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〈 Field Action Report 〉 The Strategies to Address Regional Health Inequalities in Gyeongsangnam-Do: Health Plus Happiness Plus Projects (〈사례보고〉 경상남도 지역 간 건강불평등 완화사업: 건강플러스 행복플러스 사업)

  • Jeong, Baek-Geun;Kim, Jang-Rak;Kang, Yune-Sik;Park, Ki-Soo;Lee, Jin-Hyang;Jo, Sun-Rae;Seo, Gi-Deok;Joo, Sang-Jun;Oh, Eun-Suk;Kim, Seung-Jin;Jo, Seong-Jin;Kim, Seung-Mi;Yeum, Dong-Mun;Sim, Mi-Young
    • Journal of agricultural medicine and community health
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    • v.37 no.1
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    • pp.36-51
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    • 2012
  • Objectives: This study was conducted to implement Health Plus Happiness Plus projects in Gyeongsangnam-Do and assess the policy implications of initiatives to address regional health inequalities. Methods: Health Plus Happiness Plus projects were started as strategies to address regional health inequalities in Gyeongsangnam-Do. The principles of these projects are taken from the Health Action Zones initiatives in England: participation, partnership, resource concentration in project areas. The time period for these projects is from 2010 to 2017, and the total budget is 5.6 billion won. In 2010, a 6.8 hundred million won total budget was invested in 17 project areas. Such investments fell into four broad categories: establishment of the means and local framework; survey development to analyze the health determinants; development of an education and training center; and establishment of a technical support center. Results: Education and training programs for practitioners and coordinators were provided, and project teams and project promotion committees were established in project areas. Health survey result briefing meetings were held, and 17 health committees were established in project areas. Conclusions: Health Plus Happiness Plus projects have some problems in relation to participation and partnerships, however, if these principled projects are performed continuously, they will contribute to a reduction of standardized mortality rate and regional health inequalities in Gyeongsangnam-Do and the improvement of residents' well-being in project areas.

Analysis of Occlusal Contacts Using Add-picture Method (Add-picture 방법을 이용한 교합접촉점 분석)

  • Park, Ko-Woon;Cho, Lee-Ra;Kim, Dae-Gon;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.1
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    • pp.45-58
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    • 2013
  • The purpose of this study was to analyze the area of occlusal contact points using visual method. One subject was selected who had Angle Class I, normal dentition, without dental caries, periodontal disease and temporomandibular disorders. Forty times PVS impressions were taken and 10 pairs casts were fabricated using dental super hard stone. After mounting the casts with customized loading apparatus, 78.9kg/f force was loaded as a maximum biting force. In T-Scan method, occlusal contact points measurement was repeated twice. Then, using Photoshop program (Adobe photoshop CS3, Adobe. San Jose, USA), the pixels which indicated occlusal contact points by color was recognized, and the distribution of recognized pixels were calculated to area. In Add picture method, polyether bite material applied to the occlusal surface of the casts. Then, the image of the translucent areas was recorded and classified $0{\sim}10{\mu}m$, $0{\sim}30{\mu}m$, $0{\sim}60{\mu}m$ area by the amount of transmitted light. To acquire occlusal surface, the numbers of pixels from the photograph of the contact area indicated cast converted to $mm^2$. The mean occlusal contact area by two methods was statistically analyzed (paired t-test). Part of the red and pink area in T-Scan image were almost equivalent to the $0{\sim}10{\mu}m$, $0{\sim}30{\mu}m$, $0{\sim}60{\mu}m$ area in Add picture image. The distribution of occlusal contact points were similar, but the average area of occlusal contact points was wider in T-scan image (P<.05). Pink and red area in T-scan image was wider than $0{\sim}10{\mu}m$, $0{\sim}30{\mu}m$ area in Add picture image (P<.05), but similar to $0{\sim}60{\mu}m$area in Add picture image (P>.05). Occlusal contact points in T-scan image did not indicate real occlusal contact points. Occlusal contact areas in T-scan method were enlarged results comparing with those in Add picture method.

Concerning the Constitution Court's constitutional decision and the direction of supplemental legislation concerning Article 33 paragraph 8 of the Medical Service Act - With a focus on legitimacy of a system that prohibits multiple opening of medical instituion, in the content of 2014Hun-Ba212, August 29, 2019, 2014Hun-Ga15, 2015Hun-Ma561, 2016Hun-Ba21(amalgamation), Constitutional Court of Korea - ('의료법 제33조 제8항 관련 헌법재판소의 합헌결정'에 대한 평가 및 보완 입법 방향에 대하여 -헌법재판소 2019. 8. 29. 2014헌바212, 2014헌가15, 2015헌마561, 2016헌바21(병합) 결정의 내용 중 의료기관 복수 개설금지 제도의 당위성 및 필요성을 중심으로-)

  • KIM, JOON RAE
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.143-174
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    • 2019
  • Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.

Factors Associated with Active Participation in Health Promotion Programs at a Public Health Center (보건소 건강증진 프로그램 신청자의 참여 상태와 관련 요인)

  • Park, Yeun-Ju;Park, Hyun-Hee;Ryu, So-Yeon
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.287-300
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    • 2010
  • Objectives: We identified factors associated with any participation and with "good participation" (as assessed by frequency of attendance) in health promotion programs at a public health center in Korea. Methods: The subjects included 199 women who attended a baseline examination of health promotion programs during the first half of 2009. We collected data by structured interviews and physical examinations. Participation status was quantified by the frequency of attendance to the program. We classified the subjects as non-participants (0) and participants (1+ times), and as poor participants (0-29 times) and good participants (30+ times). Results: Of the 199 subjects, there were 57 (28.6%) non-participants, while 56 (28.1%) were classified as good participants. The factors that significantly affected participation status, as identified by univariate analysis, were personal factors (age, educational level, marital status, religion, living with someone, monthly income), environmental factors (method of access, accessibility of other facilities), body mass index, hypertension, perceived barriers to health, emotional salience, affectionate domain of social support, and depression. Multiple logistic regression analyses indicated that method of access was the most significant factor affecting participation in the health promotion program, and that the factors most highly associated with good participation were emotional salience, hypertension and body mass index. Conclusions: Our findings suggest that specific factors determine and enhance participation in health promotion programs offered by public health centers. These factors should be considered during the design and evaluation of health promotion programs that are offered by public health centers.

Functional recovery after transplantation of mouse bone marrow-derived mesenchymal stem cells for hypoxic-ischemic brain injury in immature rats (저산소 허혈 뇌 손상을 유발시킨 미성숙 흰쥐에서 마우스 골수 기원 중간엽 줄기 세포 이식 후 기능 회복)

  • Choi, Wooksun;Shin, Hye Kyung;Eun, So-Hee;Kang, Hoon Chul;Park, Sung Won;Yoo, Kee Hwan;Hong, Young Sook;Lee, Joo Won;Eun, Baik-Lin
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.824-831
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    • 2009
  • Purpose : We aimed to investigate the efficacy of and functional recovery after intracerebral transplantation of different doses of mouse mesenchymal stem cells (mMSCs) in immature rat brain with hypoxic-ischemic encephalopathy (HIE). Methods : Postnatal 7-days-old Sprague-Dawley rats, which had undergone unilateral HI operation, were given stereotaxic intracerebral injections of either vehicle or mMSCs and then tested for locomotory activity in the 2nd, 4th, 6th, and 8th week of the stem cell injection. In the 8th week, Morris water maze test was performed to evaluate the learning and memory dysfunction for a week. Results : In the open field test, no differences were observed in the total distance/the total duration (F=0.412, P=0.745) among the 4 study groups. In the invisible-platform Morris water maze test, significant differences were observed in escape latency (F=380.319, P<0.01) among the 4 groups. The escape latency in the control group significantly differed from that in the high-dose mMSC and/or sham group on training days 2-5 (Scheffe's test, P<0.05) and became prominent with time progression (F=6.034, P<0.01). In spatial probe trial and visible-platform Morris water maze test, no significant improvement was observed in the rats that had undergone transplantation. Conclusion : Although the rats that received a high dose of mMSCs showed significant recovery in the learning-related behavioral test only, our data support that mMSCs may be used as a valuable source to improve outcome in HIE. Further study is necessary to identify the optimal dose that shows maximal efficacy for HIE treatment.

Ttrosine Hydroxylase in Japanese Medaka (Oryzias latipes): cDNA Cloning and Molecular Monitoring of TH Gene Expression As a Biomarker (송사리 Tyrosine Hydroxylase: cDNA 클로닝 및 생물지표로서의 TH 유전자 발현의 분자생물학적 추적)

  • Shin, Sung-Woo;Kim, Jung-Sang;Chon, Tae-Soo;Lee, Sung-Kyu;Koh, Sung-Cheol
    • Environmental Analysis Health and Toxicology
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    • v.15 no.4
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    • pp.131-137
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    • 2000
  • The release of hazardous waste materials into the environment poses serious risks in humans and ecosystems. The risk assessment of environmental pollutants including hazardous chemicals requires a comprehensive measurement of hazard and exposure of the chemicals that can be achieved by toxicity evaluation using a biological system such as biomarkers. In this report we have tried to develop a biomarker used to elucidate a molecular basis of, and to monitor abnormal behaviors caused by diazinon in Japanese medaka (Oryzias latipes) as a model organism. First, an attempt was made to clone tyrosine hydroxylase gene from Japanese medaka that would be a candidate for a biomarker for neuronal modulations and behaviors. For monitoring experiments at behavioral and molecular biological levels, the fish were treated under different sublethal conditions of diazinon and their behavioral responses were observed . In this study we have successfully cloned a partial TH gene from the medaka fish through PCR screening of an ovary cDNA library. DNA sequencing analysis revealed that the amplified fragment was 327 bp encoding 109 amino acids. Comparing the DNA sequence of medaka TH with other species, TH gene revealed the DNA sequence was completely identical to that of rat TH. In the RT-PCR, 330 Up of mRNA was consistently amplified in all the treated samples including control There were no significant differences in the TH expression level regardless of treating concentrations (1∼5,000 ppb) and time (0∼48 hr) The reason appeared to be that RT-PCR was not performed using through a quantitative analysis normalized against an actin gene expression. Organ or tissue - specific detection of TH activity and mRNA as biomarkers will be a useful monitoring tool for neurobehavioral changes in fish influenced by toxic chemicals. Furthermore, quantitative analysis of locomotive patterns and its correlation with the neurochemical and molecular data would be highly useful in measuring toxicity and hazard ofvarious environmental pollutants.

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The Study on the Role of 3D Animated Pre-visualization in VFX FilmProduction (VFX 영화 제작을 위한 3D animatied Pre-visualization(3D애니메이티드 사전시각화)의 역할에 관한 연구)

  • Park, Sung-Ho
    • Cartoon and Animation Studies
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    • s.51
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    • pp.293-319
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    • 2018
  • Thanks to the advancement of the related technologies and equipment, today's video contents like movies, animations and soap operas are rapidly expanding their expressible cinematic imagination area. In order to fulfill the elevated visual expectations of audiences and realize exciting storytelling and fantastic world, the fusion of different techniques is actively used, and the reality for visual effects and image synthesis is increasing more and more. Accordingly, recent VFX-oriented movies using CG have a much more complicated production process than before. Therefore, the importance of Pre-visualization, aka Pre-vis is becoming bigger in the planning process for sophisticated design. Pre-vis means that the advance visualization for stories or directing ideas in the planning process before starting production of movies or animations. 3D animated Pre-visualization realizing directors' abstract and ambiguous ideas in 3 dimensional environment in advance is, as a powerful means for visual storytelling, briskly used focusing on the VFX film industry on which the present CG is broadly used, and the role of Pre-vis throughout productions has increased compared to the past. The studies, however, on the role and utility of Pre-vis are not enough. Therefore, this study was conducted on the role of Pre-vis used for present VFX movie productions using the examples of 3D animated Pre-visualization production in which the researcher of this study participated. In this study, the role of the Pre-vis that is subdivided presently, is divided into and 3D animatics and their each role is analyzed with the example images. Through this, the characteristics that Pre-vis should have are clarified and the concept of the advantages and utility led by the use of Pre-vis in productions is strengthened. The goal of this study is to induce active uses of Pre-vis throughout productions after forming consensus about the various roles of Pre-vis and their utility.

Postoperative Progress and Influencing Factors in Patients after Rastelli Procedure (Rastelli 술식후 임상경과의 평가 및 영향인자)

  • Kim, Se Heui;Kim, Kyeong Sik;Lee, Jong Kyun;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kyu;Park, Young Whan;Cho, Bum Koo
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.259-264
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    • 2003
  • Purpose : We have performed an analysis on patients who received Rastelli operation in our institute and reviewed their progress postoperatively. Various factors with suspected relationship to the outcome have been considered to help in future treatment and follow-up. Methods : We analyzed retrospectively 43 patients who either received Rastelli operation in Yonsei University Cardiovascular Center from March 1995 to April 1997 or who received post-procedural cardiac catheterization and follow-up echocardiography in the out-patient department after the procedure. Results : No statistically valid relationships were found between the age of the patient, their body weight, preoperative pulmonary arterial index and pressure, presence of pulmonary branchial stenosis and postoperative results. Cases with atrioventricular concordance showed lower age and body weight, and discordant cases exhibited lower ejection fraction 3 days postoperatively. Upon follow up, lower NYHA score was seen in patients with severe residual stenosis. In the group that received cardiac catheterization after the procedure, residual stenosis and right ventricular pressure measurement in echocardiography showed good correlation with the catheterization data. Conclusion : In cases where conduit insertions of the right ventricular outflow tract are required to achieve total correction in complex cardiac deformity, early operation does not seem to provide a clear risk to the patient. In patients with atrioventricular discordance, careful postoperative observation of the ventricular function seems to be needed. Also, echocardiography appears to be a sound method in follow-up of patients after the correctional procedure.

A Study on Problems with the ROK's Bioterrorism Response System and Ways to Improve it (생물테러 대응체제의 문제점과 개선방안 연구)

  • Jung, Yook-Sang
    • Korean Security Journal
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    • no.22
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    • pp.113-144
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    • 2010
  • Bioterrorism is becoming more attractive to terrorist groups owing to the dramatic increase in the utility and lethality of biological weapons in line with today's cutting-edge biological science and technology. The Republic of Korea is facing both internal and external terrorist threats, as well as the possible biological warfare by North Korea. Therefore, it is essential to establish an effective bioterrorism response system in the ROK. In order to come up with the adequate response system for the ROK, an in-depth study has been conducted on the current bioterrorism response system of the U.S. whose preparedness is considered relatively adamant. As a result, the following facts have been found: (1)the legislation with regard to bioterrorism has been established or amended according to the current situation in the U.S., (2)the counter terrorism activities have been integrated with the Department of the Homeland Security as the central agency in order to maximize the national CT capacity, (3)Specific procedures and instructions to cope with bioterrorism have been made into manuals so as to enhance the working-level response capabilities. Next, the analysis on the ROK's bioterrorism response system has been performed in various categories, including the legislation system, task role distribution, cooperative relations, and resource application. It turned out that the ROK's legislation basis is relatively weak and it lacks the apparatus to integrate the bioterrorism response activities on the national level. The shortage of the adequate response facilities and resources, as well as the poor management of manpower have also emerged as problems that hinder the effective CT implementations. Through an analytical and comparative study of the U.S. and the ROK systems, this paper presents several ways to ameliorate improve the current system in the ROK as follows: (1)establish the anti-terrorism law, which would be the basic legal basis for the bioterrorism-related matters; and make revisions to the disaster-related legislation, relevant to bioterrorism response activities, (2)establish an integrated body that has a powerful authority to coordinate the relevant CT agencies; and converge the decentralized functions to maximize the overall response capacity, (3)install the laboratories with a high biosafety level and secure enough of the strategic medical stock-pile, (4)enhance the ability of the inexperienced response personnel by providing with a manual that has detailed instructions.

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A Web-based 'Patterns of Care Study' System for Clinical Radiation Oncology in Korea: Development, Launching, and Characteristics (우리나라 임상방사선종양을 위한 웹 기반 PCS 시스템의 개발과 특성)

  • Kim, Il Han;Chie, Eui Kyu;Oh, Do Hoon;Suh Chang-Ok;Kim, Jong Hoon;Ahn, Yong Chan;Hur, Won-Joo;Chung, Woong Ki;Choi, Doo Ho;Lee, Jae Won
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.291-298
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    • 2003
  • Purpose: We report upon a web-based system for Patterns of Care Study (PCS) devised for Korean radiation oncology. This PCS was designed to establish standard tools for clinical quality assurance, to determine basic parameters for radiation oncology processes, to offer a solid system for cooperative clinical studies and a useful standard database for comparisons with other national databases. Materials and Methods: The system consisted of a main server with two back-ups in other locations. The program uses a Linux operating system and a MySQL database. Cancers with high frequencies in radiotherapy departments in Korea from 1998 to 1999 were chosen to have a developmental priority. Results: The web-based clinical PCS .system for radiotherapy in www.pcs.re.kr was developed in early 2003 for cancers of the breast, rectum, esophagus, larynx and lung, and for brain metastasis. The total number of PCS study items exceeded one thousand. Our PCS system features user-friendliness, double entry checking, data security, encryption, hard disc mirroring, double back-up, and statistical analysis. Alphanumeric data can be input as well as image data. In addition, programs were constructed for IRB submission, random sampling of data, and departmental structure. Conclusion: For the first time in the field of PCS, we have developed a web-based system and associated working programs. With this system, we can gather sample data in a short period and thus save, cost, effort and time. Data audits should be peformed to validate input data. We propose that this system should be considered as a standard method for PCS or similar types of data collection systems.