• Title/Summary/Keyword: US health system

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An Evaluative Study of Community based Health Promotion Project (지역사회 건강 증진 사업 평가 연구 -1개 도시지역 보건소의 경험적 사례를 중심으로-)

  • Park, Sung-Ae;Park, Jung-Ho;Yun, Soon-Nyung;Lee, In-Sook
    • Research in Community and Public Health Nursing
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    • v.12 no.2
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    • pp.532-546
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    • 2001
  • This report is the result of interim evaluation of a health promotion project which was operated by a public health center of K Gu in the year of 2000. It evaluated the aspects of the aim of a project, a target group. and adequacy and appropriateness of a approaching strategy by considering data of public health center's self-evaluation, and guidelines of a group assigned to evaluate the project. The way of evaluation was dividing the project into a colligated evaluation and a evaluation by projects in the aspects of the structure, the procedure. and the result of a result. Through this. a device to improve the health improvement project was derived. The target data for evaluation was the second data and data of self-evaluation, reported data, membership register data of a health management. and interview materials with the people in charge by projects that are all collected as a project management documents. The result of evaluation is stated below. 1. Main purpose of a health promotion project is building a environment of healthy life practicing and providing information through various ways to increase the rate of practicing healthy life. Through overall project. the ultimate purpose and definite purpose were same, however, it was not quite satisfied to offer planning of a time, and a target amount in detailed strategy. As the purpose was to build environment of healthy life practicing. most of the projects had the whole community citizen as a target group. That made difficult to operate detailed projects. so the result was hard to estimate as much as the effort put into it. Also, there were too many kinds of projects and target groups to be equal to by the human source of a health promotion project team. so we were just bent on operating a project. and could not prepare for the evaluation. As the most of former evaluation of public health service was just counting number of the objects, the new way of evaluating a project wasn't familiar to us. so the evaluation of a detailed project cannot be done well. Techniques and advices needed for all of these things weren't offered appropriately. For the forward direction of unfolding project. it is desirable to operate project by selecting focused target and considering a strategy of evaluation as a strategy of reasonable spread. The evaluation of the project became difficult as participation of citizen for it was poor. So, approach strategy that can lead the motivation of community citizen should be derived. 2. For the continuation of a health promotion project, technical assistance system. description of a field in charge, and arrangement of the amount of task should be developed as a central level. Furthermore, as the health promotion project focus on behavioral modification program whose purpose is to lessen dangerous factors. the public health service model which is incorporated with former project should be developed and spread out in the field for the object-centered project plan.

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Association of Ultrasonography Features of Follicular Thyroid Carcinoma With Tumor Invasiveness and Prognosis Based on WHO Classification and TERT Promoter Mutation

  • Myoung Kyoung Kim;Hyunju Park;Young Lyun Oh;Jung Hee Shin;Tae Hyuk Kim;Soo Yeon Hahn
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.103-112
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    • 2024
  • Objective: To investigate the association of ultrasound (US) features of follicular thyroid carcinoma (FTC) with tumor invasiveness and prognosis based on the World Health Organization (WHO) classification and telomerase reverse transcriptase (TERT) promoter mutations. Materials and Methods: This retrospective study included 54 surgically confirmed FTC patients with US images and TERT promoter mutations (41 females and 13 males; median age [interquartile range], 40 years [30-51 years]). The WHO classification consisted of minimally invasive (MI), encapsulated angioinvasive (EA), and widely invasive (WI) FTCs. Alternative classifications included Group 1 (MI-FTC and EA-FTC with wild type TERT), Group 2 (WI-FTC with wild type TERT), and Group 3 (EA-FTC and WI-FTC with mutant TERT). Each nodule was categorized according to the US patterns of the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and American College of Radiology-TIRADS (ACR-TIRADS). The Jonckheere-Terpstra and Cochran-Armitage tests were used for statistical analysis. Results: Among 54 patients, 29 (53.7%) had MI-FTC, 16 (29.6%) had EA-FTC, and nine (16.7%) had WI-FTC. In both the classifications, lobulation, irregular margins, and final assessment categories showed significant differences (all Ps ≤ 0.04). Furthermore, the incidences of lobulation, irregular margin, and high suspicion category tended to increase with increasing tumor invasiveness and worse prognosis (all Ps for trend ≤ 0.006). In the WHO groups, hypoechogenicity differed significantly among the groups (P = 0.01) and tended to increase in proportion as tumor invasiveness increased (P for trend = 0.02). In the alternative group, punctate echogenic foci were associated with prognosis (P = 0.03, P for trend = 0.03). Conclusion: Increasing tumor invasiveness and worsening prognosis in FTC based on the WHO classification and TERT promoter mutation results were positively correlated with US features that indicate malignant probability according to both K-TIRADS and ACR-TIRADS.

The Literature Review of Music Therapy in the United States (음악요법에 관한 연구)

  • Lee, Won-Yu
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.245-261
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    • 2000
  • Based on the literature, status and role the music therapist in America was reviewed for this study. The process of developing a music therapy program in America suggests to us many things: In America, music therapists have sustained a mutually beneficial status with their clients for, over fifty years. Excellence in academic education and clinical training enable music therapists to continue to provide quality music therapy. The magnitude of change in to music therapy in the United States, however creates the challenge of providing real access to music therapy continues in the future. Music therapy is the use of music in the accomplishment of therapeutic aims: the restoration, maintenance, and improvement of mental and physical health. Music therapists work with individuals of all ages who require special services due to behavioral. social. learning, or physical disabilities. Employment may be in hospitals, clinics, day care facilities, schools, community mental health centers, substance abuse facilities, nursing homes, hospices, rehabilitation centers, correctional facilities, or private practices. The American Music Therapy Association (AMTA) was founded in 1998 as a result of a union between the American Association for Music Therapy (founded in 1971) and the National Association for Music Therapy(founded in 1950). Music therapists are highly qualified professionals who have completed approved degree programs and had clinical training in order to receive Board Certification(MT-BC), with the designation of Registered, Certified, or Advanced Certified Music Therapist(RMT. CMT - or ACMT). AMTA provides several mechanism for monitoring the quality of music therapy programs: Standards of Practice. a Code of Ethics, a system for Peer Review, a Judical Review Board, and an Ethics Board. According to the results of this study, the suggestions were as follows: 1. It is concluded that music therapy as a nursing intervention can be effective for the clients. 2. It is a great challenge to develope a music therapy program for nursing intervention however, it is also task and responsibility to further the development of nursing.

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Assessment of Jordanian Patient's Colorectal Cancer Awareness and Preferences towards CRC Screening: Are Jordanians Ready to Embrace CRC Screening?

  • Omran, Suha;Barakat, Husam;Muliira, Joshua Kanaabi;Bashaireh, Ibrahim;Batiha, Abdul-Moni'm
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4229-4235
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    • 2015
  • Background: Colorectal cancer (CRC is increasingly becoming a major cause of cancer morbidity and mortality in Jordan. However the population's level of awareness about CRC, CRC screening test preferences and willingness to embrace screening are not known. The aim of this study was to assess the level of CRC awareness and screening preferences among Jordanian patients. Materials and Methods: A survey assessing the CRC knowledge levels was distributed among patients attending outpatient gastroenterology clinics in public hospitals throughout Jordan. A total of 800 surveys were distributed and of these 713 (89.1%) were returned. Results: Only 22% of the participants correctly judged CRC among the choices provided as the commonest cause of cancer related deaths. The majority of participants (68.3%) underestimated their risk for CRC. Only 26.8% correctly judged their life time risk while 5% overestimated their risk. Two thirds of participants (66%) were willing to pay 500 Jordanian Dinars (equivalent to 706 US$) in order to get a prompt colonoscopy if recommended by their physician, while 25.5% reported that they would rather wait for 6 months in order to get a free colonoscopy. Conclusions: Although the participants tended to underestimate their risk for CRC, they were mostly aware of CRC as a major cause of mortality and were willing to embrace the concept of CRC screening and bear the related financial costs. These findings about CRC awareness and propensity for screening provide a good foundation as the Jordanian health system moves forward with initiatives to promote CRC screening and prevention.

Korean Longitudinal Study of Ageing: Research Design for International Comparative Studies (고령화연구패널조사의 국제비교연구 활용 가능성)

  • Boo, Ka-Chung;Chang, Ji-Yeun
    • Survey Research
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    • v.7 no.2
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    • pp.97-122
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    • 2006
  • Korean Longitudinal Study of Ageing(KLoSA)', launched in 2006, has developed a research network with 'Health and Retirement Study(HRS, US),' Studies on Health and Retirement in Europe(SHARE, EU),' and 'English Longitudinal Study of Ageing(ELSA, UK)'and tried to construct a mega data library. The KLoSA team has designed their research with focusing on the following three points, in order to use KLoSA for international comparative studies. First, KLoSA shares the key research areas such as family structure, health, employment, income, asset, subjective expectations with the comparable studies. Second, KLoSA team has developed the instrument to reflect the Korean culture and institutions. They considered the institutional characteristics in public pension and health care system and in employment practices. They also counted the cultural conventions in family life such as financial management and care exchange, Finally, KLoSA tries to capture the psychological characteristics of the Korean elderly by making the measurement scales more understandable.

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Case study of Hexavalent Chromium and Silica Exposure Assessment and Respiratory Fit-test for Paint Manufacturing Worker (페인트 제조 작업자의 6가 크롬 및 실리카 노출평가와 호흡보호구 밀착도 검사 사례)

  • Lee, Hyun Seok;Kim, Boowook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.31 no.4
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    • pp.295-303
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    • 2021
  • Objective: Paint manufacturing industry workers are exposed to various lung cancer carcinogenic substances including hexavalent chromium and crystalline silica. Studies have been conducted on lung cancer in Paint manufacturing industry workers and the concentration of hexavalent chromium in paint industry; however, the concentration of crystalline silica and hexavalent chromium and cases of lung cancer in a single Paint factory has never been reported in Korea. Methods: To determine whether the cancer was related to his work environment, we assessed the level of exposure to carcinogens during pouring and mixing talc and pigment. In addition, a mask fit test was performed for the worker. Results: Analysis of talc and silica bulk powder materials showed that crystalline silica (quartz) was 5% in talc and 100% in silica. The green and yellow pigments contained 87% and 92% of lead chromate, respectively. Our quantitative analysis of pigment powder samples showed that the hexavalent chromium contents quantified in the green and yellow pigment samples were 87% and 92%, respectively. In order to estimate his exposure level of hexavalent chromium, we measured a personal exposure level of hexavalent chromium for a worker in accordance with the National Institute for Occupational Safety and Health #7605 method. The results showed that the worker was exposed to the high level of hexavalent chromium (0.033 mg m-3). In addition, the talc powder also contained 5% quartz, and the worker's exposure level to respirable quartz exceeded OEL. As a result of the respiratory protection fit test for workers, the overall Fit Factor was '15' when wearing a second-grade mask and '25' when wearing a first-grade mask, significantly lower than the US Occupational Safety and Health Agency (OSHA) pass value of "100". Conclusion: Workers who pouring and mixing powder materials such as talc or colored pigments in paint manufacturing company may be exposed to high concentrations of carcinogenic substances. These findings indicate that it is necessary to local ventilation system inspection, safety and health education for employers and workers, and periodically monitoring and manage the working environment.

Effects of Private Insurance on Medical Expenditure (민간의료보험 가입이 의료이용에 미치는 영향)

  • Yun, Hee Suk
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.99-128
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    • 2008
  • Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

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Comparison between the Chemical Management Contents of Laws Pertaining to the Ministry of Environment and the Ministry of the Employment and Labor (환경부의 화학물질관리법, 화학물질등록 및 평가에 관한 법률, 고용노동부의 산업안전보건법의 화학물질 관련 내용 비교)

  • Yoon, Chungsik;Ham, Seunghon;Park, Jihoon;Kim, Sunju;Lee, Sangah;Lee, Kwonseob;Park, Donguk
    • Journal of Environmental Health Sciences
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    • v.40 no.5
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    • pp.331-345
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    • 2014
  • Objectives: The exponential growth of chemicals, an area of high concern in developed countries like the US (i.e., the Gore Initiative) and in the EU (i.e., REACH), as well as recent chemical accidents in Korea, have provoked nationwide concerns and resultant legal enforcement. This study aims to compare the laws of the Ministry of Environment (the Chemical Substances Control Act (CSCA), Act on the Registration and Evaluation, etc. of Chemical Substances (ARECS)) with those of the Ministry of the Employment and Labor (Occupational Safety and Health Act (OSHA)). Methods: Each law pertaining to the Ministry of Environment and the Ministry of the Employment and Labor was downloaded from the official legal information system (www.law.go.kr). The objectives of each law and the major contents related to chemical management were compared and summarized. Results: The CSCA and the ARECS are focused on the protection of people and the environment, while the OSHA relates to the protection of workers. The right to know of people and workers has been reinforced. The former two laws emphasize prevention, but the OSHA contains both preventive and post-accident measures. The role of the Ministry of Employment was reinforced with the promulgation of the CSCA and ARECS, which contain regulations such as adjacent area impact evaluation, risk control planning, chemical statistical survey and construction and operation of information, provision of risk control plans, response to chemical accidents and registration of chemical substances. Conclusion: We found that the three laws discussed here have several similar clauses designed to protect people and the environment from risks that may be caused by the use of chemicals, even though there are some differences among them in terms of objectives and contents. This review concluded that several clauses that can be regarded as double regulation should be unified in order to minimize the waste of government administrative resources and socio-economic losses.

An UHISRL design to protect patient's privacy and to block its illegal access based on RFID (환자의 프라이버시 보호와 불법 접근 차단을 위한 RFID 기반 UHISRL 설계)

  • Lee, Byung Kwan;Jeong, Eun Hee
    • Journal of Korea Society of Industrial Information Systems
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    • v.19 no.3
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    • pp.57-66
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    • 2014
  • This paper proposes the UHISRL(Ubiquitous Healthcare Information System based on Real Time Location) which manages patient, doctor, medicine by using RFID. The proposed UHISRL monitors the patient's health state, and enables us to confirm the result with Smart Phone and Tablet PC. Also, it can block Replay and Spoofing attack by using the ERHL(Extended Randomized Hash Lock) authentication scheme designed in this paper. A patient privacy is enhanced by limiting UHISRL DB access according to attributes with CP-ABE (Cipher Text - Attributed based Encryption) technique. Specially, UHISRL can prevent an unexpected accident by monitoring a chronic patient's emergency situation in real time.

A Study on EPG Internet Data Base System for Pulse Diagnosis Objectification (맥진 객관화를 위한 인터넷 DB구축 시스템에 관한 연구)

  • Lee, J.Y.;Seo, H.W.;Kim, J.H.;Lee, J.W.;Lee, M.H.
    • Proceedings of the KIEE Conference
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    • 2000.11d
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    • pp.851-853
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    • 2000
  • The rapid expansion of the medical information super-highway through the internet with the sophistication of computer engineering and its application has made telemedicine in the cyberspace possible. Recent progress in the medical informatics enables us to use the medical information regardless on the time or place limit, to make a diagnostic and therapeutic plan. according to increasing need about health of general population. There are many database oriented sites on the web, which provide medical common senses, hospital information, and medical counselling on the web. But there are few oriental pulse database on the web. The purpose of this study is to develope the Clinical Oriental Pulse Database Management System over the WWW.

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