• Title/Summary/Keyword: Physician awareness

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Current Problems of Parasitic Zoonoses in Rural Korea (한국농촌(韓國農村)의 기생충성인축공통질환(寄生蟲性人畜共通疾患)의 현황(現況)과 문제점(問題點))

  • Rim, Han-Jong
    • Journal of agricultural medicine and community health
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    • v.15 no.1
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    • pp.49-55
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    • 1990
  • Zoonoses are those diseases and infections that are naturally transmitted between vertebrate animals and man. At present, approximately 175 diseases caused by virus, rickettsia, bacteria, protozoa and helminthes as well as some of arthropods and the number is continually increasing. Although zoonoses are generally recognized as significant health problems, the actual prevalence and incidence of zoonotic infections is difficult to determine. Medical services in a rural area are scarce and ill persons may have little chance to see a physician. Furthermore, a lack of physician awareness and of appropriate diagnostic support is made often misdiagnosis. In rural Korea, parasitic disease is still important subject in the field of zoonotic infections considering its number and morbidity. Recently there was conspicuous reduction of soil-transmitted parasitic diseases (i.e. ascariasis. hookworms, trichuriasis), but clonorchiasis. intestinal trematodiases and taeniasis are a considerable problem. This is often significantly related to human behavioral patterns based on socio-economic and cultural conditions and linked with the local biologic and physical environment. The most of all parasitic zoonoses to man and animals are the food-transmitted parasitic diseases, and domestic animals such as dog, cat, pig, as well as fat and some mammals, ruminants and birds are act as reservoir hosts. In the present topics, current problems of parasitic zoonoses caused by protozoan infections (i. e. toxoplasmosis, pneumocystosis and cryptosporidiosis) which are the most common opportunistic in AIDS or immunocompromised persons, trematode infections (i.e. clonorchiasis, paragonimiasis and some intestinal tremadodiases). cestode infections such as cysticercosis and sparganosis, and some nematode infections of anisakiasis, thelaziasis and strongyloidiasis, are discussed here those on the occurrence in man and animals and the source of transmission as well as prevention and control measures in Korea.

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A Study on the Perception Changes of Physicians toward Duty to Inform - Focusing on the Influence of the Revised Medical Law - (설명의무에 대한 의사의 인식 변화 조사 연구 -의료법 개정의 영향을 중심으로-)

  • Kim, Rosa
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.235-261
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    • 2018
  • The Medical law stipulates regulations about the physician's duty to inform to contribute to patient's self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher's exact test and Binary logistic regression were performed. The results are as follows. • Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. • The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). • More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p<.0001), working type (p<.024), and department (p<.049). • There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician's duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.

Awareness of Cancer Screening During Treatment of Patients with Renal Failure: A Physician Survey in Turkey

  • Uysal-Sonmez, Ozlem;Tanriverdi, Ozgur;Uyeturk, Ummugul;Budakoglu, Isil Irem;Kazancioglu, Rumeyza;Turker, Ibrahim;Budakoglu, Burcin;Yalcintas-Arslan, Ulku;Oksuzoglu, Berna
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2165-2168
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    • 2014
  • Background: Today, survival rate of patients with chronic renal failure/hemodialysis has increased so that chronic illnesses are more likely to occur. Cancer is the main cause of morbidity and mortality in such patients. Aim: In this study, physician attitudes were examined about cancer screening in patients with renal failure. Materials and Methods: This study was done by face to face questionnaire in the $27^{th}$ National Nephrology Congress to determine if the physicians dealing with chronic renal failure, hemodialysis or renal transplanted patients, recommend cancer screening or not and the methods of screening for cervix, prostate, breast and colon cancer. Results: One hundred and fifty six physicians were included in the survey. A total of 105 (67%) participants were male and the age of responders was $48{\pm}9$ years. About 29% were specialists in nephrology, 28% internal medicine, and 5% were other areas of expertise. Some 48% of participants were hemodialysis certified general practitioners. Patients were grouped as compensated chronic renal failure, hemodialysis or renal transplanted. Of the 156 responders, 128 (82%) physicians recommended breast cancer screening and the most recommended subgroup was hemodialysis patients (15%). The most preferred methods of screening were combinations of mammography, self breast examination and physicianbreast examination. 112 (72%) physicians recommended cervix cancer screening, and the most preferred method of screening was pap-smear. Colon cancer screening was recommended by 102 (65%) physicians and prostate screening by 109 (70%) physicians. The most preferred methods of screening were fecal occult blood test and PSA plus rectal digital test, respectively. Conclusions: It is not obvious whether cancer screening in renal failure patients is different from the rest of society. There is a variety of screening methods. An answer can be found to these questions as a result of studies by a common follow-up protocol and cooperation of nephrologists and oncologists.

Convergence Awareness and Ethical Attitudes about DNR of Nursing Students (간호대학생의 DNR에 대한 융합적 인식 및 윤리적 태도)

  • Oh, Yun Jeong;Lee, Eun Mi
    • Journal of the Korea Convergence Society
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    • v.8 no.2
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    • pp.63-72
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    • 2017
  • This study was identify the awareness and ethical attitudes of DNR in nursing college students and use it as basic data to help patients with DNR. The results of the questionnaire were collected from June 1, 2016 to July 10, 2016 and analyzed using SPSS 23.0 program. As a result of the analysis, the recognition of DNR was in favor of the necessity of DNR, the decision of DNR by patient and family will, and the need for documented guidelines. Ethical attitudes favored decisions made by the patient's will, range of treatment, explanation, and guidance, and opposed decisions made by the primary care physician and reduced provision of basic care. Ethical attitudes according to general characteristics were significantly different according to grade, clinical practice experience, educational experience on ethical values, educational experience on DNR, satisfaction with life, and values for death. Based on the results of this study, more follow - up studies are needed to establish the criteria for DNR.

Trends in adherence to dietary recommendations among Korean type 2 diabetes mellitus patients

  • Park, Kyong
    • Nutrition Research and Practice
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    • v.9 no.6
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    • pp.658-666
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    • 2015
  • BACKGROUND/OBJECTIVES: The current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years. SUBJECTS/METHODS: Data were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician's diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ${\geq}126mg/dl$. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design. RESULTS: Among all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased. CONCLUSIONS: Analysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.

Relationships between the diabetes awareness and clinical indices/nutrient intakes in Korean adults: Based on the 2012-2013 Korea National Health and Nutrition Examination Survey Data

  • Lee, Seul;Park, Haeryun;Lee, Youngmi;Choi, Onjeong;Kim, Jiwon;Gray, Heewon L;Song, Kyunghee
    • Nutrition Research and Practice
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    • v.13 no.3
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    • pp.240-246
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    • 2019
  • BACKGROUND/OBJECTIVES: Diabetes is diagnosed after an average of 10-12 years of diabetic development. Strict glycemic control in diabetic patients promotes the normalization of blood glucose and reduces cardiovascular diseases (CVDs) and diabetic complications. Therefore, early diagnosis in non-aware individuals is very important. SUBJECTS/METHODS: Clinical indices and nutrient intakes in Korean diabetic adults aged 19-64 years were examined according to the awareness of diabetes, using 2012 and 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. The aware group was defined as individuals who were aware of having diabetes from diagnosis by physician before the survey and the non-aware group as individuals who were not aware of having diabetes. RESULTS: The average age was higher in the aware group compared to the non-aware group in both men (P = 0.002) and women (P = 0.004). The prevalences of hypertension and dyslipidemia were not different between the two groups, but the diagnosis rate was significantly lower in the non-aware group. In the non-aware group, total and LDL-cholesterol were significantly higher (P < 0.001), the risk for total cholesterol over 240 mg/dL was 3.4 times (95% CI: 1.58-7.52) higher (P = 0.002) and the risk for LDL-cholesterol over 160 mg/dL was 4.59 times (95% CI: 2.07-10.17) higher (P < 0.001). The calorie intake of the female non-aware group was significantly higher compared to the female aware group (P = 0.033). CONCLUSION: The results suggested that the recommendation of screening test is necessary even for young adults. Studies on the methodology for early diagnosis of diabetes are also needed.

Lead Poisoning: Historical Aspects of a Paradigmatic "Occupational and Environmental Disease"

  • Riva, Michele Augusto;Lafranconi, Alessandra;D'orso, Marco Italo;Cesana, Giancarlo
    • Safety and Health at Work
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    • v.3 no.1
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    • pp.11-16
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    • 2012
  • Lead poisoning is one of the earliest identified and most known occupational disease. Its acute effects have been recognized from antiquity when this condition principally afflicted manual workers and slaves, actually scarcely considered by the medicine of that time. The Industrial Revolution caused an epidemic of metal intoxication, urging scientists and physician of that period to study and identify specific symptoms and organ alterations related to chronic lead poisoning. During the 20th century, the acknowledgment of occupational and environmental toxicity of lead fostered public awareness and legislation to protect health. More recently, the identification of sub-clinical effects have greatly modified the concept of lead poisoning and the approaches of medicine towards this condition. Nowadays, lead poisoning is rarely seen in developed countries, but it still represents a major environmental problem in certain areas. Consequently, it may appear as a paradigm of "occupational and environmental disease," and the history of this condition seems to parallel the historical development of modern "Occupational and Environmental Health" as a more complete medical discipline.

Primary Care Physicians' Cancer Screening Recommendation Practices and Perceptions of Cancer Risk of Asian Americans

  • Kwon, Harry T.;Ma, Grace X.;Gold, Robert S.;Atkinson, Nancy L.;Wang, Min Qi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1999-2004
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    • 2013
  • Asian Americans experience disproportionate incidence and mortality rates of certain cancers, compared to other racial/ethnic groups. Primary care physicians are a critical source for cancer screening recommendations and play a significant role in increasing cancer screening of their patients. This study assessed primary care physicians' perceptions of cancer risk in Asians and screening recommendation practices. Primary care physicians practicing in New Jersey and New York City (n=100) completed a 30-question survey on medical practice characteristics, Asian patient communication, cancer screening guidelines, and Asian cancer risk. Liver cancer and stomach cancer were perceived as higher cancer risks among Asian Americans than among the general population, and breast and prostate cancer were perceived as lower risks. Physicians are integral public health liaisons who can be both influential and resourceful toward educating Asian Americans about specific cancer awareness and screening information.

Impact of perinatal environmental tobacco smoke on the development of childhood allergic diseases

  • Yang, Hyeon-Jong
    • Clinical and Experimental Pediatrics
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    • v.59 no.8
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    • pp.319-327
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    • 2016
  • Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and food allergy, are most common chronic, noncommunicable diseases in childhood. In the past few decades, the prevalence has increased abruptly worldwide. There are 2 possible explanations for the rising prevalence of allergic diseases worldwide, that an increased disease-awareness of physician, patient, or caregivers, and an abrupt exposure to unknown hazards. Unfortunately, the underlying mechanisms remain largely unknown. Despite the continuing efforts worldwide, the etiologies and rising prevalence remain unclear. Thus, it is important to identify and control risk factors in the susceptible individual for the best prevention and management. Genetic susceptibility or environments may be a potential background for the development of allergic disease, however they alone cannot explain the rising prevalence worldwide. There is growing evidence that epigenetic change depends on the gene, environment, and their interactions, may induce a long-lasting altered gene expression and the consequent development of allergic diseases. In epigenetic mechanisms, environmental tobacco smoke (ETS) exposure during critical period (i.e., during pregnancy and early life) are considered as a potential cause of the development of childhood allergic diseases. However, the causal relationship is still unclear. This review aimed to highlight the impact of ETS exposure during the perinatal period on the development of childhood allergic diseases and to propose a future research direction.

Republic of Korea Entrepreneurship Ecosystem Status and Recognition Research: Focusing on Entrepreneurs, Entrepreneurs Preliminary, Student Centered Comparative Analysis on the Status and Recognition (대한민국 창업생태계 현황 및 인식 연구: 창업가, 예비창업가, 학생을 중심으로 현황 및 인식 비교 분석)

  • Kim, Sung Hoon;Nam, Jung min
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.6
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    • pp.175-183
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    • 2016
  • The government set up "national happiness, the hope of a new era of national vision under' job center of the creative economy" to achieve by national goals in the first and figure achieved through the establishment of new growth engines of the youth unemployment problem solve and national level there are a number of business start-up support. September 8, 2015 announced the Government's look at the '2016 Year of the budget, the government for new growth engines greatly promoted the venture entrepreneurship ecosystem revitalization and research and development (R & D) the business for enhanced performance in 2017. According to the direction of this study is to evaluate the current creative economy business incubator at the comparison whether the correct orientation mainly entrepreneurs, entrepreneurs preliminary recognition of student entrepreneurship ecosystem. Entrepreneurs 113 people in that way, 71 people pre-entrepreneurs, students 60, workers were founding agencies conducted an online survey of 47 people, 16 people Investors, 50 public and 11 additional persons including a total of 368 people. This study is in line with the orientation of these entrepreneurs to create economic status and recognition of the Republic of Korea entrepreneurship ecosystem, pre- entrepreneurs, students will examine the comparative analysis around. Analysis, social perception of entrepreneurship is somewhat higher than it was confirmed that the negative response of 32.2% to 36.3% of positive response. Social awareness of entrepreneurs showed a 2-fold higher response rate than the negative of response of 17.1% to 41.7% responding that positive recognition for the current start-up environment is bad, the response is good response to higher response rate than 23.5% to 41.1% It showed. The percentage of responses that better respect the entrepreneurship environment of the future Republic of Korea showed a higher response rate than the rate of 23% in response to deteriorate to 41.2%, with 52.9% awareness is the percentage that responded that the bad part about the ruthless Korea's entrepreneurship environment in China good part as response rate approximately three times greater than the 17.7% showed high response rates. Social awareness of entrepreneurs experience the presence of the founding start-up experience was confirmed that the more negative the number increases, the more the contrary the number of start-up experience increased awareness of the current and future environment of entrepreneurship was identified as a positive entrepreneurship environment. Also recognized was confirmed to change the parent of the more positive changes in the start-up of entrepreneurs doctor also positive about entrepreneurship, start-up entrepreneurs start with a doctor's motivation for founding non-economic reasons than for economic reasons has confirmed Higher. This study showed the overall level overview analysis of the status and recognition of the Republic of Korea entrepreneurship ecosystem. Future studies need to be a proposal for an existing previous studies for more precise direction to go forth to analyze the entrepreneurship ecosystem with a focus on problems and improvement of the Republic of Korea entrepreneurship ecosystem.

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