Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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제26권1호
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pp.12-21
/
2015
In an effort to expand working opportunities for women and encourage childbirth, the government of Korea introduced the free infant care policy in 2013. This policy, however, was controversial with regard to issues, such as budget shortages and dissatisfaction based on socioeconomic status. In addition, the lack of evidence-based data regarding adequate age criteria for the entry of children into childcare facilities was noted as a challenge. As child development professionals who are concerned with mental health issues, we investigated the influence and challenges of the free infant care policy with regard to infant mental health. In this review, we examined the policies enacted by developed countries, such as the United Kingdom (UK), and compared them with those in Korea. The childcare systems in Korea and the UK differ historically and socially, but show some similarities, such as maternal responsibility for parenting and household issues. Like Korea, the need for UK childcare facilities increased in the 1990's in response to market recovery and associated increase in female employment. Among the new policies in the UK, the Sure Start program has begun to provide integrated services for infants, particularly to those 0-4 years of age, who are vulnerable to social exclusion. Similar to the Dream Start program in Korea, it has been successful in providing family-related services, resulting in improvements in problematic behaviors of children, enhanced parenting skills, and decreased rates of severely injured children.
This study were conducted to assess the physical growth and developmental status of infants in orphanage in order to provide an empirical data. The subjects for this study were 104 infants and toddlers who were reared in an orphanage in D Metropolitan city. The instrument used for this study were anthropometric assessment and DDST for normative data of development. Data has been collected from September 1st, 1998 to August 31st, 2000 and were analyzed using SPSS/PC(Version 10.0) with frequency, mean, standard deviation, ANOVA and Chi-square test. The results of this study were as follows; 1. 30.8% of infants in orphanage had abnormal weight, 26.9% had abnormal length, and 22.1% had abnormal head circumference and most of them were distributed below 50 percentile of growth chart. 2. 53.8% of infants in orphanage had normal, 27.9% had qustionable, and 18.3% had abnormal developmental screening test results, especially, 31.5% of infants in orphanage ages 3 to 5 years had abnormal developmental screening test results, according to the Denver Developmental Screening Test(DDST). There was a significant developmental delay noted in the language and fine motor-adaptive sector. 3. It is anticipated that developmental delays would increase in severity by older the mean age of orphanage infants and longer the time being raised in orphanage. It would be concluded that the physical growth and developmental status of orphaned infants were very vulnerable and serious and it is suggested that there needed an effective intervention strategies to promote growth and development of infants in orphanage.
Purpose: The aim of this study was to evaluate the influence of the mothers' native country on influenza vaccinations in adolescents in multicultural families. Methods: Data were gathered from the 13th (2017) Youth Risk Behavior Web-Based Survey. Logistic regression analyses were conducted using a complex sample data analysis method. The participants in this study had a father who was born in Korea and a mother born outside of Korea. The sample included 481 adolescents. Results: The analysis of non-adjusted confounding variables showed that influenza vaccination was higher in multicultural adolescents whose mother's native country had an annual minimum temperature less than $21^{\circ}C$ (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.20~2.74). Furthermore, when the analysis was adjusted for confounding variables, an annual minimum temperature less than $21^{\circ}C$ in the mother's native country had a statistically significant association with influenza vaccination (OR: 2.12, 95% CI: 1.36~3.29). Conclusion: Multicultural adolescents belong to a socioeconomically vulnerable class, and their health promotion behaviors are influenced by their mothers' culture. Thus, healthcare providers and school nurses should provide adolescents with appropriate information related to influenza vaccination depending on their mothers' culture and their family's cultural background.
Purpose: This study was conducted to monitor the development of Korean premature infant at six-month age and to explore factors related to developmental status of the premature infants. Methods: Participants were 58 premature infants whose corrected age was six-months old and their mothers. The developmental states of infants were followed-up with the Korean Prescreening Developmental Questionnaire (KPDQ-II). Clinical characteristics of the infants were identified from the medical records. Other characteristics including Edinburgh Postnatal Depression Scale, husband's support, social support, and mother-infant attachment were assessed using self-report questionnaires from the mothers. Results: Forty three percent of the infants were in the group of questionable status of development on the KPDQ-II. There were significant differences between the premature infants with normal developmental status and those with questionable developmental status depending on gender ($x^2$=5.03, p=.034), gestational age (t=2.59, p=.012), hospital stay (p=.013), revised Neurobiologic Risk Score (p=.005) and mother-infant attachment score (t=2.12, p=.040). Conclusion: Mother-infant attachment, as well as physiological state of premature infants, is an important variable in early development. Therefore, early monitoring for the development has to be done for physiologically vulnerable premature groups. Also, providing proper nursing support to improve maternal attachment needs to be considered.
This paper discusses the implications of the birth notification system and the Protected Birth Act in Korea. Aiming to prevent infanticide and abandonment of infants, the law will enter into force on July 19, 2024 in South Korea. The birth notification system mandates that both parents and the head of the medical institution where the birth occurred must report the event. In parallel, the Protected Birth Act will be implemented, allowing pregnant women in crisis who wish to remain anonymous, the option to give birth outside of a hospital setting in a way that safeguards the life and health of the child. However, many issues are being raised in Korean society in advance of the implementation of the Protected Birth Act. There is widespread concern that the Protected Birth Act fails to protect either women or children, especially as it raises issues regarding the need for legislation to protect children with disabilities and to address gaps for migrant women and children. This paper examines the gender and healthcare issues relating to the Protected Birth Act, focusing on women's health and human rights. The Act continues to perpetuate discrimination against out-of-wedlock pregnancies and upholds the ideology of the traditional family model. Furthermore, the legislative process did not address protective measures for the various reasons behind child abandonment. Critical issues such as women's autonomy, safe pregnancy termination, and paternal responsibility in childbirth are also notably absent. However, with the Act set to take effect soon, it is crucial for healthcare providers to comprehend the rationale and procedures associated with birth notification and the Protected Birth Act, and to prepare for its nationwide implementation. The law defines the socially vulnerable as its main beneficiaries, and it is necessary to strengthen social safety nets to improve their access to healthcare, eliminate prejudice and discrimination against out-of-wedlock pregnancies, and embrace the diversity of our society. We eagerly anticipate future discussions on gender and healthcare issues, as well as amendments to the law that reflect real-world circumstances to provide genuine protection for pregnant women in crisis and their infants.
Iyus Yosep;Heni Purnama;Linlin Lindayani;Yen-Chin Chen;Diwa Agus Sudrajat;Muhammad Rizka Firdaus
Journal of the Korean Academy of Child and Adolescent Psychiatry
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제35권1호
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pp.75-81
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2024
Objectives: Although adolescents appear less vulnerable to coronavirus disease (COVID-19), the side effects of this pandemic can still be devastating. Bullying and suicidality are significant global issues with detrimental effects on young people, particularly during school closure. This study aimed to identify the relationship between bullying and suicide risk among adolescents in Indonesia during the COVID-19 pandemic. Methods: A cross-sectional study was conducted on adolescents aged 14-18 years in May 2020 in Bandung, Indonesia, using a web-based closed survey. The Adolescent Peer Relations Instrument and the Suicide Behavior Questionnaire-Revised were used to measure bullying and risk of suicide. Multinomial logistic regression analysis was performed. Results: This study included 268 participants in 2020 and 175 participants in 2019. In 2020, the prevalence of perpetrators and victims of bullying combined was 74.6%. Meanwhile, in 2019, the prevalence of perpetrators and victims of bullying combined was 82.9%. Risk of suicide increased from 26.1% in 2019 (before the COVID-19 pandemic) to 36.5% in 2020 (during the first wave of the COVID-19 pandemic). The risk of perpetrators and suicide victims was higher than that of perpetrators and victims alone (odds ratio [OR]=4.0, 95% confidence interval [CI]=1.5-6.6 vs. OR=1.3, 95% CI=1.0-2.9 and OR=1.6, 95% CI=1.1-2.8, respectively). Conclusion: Bullying can enhance the likelihood of suicide among adolescents in Indonesia, and the risk was highest for the combination of victims and perpetrators. It is very important to provide early risk prediction for youths with bullying behavior and improve the knowledge and understanding of families and schools regarding the negative effects of bullying behavior.
Backgrounds: The objective of school zones was to define protective areas and to keep children vulnerable to traffic accidents from the risk. The current "Rules on the Designation and Management of School Zones" included provisions on the installation of traffic safety facilities and road facilities, but they were not sufficient for children's traffic safety and there were many difficulties in applying standards to the fields. Purposes: With these problems to be solved, the present study surveyed the current state of safety facilities in school footpaths and school zones around elementary schools and suggested plans to improve them. This study studied various factors like the physical environment and the safety facilities in the school zone. Methods: The present researcher visited four elementary schools selected for this study, and surveyed safety facilities in the school zones around the elementary schools using a schedule prepared by the researcher. Results: According to the results of the case study, all of the four schools were designated as school zones, but the designation appeared nominal without sufficient safety facilities that can ensure children's safety. Based on the results of the survey, suggestions were made to improve traffic facilities in school zones and school footpaths as well as safety guidance.
The purpose of this study was to investigate the determinants of households with risky debt loads. The study used financial ratios to determine which households were over-indebted. The 3 ratios used were Debt to Asset ratio, Debt to Financial asset ratio, and Debt Service ratio. Data for this study was the 2011 Survey of Household Finance. Households that demonstrated total debts of 70% or more when compared to total assets were 8.8%. Households that demonstrated a debt load totaling 5 or more times their total financial assets were 19%. Households with monthly repayment obligations of 40% or more of disposable income were 20%. Households that fulfilled all 3 financial ratio criteria were 1.5% of total indebted households. Over-indebted households demonstrated severe economic condition in terms of debt, but not all over-indebted households were categorized as being in economically vulnerable group. The major determinants of households with risky debts were income, asset, purpose of loans, and spending behavior of the households.
Spinal cord injury in child often occurs without evidence of fracture or dislocation. The mechanisms of neural damage in this syndrome of spinal cord injury without radiographic abnormality(SCIWORA) include flexion, hyperextension, longitudinal distraction, and ischemia. Inherent elasticity of the vertebral column in infants and young children, among other age-related anatomical peculiarities, render the pediatric spine exceedingly vulnerable to deforming forces. The neurological lesions encountered in this syndrome include a high incidence of complete and severe partial cord lesions. Children younger than 8years old sustain more serious neurological damage and suffer a larger number of upper cervical cord lesions than children aged over 8 years. Of the children with SCIWORA. 52% have delayed onset of paralysis up to 4 days after injury, and most of these children recall transient paresthesia, numbness, or subjective paralysis. The long-term prognosis in cases of SCIWORA is grim. Most children with complete and severe lesions do not recover; only those with initially mild neural injuries make satisfactory neurological recovery.
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