• 보건행정학회지
• /
• 제30권3호
• /
• pp.277-285
• /
• 2020

Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

• 한국환경보건학회지
• /
• 제39권4호
• /
• pp.299-311
• /
• 2013

Background: Environmental hazards are responsible for as much as a quarter of the total world-wide burden of disease. Therefore, appropriate management of environmental hazards is a critical part of the effort to improve human health. This review aims to summarize current issues, topics, and programs at international institutions such as the World Health Organization (WHO) and the Organization for Economic Cooperation and Development (OECD) in the area of environmental health. Results: The WHO European Center for Environmental Health (ECEH) plays a significant role in implementing environmental health policies and also takes the lead in related issues in Europe. It has developed an Environmental Health Information System and environmental health inequality indicators. In the environmental health area, the OECD focuses most on chemical management programs. It foresees that air pollution and chemical risk management will become the leading environmental health issues if appropriate measures are not taken. Several topics were identified that require greater effort in Korea, including cancer as an environment-related disease, an environmental health information system, and environmental health inequality issues. Conclusions: More active roles are expected from Korea in international societies, in part because of the introduction of the Environmental Health Act of 2008, and active involvement in related activities in WHO WPRO/SEARO. Understanding recent developments and concerns at major international organizations like WHO and the OECD will assist in the implementation of effective international collaboration and the identification of a better strategies for improving environmental health performances in Korea.

• 대한한방내과학회지
• /
• 제27권4호
• /
• pp.975-983
• /
• 2006

Degenerative arthritis is characterized by progressive degenerative change, particularly change occurring to the joint due to the burden of body weight. Arthritis means inflammation occurring to the joint: it causes pain and limits exercise involving movement of the joint. Edema is not a disease but a condition which is accompanied by progression of a certain disease. Degenerative arthritis patients also have various diseases and mostly brings edema. Even though the cause is known to be abrasion of the joints, there are many cases in which walking difficulties are caused by pressure and pain due to edema. We found patients with walking difficulties caused by pain and increase of pressure in the joints walk better after treatment of both the pain and edema.

• Journal of Community Nutrition
• /
• 제4권1호
• /
• pp.51-58
• /
• 2002

Eating behavior change as a result of nutrition education interventions as secondary prevention strategies can contribute to an increase in life expectancy and better health for older adults in the United States (U.S.). Many of the chronic conditions prevalent in older adults are modifiable by dietary changes, including heart disease, diabetes mellitus, hypertension, obesity and osteoporosis. Important demographic observations in the U.S. including the projected large increase in number of older adults by 2030 have implications for nutrition education focus and services. A comprehensive review of nutrition education interventions for older adults in the U.S. published in 1995 identified elements from adult education theories that contribute to the effectiveness of nutrition education. These elements have been the focus of more recent studies with older adults providing additional evidence for relationships between concepts from commonly used behavior change theories and dietary patterns or change. In the U.S, an important program contributing to nutritional adequacy of the diet for older adults is the Elderly Nutrition Program which provides resources for congregate dining and includes a mandatory nutrition education component. Nutrition education is also provided through clinic based programs, and print and broadcast media. Application of the Transtheoretical Model has shown that the level of interest or motivation to comply with dietary guidance may be greater for some older adults due to an increasing burden of chronic disease and poorer quality of life, while others may not feel a need to change lifestyle habits.

• 한국치위생학회지
• /
• 제6권3호
• /
• pp.243-261
• /
• 2006

Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.

• 대한핵의학회지
• /
• 제37권4호
• /
• pp.207-218
• /
• 2003

Myocardial perfusion imaging has been increasingly used to provide prognostic data and guidance on the choice of appropriate management of patients with known or suspected coronary artery disease. The electrocardiogram gated myocardial SPECT program is corning into wide use with an advent of $^{99m}Tc-labeled$ tracers and an improvement of SPECT machines. The gated technique permits measurement of important cardiac prognostic indicators without any further discomforts or radiation burden in patients underwent standard myocardial perfusion SPECT. In addition, gated study significantly improves diagnostic yield by reducing the number of borderline interpretations and could find myocardial stunning and viable myocardium. Gated single photon emission computed tomography (SPECT) imaging allows the automated calculation of end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and the assessment of regional wall motion and thickening, and it have dramatically improved assessment of coronary artery disease in routine nuclear practice. This allows the simultaneous assessment of both perfusion and function within the same acquisition, and serves as a cost-effective technique for providing more diagnostic data with fewer diagnostic tests. Because the diagnostic and prognostic power derived from knowledge of left ventricular function can be added to that provided by assessing myocardial perfusion, gated SPECT imaging has rapidly gained widespread acceptance and is now used on a routine clinical basis in a growing number of laboratories, including South Korea. The gated SPECT technique for measurement of left ventricular parameters has been validated against a variety of well established techniques. In this work, overview of gated myocardial perfusion SPECT focus on functional parameters is presented.

• Journal of Dairy Science and Biotechnology
• /
• 제37권1호
• /
• pp.27-32
• /
• 2019

Fermented milk has been developed with its functionalities, and its health-promoting ability has been spotlighted due to its relationship with diseases such as cancer, cardiovascular disease, and diabetes, and gut microbiota. As national burden of cardiovascular disease increases over time, there is a need to prevent hypercholesterolemia. To achieve that, gut microbiota, which is altered by host's diet and environment, plays important roles in lowering cholesterol in the blood. Moreover, fermented milk may be effective as a cholesterol-lowering agent by altering gut microbiota composition. Gut microbiota may alter not only functions of the fermented milk but also bio-accessibility of functional materials. These results suggested that gut microbiota composition influences the impact of fermented milk. Thus, we should understand how functional materials are degraded by gut microbiota and absorbed into the gut.

• 대한치매학회지
• /
• 제17권3호
• /
• pp.120-129
• /
• 2018

Background and Purpose: Prospective memory (PM) has a known relationship with frontal function, and PM decline has been observed in amnestic mild cognitive impairment (aMCI). Cerebral small vessel disease, as evidenced by white matter hyperintensities (WMHs), is linked to frontal dysfunction. This study was undertaken to evaluate the relationship between PM decline and WMHs in patients with aMCI. Methods: Of 74 enrollees with aMCI, 69 completed this prospective study. We compared total scores and sub-scores of the Prospective and Retrospective Memory Questionnaire (PRMQ) administered at baseline and 3 months later, stratifying patients by degree of WMHs. Results: A significant decline was seen in PRMQ total scores and PM scores at the 3-month mark in patients with moderate (vs. mild) degrees of WMHs ($-2.8{\pm}7.2$ vs. $0.2{\pm}7.1$; p=0.032). In addition, patients with moderate (vs. mild) degrees of deep WMHs (DWMHs) showed greater PM decline, whereas PM loss in patients with mild, moderate, or severe degrees of periventricular WMHs (PVWMHs) did not differ significantly. Conclusions: Findings of this study indicate that the burden of WMHs is consistently implicated in PM deterioration experienced by patients with aMCI, and signifies greater PM decline, especially in instances of extensive DWMHs. Greater attention to the change of PM is therefore needed in aMCI patients with WMHs.

• Journal of Nutrition and Health
• /
• 제52권1호
• /
• pp.1-5
• /
• 2019

Purpose: This review describes the historical changes in nutrition philosophy from a reductionist to a holistic approach during the $20^{th}$ century. Also, the role and efficient use of a holistic approach to precision nutrition are discussed. Results: Over the past century, significant progress has been made in human nutrition research, unraveling fundamental mechanisms of single nutrients on single targets or pathways. This kind of a reductionist approach has helped to save populations from nutrient deficiency diseases and improve associated health outcomes in large parts of the world. However, a new set of nutrition problems, like obesity and diet-related chronic diseases, are growing each year worldwide, increasing the financial burden on the health care system. A linear cause-effect association between single nutrients and a single physiologic effect, is insufficient to solve the complex nutrition-health relationships. Research that involves a more holistic rather than reductionist approach is needed to tackle a new set of nutrition problems. Recent advances in technology, informatics, and statistical methods are enabling an understanding of the diversity of individuals and the complex interactions between foods and human bodies, leading to the concept of "precision nutrition." Conclusion: The emerging goal of precision nutrition is to provide tailored dietary advice for maintaining health and preventing obesity and diet-related chronic diseases. The parts are already being installed. To grab the complexity, reductionism and holism must be used interdependently.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제42권
• /
• pp.26.1-26.6
• /
• 2020

Background: Orofacial clefts (OFCs) comprise a wide range of malformations, including cleft lip, cleft palate, and cleft lip with cleft palate, which can vary in terms of etiology, severity, and disease burden. Objective(s): This study aimed to evaluate the correlation between various risk factors and orofacial cleft disorder spectrum in newborns. Study design: A total of 323 cases and 400 controls were enrolled in this study and evaluated in terms of the maternal history of abortion or miscarriage, child's sex, maternal and paternal age, maternal history of systemic disease, history of medication therapy during pregnancy, birth order, consanguineous marriage, and complications during pregnancy. Results: Analysis of the results suggested that consanguineous marriage, a maternal history of abortion/miscarriage, and complications during pregnancy could potentially increase the risk of OFCs in children (P < 0.05). However, the analyses revealed that the other variables could not potentially increase the risk of OFCs (P > 0.05). Conclusion(s): Multiple cofactors may simultaneously contribute to the formation of such abnormalities; therefore, a comprehensive, multidisciplinary care program is necessary to ensure a successful pregnancy period and the birth of a healthy newborn.