• Title/Summary/Keyword: Remote medicine

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A Baseline Survey on Development of Primary Health Care in the Rural Korea -Sanpuk Village, Kumsa-Myun, Yuju- Gun, Kyunggi-Do- (농촌지역의 일차보건사업 개발을 위한 기초조사 연구 - 경기도 여주군 금사면 산북부락을 중심으로 -)

  • Kim, Myung-Ho;Yun, Suk-Woo;Rhee, Hae-Soak
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.5-27
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    • 1987
  • It is widely recognized that primary health care in the community is one of the most important and effective health measures in these days. However, it is reality that unsatisfactory health care system, ineffective utilization of health care by the community people in the rural area are hampering better understanding for primary health care. Therefore promoting health for the rural people and increasing understanding about primary health care, the baseline survey in the community focused in examination for safe community water supply was carried out. The survey was conducted through August 25-31, 1986 in order to find out health problems and relevant factors and to define the demographic characteristics of $^*$Sanpuk village, Kumsa-Myun, Yuju-Gun, Kyunggi-Do, Korea. Household survey was carried out for every home by trained interviewers. The major results are found out as follows : 1) 84.2%(400 houses) of total households were surveyed because 15.8%(75 houses) were unable to survey due to either refusal against interview or absence of family. These 400 households were composed of 1,697 residents(male:830, female 867). Educational level of respondents showed 34.1% as elementary school graduated. Religion distribution showed Buddism(23.8%) as the most dominant. 50.7% of respondents married in the area. 2) Most households(91.5%) have lived in their own house in Sanpuk area. Average family size showed 4.3. More than half of residents(64.2%) have used public supplied water tap. Only 1.5% of the households had a flush toliet. The rest of households have still used primitive insanitary latrines. 3) 32.5% of residents have used gas burner for cooking and for heating in the house, and the coal briquet were used for boiler. Lack of convenient public transportation was the chief complaint for their day life. 4) Each household occupied 1,990 pyungs of rice paddy and 1,170 pyungs of ordinary field in average. Beside farming products, mushroom was the highest product. 5) Sixth percent of households in the survey area regularly participated in community meeting one hand and on the other hand 39.5% never participated. Most of respondents closely contacted with their neighbours and they seemed very friendly each other. 6) The prevalence rate of illness and injury during recent 15 days showed 48.3 per 1,000. The prevalence rate of chronic illnesses during the past one year showed 74 per 1,000. Injury and accident lead the higher portion(22.0%) in the former and in the latter pain(arthritis, back-pain) showed 27.0% as the dominant sickness. 87.8% of the ill residents in the former received medical treatment. As the most frequently utilized medical facility, the clinic or hospital were counted. Among the residents suffering from chronic illnesses, 77.3% in Sanpuk area get some kind of medical treatments and they rarely utilized the clinic or hospital. The reason why the patient did not receive any medical care was found out the fact that symptoms of illness was light or mild and economic problems was serious. 7) Average age of marriage showed 21.6 years old in the women and the average duration of marital period was shown for 15.1 years. The married woman in reproductive age in Sanpuk area had experienced pregnancies 4 times in the aver-age including 0.7 time of pregnancy in average were interrupted by induced abortion and 0.3 time by spontaneous abortion respectively. The practicing rate of the family planning of the married woman during reproductive ages showed 70.7% and the tuballigation was found out as the most frequently used contraceptives. 8) Among woman who has children under 2 years old, 70.0% had received the prenatal care for the last pregnancy. However, the average number of prenatal care visitis per woman showed 3.3 times. Fifty-two % of woman who received the postnatal care for the last delivery showed only 37.5%. 9) Immunization rate of the children under 2 years old showed relatively high and looked successful. The breast feeding for these children showed dominantly in the most. Most of the mothers in Sanpuk area had started the supplementary diet during weaning period of their infants of 6th and 7th month after birth. * : Sanpuk area is a demstration area for community development which has been supported by the Community Development Foundation during the part 10 years. The village is relatively closer to urban area such as Seoul, However, it has a similar characteristics shown as a remote village because of geographical location and inconvenient transportation at present.

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A Study of the Relationship between Personality Traits and Job Satisfaction of Community Health Practitioners in a Rural Area (일부 보건진료원의 성격특성과 직무만족도에 관한 연구)

  • Lee, Soon-Ryae;Park, Sang-Hag
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.331-350
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    • 1999
  • This study was attempted to examine relationship between personality traits and job satisfaction of community health practitioners(CHPs) working in remote rural area in order to suggest some methods to enhance their lob performance and the degrees of job satisfaction. The General Personality Test and the revised version of Job Satisfaction Questionnaire were administered to 200 of 348 CHPs in the Kwangju-Chonnam area and then the percentages, means, standard deviations and Pearson's correlation coefficients of these data were obtained, ANOVA and logistic analysis were used. The results of study were as follows : 1. CHPs without religion were more satisfied with their salary than those with religion. 2. CHPs who hoped for continuous education showed higher scores than the others on necessary job, professional pride and autonomy. Those who chose for independent job showed higher scores than the others on both necessary job and professional pride. Those who hope for long duration showed higher scores than the others on both necessary job and professional pride. Those who were satisfied with the present occupation showed higher scores than the others on pay satisfaction, necessary job, professional pride, interaction, autonomy and demand from organization. 3. Their autonomy scores differed significantly according to work status, both interaction and autonomy scores did so according to the fields of the past job in CHP, and their autonomy scores according to location of clinics. Their interaction scores differed significantly according to the frequency of home visits per mouth, both the degrees of salary satisfaction and professional pride scores did so according to the frequency of counseling education per mouth, and their professional pride scores did so according to total income per year. 4. The levels of their responsibility and self-confidence showed the highest of all personality traits variables. 5. The professional pride score of CHPs showed the highest of all job satisfaction variables. 6. Dominance were mostly correlated with autonomy and responsibility were mostly associated with professional pride. Both emotional stability and self-confidence were mostly related necessary job. In conclusion, religion, location of clinics, clinical experience, opportunity for education, dominance, self-confidence, the duration of services hoped for, satisfaction with the present occupation, the field of past job and administrative affairs were found to be the important factors in the degrees of their job satisfaction. Therefore, the methods to consider these variables will be necessary to develop for enhancing the efficiency of their Job performance and the degrees of job satisfaction.

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Measurement and Monte Carlo Simulation of 6 MV X-rays for Small Radiation Fields (선형가속기의 6 MV X-선에 대한 소형 조사면 측정과 몬테 카를로 시뮬레이션)

  • Jeong Dong Hyeok;Lee Jeong Ok;Kang Jeong Ku;Kim Soo Kon;Kim Seung Kon;Moon Sun Rock
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.195-202
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    • 1998
  • Purpose : In order to obtain basic data for treatment plan in radiosurgery, we measured small fields of 6 MV X-rays and compared the measured data with our Monte Carlo simulations for the small fields. Materials and Methods : The small fields of 1.0, 2.0 and 3.0 cm in diameter were used in this study. Percentage depth dose (PDD) and beam Profiles of those fields were measured and calculated. A small semiconductor detector, water phantoms, and a remote control system were used for the measurement Monte Carlo simulations were Performed using the EGS4 code with the input data prepared for the energy distribution of 6 MV X-rays, beam divergence, circular fields and the geometry of the water phantoms. Results : In the case of PDD values, the calculated values were lower than the measured values for all fields and depths, with the differences being 0.3 to 5.7% at the depths of 20 to 20.0 cm and 0.0 to 8.9% at the surface regions. As a result of the analysis of beam profiles for all field sizes at a depth of loom in water phantom, the measured 90% dose widths were in good agreement with the calculated values, however, the calculated Penumbra radii were 0.1 cm shorter than measured values. Conclusion : The measured PDDs and beam profiles agreement with the Monte Carlo calculations approximately. However, it is different when it comes to calculations in the area of phantom surface and penumbra because the Monte Carlo calculations were performed under the simplified geometries. Therefore, we have to study how to include the actual geometries and more precise data for the field area in Monte Carlo calculations. The Monte Carlo calculations will be used as a useful tool for the very complicated conditions in measurement and verification.

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High versus Low Dose-Rate Intracavitary Irradiation for Adenocarcinoma of the Uterine Cervix (자궁경부 선암 환자에서 고선량률 강내치료와 저선량률 강내치료의 비교)

  • Kim Woo Chul;Kim Gwi Eon;Chung Eun Ji;Suh Chang Ok;Hong Soon Won;Cho Young Kap;Loh JK
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.32-39
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    • 2000
  • Purpose :The incidence of adenocarcinoma of the uterine cervix is low. Traditionally, Low Dose Rate (LDR) brachytherapy has been used as a standard modality in the treatment for patients with carcinoma of the uterine cervix. The purpose of this report is to evaluate the effects of the High dose rate (HDR) brachytherapy in the patients with adenocarcinoma of the uterine cervix compared with the LDR. : From January 1971 to December 1992, 106 patients of adenocarcinoma of uterine cervix were treated with radiation therapy in the Department of Radiation Oncology, Yonsei University with curative intent. LDR brachytherapy was carried out on 35 patients and 71 patients were treated with HDR brachytherapy. In LDR Group, 8 patients were in stage I, 18 in stage II and 9 in stage III. External radiation therapy was delivered with 10 MV X-ray, daily 2 Gy fractionation, total dose 40$\~$46Gy (median 48 Gy). And LDR Radium intracavitary irradiation was peformed with Henschke applicator, 22$\~$59 Gy to point A (median 43 Gy). In HDR Group, there were 16 patients in stage 1, 38 in stage II and 17 in stage III. The total dose of external radiation was 40$\~$61 Gy(median 45 Gy), daily 1.8$\~$2.0 Gy. HDR Co-60 intracavitary irradiation was peformed with RALS (Remote Afterloading System), 30 $\~$ 57 Gy(median 39 Gy) to point A, 3 times a week, 3 Gy per fraction. Conclusion : The 5-year overall survival rate in LDR Group was 72.9$\%$, 61.9$\%$, 45.0$\%$ in stage I, II, III, respectively and corresponding figures for HDR were 87.1$\%$, 58.3$\%$, 41.2$\%$, respectively (p>0.05). There was no statistical difference in terms of the 5-year overall survival rate between HDR Group and LDR Group in adenocarcinoma of the uterine cervix. There was 11$\%$ of late complication rates in LDR Group and 27$\%$ in HDR Group. There were no prognostic factors compared HDR with LDR group. The incidence of the late complication rate in HDR Group stage II, III was higher than that in LDR Group(16.7$\%$ vs. 31.6$\%$ in stage II, 11.1$\%$ vs. 35.3$\%$ In stage III, p>0.05). Although the incidence of radiation induced late complication rate was higher in HDR Group stage II and III patients than that in the LDR Group, statistical significance was not detected and within acceptable level. Conclusion : There was no difference in terms of 5-year survival rate and failure pattern in the patients with adenocarcinoma of the uterine cervix treated with HDR and LDR brachytherapy. Even late complication rates were higher in the HDR group It was an acceptable range. This retrospective study suggests that HDR brachytherapy seems to replace the LDR brachytherapy in the adenocarcinoma of the uterine cervix. However, further studies will be required to refine the dose rate effects.

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A Study on Curriculum Development For Community Health Practitioners (보건진료원 직무교육 교과과정 개선을 위한 일 연구)

  • 조원정;이경자
    • Journal of Korean Academy of Nursing
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    • v.22 no.2
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    • pp.207-226
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    • 1992
  • This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

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Wearable Computers

  • Cho, Gil-Soo;Barfield, Woodrow;Baird, Kevin
    • Fiber Technology and Industry
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    • v.2 no.4
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    • pp.490-508
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    • 1998
  • One of the latest fields of research in the area of output devices is tactual display devices [13,31]. These tactual or haptic devices allow the user to receive haptic feedback output from a variety of sources. This allows the user to actually feel virtual objects and manipulate them by touch. This is an emerging technology and will be instrumental in enhancing the realism of wearable augmented environments for certain applications. Tactual displays have previously been used for scientific visualization in virtual environments by chemists and engineers to improve perception and understanding of force fields and of world models populated with the impenetrable. In addition to tactual displays, the use of wearable audio displays that allow sound to be spatialized are being developed. With wearable computers, designers will soon be able to pair spatialized sound to virtual representations of objects when appropriate to make the wearable computer experience even more realistic to the user. Furthermore, as the number and complexity of wearable computing applications continues to grow, there will be increasing needs for systems that are faster, lighter, and have higher resolution displays. Better networking technology will also need to be developed to allow all users of wearable computers to have high bandwidth connections for real time information gathering and collaboration. In addition to the technology advances that make users need to wear computers in everyday life, there is also the desire to have users want to wear their computers. In order to do this, wearable computing needs to be unobtrusive and socially acceptable. By making wearables smaller and lighter, or actually embedding them in clothing, users can conceal them easily and wear them comfortably. The military is currently working on the development of the Personal Information Carrier (PIC) or digital dog tag. The PIC is a small electronic storage device containing medical information about the wearer. While old military dog tags contained only 5 lines of information, the digital tags may contain volumes of multi-media information including medical history, X-rays, and cardiograms. Using hand held devices in the field, medics would be able to call this information up in real time for better treatment. A fully functional transmittable device is still years off, but this technology once developed in the military, could be adapted tp civilian users and provide ant information, medical or otherwise, in a portable, not obstructive, and fashionable way. Another future device that could increase safety and well being of its users is the nose on-a-chip developed by the Oak Ridge National Lab in Tennessee. This tiny digital silicon chip about the size of a dime, is capable of 'smelling' natural gas leaks in stoves, heaters, and other appliances. It can also detect dangerous levels of carbon monoxide. This device can also be configured to notify the fire department when a leak is detected. This nose chip should be commercially available within 2 years, and is inexpensive, requires low power, and is very sensitive. Along with gas detection capabilities, this device may someday also be configured to detect smoke and other harmful gases. By embedding this chip into workers uniforms, name tags, etc., this could be a lifesaving computational accessory. In addition to the future safety technology soon to be available as accessories are devices that are for entertainment and security. The LCI computer group is developing a Smartpen, that electronically verifies a user's signature. With the increase in credit card use and the rise in forgeries, is the need for commercial industries to constantly verify signatures. This Smartpen writes like a normal pen but uses sensors to detect the motion of the pen as the user signs their name to authenticate the signature. This computational accessory should be available in 1999, and would bring increased peace of mind to consumers and vendors alike. In the entertainment domain, Panasonic is creating the first portable hand-held DVD player. This device weight less than 3 pounds and has a screen about 6' across. The color LCD has the same 16:9 aspect ratio of a cinema screen and supports a high resolution of 280,000 pixels and stereo sound. The player can play standard DVD movies and has a hour battery life for mobile use. To summarize, in this paper we presented concepts related to the design and use of wearable computers with extensions to smart spaces. For some time, researchers in telerobotics have used computer graphics to enhance remote scenes. Recent advances in augmented reality displays make it possible to enhance the user's local environment with 'information'. As shown in this paper, there are many application areas for this technology such as medicine, manufacturing, training, and recreation. Wearable computers allow a much closer association of information with the user. By embedding sensors in the wearable to allow it to see what the user sees, hear what the user hears, sense the user's physical state, and analyze what the user is typing, an intelligent agent may be able to analyze what the user is doing and try to predict the resources he will need next or in the near future. Using this information, the agent may download files, reserve communications bandwidth, post reminders, or automatically send updates to colleagues to help facilitate the user's daily interactions. This intelligent wearable computer would be able to act as a personal assistant, who is always around, knows the user's personal preferences and tastes, and tries to streamline interactions with the rest of the world.

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