• Title/Summary/Keyword: Medical education

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Analysis of Actual Conditions of Unnatural Death Cases and Questionnaire for Initial Crime Scene Investigation of Police (변사체 발생실태 및 경찰의 현장 초동조치에 관한 설문 분석 - 경북지역을 중심으로 -)

  • Cho, Doo-Won;Chae, Jong-Min
    • Journal of forensic and investigative science
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    • v.1 no.1
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    • pp.11-30
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    • 2006
  • The preliminary investigative activities by the police officer play a critical role in identifying the cause of death in unnatural death investigations. The failure to secure the crime scene leads to the destruction of significant evidence, which results in the difficulty or impossibility to identify the cause of death. In order to prevent this jeopardizing crucial evidence, and to identify the level of preliminary investigation on the scene, this research is conducted and analyzed with questionnaires of 300 police first responders and 100 detectives. As a result, it was disclosed that there is a possibility for first responders to fail to ensure scene security, scene observation, and canvass interviews. Besides, when medical personnel have no choice but to contaminate the crime scene in order to save lives, it is necessary for them to take photos and to take proper actions before they enter the scene. The importance of scene-control education cannot be emphasized enough in order to prevent media from entering and destroying the evidence. Through research of actual conditions of unnatural death cases which occurred in Kyongbook Province for last five years, the statistics regarding a few different types of death were analyzed as follows. Evidence that homicide, suicide, accidental death, and disaster deaths have increased year by year. Therefore, it is deemed necessary for the government to take multilateral policies to reduce them, and for police to reinforce their investigative skills. Further, the insufficient number of autopsy facilities and forensic pathologists, only 13% of the deceased (1,237 cases) have had an autopsy conducted to identify the cause of death for last five years. The other, 87.3% (8,496 cases) of the deceased, were handled through simple postmortem examination. The significance of this percentage is that there is still the possibility not revealing the cause of unjust deaths. Therefore, it is necessary to furnish police agency with the reasonable amount of funding for autopsies and maintaining enough forensic pathologists.

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A Comparative Study on Injury Severity, Self esteem, Health Locus of control and Health Promotion Lifestyles between Helmeted and Nonhelmeted Motorcycle Accident Victims (오토바이 사고환자의 안전모 착용여부에 따른 뇌 손상비교와 자아존중감, 건강통제위 성격, 건강증진행위의 비교연구)

  • 최스미
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.585-601
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    • 1993
  • Data on 63 patients who had had motorcycle accidents and who were admitted to four general hospitals in the Chung Chung Nam Do area from July / 1993 to August 1993 were analyzed. The tool used for this study was a structured questionnaire which consisted of ten items on self- esteem, 18 items on health locus of control and 37 items profiling health prometion lifestyle. Injury severity scores were calculated bated based on data from the patients’ medical records. The collected data were analyzed using the SPSS, yielding descriptive statistics, t-test, ANOVA, Pearson’s Product Moment Correlation. The findings of this study are as follows. 1) Of the 63 injured motorcyclists, 35(55.6%) were helmeted and 28(44.4%) were nonhelmeted, and the nonhelmeted motorcyclists were predominantly young and male. The demographic variables for the helmeted and nonhelmeted groups were heterogeneous for age and occupation. 2) The results of the comparison between the two groups showed a statistically significant difference in the injury severity score(t=-4.70, p=0.000). The helmeted group had lower scores on injury severity score (9.00±3.93) than the nonhelmeted group(14.32土5.05). More than 60% of the nonhelmeted motorcyclists had brain injuries compared to only a third of the helmeted cyclists. 3) There .was a statistically significant difference between the two groups on self esteem(t=4.5, 000). The helmeted group had a higher mean score (31.27±2.72) than the nonhelmeted group(27.46±3.80). 4) The means for Internal health locus of control (IHLC), Powerful others health locus of control (PHLC), and Chance health locus of control (CHLC) in the two groups were similar to instrument norms reported in other literature. The mean scores on the IHLC in the two groups were higher than scores on the PHLC or the CHLC. However, there was a significant difference between the mean scores for the two groups on the PHLC (t=2.85, P=0.006). 5) The mean score for the helmeted group on the health promotion lifestyle profile was higher than the mean score for the nonhelmeted group(107.30±11.10, 96.57土 15.54 respectively), and there was a significant difference between the mean scores (t=3.64, p=0.001) . The highest score for helmeted group on the health promotion lifestyle profile was in the health care domain. However, for the nonhelmeted group the highest score was in the exercise domain and the lowest score was in the health care domain. 6) With regard to the relationship between health promotion lifestyle, health locus of control and self esteem in the two groups, the correlation coefficient between health promotion lifestyle and internal health locus of control for the helmeted group was 50(p〈0.01). For the nonhelmeted group, there was no correlation between health promotion lifestyle and internal health locus of control. However, there were significant correlation between health pro-motion lifestyle and external locus of control(r=0. 46, p〈0.01), and self esteem(r=0.495, p〈0.01). 7) Among the demographic variables, age and education had an impact on individual’s self-esteem The modifying factors of age made a contribution to explaining health - promoting lifestyle. In the present study, more than 40% rf the motorcyclists were riding without a helmet. The incidence of brain injury for patients riding without a helmet was nearly twice as high in the nonhelmeted rider as compared to the helmeted rider. The nonhelmeted motorcyclists in this study had lower self-esteem, obtained a higher score on the IHLC, and were not strongly engaged in performing health promotion activities as compared to the helmeted riders. However, some of the nonhelmeted riders who had a strong belief in PHLC were positively associated with engaging in health promotion activities. Based on the results obtained from this study, strategies to promote helmet usage for motorcyclists have to be developed.

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Adaptation Process to Menopause (폐경에 대한 적응 과정)

  • 이미라
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.623-634
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    • 1994
  • Although the average menopausal age has not changed, women's life span has increased. Today's women live longer after their menopause than those in the past, and this calls for attention in both nursing and medical fields. Many studies have revealed how women reacted to menopause and suffered from it. But they did not discriminate the menopausal meaning and effects from the climacteric phenomena. So, this author tried to clarify what menopause itself meant to the climacteric women, by means of grounded theory methodology. The interviewees were 21 women, whose ages were between 46 and 60 years. They were selected by theoretical sampling technique, and the author tried to include all levels of important variables such as age, educational background, religion and job. Data were collected by the author through in -depth interviews and observations in July, 1994. The interviews were mostly done in the homes of the subjects, or in some cases at the author's office or in a hospital. Interviews took from 30 minutes to 2 hours. Interviews were tape recorded and transcribed later by a research assistant. Data were analyzed as gathered, by the constant comparative method proposed by Strauss and Corbin. Eleven concepts were discovered from the data, and they were grouped under six higher order categories. These six categories were "to give menopause a meaning", "to experience value change", "to have self-help strategies", "to have no strategies", "to live a life worth living", "to have a sense of powerlessness" Among these "to experionce value change" was . selected as the core category. Five major categories were systematically integrated around the core category. Women's adaptation to menopause was defined as proceeding as follows : Most women felt relief and sorrow at the same time when they faced menopause, and some only sorrow or agony. Then, they consulted with others about menopausal symptoms, or tried to think of them by themselves. Finally, they gave menopause a meaning, which was that menopause and its symptoms were natural phenomena. But menopause made women reflect on them-selves and their past lives. As they reflected on themselves, their value on life began to change. As their value changed, some women seeked self help strategies. Those self help strategies were what they had learned from collegues, professionals or mass media. The quality of their lives depended on whether they practiced self help strategies or not. Three types of lives were found. Twelve women enjoyed a life worth living, and practiced the self help strategies, because they accepted menopause a chance to change. They were characterized by a high educational level, having a professional job and a sincere faith in God. Seven women were living as usual, because they did not have the necessity to change. They were high school graduates and house wives. Two women recognized menopause a chance to change, but they did not try self help strategies. Their characteristic was low educational level. Those who did not try self help strategies complained of powerlessness to varying degrees. The educational background, full-time jobs and faith helped women adapt to menopause positively. But social support was not helpful to women's adaptation to menepause. Three hypotheses were derived from the analysis. (1) The higher the educational level, the more theneed to change. (2) Women with higher educational background will practice self help strategies more than those with lower edcational background. (3) The more women practice self help strategies, the worthier lives they will live. Suggestions for further studies are as follows. (1) Studies to test hypotheses are needed. (2) A study to find the relationship between the degree of practicing self help strategies and locus of control. (3) Spiritual approaches would better be applied to help menopausal women. (4) Education through mass media should be given mere frequently.

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On the Determinants of Health Care Utilization of the Physically Disabled (지체장애인의 의료이용에 영향을 미치는 요인)

  • Kim, Keon-Yeop;Lee, Young-Sook;Park, Ki-Soo;Son, Jae-Hee;Kam, Sin;Chun, Byung-Yeol;Park, Jae-Yong;Yeh, Min-Hae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.2 s.61
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    • pp.323-334
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    • 1998
  • To investigate determinants of health care utilization of the physically disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization .ate was 81.9%(69.1% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically significant relationship with health care utilization(p<0.05). By path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.1%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health concern toward physically disabled should be implemented to increase health care utilization rate.

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A Study on Therapeutic Compliance of Hypertensive Patients in a Rural Health Subcenter (일개 농촌지역 보건지소 고혈압 환자의 치료지속성)

  • Song, Min-Keun
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.155-164
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    • 2002
  • Hypertension is the most frequent disease of chronic circulatory diseases and major intermediate cause or risk of the cerebrovascular disease which is a leading cause of death in Korea. Therefore, management of hypertension is an important issue in Korean healthcare. Especially, therapeutic compliance of hypertensives is very important because the hypertensive patients should receive anti-hypertensive treatment as long as the condition exists. However, many patients drop out of treatment, which is a major problem that needs to be solved through a hypertension control program. This study was carried out to provide basic data and counter measule for the hypertension control program in the community which aimed to keep the patients receiving treatment continuously. In order to investigate compliance of hypertensive patients during three months follow-up and the rate of control of hypertension, the data were collected during February, 2001, by reviewing medical records of 295 hypertensive patients who had been registered to Gunnam-myeon health subcenter before November, 2000. The author also study the dropout reasons by interviewing 58 patients among 68 dropout patients. The results were as follows: 1. Among the 295 subjects, 108(36.6%) were male and 187(63.4%) were female. Statistically, female hypertensives had a higher mean age than male(64.6 vs 66.3, p<0.05). 2. The 54.9% of the patients took anti-hypertensive medicine continuously for the past three months. And 19.3% had drug intermittently, and 25.8% dropped out of treatment. 3. Among several variables, such as sex, age, health insurance, the time taken from a patient's village to the health subcenter, only the last one was found to be significantly related to therapeutic compliance in the contingency table analysis. 4. The dropout reasons by multiple response were as follows, 'no symptom or no problem' (23.9%), 'change to other hospitals'(19.4%), 'geographical barrier'(17.9%), 'change to a neighborhood drugstore' (14.9%), 'immobility'(7.5%), 'economic barrier'(6.0%), 'unsatisfactory services of the health subcenter'(4.4%). 5. The mean blood pressure of 295 subjects was $144.9{\pm}12.9/86.88{\pm}8.6mmHg$. 6. The 32.5% of the subjects were controlled below 140/90mmHg. Conclusions: In order to improve the low rates of treatment and control of hypertension in rural hypertensives, a more active and systematic hypertension control program, including out-reaching follow-up management, is required in rural area. Especially, for health education of hypertensive patients, emphasis should placed on correcting wrong attitude toward hypertension.

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A Study on the Awareness of Dental Patients about Dental Hygienists (치과내원환자의 치과위생사에 대한 인식도 조사 연구)

  • Park, Sung-Suk;Choo, Pyung-Ku
    • Journal of dental hygiene science
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    • v.10 no.3
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    • pp.191-197
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    • 2010
  • The purpose of this study was to examine the awareness of dental patients using dental institutions about dental hygienists in an effort to help educate dental hygiene students to have the right image of dental hygienists. And it's also meant to provide education for dental hygienists to develop their own capabilities, attitude and values to render quality medical services to patients. The subjects in this study were the patients who visited dental clinics and hospitals to receive treatment. A self- administered survey was conducted from March 5 to April 13, 2010, in consideration of their general characteristics. The answer sheets from 204 respondents were gathered, and 197 answer sheets were analyzed except seven incomplete ones. A factor analysis was carried out to find out their general characteristics, and independent-samples t-test and one-way ANOVA were utilized to get statistical data on mean and standard deviation. A SPSS 12.0 program was employed to analyze all the collected data. And it's found that the largest number of the patients thought that the main duty of dental hygienists was to give treatment to patients, and they took a favorable view of their services. They weren't well aware of the process of nurturing dental hygienists and their curriculum, and they put a relatively strong confidence in their treatment and had relatively favorable experiences with them.

Regional Differentials in Mortality in Korea, 1990-2000 (사망력 수준의 시ㆍ군별 편차 및 그 변화 추이, 1990∼2000)

  • 김두섭;박효준
    • Korea journal of population studies
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    • v.26 no.1
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    • pp.1-30
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    • 2003
  • This paper attempts to explore the effects of ecological and socioeconomic factors on the level of mortality and the changing trends of such effects during the period of 1990∼2000. For this purpose the population census data and micro-data from the vital statistics for years 1990, 1995 and 2000 were used. As indicators of mortality, the crude death rate(CDR), the standardized death rate(SDR) and the longevity rate were calculated for 170 'Si' s and 'Gun's. Using GIS, this paper first presents the mortality and longevity maps for years 1990, 1995 and 2000. Then ANOVA and regression analyses are carried out in an effort to generalize the effects of ecological and socioeconomic factors on the CDR, the SDR and the longevity rate. When the mortality and longevity maps are examined, three indices of mortality are found to be markedly high in the southwest coastal regions of Cholla-Nam-Do. By contrast, Seoul and Pusan metropolitan areas show substantially low level of mortality and longevity in these indices. It is also found that the regional differentials in the SDR and the longevity rate show a trend of becoming smaller after 1990. The research, however, does not find any linear relationship between the SDR and the longevity rate. The causal mechanisms of the two indices are found to be different. The results of the ANOVA and the regression analysis reveal that the locational factors of both mountainous and farming regions tend to increase the CDR and SDR while both coastal and farming regions disclose a tendency of increasing the longevity rate. The level of statistical significance of these analytical results is found to be weaker when socioeconomic factors such as education, income, marital status, availability of medical care, and sanitary conditions of the region are taken into account. The regional differentials in the mortality level seem to have a clear relationship not only with the socioeconomic factors but also with the age structure influenced by the age selectivity of migration during the past 40 years.

Survey on the Hospice Care Needs of Hospice Volunteers (호스피스 자원봉사자의 호스피스 케어 요구도 분석)

  • Cho, Hyun;Kang, Hee-Sook;Kim, Jeoung-Hee
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.155-162
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    • 2002
  • Purpose : The purpose of this study is to provide preliminary information on the hospice care needs of hospice volunteers. Methods : The sample of this study was obtained from those who completed the hospice volunteer education program in three different areas in Korea. This study was conducted by a self-administered questionnaire. The sample analyzed for this study contained 88 hospice volunteers. Frequency, percentage, mean, standard deviation, and logistic regression analysis were performed to produce the findings of this study. Results : The characteristics of the study sample were $40{\sim}49$ aged, middle class, christianity, married women with high school diplomas. They attended at the hospice center with less than 1 year experience. Majority of them had no family members who received a hospice care. The hospice care was strongly required in the field of information, particularly regarding their diseases and treatments. The identified hospice care needs were the prevention and treatment of gangrene in the field of physical needs, the maintenance of closer relationship with their doctors in the field of emotional needs, and the support of supporting medical insurance in the field of socioeconomic needs. The significant predictors were 'having hospice care taker among family members' in the field of the total hospice care needs and physical needs. Two predictable variables were found in the field of emotional needs. However, none were found to be a predictable variable in the field of information and socioeconomic needs. Conclusion : The findings or this study have a weekness of generalizability due to the sampling methodology used in this study. Thus, further research should be designed in relation to this topic with a probability sampling method.

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An Epidemiologic Study on the Seropositive Rate of Hepatitis A Virus in Children of Gwangju and Jeonnam (광주, 전남 지역 소아의 A형 간염 항체 보유율에 대한 연구)

  • Jung, Ji;Ahn, Young-Joon;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.1
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    • pp.67-73
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    • 2011
  • Purpose: Recently, the incidence of acute hepatitis A has increased nationwide and is related to a low rate of IgG anti-HAV production. To establish effective measures for preventing hepatitis A virus infection, an epidemiologic study on the seroprevalence of anti-HAV is needed. Thus, we investigated the seroprevalence of IgG anti-HAV in children living in Gwangju and Jeonnam. Methods: IgG anti-HAV levels were measured in a total of 1,435 patients who visited Chosun University Hospital between January 2009 and December 2009. Results: The overall seropositve rate was 40.8% (586/1,435). The seropositive rates were 41% among children under the age of 1 year, 49.9% for children 1~5 years old, 51.1% among individuals 5~10 years old, 12.9% for individuals 10~15 years old, and 8.2% for subjects over 15 years old. There was no significant difference between genders in any group. The seropositive rates in Gwangju and Jeonnam were 57.3% and 32.9% for children under the age of 1 year, 52.5% and 44.3% for children 1~5 years old, 60.2% and 33.9% among children 5~10 years old, 14.1% and 9.7% for children 10~15 years old, and 10.8% and 4.2% for individuals over 15 years old. Conclusion: The results demonstrated the low rates of IgG anti-HAV, particularly among subjects over 10 years old, which suggests the possibility of increasing clinical HAV infection rates among adults in the near future. We should actively prevent the spread of hepatitis A virus. Vaccination is the most effective means of preventing hepatitis A virus transmission among persons at risk for infection. Hepatitis A vaccination is recommended for children who have low IgG anti-HAV seropositive rates.

Gastroscopic Findings of Rural Residents with Symptoms of Chronic Gastrointestinal Disorder (만성(漫性) 위장장애증상(胃腸障碍症狀)을 가진 농촌주민(農村住民)들의 위내시경(胃內視鏡) 검사소견(檢査所見))

  • Park, Jung-Han;Chun, Byung-Yeol;Lee, Dong-Koo;Choi, Yong-Whan
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.1 s.19
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    • pp.85-90
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    • 1986
  • This study was conducted in July-August, 1984, to define the causes of chronic gastrointestinal symptoms in rural population and to provide data for the management of such patients. A household survey was conducted to identify all the residents of Youngchun and Sungiu counties in Kyungpook province who were over 20 years of age, had chronic upper gastrointestinal symptoms for over the last 6 months, never had medical examination for the symptoms, and volunteered to participate in the gastroscopic examination. Gastroscopy was done for 106 males and 108 females. Gastric ulcer was found in 16.8% of all the examinees, duodenal ulcer in 15.4%, gastritis in 14.0%, and gastric cancer in 3.7%. No lesion was found by gastroscopy in 52.3%. Gastric ulcer more common in male(26.4%) than in female(7.4%) (p<0.01) and the same was true for duodenal ulcer(20.8% of male, 10.2% of female). Gastric cancer was found in 7.5% of the male while none of the female had gastric cancer. A higher proportion of the female (68.5%) showed normal finding in the gastroscopy than the male(35.9%) (p<0.01). No significant association was found between the upper gastrointestinal symptoms and the gastroscopic findings. The higher prevalence rate of gastric ulcer than that of duodenal ulcer in this study which is the reverse of the study findings of urban area in Korea and western countries may be related in part with the dietary habit and social environment of the rural population. Although early diagnosis is the most important for the treatment of gastric cancer, many of the people with chronic upper gastrointestinal complaints defer the diagnosis and treatment. It is may be due to lack of the knowledge of diseases and the health care attitude of the rural people. A national program for the health education and mass screening for the gastric cancer should be developed.

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