Objective: The aim of this study is to review the literatures on the regulation, standard and guideline for the human vibration in Korea and other countries. Background: This review can be used to prevent various diseases caused by the human vibration as a basis for the development of the policy. Results: In Korea, the general employers' duties related to human vibration are set forth the Health Measures(Article 24) in the Occupational Safety and Health Act. And then an employer shall take measures to protect the health of the workers concerned by improving other working conditions relating to working hours for the vibration prevention measures referred to in Article 24 of the Act. The European Union adopted a Directive in 2002 on minimum requirements for the health and safety of workers exposed to vibration. New Regulations on Vibration at Work will be introduced in Great Britain on 2005 to implement the Directive. In the U.S., both ANSI and ACGIH adopted the ISO standard for measurement and suggested exposure action and limit values. In Japan, the Ministry of Labor decided that the vibration syndrome among operators of rock drills and riveters etc. could be included in an occupational disease(1947). In addition, ISO standard was based on proposals and draft documents of many countries such as U.K, Japan and European, etc. Conclusion: In Korea, Occupational Safety and Health Act prevent vibration to health, but do not include exposure limits. It is therefore important to consider the new duties regarding to vibration risks added to the general duties.
Proceedings of the Korean Society for Noise and Vibration Engineering Conference
/
2006.05a
/
pp.759-763
/
2006
The World Health Organization(WHO) has recommended population of sleep disturbance as one of the environmental health indicators. But the percentage of respondents who felt highly sleep disturbed, that is, %HSD can???thave application to sleep disturbance from instantaneous noise. Therefore, this study has been carried out to present the technique for assessing sleep disturbance on instantaneous noise quantitatively. The study of sleep disturbance on night time instantaneous railway noise has been undertaken. Noise monitor has been in operation from 22 hours to 7 hours during 6 nights at 12 locations. To assess instantaneous noise induced sleep disturbance, it was decided to measure body movement by actiwatch. %motility was used as indicators of sleep disturbance. %motility is the expected value of probability of motility value during 7 epochs (105s) of any noise event. The measures of instantaneous motility have been related to measures of instantaneous railway noise events. The relationship shows that %motility is a good predictor for assessing sleep disturbance and Korean is more sensitive to noise than European although the railway noise have been considered in this study. This study can be extended to assessing long-term sleep disturbance and give a guideline far policy decision.
Journal of The Korea Institute of Healthcare Architecture
/
v.13
no.3
/
pp.25-33
/
2007
This study is about change a necessary and natural change from institutionalized hospital based health care to a more patient centered, accessible health care. Rapidly change of social and medical facts such as growing aging population, malady, changing of medical policy are made new paradigm. This paradigm is both required to the hospital ; consolidate department and service; architectural change. Benefit to patient and hospital are many, so there are many challenges in Korean general hospital. The purpose of this study is find architectural design guideline to Korean general hospital which is struggling to change from to functional organization to the patient based care center. As a result, the type is divided into three classes, consultation type(C), some of examinations are added on consultation type(EAC), consultation and examination are fully integrated type(CEI). Each type has different organization and the proportion of area, group unit, process of treatment.
Kim, Dongsu;Lim, Byungmook;Han, Dongwoon;Park, Ji-eun;Jung, Hyoung-Sun
Journal of Society of Preventive Korean Medicine
/
v.21
no.3
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pp.1-10
/
2017
Objectives : The purpose of this study is to investigate the practice patterns of traditional Korean medicine (TKM) doctors and the acceptance of payment model in order to develop a new TKM health insurance payment model linked with TKM clinical practice guidelines (CPGs). Methods : Lumbar herniated intervertebral disc (HIVD) and idiopathic facial palsy (IFP) were selected as a test diseases to develop a new TKM payment model. The level of benefit coverage in the National Health Insurance (NHI) was designed. The survey asked 228 TKM doctors about their practice patterns in HIVD and IFP patients and acceptance of new payment model. Results : Mean of medical cost for treatment of HIVD was 441,000 KW, mean of treatment period ranged from 4.9 to 17.5 weeks, and mean of number of treatment ranged from 14.6 to 50.4 HIVD patients. In the case of IFP, mean of medical cost for treatment of IFP was 468,000 KW, mean of treatment period was at least 4.2 and up to 15.9 weeks and mean of number of treatment ranged from 14.2 to 52 IFP patients. Conclusions : Current study suggests that mixed payment model of per-visit and episode-based model seem to be proper. The model 1 bundles both items which were covered and not covered by NHI in a rational way. The model 2 is based on the development and application of critical pathway. Lastly, model 3 suggests bundling of items covered by current NHI. Acceptance of TKM doctors is expected to be highest in the model 3.
Five sampling sites were selected to investigate the distribution characteristics of air pollutants with pollution sources and weather conditions in Ulsan. $SO_2,\;NO_2,\;O_3,\;CO,\;PM_{10}$ concentrations and weather conditions with time were analyzed by using several statistical methods. Also, the distribution characteristics of ambient air quality were estimated by pollution-rose and multi-regression analysis. As a result of the analysis, $NO_2,\;CO\;and\;PM_{10}$ concentrations were high in winter season, whereas $SO_2\;and\;O_3$ concentrations were high in summer season. This concentration distribution was caused by the unfavorable geographical location, which the residential area was located at the downwind direction to industrial area. From the pollution-rose, we confirmed that each pollutant influenced the downwind residential areas because of seasonal wind direction. $SO_2$ concentration has shown positive correlation of $0.2{\simm}0.3$ for $NO_2,\;PM_{10}$ and temperature, while $O_3$ concentration has shown negative correlation. Also, $NO_2$ and CO concentrations, pollutants generated by combustion, have shown positive correlation, while $O_3$ concentration and temperature have shown negative correlation. Therefore, it could be suggested that a seasonal air quality policy and a new guideline of air quality was necessary in each season with wind directions to reduce the air pollution level in Ulsan.
The purpose of the study is 1) to explore clinic and hospital CEOs' satisfaction and expectation level on the affiliation with the larger size teaching hospitals, 2) to find the factors influencing the satisfaction and expectation level on the affiliation with the large hospitals. Data for analysis was collected to use self-administrative structured questionnaire on 335 CEOs of small or middle sized clinics and hospitals affiliated with large sized teaching hospitals located in Seoul and Kyung Ki Province. For the study, the researchers develop the constructs for questions on the satisfaction and the expectation of the affiliation, the attitude, knowledge on the affiliation, previous relationship of the affiliation, and selection guideline of the affiliation with exploratory factor analysis and reliability test. Through the confirmative factor analysis using AMOS 4, the researchers develop constructs based on exact relationship between constructs and questions. CEOs' expressive and unexpressive satisfaction level are 2.54 of 5 point(38.5 of 100) and 2.78 of 5 point(44.5 of 100), and the expressive and unexpressive expectation level are 2.77 of 5 point(44.3) and 3.16 of 5 point(54.0). These levels are relatively row for importance of affiliation. Expectation levels do not influence satisfaction levels. Attitude of affiliation influences expressive expectation and unexpressive satisfaction, reason for affiliation unexpressive satisfaction, and previous relationship to affiliated hospitals influence both of expressive and unexpressive satisfaction. The expressive expectation level and the expressive satisfaction level influence unexpressive expectation and unexpressive satisfaction, respectively. There is cognitive dissonance between expectation and satisfaction, therefore numbers of affiliation might be smaller or weaker in the future than present time. Many CEOs feel environmental press such as competition and the press of health insurance, but they might not think affiliation is best solution. Therefore, large hospitals try to give affiliated clinics and hospitals practical benefits to increase satisfaction and expectation levels, and they need to new affiliation form such as joint venture and joint ownership. The expectation and the satisfaction level was influenced by CEOs' gender, type of health service facilities, distances between the affiliated facility and the large mother hospital, and reason for affiliation.
Background: Medication policy development in Thailand is continually promoting rational drug use. Letrozole, an endocrine therapy drug, is usually prescribed for post-menopausal status early and advanced stage breast cancer. After Ministry of Public Health announced Letrozole as compulsory licensed drug in 2009, more breast cancer patients can access to this drug at low cost especially those within universal coverage schemes. To ensure that Letrozole is rationally prescribed, the drug utilization study was conducted. Objectives: The aim of this study was to describe the appropriate use of Letrozole in breast cancer and the relationship between appropriate use and health benefit schemes. Materials and Methods: A retrospective study to evaluate use of Letrozole in breast cancer patients was performed for six months between January - June 2010 in seven regional cancer hospitals, Thailand. All prescriptions of Letrozole were identified from pharmacy dispensing databases and prescription papers. A medical record review was also performed to evaluate appropriate use referring to the drug use evaluation criteria. The approved criterion of this study was referred from the guideline of Thai National Formulary version 2010. Results: There were 681 prescriptions of Letrozole for 254 breast cancer patients with an average age of $58.6{\pm}10.0years$. The patients in universal coverage scheme (UCS), civil servant medication benefit scheme (CSMBS) and social security scheme (SSS) were 77.7%, 18.5% and 8.7% respectively. 10.6% were prescribed Letrozole for the first time. Letrozole were prescribed by oncologists (82.8%). The average number of tablets per prescription was $58{\pm}10$. Calcium supplements were prescribed concomitant with Letrozole for 19.4%. To assess drug use evaluation criteria, 45 prescriptions were excluded because of uncompleted clinical data, 636 prescriptions were evaluated. The study showed 86 prescriptions (13.5%) with inappropriate use including 6 (0.9%) not prescribed for estrogen receptor (ER) and/or progesterone receptor (PR) positive, 31 (4.9%) not prescribed for post-menopausal and 49 (7.7%) not prescribed for an appropriate duration. Appropriate use percentages in different health benefit schemes were similar, 85.7% of CSMBS, 86.4% of SSS and 86.7% of UCS. The relationship between health benefit scheme and appropriate use of Letrozole was not significantly different, ${\chi}^2$ (2, N = 636) = 0.081, p > 0.05. Conclusions: The study showed inappropriate use in breast cancer patients because of non-compliance with duration, menopausal status and hormone receptor requirements. To prescribe appropriate indication did not referred to the appropriate practice along the treatment. Drug use evaluation proved very useful for detecting the sign of inappropriate use and allows immediate feedback to the stakeholder for developing medication policy in the future. Importantly, there was no significantly difference in appropriate use of Letrozole across health benefit schemes.
Purpose: The purpose of this study was to describe the current status of managing educational programs for tobacco use prevention at middle and high schools located in Busan. Methods: Using a survey method with a 29-item self-administration questionnaire, the data were collected from January 10 through February 18, 2005, from school nurses as well as teachers major in healthcare of 227 participant schools. Results: A strategic plan for school-based educational programs of tobacco use prevention was mainly developed by a school nurse at middle school and a teacher in charge of school discipline at high school. The educational programs for tobacco use prevention were implemented for approximately 40% of schools in Busan with the budget ranged from 110,000 won to 200,000 won a year. Eighty five percepts of the schools had anti-tobacco regulations and guidelines in place. Twenty two percents of the middle and high schools collected the data regarding adolescents' smoking status periodically. Over 70% of schools provided tobacco use prevention education programs as a part of regular semester curriculum. Conclusions: For making the management of educational programs for tobacco use prevention effective and consistent with government's anti-smoking policy, schools need (a) development of tobacco management guideline and regulations with participation of teachers, students, and parents, (b) clear job and role descriptions for personnel to plan and implement anti-tobacco programs, (c) compilation of the budget enough to implement the programs, (d) periodically assessment of adolescents' smoking status, and evaluation of the programs to monitor whether those are effective for adolescents' health promotion; and (e) to make an effort to less range of quality in educational programs for tobacco use.
Purpose: The aim of this study was to analyze economical efficiency of home care service by comparing a cost-utility ratio(CUR) between home care and hospitalization. Method: The analytic framework of this study was constructed in 5 stages: Identifying the analytic perspectives, measurement of costs, measurement of utility, analysis of CUR, and sensitivity test. Data was collected by reviewing medical records, home care service records, medical fee claims, and other related research. Result: The mean of the annual total cost was 23,317,636 Won in home care and 73,739,352 Won in hospital care. QALY was 0.389 in home care and 0.474 in hospital care, so CUR was 299,712,545 QALY in home care and 777,841,266 QALY in hospital care. Conclusion: The findings affirmed that home care had an economical efficiency in the aspect of utility compared to hospitalization. Therefore, the findings of this study can be used to develop a governmental health policy or to expand the home care system. In addition, the cost-utility analysis framework and process of this study will be an example model for cost-utility analysis in nursing research. Therefore, it will be used as a guideline for future research related to cost-utility analysis in nursing.
Globally, consumers' enormous and increasing appetite for meat is one of the biggest causes of climate change because livestock industry emits more greenhouse gas than transportation. The purpose of this study is to analyze consumer awareness about the impact of meat consumption on sustainability in response to climate change. Based on the theory of planned behavior, the attitudes, subjective norms, perceived behavioral control, prior knowledge, and risk perception variables were analyzed to evaluate the impact of climate change awareness over consumer behavior on meat consumption. Major findings are as follows: consumers were aware of climate change but has made few changes to their meat consumption. In addition, changes in meat consumption were found to be caused by health safety concerns, such as disease outbreaks. Significant variables related to meat consumption patterns associated to climate change impacts were household income, age, attitude, subjective norm, perceived behavioral control, and prior knowledge. These results suggest some implications for policy. There is a need for public relations and education to make the public aware of and better understanding of link between climate change and diet. Also, government should make efforts to raise awareness of mitigation of climate change such as comprehensive food labels which are identifying lesser impacts on climate and better dietary guideline instructions which would include coping with climate change.
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