• Korean Journal of Oriental Medicine
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• v.16 no.3
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• pp.127-133
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• 2010

The purpose of this study is to develop the order communication system for Traditional Korean Medicine(TKM) which can support prescribing decisions and provide the toxicological information. The relative vulnerability of the infrastructure of TKM has made us start the study. We carried out the benchmarking for TKM charting solution firstly, and then designed the intelligent search and supporting method for prescription decisions. We developed of the medical herbs database and the web-based order communication program which can be used in medical field actually. This system supplies a various functions to oriental medical doctors such as management for prescription history, search for herb's effects, generating prescriptions, inventory management, alerting of toxicity and taboo, guideline for taking medicine, and so on. The design and implementation process has been described in this research. We expect that this system will play an important role in electronic medical record(EMR) or electronic health record(EHR) binding diagnosis and management functions.

• Journal of Korea Multimedia Society
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• v.11 no.3
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• pp.386-397
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• 2008

This study proposes the actualization of a standard data model for activities through the development of clinical document architecture for medication administration using the health level 7 development frameworks(HDF) process based on object oriented analysis and development method of health level 7 V 3. Medication administration is the most common activity performed by clinical professionals at healthcare settings. A standardized information model and structured hospital information system are necessary to achieve evidence-based clinical activities. We had used HDF and various tools(Rose tree, RMIM designer, V3 generator) to create the clinical document architecture(CDA). This allowed us to illustrate each step of the HDF in the administration of medication. This study generated a information model of the medication administration process, which is one clinical activity. It should become a fundamental conceptual model for understanding international standard methodology by information technology(IT) developers with the objective of modeling healthcare information systems.

• The Korean Journal of Food And Nutrition
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• v.22 no.1
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• pp.110-122
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• 2009

Along with the increasing interests of modem-day society toward topics of health and beauty, various studies are being actively conducted on the effects of diet for obesity prevention, and separate from aspects of disease prevention and health promotion. This study aimed to examine individual perceptions of obesity by age, and to prepare basic data for implementing an age-based weight control system, by comparing attitudes toward weight control. The research and analysis were conducted using questionnaires, provided to high school students(teenagers, 189 students), college students(20 or older, 116 students), and adults(30 or over, 88 adults) living in Daegu City. In terms of the respondents' perceptions of obesity, among those who described themselves as overweight, only about 10% were actually proven to be overweight. Also, significantly more female students than male students perceived themselves as overweight, despite the fact that they were in a normal weight range(p<0.007). There was no significant difference in the cause of obesity by gender, but it was found to be attributed to a lack of exercise for teenagers, and poor eating habits for those in their twenties and thirties. Concerning the intention to participate in a weight management class, the female teenagers showed significantly more interest than the male teenagers(p<0.017). Also, with regard to the respondents' attitudes toward weight control, the teenage females showed significantly higher interest in weight control than the teenage males p<0.003 and those in their twenties p<0.001. Moreover, regarding the period in which the respondents became most interested in weight, the teenage male students were most interested in weight during their middle school years and teenage females became most interested during their high school years. Therefore, the information from this study leads us to propose there is a need to correct the suggested reckless dieting that is occurring within an appearance-based society, as well as a need to establish a systematic weight control system, along with gathering subsequent basic data.

• Korean Journal of Clinical Laboratory Science
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• v.45 no.2
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• pp.66-72
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• 2013

Fine Needle Aspiration Biopsy Cytology (FNABC), which is known as the most accurate and cost-effective method for diagnosis of the thyroid nodule, may still result in indeterminate cases that are cellular paucity and show minor nuclear atypia. However, most cases are associated with suspicion of papillary thyroid carcinoma (PTC). A B-type Raf kinase (BRAF) mutation was found in about half of PTCs which is currently helping us to differentiate malignancies from benign lesions. Cases studied included 46 histological, confirmed PTC cases. FNABC 102 cell paucity and 74 atypia benign cases were previously diagnosed as suspicious of PTC using cytologic examination. These cases were analyzed for BRAF mutation by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with a new restriction enzyme. In this study, the sensitivity and specificity were calculated and, BRAF mutation was detected by means of a histological method in 23 of 46 cases of PTC and no mutation was found in 22 cases. However, one case was not detected. In using FNABC, BRAF mutation was detected in 6 of 102 cases in cell paucity and in 11 of 74 cases in the atypia. Two cases were not detected in the atypia. The sensitivity and specificity of PCR-RFLP in FNABC were 60% and 97.4% respectively. Assessment of Formalin Fixed Paraffin Embedding (FFPE) block demonstrated similarly a 51.1% positive and 48.9% negative in PTC. Evaluation of BRAF mutation revealed high specificity and low sensitivity in using FNABC method. This study suggests that BRAF mutation analysis should be useful for the clinical diagnosis of PTC in FNABC with cytological findings suspicious for PTC.

• The Journal of Korean Academic Society of Nursing Education
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• v.5 no.1
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• pp.97-105
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• 1999

Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.335-373
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• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• Women's Health Nursing
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• v.2 no.1
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• pp.106-124
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• 1996

This paper reviews battering, sexual violence and divorce experienced among women. There three problems have negative influence on health status in women and are further developed to social problems such as family dissolution. The victims of the problems may manifest physical injury, emotional difficulties and social withdrawl, while their children may show problems caused by lack of parental caring and by resembling abusive behaviors of their parents. Hence, nurses need to pay attention to batting, sexual violence, and divorce and to develop relevant nursing interventions for them. Some strategies of dealing with those problems are presented in the following. First, we have to eliminate sexism prevailing in out society. Our society is assigning inequal and asymmetrical gender role. Mass media should inspire equality between genders and show a healthy model of family and community. Second, social system and laws should be changed through collective efforts. Those living conditions of women cannot be changed by the effort of women themselves only. We all need to work for establishing and changing the law, so that those women in suffering can obtain immediate and adequate protection. Third, social support system of consulting and referring women's problems should be established. Such support system as hot line, shelter and counseling clinics would help women in crisis. Fourth, job training and arrangement should be available to women who are divorced. Fifth, there should be self-help group for those women in suffering. Self-help group would help those women in sharing their problems and feelings and in establishing coping strategies. Nurses, as the largest group among health professionals, are sensitive and respond to health needs of clients and have an effect on managing women's health. However, we nurses have not been ready for dealing with problems of women, although most of us are women. we not need to change our perspective of women's health problems from a traditional medical perspective to feministic one. Accordingly, nurses need to develop realistic way of caring those women in suffering and to assist them in making decisions for their lives by themselves.

• Korean Journal of Agricultural Science
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• v.23 no.2
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• pp.301-322
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• 1996

This study is first aimed at identifying the possibility of labour saving and production cost decreasing in rice production with respect to seed broad casting technology. Comparison of labour inputs and production costs of rice in-between USA and Korea and recommendation of policy guidelines for the continous rice cultivation are the second objective of this study. Under the WTO system, rice enterprice is the most vulnerable crop in the sense of labour productivity and price competitiveness in the international market. How to adapt labour saving technology and how to decrease production costs are the most imminent problems to be solved in rice production. To achieve the objectives, survey on nine rice enterprice farms were made in Daeho tidal farmland with respect to the size of farm, labour inputs, productivity, farm mechanization and farm land base development. The existing data on labour saving technology by seed broadcasting which had surveyed by Rural Development Administration were collected to compare the surveyed data from Daeho tidal farm land The study results and policy recommendation are summarized as follows; 1. Labour requirements per 10a for rice enterprise farms with seed broadcasting and with transplanting were estimated 11.4 and 18.5hours respectively. 'This above labour inputs were equivalent to 1/3-1/5 of the national average labour inputs of 53.6 hours which were included transplanting and harvesting by machinery. Considering the labour requirement of 1.7 hours per 10a for the USA rice production, Korea rice culture has possibility to decrease labour demand upto USA level of labour inputs. 2. Production cost of rice in Korea were estimated US$4,181 per ha which were higher than that of USA by 3.00 times and production costs per ton were shown as US$313 for USA rice and US$1,018 for Korean rice. 3. Land productivity of rice per 10a in America was reached to 4,325kg and the counterpart of Korea was about 4,181kg in recent year. In the sense of land productivity, both yields of rice were comparable. 4. The price of japonica type rice similar to Korean traditional rice in international market in 1994 was f.o.b US$466 per ton which was equivalent to import parity price of US$830 per ton in domestic market. The price of rice purchased by Korean G't and received by farmers were amounted to US$ 2,013 and US$ 1,663 respectively in the same year. Domestic prices mentioned above were higher than the import parity price as US$830 by 2.0-2.4 times. 5. American rice production competitive to Korean rice was equivalent to 17,012 thousand tons, 1.28% of the world production of rice in 1991 and consumption of rice in America was amounted to 2,633 thousand tons. Exportable quantity of USA rice were estimated as 4,379 thousand tons of which 52.3%, 2,300 thousand tons, were exported indeed in the same year. 6. The quantity of Korean rice produced in 1991 was estimated 1.00% of the world production. The world amount of rice exported in 1991 was reached to 2.45% of the world production of which 34.2% was occupied by USA The remaining quantities of world exported rice were dominated by Tiland, Pakistan and Vietnam where produced indica variety. 7. Under the given technology, labour inputs per 10a for rice production could be possible to save by 70% of the national average labour requirement of 53.6 hours through implmenting complete farm mechanization with land consolidation and on-farm development and improvement of fanning practices like seedbroad casting txchnology etc. On the other hand, prduction costs of rice could be decreased by 10% rather than 49% as target indicated in the Rural Development Counter Measures of Korean Government in 1994 owing to increasing farm mechanization cost and interest on land service with high price. Accordingly production cost of rice per kg could be decreased only by 10% of the 1994 production cost. 8. Rice policy of Korean government in the future should take into account the labour saving technology to solve labour shortage in rural area and to enhance off-farm incomes by creating job opportunities in agro-industrial zones and special production area. On account of the staple food and main energy source for people's health, rice production even encountered vulnerable economic settings should be continued without price distortion policies and discouraging farmer's intention to cultivate rice by importing institutionally the direct income subsidy system.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1845-1850
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• 2015

Background: Cancer is recently one of the major concerns of the public health both in the world and Iran. To inform priorities for cancer control, this study estimated years of potential life lost (YPLL) and productivity losses due to cancer-related premature mortality in Iran in 2012. Materials and Methods: The number of cancer deaths by sex for all cancers and the ten leading causes of cancer deaths in Iran in 2012 were obtained from the GLOBOCAN database. The life expectancy method and the human capital approach were used to estimate the YPLL and the value of productivity lost due to cancer-related premature mortality. Results: There were 53,350 cancer-related deaths in Iran. We estimated that these cancer deaths resulted in 1,112,680 YPLL in total, 563,332 (50.6%) in males and 549,348 (49.4%) in females. The top 10 ranked cancers accounted for 75% of total death and 70% of total YPLL in the males and 69% for both death and YPLL in the females. The largest contributors for YPLL in the two genders were stomach and breast cancers, respectively. The total cost of lost productivity due to cancer-related premature mortality discounted at 3% rate in Iran, was US$ 1.93 billion. The most costly cancer for the males was stomach, while for the females it was breast cancer. The percentage of the total costs that were attributable to the top 10 cancers was 67% in the males and 71% in the females. Conclusions: The YPLL and productivity losses due to cancer-related premature mortality are substantial in Iran. Setting resource allocation priorities to cancers that occur in younger working-age individuals (such as brain and central nervous system) and/or cancers with high incidence and mortality rates (such as stomach and breast) could potentially decrease the productivity losses and the YPLL to a great extent in Iran.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.19 no.3
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• pp.270-279
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• 2009

In order to check a necessity of health control for the laborers who are in use of mixed organic solvents in the printing industries, this study evaluated the use status of mixed organic solvents, health subjective symptoms on the exposure of the solvents, health hazard for each kind of printings for the employees who work for the printing industries located in Seoul and Gyeonggi. The study analyzed 228 sites and 311 people responded of the total 250 sites surveyed from March to September 2007, and obtained the following results; 1) Estimating the exposure of the mixed organic solvents, the study found that estimation of mixture(EM) was different for each kind of printings at a level of significance, excessiveness of EM was 7.5%, the highest, for gravure printing, 5.6% for screen printing, 4.7% for master printing, 2.9% for offset printing. 2) As to the mean scores of health subjective symptoms for each kind of printings, workers in screen printing showed high scores in every subjective symptom, of which symptom of central nervous system was 3.75, the highest, and the difference was statistically at a level of significance(p<0.01). 3) Results of the hazard analysis for carcinogens and non-carcinogens contained in the mixed organic solvents exposed to the workers showed that cancer risk of offset printing workers was $7.8{\times}10^{-9}$ for benzene, the mean cancer risk was $2.02.{\times}10^{-8}$ from Monte-Carlo simulation, and both risks did not exceed the US EPA permissible standard of $1{\times}10^{-6}$. The total hazard indices of the non-carcinogens estimated was 3.523, the highest, for gravure printing, 2.381 for master printing, 1.125 for screen printing, respectively, and all exceeded 1.