• Title/Summary/Keyword: Public health and medical services

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Role of the HPV DNA Test in Follow-up of Treated Cervical Intraepithelial Neoplasia in Bangladesh

  • Nessa, Ashrafun;Rashid, Mohammad Harun Ur;Jahan, Munira;Ferdous, Noor-E;Nahar, Pervin Akhter Shamsun;Chowdhury, Afroza
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8063-8067
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    • 2014
  • Background: Cervical cancer is a major public health problem in Bangladesh. Persistence of high risk human papillomavirus (HRHPV) influences the progression of the disease, with an important role in followup for cervical intraepithelial neoplasia (CIN). Objective: To establish application of high risk HPV DNA test in the follow-up of women after treatment of CIN. Materials and Methods: This cross-sectional and hospital based study was carried out among 145 CIN treated women during the previous six months to three years at the colposcopy clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka, between January 2011 and June 2012. Pap smear and HPV samples were collected and colposcopy was performed to find out the persistence of the disease. Cervical samples obtained were tested for HPV DNA using the Hybrid Capture II (HC-II) test. A cervical biopsy was collected whenever necessary. The results were compared to assess the efficacy of different methods during follow up such as Pap smear, HPV test and colposcopy. Results: Mean age of the recruited women (n=145) was 33.6 (${\pm}7.6$), mean age of marriage was 16.8 (${\pm}2.9$) and mean age of 1st delivery was 18.8 (${\pm}3.5$) years. More than half had high grade CIN before treatment and 115 (79.3%) women were managed by LEEP and 20.7% were managed by cold coagulation. Among the 145 treated women, 139 were negative for HPV DNA and six of them (4.1%) were HPV positive. Sensitivity of Pap smear (40.0) and HPV DNA test (40.0) was poor, but specificity was quite satisfactory (>93.0) for all the tests. Conclusions: The high risk HPV DNA test can be an effective method of identifying residual disease. It can be added to colposcopy and this should be applied to all treated women attending for their first or second post-treatment follow-up visit at 6 months to one year, irrespective of the grade of treated CIN.

Factors Related to Nurse Staffing Levels in Tertiary and General Hospitals

  • Kim Yun Mi;June Kyung Ja;Cho Sung-Hyun
    • Journal of Korean Academy of Nursing
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    • v.35 no.8
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    • pp.1493-1499
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    • 2005
  • Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

Study on Short Term Smoking Cessation Treatment in Dental Hospitals in Korea (국내 치과대학병원에서 시행한 단기 금연진료에 대한 조사)

  • Song, Je-Il;Lee, Gi-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.245-258
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    • 2010
  • Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.

A Survey for Performance Measurement Indicators of Nursing Organizations in Hospitals (병원 간호조직의 성과평가지표에 관한 조사 연구)

  • Lee, Hae-Jong;Kang, Kyeong-Hwa;Jang, Soo-Jung;Kim, In-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.4
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    • pp.385-399
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    • 2005
  • Objective: The objective was to extract a preliminary performance measurement indicators of nursing organizations in hospitals using the BSC(Balanced Score Card) developed by Kaplan and Norton, and to analyze the content validity and evaluation methods of the performance measurement indicators with actual nurses in the nursing organization as participants in the study. Methods: The preliminary performance measurement indicators was created through a literature review and had the content validity by a professional. This survey was sent via post to 316 nurse managers and nurses with more than 5 years of experience in seven secondary and tertiary hospitals in the Seoul Gyonggi district. The completed questionnaires were returned by mail. Results: Fourteen indicators for finances, 16 for customer services, 27 for internal business processes, and 13 for learning and growth were selected. Conclusion: Amidst a rapidly changing medical environment, a first step was taken towards developing a performance measurement from various perspectives for nursing organizations in hospitals from various perspectives, rather than just one or a past-oriented perspective. However, as the most important thing is to actually use these indicators, continuous interest in publicity and education must be developed.

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Significance of Earth Science in the Entrance Examination of the Medical and Dental Graduate School (의.치의학 전문대학원 입시에서의 지구과학의 중요성)

  • Kim, Jeong-Yul;Shin, In-Hyun;Kwon, Kyung-Rim
    • Journal of the Korean earth science society
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    • v.27 no.4
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    • pp.486-502
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    • 2006
  • Earth Science is the study of Earth, where diverse organisms live, and it mainly focuses on the healthy, wealthy, and comfortable environment for our descendants. UNESCO and IUGS recently established the International Working Group on Medical Geology (1996), IGCP 454 Medical Geology (2000-2004), and International Medical Geology Association (IMGA, 2006) with the primary concerns of increasing awareness of Medical Geology among scientists, medical specialists, and the general public. Medical Geology and IMGA have been very successful in informing(educating) about the relationship between geological factors and health problems in humans and animals in the world through numerous international meetings, seminars, workshops, symposiums, and publications. Since there is a close correlation between Earth Science and Medical/ Dental Sciences as shown in the Medical Geology and IMGA, Earth Science, as with other areas in science, (i.e., Biology, Chemistry and Physics) should be included in the Medical Education Eligibility Test (MEET) and Dental Education Eligibility Test (DEET) for the Medical and Dental Graduate School. In this brief note, services and activities of UNESCO IGCP 454 Medical Geology and IMGA are introduced, sothat the inclusion of Earth Science as a subject requirement in the MEET and DEET can be considered. Such outcome will balance the development of Science Education in Korea.

Characteristics of Disease and Assistance Required for Bed-Ridden Elderly Patients at Home in Rural Areas (일부 농촌지역 재가 와병노인의 질환 및 개호의 특성)

  • Kim, Jin-Ho;Jeong, Yong-Jun;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.49-59
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    • 2003
  • Objectives: This study was intended to provide basic data available for the establishment of comprehensive and systematic public medical service for older persons about their concurrent pathology and time span for their bedridden state, and thereby, the medical service, and individual cares they have received. Methods: The study subjects included 207 elderly residents of men and women aged over 65, who were in the bedridden state at home at the time of investigation in September of 2002 at 11 'Myon' in Kongju city, Chungchongnamdo Province. They were asked to respond to the questionnaires by using interviews at their homes. Results: Of the elderly population studied, the overall rate of bedridden states was 1.61%(1.46% in men and 1.71% in women) and there was an increasing tendency with age in both sexes. The causes for bedridden states indicated that hypertension and atherosclerosis accounted for 43.6 % of them in men, and lumbago neuralgia spinal disease 40.3% in women as the most frequent cause, respectively. The mean years of bedridden states were greater in men(4.81${\pm}$2.89) than women(4.98${\pm}$2.89). By age groups, both sexes showed an increasing tendency of time span with age. The items of care required for the bedridden showed that bathing was the most frequent and it was followed by toileting, dressing and feeding in a decreasing order of frequency. The number of care per one patient was 3.4 in men and 3.5 in women with the increased tendency with decreasing age Ain both sexes. Conclusions: Though the proportion of bed-ridden patients increased according to the increasing age, there are substantial limitations in reducing the prevalence of chronic diseases. Therefore, it is required to establish the appropriate measures, such as various resources of health care services for dealing with the steadily increasing rate of bed-ridden patients.

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Recognition of college-preparatory students for dental hygienist (대입준비생들의 치과위생사에 관한 인식도 조사)

  • Kim, Dong-Yeol;Lee, Seung-Hun
    • Journal of Korean society of Dental Hygiene
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    • v.12 no.1
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    • pp.103-111
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    • 2012
  • Objectives : The purpose of this study was to survey the recognition of college-preparatory students who interested and prevented themselves in oral health diseases for dental hygienist in Yeungnam South Korea. Methods : The subjects in this study were 328 students who was seriously worried for career and entrance into a school. The survey period was from August 16th 2011 to November 26th 2011, and the data was collected from the high school students in Yeungnam and the preparatory students who visited S college in Gyeongju. This study was conducted by using the self-reported questionnaire. Results : The result of this study are as follows. 87.2% of the subjects have recognized about the name of dental hygienist, 51.5% have distinguished dental hygienist in the clinic, and 67.4% have recognized about education of dental hygienist that was more than a college graduate. The received services from dental hygienist was scalling(15.6%), assistant of treatment(14.7%), tooth brushing instrument(11.5%), Reception & receipt(11.0%), and etc. The majority of the subjects have recognized that dental hygienist was the professional(4.82 points), the important role in oral health(4.88 points), and the intermediary between patients and dentists(4.60 points). And they were friendly(4.64 points), responsible(4.81 points), and worthwhile job(5.01 points). However their appellation has not been established yet(4.00 points), they was difficult to distinguish from nursing assistants(4.37 points), and their task did not differs from AN(4.53 points). Also they compared to other job was not stressful job(3.58 points). Conclusions : Refer to these results, those will be the basis for professional development and status establish of clinical dental hygienists and for the upright role as a professional medical personnel of dental hygiene students. In addition, those will help to patients in the future, and become an effective instrument to learn knowledge, skill, and service that needed to conduct business.

A study on the self-evaluation of job performance and creativity of dental hygienists (치과위생사 직무와 개인의 창의성에 의한 자기평가 연구)

  • Hong, Sun-Hwa;Goo, Kyong-Mi
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.6
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    • pp.1037-1048
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    • 2010
  • Objectives : The awareness of health care need increasing attention from the public along with changing professional human-resources activity. As there are increasing social demand for the roles and professionalism of dental hygienists, the purpose of this study was to examine the job performance, creativity and organizational climate of dental hygienists by their own self-diagnostic evaluation in an attempt to help enhance their work ability. Methods : According to the data released as August 2008 by the Dental Association and public health centers in Gwangju, 735 dental hygienists worked at 425 dental clinics. The subjects in this study were 156 dental hygienists at 85 dental clinics who were selected by proportionate sampling method from among the dental hygienists. After an interview survey was conducted in person, the answer sheets from 132 respondents were analyzed except 24 incomplete ones. The questionnaire used in this study consisted of 49 items. A five-point Likert scale was used and SPSS 12.0 program was analyzed the data. Results : 1. As a result of checking the types of works, treatment cooperation(54%), and oral health education often(45%), They weren't responsible for preventive treatment(42%). 2. When they made a self-diagnostic evaluation of creativity and organizational climate, they put the highest value on their autonomy(2.21), followed by positive attitude(2.10). Out of seven organizational climate, challenging spirits(2.81) ranked highest, followed by reliability(2.66). 3. Major management eopmubyeol individual creativity compared with three business relationships and a positive attitude in the case of the high group received oral health education and care management services in a group doing the most was General office work and office assistance work in the medical assistance group that was doing business primarily. 4. In the relationship between self-assesment score and three performance duties, Positive difference was noted in the group with positive attitude and elevated autonomy in terms of performing oral health education. Conclusions : As a result, individual creativity and organization of the atmosphere, each detail, through analysis of the self-assessment model, developed guide on the investigation by doing a dental hygienist, a unique business promotion and Enlargement of the study suggested the need to be considered is.

Older Parents with Disabled Adult Children in Later Life: Health and Welfare Needs (성인장애자녀를 돌보는 저소득 노인부모의 보건복지 욕구)

  • Kim, Eunhye;Suk, Min-Hyun;Youn, Jung-Hye
    • 한국노년학
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    • v.30 no.4
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    • pp.1213-1223
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    • 2010
  • The purpose of this study is to explore and describe the health and welfare needs experienced by old parents living with disabled adult children, and to help generate research interest and public policy attention on this critical issue. For the purpose of this study, the survey was conducted with older parents who are living with dependent adult children with physical or mental disability. Among collected data for this study, data for 105 older parents were analyzed. The results showed that older parents have suffered with care responsibilities for their disabled adult children as well as special needs resulted from their old age. And older parents have little or even nothing prepared for later life because of lifetime economic, physical and social difficulties related to their disabled children. Also these difficulties had a significant impact on their idea of health and welfare needs in later life. It showed that older parents had mainly concerned and wanted to have the direct cash benefits and medical provisions but hardly recognised the importance of other services such as leisure activities. Preliminary suggestions of this study therefore may be helpful to improve the public policy approach in order to better serve older parents with disabled adult children in the coming aging society.

An Investigation of Factors Affecting Management Efficiency in Korean General Hospitals Using DEA Model (DEA모형을 이용한 종합병원의 효율성 측정과 영향요인)

  • Ahn, In-Whan;Yang, Dong-Hyun
    • Korea Journal of Hospital Management
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    • v.10 no.1
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    • pp.71-92
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    • 2005
  • The purpose of this study is to analyze the efficiency in management of general hospitals and investigate the major factors on efficiency. Specifically, the management of each general hospital is evaluated by using Data Envelopment Analysis(DEA) technique which is a nonparametric statistical method for measurement of efficiency. Then, the influencing factors are investigated through analyses of Decision-Tree Model and Tobit Regression. The target hospitals were general hospitals in which bed sizes are between 200 and 500 among a total of 276 general hospitals. The main data of financial indicators were collected from 48 hospitals, and it was analyzed by using two statistical models. For Model I, three input and two output variables were used for efficiency evaluation. In particular, three input variables were the number of medical doctors, the number of paramedical personnel, and the bed size. And, two output variables were the numbers of inpatients and outpatients per year, adjusted by bed-size. The results of DEA analysis showed that only seven out of 48 hospitals(15%) turned out to be efficient. The decision-tree analysis also showed that there were six significant influencing factors for Model I. Six factors for Model I were Bed Occupancy Rate, Cost per Adjusted Inpatient, New Visit Ratio of Outpatients, Retired Ratio, Net Profit to Gross Revenues, Net Profit to Total Assets. In addition, the management efficiency of hospital is proved to increase as profit and patient-induced indicators increase and cost-related indicators decrease, by the Tobit regression model of independent variables derived from the decision-tree analysis. This study may be contributable to the development of analytic methodology regarding the efficiency of hospital management in that it suggests the synthetic measures by utilizing DEA model instead of suggesting simple ratio-analyzing results.

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