• Title/Summary/Keyword: Medical care level

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The Diagnostic Value of Interferon-γ Assay in Patients with Active Tuberculosis (활동성 결핵의 진단에서 혈청 인터페론 감마 측정법의 유용성)

  • Park, So Young;Park, Yong Bum;Choi, Jeong Hee;Lee, Jae Young;Kim, Jae-Seok;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.13-19
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    • 2009
  • Background: The interferon-gamma assay is reported to have high sensitivity and specificity for making the diagnosis of latent tuberculosis infection. The clinical usefulness of this essay for detecting active tuberculosis has not fully defined. We evaluated the diagnostic value of the commercial interferon-gamma assay kit (QuantiFERONTB GOLD) for patients with suspected tuberculosis. Methods: From January to August 2007, we recruited 52 patients with suspected tuberculosis infection. We performed chest X-ray, sputum smear, culture, PCR and the QuantiFERON-TB GOLD test. Pleural fluid analysis and pleural biopsy were also done for the patients with pleural effusion. Results: Of the 52 patients we studied, 30 patients had a positive QuantiFERON-TB GOLD test result. 35 patients were finally diagnosed with active tuberculosis: twenty-five with a positive QuantiFERON-TB GOLD test and 10 with a negative QuantiFERON-TB GOLD test. The sensitivity of the QuantiFERON-TB GOLD test was 71.4% and the specificity was 64.7%. The positive predictive value was 0.83 and the negative predictive value was 0.50. There was no significant difference of any of the clinical and laboratory characteristics between the two groups of patients except the C-reactive protein (CRP) level. The CRP level was 29.2${\pm}$27.3 mg/dL in the pulmonary tuberculosis patients with a positive QuantiFERON-TB GOLD test and 72.9${\pm}$67.9 mg/dL in the patients with a negative QuantiFERON-TB GOLD test (p<0.05). Conclusion: The sensitivity and specificity of the QuantiFERON-TB GOLD test were inadequate for making the diagnosis of active tuberculosis. We suggest that the QuantiFERON-TB GOLD test should not be used by itself to exclude the diagnosis of active tuberculosis. The relationship of the QuantiFERON-TB GOLD test and the CRP level in patients with TB would be further investigated.

A Study of Health Condion and Shift Service of the Nurse in (종합병원 간호사의 교대근무와 건강상태에 관한 연구)

  • Kim, Soon-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.119-133
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    • 1997
  • Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

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Treatment and Follow-up of Human Papillomavirus Infected Women in a Municipality in Southern Brazil

  • Ruggeri, Joao Batista;Agnolo, Catia Millene Dell;Gravena, Angela Andreia Franca;Demitto, Marcela de Oliveira;Lopes, Tiara Cristina Romeiro;Delatorre, Silvana;Carvalho, Maria Dalva de Barros;Consolaro, Marcia Edilaine Lopes;Pelloso, Sandra Marisa
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6521-6526
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    • 2015
  • Background: This study aimed toanalyze the risk behavior for cervical cancer (CC) and the human papillomavirus (HPV) prevalence and resolution among women who received care through the private healthcare network of a municipality in southern Brazil. Materials and Methods: This descriptive and retrospective study was conducted with 25 women aged 20 to 59 years who received care through the private healthcare network and were treated at a specialty clinic in the period from January to December 2012 in a municipality in Northwest Parana, Southern Brazil. Data from medical records with cytological and HPV results were used. Following treatment, these women were followed-up and reassessed after 6 months. Data were statistically analyzed using the t-test and chi-squared test at a 5% significance level. Results: The mean age of the studied women was $27.8{\pm}7.75$ years old, and the majority were married, with paid employment and were non-smokers. The mean age at menarche was $13.0{\pm}0.50$ years old, and the mean age at first intercourse was $17.5{\pm}1.78$ years, with only 8.0% (2) initiating sexual activity at an age ${\leq}15$ years old. The majority had 1 to 2 children (60.0%), while 88.0% reported having had one sexual partner in their lifetime, and all the women were sexually active. A total of 68.0% used a hormonal contraceptive method. All the women had leukorrhea and pain and were infected by a single HPV type. Regarding the lesion grade, 80.0% showed high risk and 20.0% low risk. The most prevalent high-risk HPV strain was 16. Conclusions: These findings provide relevant information on HPV risk factors and infection, as well as the treatment and 6-month follow-up results, in economically and socially advantaged women with no traditional risk factors, corroborating previous reports that different risk factors may be described in different populations. Thus, this study reinforces the fact that even women without the traditional risk factors should undergo HPVmonitoring and assessment to determine the persistence of infection, promoting early diagnosis of the lesions presented and appropriate treatment to thus prevent the occurrence of CC.

Globalization and Independency of Populist Nations' Welfare Policies: Focusing on the Influences of Multinational Pharmaceutical Companies on the Korean Government's Policy on the Pharmaceutical Industry (세계화와 국민국가의 복지정책 자율성: 다국적 제약자본이 우리나라 제약정책 결정에 미친 영향을 중심으로)

  • Lee, Su-Yun;Kim, Young-Mi
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.5-30
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    • 2005
  • Globalization has conflicting effects on pharmaceutical policies. A change into a 'populist competitive nation' due to globalization strengthens policies to reduce drug manufacturing costs while the WTO's TRIPS Agreement that is affected by multinational pharmaceutical companies increases drug manufacturing costs by bolstering the patent rights on new drugs. Currently, the independency of populist nations' policies to reduce drug manufacturing cost is being compromised because multinational organizations(such as the European Union) which represents the interests of the multinational pharmaceutical companies put restrictions on the pharmaceutical policies of populist nations for purposes of promoting the industrial goals of the multinational companies. Korea is no exception. Up until the late 1990s, the main feature of the pharmaceutical policies in Korea was keeping the drug price at the cost level based on a growth-driven ideology, and this was Korea's unique policy tools as a developing nation. However, the increase in the power of multinational pharmaceutical companies currently infringes on the independency of Korea's pharmaceutical policies. Expensive imported drugs were originally covered by the national health insurance plan, but starting from 1999 such drugs began to be covered by the plan. After separation of medical and pharmaceutical services, the use of expensive drugs was increased, and the Korean government planned to introduce the reference price policy in order to contain the cost of the national health insurance plan. However, due to pressures from the U.S. government as well as multinational pharmaceutical companies, implementation of the policy has been postponed. In addition, due to a pressure from the U.S. government, a working group was created which would affect the health care policy of the Korean government. Discussions so far on globalization was about whether the change into populist competitive nations due to globalization resulted in the reduction of welfare spending. However, this study shows not only the reduction of health care cost through policies to reduce drug manufacturing costs but increase in welfare spending by raising the strengths of multinational pharmaceutical companies that are for-profit providers of welfare service. While focusing on the contradictory effects of globalization on pharmaceutical policies of a nation, this study looked at how these conflicting effects end up promoting the interests of multinational pharmaceutical companies by examining the Korean case.

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The Utilization Rate of Community Health Practitioner Post by Some Rural Residents and Its Associated Factors (일부 농촌지역 주민의 보건진료소 이용도와 관련요인)

  • Lee, Woon-A;Ryu, So-Yeon;Park, Jong;Kim, Suk-Il;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.133-147
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    • 2000
  • To provide data for the improvement of primary health care through the study on the utilization rate of community health practitioner(CHP) post and its related factors toward some rural residents in Mooan County Chollanamdo, a questionnaire survey was made from 382 persons during August 1999. Comparison was made between persons at the seaside area under difficult transportation and persons at the railroad area under convenient transportation. The results are as follows: 1. For the last one year, 83.3% of seaside area residents and 67.0% of railroad area residents used CHP post. As the purpose of visit to CHP post at seaside area, 94.3% visited for medical care, 25.3% for chronic disease control and 22.2% for health counselling and 14.1% for chronic disease control. 2. By simple analysis, sex, age, marital status, educational level, residence area, distance from living village to CHP post, presence of chronic diseases, satisfaction with CHP and confidence on CHP were related significantly with the utilization of CHP post for the last one year. 3. By multiple logistic regression, statistically significant variables related with the utilization rate of CHP post for the last one year were analyzed as age, sex, residence area and distance from living village to CHP post.

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A Survey on Utilization of Health Center and Health Service Demand of Residents in a Urban and Rural Unified Community (일개 도시·농촌 통합지역 주민의 보건기관 이용경험과 보건서비스 요구도 조사)

  • Lim, Bu-Doll;Lee, Ju-Young
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.99-112
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    • 2000
  • This survey was conducted to assess the utilization of health center including health sub-center and community health post and the health service demand of residents in a urban and rural unified community. Officials in Up·Myun·Dong offices visited randomly sampled 4,027 households(4.6% of total households in unified City) which included 3,337 households in urban area(4.9% of total households) and 690 households in rural area(3.7% of total households) and interviewed with heads or housewives of the households in September, 1995. There were significant differences in health-related demographic characteristics including age-sex distribution, educational level, period of residence in the community and medical insurance status of the interviewees between urban and rural areas. Of the respondents, 64.8% in urban area and 55.6% in rural replied that they had utilized the health center in the past. The most common purpose for visiting the health center was to get vaccination in urban area and to get outpatient care in rural area. The top priority health center activity that needs to be reinforced was communicable disease control and over 90% of the respondents preferred to have mobile clinic and home health care service in were also highly demanded. Eighty-six percent of the urban respondents replied that a health sub-center must be established in urban area. In the rural area, 90.3% of the respondents replied that they wanted to maintain the health sub-center and 88.3% wanted to maintain the community health post. Along with the improvement of facilities and equipments of the health center by Rural Health Service Improvement Project, new health service programs must be developed to meet the demand of the community.

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The Changes of Cuff Pressure from Endotracheal Intubation for Long-term Mechanical Ventilation (장기간 기계호흡 환자에서 기관내 관의 기낭압의 변화)

  • Jung, Bock-Hyun;Park, Whan;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.2
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    • pp.156-165
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    • 2002
  • Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.

The Death Orientation of nursing students in Korea and China (한국과 중국 간호대학생의 죽음에 대한 의식)

  • Li, Zhen-Shu;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.1-12
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    • 2008
  • Perpose: The purpose of this study was to investigate the perception of death between Korean and Chinese nursing students. And it will help develop curriculum for preparing death, the quality of hospice care, as well as nursing education and practice. Methods: Data was collected from 492 nursing students participated(248 Korean and 244 Chinese) by questionnaire designed for examining Death Orientation (Thorson & Powell, 1988). They were analyzed using Cronbach's Alpha coefficients, factor analysis, t-test, ANOVA and regression analysis (SPSS; win 12.0 version) Results: More than half of the Korean nursing students followed a religion (58.5%) while the majority of Chinese nursing students did not follow a religion (93.9%). In the view of the afterlife, nursing students in China had two views. 'I really don't know what happens after a person dies (30.3%)' and ‘There is no afterlife and death is the end (29.5%)’. On the other hand the Korean nursing students’ answer were, 'After dying, a person goes to heaven or hell (27.3%)' and 'I really don't know what happens after a person dies. (22.9%)' The study also found that the average of 25 items in Death Orientation is 2.36points of nursing students in Korea and 2.50points of nursing students in China. This means that the concern, anxiety and fear were of the middle level for the Chinese Students and were higher than Korean students (t=3.51, p=.000). In the low factor of death orientation, those in Korea had higher 'anxiety of burden to family' than those in China (t=-3.50, p=.001). The nursing students in China had higher 'anxiety of the unknown (t=4.96, p=.000)', 'fear of suffering (t=6.88, p=.000), 'fear of extinction body and life (t=5.20, p=.000), 'fear of lost self-control(t=2.12, p=.034)', and 'anxiety of future existence and nonexistence (t=2.33, p=.020)' than those in Korea. There was no statistically significant difference for the 'concern of body and fear of identity lost' category. The death orientation of Korean nursing students had statistically significant differences according to age (t=3.20, p=.002), religion (t=2.56, p=.011), and afterlife (F=4.64, p=.000). The contribution of Death Orientation had a statistically significant difference, the afterlife variable (0.735, p=0.001). The death orientation of Chinese nursing students did not have any statistically significant differences. Conclusion: In conclusion, there were differences in death orientation between Korean and Chinese nursing students. In particular, those who believed in afterlife showed acceptance of death. The results of this study suggest that nursing curricula should include education program on death and spiritual nursing. Additional studies are needed to establish death education in China with careful considerations on Chinese policies, cultures and social systems.

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Comparative Analysis of Oral Health Awareness, Knowledge and Behavior according to the Major of Some Female Students for Life Care (일부 여학생들의 라이프케어를 위한 전공별 구강보건 인식, 지식 및 행태 비교분석)

  • Lee, Mi-Lim;Lee, Hyo-Cheol
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.1
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    • pp.149-158
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    • 2020
  • The purpose of this study was to examine relation of oral health awareness, knowledge and behavior in department dental hygiene, health-related majors and health-unrelated majors in attempt to provide basic data of oral health promotion and oral health education. This study were 591 female H university students in Gwangju. The interests of oral health, the recognition of importance for oral health, and recognition of one's own oral health status were highest in dental hygiene students, followed by health-unrelated majors and health-related majors. The level of oral health knowledge by the major was highest in dental hygiene students(9.73), followed by health-related majors(9.14) and health-unrelated majors(9.05). In the oral health behavior by major, students who brushed more than three times a day, used the oral care products and received regular dental examinations within 1 year were the highest in the dental hygiene major, followed by health-related majors and health-unrelated majors. The experience of scaling within 1 year was the highest in the dental hygiene major, followed by health-related majors and health-unrelated majors. The higher the oral health knowledge, increased awareness of oral health concern and the importance of oral health. Also, the higher the degree of interest in oral health, the greater the recognition that oral health is important and the more the oral health condition is perceived as healthy, It was found that the number of brushing increased. In this results, the higher the oral health knowledge, the higher the oral health awareness and the oral health behavior. It is necessary to find ways to develop or utilize various oral health education for university students.

The Crisis of AIDS and responses of South African Churches in the task of new national building (새로운 민주주의 국가건설의 과제 속에 직면한 AIDS와 이에 대한 교회의 반응과 과제: 남아프리카 공화국을 중심으로)

  • Kim, Dae-Yoong
    • Journal of the Korean Association of African Studies
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    • v.29
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    • pp.27-53
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    • 2009
  • At the start of the new century, South Africa probably had the largest number of HIV-infected people of any country in the world. The only nation that comes close is India with a population of one billion people compared to South Africa's figure of 57 million. The tragedy is that this did not have to happen. South Africa was aware of the dangers posed by AIDS as early as 1985. In 1991, the national survey of women attending antenatal clinics found that only 0.8percent were infected. In 1994, when the new government took power, the figure was still comparatively low at 7.6 %. The 2004 figure which has been published is 26.5%. This article tracks the epidemic globally, in the region and in South Africa. I explain some of the basic concepts around the disease and look at what may happen with respect to numbers. The situation is bad, and the number of people falling ill, dying and leaving families will rise over next few years. This will impact on South Africa in a number of important ways. This article assesses the demographic, economic and social consequences of the epidemic. It disposes of a number of myths and present the real facts. The AIDS in South Africa is not related to individuals only. It warns that AIDS in Africa is becoming a community and systemic problem. The acuteness of the problem does not stem merely from the fact that communities are affected, or could even be wipe out by the end of this decade, but from the fact that AIDS will place incredible burdens and obligations upon medical services, health care and religious communities such as churches. The facts confront churches' mission with the important question: who is going to take care of all the patients and where? The reality is that people dying of AIDS will have to be cared for at home by relatives and friends. A further question that arises is whether our people are prepared for this. AIDS was considered to be a homo-plague and the hunt was on for a scapegoat in the light of the fatal implication of the disease. At present we are in the strategic phase where we all realize that it will be of no avail to scare people with the ominous threat of AIDS AIDS destroys the optimism of our achievement ethics. This exposure of the culture of optimism is also an exposure of the so-called 'human basic fear which accuses Christianity that their concept of sin is a damper on man's search for liberation and basic need to be freed from all Imitation. AIDS is also a test for our ecclesiastical genuineness and the sincerity of our mission sensibility. It poses the question: How unconditional is Christian love? Is there room for the AIDS sufferer in the community of believers, despite the fact he is an acknowledged homosexual? The question to put to the church is whether the community of believers is an exclusive to put to the koinonia which excludes homosexuals. They may be welcome on principle, but in actual fact are not acceptable to the church community. As South Africa enters the new century, it is clear that the epidemic is not having a measurable impact. However, the impact of AIDS is gradual, subtle and incremental. The author's proposal of what is currently most needed in South Africa is that the little things will make a difference. It's about doing lots of little things better at grassroots level, with the emphasis on doing. There are so many community, churches and NGOs initiatives worth building on and intensifying. One must not underestimate the therapeutic value of working together in small groups to overcome a problem