• Title/Summary/Keyword: clinical knowledge

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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A Preliminary Study on Setting Philosophy and Curriculum Development in Nursing Education (간호교육 철학정립 및 교육과정 개발을 위한 기초조사)

  • 정연강;김윤회;양광희;한경자;한상임
    • Journal of Korean Academy of Nursing
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    • v.18 no.2
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    • pp.162-188
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    • 1988
  • The purpose of this study is to guide the direction of the Korean nursing education to analysize ⑴ the philosophy and objectives ⑵ curriculum, and ⑶ educational environment. This analysis is based on the data from 50 nursing schools (14 4-year colleges and 35 3-year colleges) The survey was conducted from Dec. 1986 through Jan. 1987 by mail. 1) Educational philosophy and objectives 10 4-year colleges and 8 3-year college program have curricular philosoph. Most popular curricular philosophies are human beings, health, nursing, nursology, nursing education, nurses role in the present and in the future. 10 nursing schools mentioned that human being is the subject to interact with : environment physically, mentally and socially. 2 schools mentioned that health is the state of functioning well physically, mentally and socially. 13 schools mentioned that the nursing is the dynamic act to maintain and to promote the highest possible level of health. 4 schools mentioned that the nursology is an applied science. 4 schools mentioned that nursing education is the process to induce the behavioural changes based on the individual ability. There is different opinion about the nurses' role between 4-year college and 3-year college. In the responses from 4-year colleges they focus on the leadership in effective changes, self-regulating and self-determining responsibilities, applying the new technology, continuing education, and participation in research to further nursing knowledge. In the responses from 3-year colleges, they focus on the education in college, primary health care nursing, direct care provider and public health education. Among 50 respondents 40 schools have educational goals which can be divided into two categories. One is to establish the moral and the other is to develop the professionalism. 2) Curriculm The analsis of curriculum is only based on the data from the 4-year colleges because the most of 3-year colleges follow the curriculum guideline set by the Ministry of Education. a) Comparison of the credits in cultural subject and in nursing major. The average required credit for graduation is 154.6 and the median credit is the range of 140-149. The average credit of cultural subjects is 43.4. In detail, the average number of credit of required course and elective courses are 24.1 and 19.3 respectively. The average credit for major subject is 111.2. In detail, the average credit for required courses and electives course are 100.9 and 10.4 respectively. In 5 colleges, students are offered even on elective course b) Comparison of the credit by class. The average earned credits are as follows : 41.1 in freshman, 400 in sophormore 38.3 in junior and 32.4 in senior. Cultural subjects are studied in early phases. c) Comparison of the compulsory and elective cultural subject by institute. The range of credit is 7-43 in compulsory cultural subjects and there are lot of differences among institutions. While all respondents require liberal arts as compulsary subjects, few respondents lists social science, natural science and behavioral science as required subjects. Social science-related subjects are frequently chosen as cultural subjects d) Distribution of creditsin cultural subjects by institute. The liberal art subjects are taught in 20 institute. English and physical education courses are taught in all instituions. The social science subjects are taught in 15 colleges and the basic Psycology and the Basic sociology are the most popular subjects. The natural science subjects are taught in 7 colleges and Biology and Chemistry are the most popular subjects among them. e) Distribution of credits in major basic courses by institute. Most of the institutes select Anatomy, Microbiology, Physiology, biochemistry and Pathology as basic major courses. f) Comparison of the required and elective courses for nursing major by institutions. Subjects and credit ranges in major are varing by institute. More than half of the respondents select the following subjects as required major subjects. (1) Adults Health Nursing and Practice (19.5 credits) (2) Mother and Child Care and Practice (8.9 credits) (3) Community Health Care and Practice (8.5 credits) (4) Psychiatric Nursing Care and Practice (8.1 credits) (5) Nursing Management and Practice (3.9 credits) (6) Fundamental of Nursing, Nursing Research and Health Assessment and Practice. Three institutions select Introduction to nursing, Rehabilitation Nursing, School Nursing, Public Health Nursing, Nursing English, Communication, Human Development as electives in nursing major. 3) Educational environment a) Nursing institution There are forty-three 3-year colleges and seventeen 4-year colleges and 81.4% of which are private b) Number of students and faculty 19.2% of the students are in 4-year colleges and 80.8% of the students are in 3-year colleges. In 4-year colleges, the number of nursing faculty members is in the other of assistant professor, instructor and professor. In 3-year colleges, the orderiis lecturer, associate professor, full time instructor and assistant professor. In 4-year colleges, 18.8 students are allocated per nursing faculty and in 3-year colleges, 33.1 students are allocated per nursing faculty. c) Clinical practices 66.7% of the 4-year colleges practice over 1201 hours in clinic and 28.5% of 3-year colleges practice over 1201 hours in clinic. In 4-year colleges, 11.5 students are allocated per nursing faculty and in 3-year colleges,17 students are allocated per nursing faculty The survey shows no difference in the procedure between 4-year colleges and 3-year colleges but 3-year colleges choose the more variety practicing site such as special hospital and community health clinic. d) Audiovisual facilities The survey shows a lot of difference in audiovisual facilities among institution and 3-year colleges are less equipped than 4-year colleges.

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A Study on Performance and Achievement of Village Health Workers in Rural Primary Health Care Program (농촌 일차 보건사업에 있어서 마을건강원 업무량 및 업적에 관한 연구)

  • Hur, Dal-Young;Lee, Myoung-Sook;Yum, Yong-Tae;Kim, Soon-Duck
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.36-53
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    • 1987
  • It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

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The Study of DNA Mutations of Phenylketonuria in Koreans (한국인에서의 페닐케톤뇨증의 유전자변이에 대한 고찰)

  • Yoo, Su-Jung;Hong, Yong-Hee;Lee, Yong-Wha;Jung, Sung-Chul;Ki, Chang-Seok;Lee, Dong-Hwan
    • Journal of Genetic Medicine
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    • v.5 no.1
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    • pp.26-33
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    • 2008
  • Purpose : Phenylketonuria(PKU) is an inborn error of metabolism and a genetic disorder resulting from a deficiency of phenylalanine hydroxylase(PAH) and decreased activity of tetrahydrobiopterin(BH4).In this study the correlation between the DNA mutation and clinical manifestations was investigated and PAH DNA mutations were compared bewteen Asian and Caucasian populations. Methods : DNA was isolated from peripheral leukocytes. The PAH gene was amplified by Polymerase Chain Reaction(PCR) and the sequence was analyzed with Multiplex Ligation-dependent Probe Amplification(MLPA). Results : We characterized the PAH gene of 102 independent Korean patients with PKU. PAH nucleotide sequence analysis revealed 44 different mutations, including 10 novel mutations comprising 9 missense mutations(N207D, K95del, A447P, G344D, P69S, S391I, A202T, G103S, and I306L) and 1 novel splice-site variant mutation(IVS10-3C>G). R243Q was the most prevalent mutation in this study. A259T has not previously been reported in Asian populations, but we found that this mutation had a frequency of 10.1% in our study. Furthermore, the genotypes of $BH_4$ responsive patients were analyzed and were divided into two groups: $BH_4$ medication-only group and $BH_4$ medication with diet therapy group. In the $BH_4$ medication-only group and $BH_4$ medication with diet therapy group, R241C was the most common mutation. Conclusion : Novel mutations in the PAH gene of PKU patients are still being discovered. Additional information as to the frequency of mutations in the tetrahydrobiopterine responsive gene is also accumulating. We anticipate that knowledge of these PKU gene mutations will assist the diagnosis, genetic counseling, and therapeutic treatment of PKU patients in future.

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A comparative study of educators vs, non-educators designed to improve dental radiographic quality control - Focusing on theories of dental radiographic and practical training and clinical practice education - (치과방사선 질관리 향상을 위한 교육자 대비 비교육자 비교연구 - 치과방사선학 이론 및 실습교육과 임상실습교육을 중심으로 -)

  • Kim, Seung-Hee;Hong, Su-Min;Lee, Kwang-Ok
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.421-426
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    • 2012
  • The purpose of this study was to investigate the knowledge of dental hygiene students of the quality assurance of dental radiation such quality assurance and related educational experiences in an effort to accelerate the preparation of a curriculum for systematic quality-assurance. The subjects in this study were 453 dental hygiene students who participated in dental radiography courses. Varied statistical analyses such as frequency analyses, reliability, chi-square, and independent samples t-tests were conducted on the data collected, using SPSS 12.0. Scheffe test was also used after one-way ANOVA as post-hoc tests. Results showed that (a) the students' acknowledge level of Radiographic Quality Assurance was $7.71{\pm}1.7$ out of 12 on average. The more theory and practical classes students took, the higher points they got (p<0.001); (b) Most of the students experienced 1-3 lessons out of 13 in practical training and 26.3% of students did not take any practical lesson. ;(c)Students who did not take any practical training got 7.20 points out of 13, students who took 1-3 lessons got 7.84 points out of 13, students who took 4-5 lessons got 7.87 points out of 13, and students who took more than 6 lessons got 8.14 points out of 13 on average. The more practical classes they took the higher acknowledge level they were. Therefore it needs to provide adequate practical lessons to them.

A study on the state of inservice education for dental hygienists and their relevant awareness (치과위생사의 보수교육 실태 및 인식에 관한 연구)

  • Jung, Jae-Yeon;Kim, Kyung-Mi;Cho, Myung-Sook;Ahn, Geum-Sun;Song, Kyoung-Hee;Choi, Hye-Jung;Choi, Youn-Seon;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.1
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    • pp.73-89
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    • 2007
  • The purpose of this study was to examine the reality of inservice education provided to members of Korean Dental Hygienists Association, the state of relevant academic conferences, and the perception of the members about inservice education and academic conference. It's basically meant to help boost their participation in inservice education and their satisfaction with it, and to show some of the right directions for that. The subjects in this study were dental hygienists who attended a symposium on July 1, 2006. After a survey was conducted, the answer sheets from 489 participants were analyzed, and the findings of the study were as follows: 1. General hospitals and university hospitals made up the largest group(91.4%) that gave a monthly leave of absence, and the second largest group was dental hospitals(75.4%), followed by dental clinics(58.3%) and public dental clinics(48.0%). The most common closing time in dental clinics and dental hospitals was 5 p.m., and that was 12 p.m. in general hospitals and university hospitals. The dental hygienists in public dental clinics didn't work on Saturdays. By type of workplace, treatment was the most common duty for the dental hygienists in dental clinics and dental hospitals to perform, and those who worked at general hospitals, university hospitals and public health clinics were in charge of extensive range of jobs. 2. The rates of the dental hygienists who took that education stood at 94.9% in public dental clinics, 78.7% in dental hospitals and 75.3% in dental clinics, general hospitals and university hospitals. Regarding how many marks they got on an yearly basis, those who got eight marks or more made up the largest group(55.6%), followed by four marks or more(11.8%), six marks or more(3.4%), and two marks or more(1.5%). As for the usefulness of inservice education for their job performance, the largest number of the dental hygienists(40.8%) found it to be helpful, and the second greatest group(37.5%) considered its effectiveness to be so-so. The third largest group(8.4%) found it to be of great use, and the fourth biggest group(4.2%) considered it to be of no service. The fifth biggest group(l.3%) thought it was absolutely useless. By type of workplace, the workers in dental clinics, dental hospitals, general hospitals and university hospitals wanted the most to learn how to take care of clinical work(acquisition of up-to-date technology), and those in public health clinics hoped the most to learn about public dental health. By type of workplace, the workers in dental clinics had their sight set on self-development the most, and the dental hygienists in dental hospitals, general hospitals, university hospitals and public health clinics were most in pursuit of acquiring new knowledge. By type of workplace, the specific given conditions at work were most singled out by the dental clinic workers as the reason, and the dental hospital employees pointed out time constraints the most. The dental hygienists in general hospitals and university hospitals cited time constraints and financial burden the most, and the public health clinic personnels mentioned inaccessibility of a place for inservice education as the reason. 3. The public health clinic workers participated in academic conferences the most(90.8%), followed by the general and university hospital personnels(68.8%), dental hospital employees(65.6%) and dental clinic workers(65.5%). By type of workplace, the public health clinic workers(73.5%) expressed the most satisfaction, followed by the general and university hospital employees(67.7%), dental clinic workers(62.3%) and dental hospital personnels(54.1%). By type of workplace, the employees of dental clinics, dental hospitals, general hospitals and university hospitals preferred Saturdays, and the public health clinic workers had a liking for weekdays. As for a favored place, hotels were most preferred, followed by university hospitals, general hospitals, college lecture rooms, district halls and local public institutions. Hotels were most favored regardless of the type of workplace. 4. Regarding outlook on inservice education, they had the highest opinion on the facilities and given conditions of lecture rooms($3.41{\pm}0.83$), followed by the professionalism of lecturers($3.34{\pm}0.83$), procedures of receipt and attendance confirmation($3.34{\pm}0.83$) and class size($3.13{\pm}0.89$). On the contrary, they took the most dismal view of the inaccessibility of a place of inservice education($2.08{\pm}0.92$), followed by limited opportunity and limited date for that education($2.51{\pm}0.99$), extra financial burden($2.53{\pm}1.18$) and high tuition fee($2.57{\pm}0.96$).

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Longitudinal Study of Iron Concentration in Korean Preterm Human Milk

  • Lim, Gi-Na;Koo, Mi-Sung;Kim, Ellen Ai-Rhan;Min, Won-Ki;Yoon, Sung-Chul
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.104-110
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    • 2011
  • Purpose: The unique nutrient requirements of premature infants necessitate knowledge of the composition of human milk produced by mothers of such infants. We investigated longitudinal changes in iron concentration of preterm human milk and compared to those observed in human milk of mothers of 1-week old term infants to determine optimal iron supplementation guidelines when preterm infants are nourished exclusively by breast feeding. Methods: Human milk samples were collected at 1, 2, 4, 6, 8 and 12 weeks postpartum from 103 mothers who delivered infants of gestational age <34 weeks or weighing <1,800 g. Term human milk samples were collected at 1 week postpartum from 24 mothers. Results: There were no significant differences in the iron concentrations of preterm human milk obtained at 2 to 8 weeks postpartum (36.3${\pm}$23.1 to 45.8${\pm}$26.0 $\mu$g/dL), but these concentrations were higher than those noted at 1 week in preterm (23.1${\pm}$14.6 $\mu$g/ dL) and term (25.2${\pm}$7.55 $\mu$g/dL) infants. The iron concentration in preterm human milk obtained at corrected term age (42.2${\pm}$19.4 $\mu$g/dL) was significantly higher than that of mature term human milk (25.2${\pm}$7.55 $\mu$g/dL). Conclusion: The concentration of iron in preterm human milk was consistently low during the first 3 months of lactation. Supplementation with iron of at least 2 mg/kg/day should be considered for preterm infants who are exclusively breastfed and who have low body iron stores, to meet the minimum enteral iron requirements recommended by AAP-CON (2004).

Heojun's Outlook on Nature (허준(許浚)의 자연관(自然觀) - 『동의보감(東醫寶鑑)』을 중심으로 -)

  • Park, Seong-Kue;Kim, Sue Joong;Kim, Nam Il
    • The Journal of Korean Medical History
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    • v.18 no.2
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    • pp.197-227
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    • 2005
  • Heojun was the top scientist on Medicine in the 16th and 17th centuries and wrote the Dongeubogam describing the top-level medical theory and technology. So far, his outlook on nature has been disregarded even though his medicine is still effective. Through this study, I would like to know if his outlook on nature as well as his medicine is still effective. The conclusions are as follows: 1. According to his output, the origin of the universe started from the spinning of One Gi(一氣) which is quite different from Hawking's theory. Hawking assumed that the origin of the universe started from the Big-bang and will end to the Big-crunch. However, the current report on the origin of a star is quite similar to Heojun's theory and we acknowledge that his view on the origin of the universe is still effective. 2. According to his output, the universe repeats expanding and contracting forever while Hawking assumed it will come to the end, the Big-crunch, based on the expanding universe theory. Some scientists assists that Hawking's assumption should have some contradictions. Now, we acknowledge that Heojun's universal cycling theory which corresponds with modern physical theories is still effective, which would lead to a new environmental movement. 3. His view on the structure of the universe is quite different from the output of the current science, which results from his thought that the nature should be reviewed from the point of human's view. His view on the structure will be able to be updated based on the output of the current science. 4. The universe analogy started from the East Asian area as well as the Greek and Roman area in the ancient. The idea has disappeared since the scientific revolution era in the West while the idea has been deepened and abundant in the East and has become one of the major philosophical bases. Heojun emphasized its importance from the beginning of his book. 5. The nation analogy has been popular all times and places. According to his output, governing a country is like controlling one's body. 6. According to Needham's output, the universe analogy and the nation analogy were based on the ancient developed alchemy. And Harper assumed that Taiosm was based on the macrobiotic hygiene which was developed by the ancient developed alchemists. We acknowledge that xian(仙) cult, macrobiotic hygiene, medicine, alchemy and the ancient philosophy started from our ancients. Heojun's output restored our ancient tradition by combining the macrobiotic hygiene and philosophy with medicine. 7. Roughly predicting yearly weather would be unacceptable by the current scientist but Heojun's yearly weather forecast is still used in the clinic and seems effective to prepare from any epidemic disease. 8. 'Day and Night' and Four seasons are the most important factors to the macrobiotic hygiene according to the Dongeubogam. The new environmental movements should be based on the most important factors, otherwise the human beings as well as the environment would fail to survive. 9. Wind, Coldness, Heat, Humidity, Dryness and Fire represents weather. The six weather factors represent one of six phases of a year which is decided by the areal factors. Heojun preferred the six factors generated in the body itself to them from the outside. He thought a human being was a universe and the six factors generated in the body responded to the factors of the outside. 10. According to his output, Heat and Humidity are the most important factors which make a human being ill. 11. Life span, disease, food, and dwelling are dependent upon the geographical feature, according to Heojun's output. In addition, one's appearance and his five viscera and the six entrails depend on the food as well as the geographical feature. 12. Heath is related with the environment and they effects upon each other. If one is weak, he will be deeply effected by the nature. On the other hand, if one is strong, he will effect on the nature. That's why people live together. 13. According to Heojun's work, the society is an important factor comprising the environment. During a peaceful era, the society becomes stable and human beings are stable as well while they will be on fire during a chaotic era. 14. Medicine deals with human beings who live in the nature, so any medical book cannot be excellent unless it has any description on the nature. Heojun's outlook on the nature turned out to be logical and suitable even from the point of the current view and it is still effective as if his clinical knowledge and technology are still effective. Something unsuitable may be substituted with the output of the current science.

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Effect of Toothbrushing Facilities on PHP Index and Oral Health-Related Behaviors in Middle Schools (양치시설 설치여부에 따른 중학생의 구강환경관리능력 및 구강건강관리 행태 변화)

  • Kim, Soo-Hwa;Hwang, Yoon-Sook;Kim, Kwang-Soo;Jung, Jae-Yeon;Yoo, Young-Jae;Lim, Mi-Hee
    • Journal of dental hygiene science
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    • v.13 no.3
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    • pp.271-280
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    • 2013
  • This study aims to analyze the effects of tooth-brushing facilities (TBF) at middle schools that installed TBF in 2012 as part of the oral health project in Seongdong-gu, Seoul. The subjects were the first graders at A middle school that installed TBF previously and B middle school that installed TBF in 2012. The results are as follows: DMFT, DMFS and CPI didn't show significant difference by schools (p>0.05), but code (0) was higher and code (2) was lower in female students than male students (p<0.05). As to PHP index, the students at A school with TBF indicated better oral hygiene (p<0.01). In the research on before and after installing TBF, the oral hygiene was improved significantly more after the installation than before (p <0.01). In the comparison on the oral health-related behavior, the percentage of not brushing after lunch was higher B school than A school and the frequency of toothbrushing after lunch was higher A school than B school (p<0.01). About the reasons why not to brush after lunch, there was difference in 'lack of the place' as A school showed 2.6% while B school without TBF indicated 14.2% (p<0.01). About the changes of the oral health-related behavior before and after TBF installation, the percentage of not brushing after lunch increased from 78.7% to 83.8% after the installation. The average frequency of tooth-brushing after lunch for one week also decreased from 0.50 to 0.34 (p>0.05). Among the reasons why not to brush after lunch, 'lack of the place' significantly reduced, but 'because other friends don't do it' increased greatly after the installation (p <0.05). Only with the improvement of oral health knowledge, we cannot expect either clinical or behavioral significance. Not only schools but policies of governmental agencies and financial support, cooperation of community-related groups for program development and evaluation will contribute altogether to helping teenagers to habitualize proper oral health management.

The Experience and Competence of Physicians Who Provide Emergency Health Care at Public Health Sub-Centers on Remote Islands in Korea (도서지역 보건지소 공중보건의사의 응급의료 경험 및 대처능력 고찰)

  • Seo, Je-Hyun;Lee, Su-Jin;Ha, Jeong-Hoon;Kwon, Duck-Geun;Kim, Jung-Ho;Lee, Jae-Hyuk;Na, Baeg-Ju;Kang, Yoon-Hwa
    • Journal of agricultural medicine and community health
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    • v.36 no.1
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    • pp.36-46
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    • 2011
  • Objectives: To investigate the experience and competence of physicians providing emergency medical services at public health sub-centers on remote Korean islands. Methods: This study enrolled 79 doctors who work at public health sub-centers on remote Korean islands. Data were collected in December 2009 via self-administered e-mail questionnaires. The response rate was 44.3%. Results: Emergent situations occurred at most (58.68%) of the public health sub-centers that were surveyed in December 2009. An average of 1.92 cases required treatment by public health physicians. Only 20.25% of the physicians were specialists in emergency medicine, while the remainder were general practitioners (GPs) without clinical experience as emergency doctors. We also found that the physicians we surveyed had insufficient knowledge of emergency medical care. At some health centers only one doctor was available, and there was no medical team in holiday, although most of the physicians indicated that the ideal number of doctors per center was two or three. In cases of emergency, patients were often sent to the mainland by ship without receiving first-aid treatment. The public health sub-centers lacked the necessary medical equipment to save lives in emergencies and lacked escort systems for emergency patients. Conclusions: The Korean government should address the importance of providing emergency care in remote areas. Health administrators should provide suitable manpower, medical equipment, guidelines for emergency medicine, and education for public health physicians on remote islands.