the experimental group were given exercises consisting of walking and band resistant training for 12 weeks. Auxological data(including height, weight and body fat mass) and laboratory data (fasting blood sugar, insulin, adiponectin) were checked at baseline and at the 1 week, and at the 4 weeks and 12 weeks stages of their exercise program. Insulin resistance and sensitivity were evaluated indirectly using HOMA index and QUICKI index. Results : Adiponectin gradually decreased until the 4 weeks point and gradually increased thereafter to the starting level at the 12 weeks stage. Body weight, body mass index(BMI) and HOMA index significantly decreased more at the 1 week, 4 weeks, and 12 weeks stages in the experimental group than in the control group. Body fat mass significantly decreased at 12 weeks. The change of insulin was significantly correlated with changes of body weight and BMI. But there was no correlation between changes of adiponectin and changes of insulin. Conclusion : Exercise seems to effect the adiponectin concentration. And it might be assumed that exercise increases the adiponectin concentration if it is continued for long time(may be more than 12 weeks). More studies may be necessary to draw that conclusion.

The Difference of Standardized Uptake Value on PET-CT According to Change of CT Parameters (PET-CT에서 CT의 관전압 및 관전류에 따른 SUV값의 변화)

  • Shin, Gyoo-Seul;Dong, Kyeong-Rae
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.373-379
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    • 2007
  • Purpose : There is difference between PET and PET/CT method on their transmission image for attenuation correction. The CT image is used for attenuation correction on PET/CT and the parameters of CT may be affected on PET image. We performed the phantom study to evaluate whether the change of CT parameters(kilovolts peak and milliampere) affect standardized uptake value(SUV) on PET image. Material and Method: The data spectrum lung phantom containing diluted [18F]fluorodeoxyglucose ([18F]FDG) solution(1.909 mCi for phantom 1, $913\;{\mu}Ci$ for phantom 2) was used. The CT images of phantom were acquired with varying parameters (80, 100, 120, 140 for kVp, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100 for mA). The PET images were reconstructed with the each CT images and SUVs were compared. Result : The SUVs of phantom 1 reconstructed with each 80, 100, 120 and 140 kVp showed $12.26{\pm}0.009$, $12.27{\pm}0.005$, $12.27{\pm}0.006$ and $12.27{\pm}0.009$, respectively. The SUVs of phantom 2 revealed $4.52{\pm}0.043$, $4.53{\pm}0.004$, $4.52{\pm}0.007$ and $4.52{\pm}0.005$ with elevation of voltage. There was no statistically significant difference of SUVs between groups based on various kVp. Also SUVs of phantom 1 and 2 showed no significant change with elevation of milliampere in CT parameter. Conclusion : The parameters of CT did not significantly affect SUV on PET image in our study. Therefore we can apply various parameters of CT appropriated for clinical conditions without significant change of SUV on PET CT image.

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