• The Journal of the Korean dental association
• /
• v.48 no.1
• /
• pp.6-11
• /
• 2010

Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

• Journal of Radiation Protection and Research
• /
• v.45 no.2
• /
• pp.53-68
• /
• 2020

Background: International organizations such as the World Health Organization (WHO) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) reported public exposure doses due to radionuclides released in the Fukushima nuclear accident a few years after the event. However, the reported doses were generally overestimated due to conservative assumptions such as a longer stay in deliberate areas designated for evacuation than the actual stay. After these reports had been published, more realistic dose values were reported by Japanese scientists. Materials and Methods: The present paper reviews those reports, including the most recently published articles; and summarizes estimated effective doses (external and internal) and issues related to their estimation. Results and Discussion: External dose estimation can be categorized as taking two approaches-estimation from ambient dose rate and peoples' behavior patterns-and measurements using personal dosimeters. The former approach was useful for estimating external doses in an early stage after the accident. The first 4-month doses were less than 2 mSv for most (94%) study subjects. Later on, individual doses came to be monitored by personal dosimeter measurements. On the basis of these measurements, the estimated median annual external dose was reported to be < 1 mSv in 2011 for 22 municipalities of Fukushima Prefecture. Internal dose estimation also can be categorized as taking two approaches: estimation from whole-body counting and estimation from monitoring of environmental samples such as radioactivity concentrations in food and drinking water. According to results by the former approach, committed effective dose due to ¹³⁴Cs and ¹³⁷Cs could be less than 0.1 mSv for most residents including those from evacuated areas. Conclusion: Realistic doses estimated by Japanese scientists indicated that the doses reported by WHO and UNSCEAR were generally overestimated. Average values for the first-year effective doses for residents in two affected areas (Namie Town and Iitate Village) were not likely to reach 10 mSv, the lower end of the doses estimated by WHO.

• Genomics & Informatics
• /
• v.4 no.4
• /
• pp.161-166
• /
• 2006

The establishment of DNA microarray technology has enabled high-throughput analysis and molecular profiling of various types of cancers. By using the gene expression data from microarray analysis we are able to investigate diagnostic applications at the molecular level. The most important step in the application of microarray technology to cancer diagnostics is the selection of specific markers from gene expression profiles. In order to select markers of Immortalization and transformation we used c-myc and $H-ras^{V12}$ oncogene-transfected NIH3T3 cells as our model system. We have identified 8751 differentially expressed genes in the immortalization/transformation model by multivariate permutation F-test (95% confidence, FDR<0.01). Using the support vector machine algorithm, we selected 13 discriminative genes which could be used to predict immortalization and transformation with perfect accuracy. We assayed $H-ras^{V12}$-transfected 'transformed' cells to validate our immortalization/transformation dassification system. The selected molecular markers generated valuable additional information for tumor diagnosis, prognosis and therapy development.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.1
• /
• pp.239-247
• /
• 2016

Background: The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. Materials and Methods: Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. Results: The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. Conclusions: An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.4
• /
• pp.2223-2227
• /
• 2016

Background: Breast cancer is the most common cancer among Iranian women. Since development of the disease in Iranian women occurs relatively early, the survival rate matters considerably. In different countries, survival of breast cancer patients varies considerably. Therefore, the one-year, three-year, five-year, and ten-year survival rates for breast cancer in Iran were assessed using a meta-analysis. Materials and Methods: This systematic review and meta-analysis was based on valid Iranian sources including SID, MAGIRAN and IRANMEDEX, along with reliable English databases, namely, PUBMED and SCOPUS. In domestic databases, a search was conducted based on key words of breast cancer and survival rate, and in international databases, with "breast cancer" and the equivalent of "neoplasm" of Mesh Word, "survival rate" and "Iran." Then all reviewed papers and theses which met the inclusion criteria were selected for investigation. To conduct the analysis STATA 11.2 software and random-effects models were used. Results: In 24 studies, 22,745 participants were included. The one-year, three-year, five-year and ten-year survival rates were 0.956, 0.808, 0.695 and 0.559, respectively. The minimum and maximum survival rates for 5-years were 0.48 and 0.87. The average age of the onset of the disease was 48.3. Conclusions: As in Iran, since the onset of the disease is at low age, in spite of the relatively high survival rate as compared to other cancers, prevention and screening programs at early age for early stage diagnosis seems necessary.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.3
• /
• pp.941-944
• /
• 2012

Objective: The aim of current study was to evaluate the changes of health-related quality of life (HRQoL) and its clinical, demographic and socioeconomic determinants during chemotherapy and 4 months follow-up in women with breast cancer using a repeated measures framework. Methods and Materials: A double blind cohort study was performed in 100 breast cancer patients given fluorouracil, doxorubicin and cyclophosphamide (FAC) or docetaxel, doxorubicin, cyclophosphamide (TAC) in south of Iran. HRQoL was assessed at baseline, end of chemotherapy and four months thereafter using the QLQ-C30 questionnaire from European Organization for Research and Treatment of Cancer (EORTC). Generalized estimating equations (GEE) was applied for statistical analysis. Results: The mean of age at baseline was $48.5{\pm}10.6$. 70% and 14% of patients were married and smokers, respectively, and 20% suffered from another disease besides breast cancer. The results of GEE showed that after control for baseline scores, the HRQoL significantly improved over time. Although, the patients in FAC group had higher scores than the TAC group, the differences also diminished over time. Smoking, marital status and having child affected some scales of HRQoL. None of other variables were significantly related to HRQoL. Conclusion: Although patients in TAC groups had lower level of HRQoL over 8 months follow up, they experienced faster improvement than the FAC group. This implies that in long-term, improvements in TAC group are higher than FAC. Having children was positively correlated with HRQoL. Generally, there were no demographic and socio-economic differences in HRQoL in these patients between the chemotherapeutic regimens.

• The Korean Nurse
• /
• v.32 no.2
• /
• pp.51-62
• /
• 1993

The hospital is not the place for functional isolationalism, that is, for each department to do their own activities independently. Rather it is an organization in which each part is joined together and concentrating on the same objectives. The hospital must maintain a one-system-function, so that all the resources of the hospital may be used efficiently. Although we do not yet completely understand how the nursing image as perceived by the medical team and the other members of the interdisciplinary team affects nursing practice. It is important to identify how the client recognizes the nursing image as this will influence the growth of the nursing profession directly and indirectly. So we must reevaluate the nursing image as presented to the client and find the ways to present them with a better image of nursing. The study procedures were as follow; First, the image of nurses was analyzed. The subjects for this study were 270 nurses, 172 doctors, 237 hospital employees, and 240 patients and their families from 5 local branches of the Yonsei Medical Center. The four negative responses shown in this study are as follows; 1) Nurses don't listen to patients. 2) Nurses are self-centered. 3) Nurses and careless. 4) Nurses are mechanical. Second, the concrete causes of the four negative responses were analyzed. Third, the contribution of the nurses for clinical practice, research and education was analyzed. Data were collected by questionnaires all seps of the research. Data were analyzed by use of SPSS/PC. In conclusion, the image of nurses differed according to which group, the respondents belonged. Generally, the public have a positive image of nurses, but hospital employees have a negative images of nurses. Further the nurses gave themselves a low grade. They showed negative as to the value of their job, professionality and their contribution to clinical practice when it was compared to that of the doctors.

• Journal of Preventive Medicine and Public Health
• /
• v.53 no.5
• /
• pp.362-370
• /
• 2020

Objectives: Despite greater access to training positions and the presence of more women in emergency medicine, it has remained a men-dominated field. This study aims to identify the key issues causing the gender gap in Korea and establish measures to overcome them. Methods: Using the annual statistical reports of the National Emergency Medical Center and data published on the Korean Society of Emergency Medicine website, cases that listed the current status and positions of members in its organization and its committees were analyzed. Secondary analysis was conducted using data from the 2015 Korean Society of Emergency Survey that included physicians' demographics, academic ranking, years of experience, clinical work hours, training and board certification, core faculty status, position, and salaries. Results: As of September 2019, women account for only 12.7% of the total number of emergency physicians (EP) in Korea; of 119 chair/vice-chair academic positions, women represented only 9.2%. Women EP were more often assistant professors and fellowship-trained, with fewer in core faculty. However, they worked the same numbers of clinical hours as their men counterparts. The median annual salary of women EP was less than that of men EP after adjusting for academic hospital rank, clinical hours, and core faculty status. Conclusions: A gender gap still exists among Korean EP, and women earn less than men regardless of their rank, clinical hours, or training. Future studies should evaluate more data and develop system-wide practices to eliminate gender disparities.

• Journal of Korean society of Dental Hygiene
• /
• v.7 no.3
• /
• pp.301-316
• /
• 2007

With these changes in the environment of dental service, dental hygienists are suggested to change their roles to cope with the changes. Hygienists are putting forth many efforts to promote smooth and efficient dental treatments, and as a practical measure. As a part to cope with such changes. Korea Dental Hygienists Association(KDHA) has prepared the system of Specialized Dental Hygienist and put the system into enforcement through an affiliated organization, Korean Academy of Dental Hygiene. The purpose of this study is to investigate the specialized nurse system in our country's medical environment and the specialized dental hygienist systems in other countries as similar cases comparable to the specialized dental hygienist system in our country and present basic data for the establishment of specialized dental hygienist system. For this study, a survey of dental specialists, such as dentists, dental hygienists and nurses, and patients, has been conducted qualitatively through person-to-person depth interview. The interview questions were related to the need for a specialized dental hygienist system, educational programs, functions and roles, and issues that must be solved for establishment of the system. Based on the interview results, the following conclusions were derived. The specialized dental hygienist system must encourage dental hygienists to possess advanced abilities in clinical practices, present systematic and developmental directions in educational programs, and stimulate specialized dental hygienists to actively work as manager and supervisor, medical health service providers, educators, and researchers. Lastly, for issues that must be solved for the establishment of the system, the duties and jobs of specialized dental hygienists must be defined more concretely, which must be acknowledged by people working in related occupations, citizens and the government. Furthermore, we need to examine the scope of duties of dental hygienists and enact laws and systems to protect the scope. These roles will lead dental hygienists to lay the foundation that allow them to make enthusiastic activities as an oral hygienist and clinician as well as show the way how to act as an educator, a researcher, a manager and an administrator.

• Health Policy and Management
• /
• v.28 no.3
• /
• pp.217-221
• /
• 2018

Korea Institute for Family Planning (KIFP) was established on July 1, 1971 (Law 2270) and Korea Health Development Institute (KHDI) was established on April 19, 1976 (Law 2857). Korea Institute for Population and Health (KIPH) was formed through the merger of KIFP and KHDI (Act 3417) on July 1, 1981. Korea Institute for Health and Social Affairs (KIHASA), the former KIPH, was renamed KIHASA on December 30, 1989 (Law 4181) with its additional function of research in social security. It was transferred on January 29, 1999 to the Office of State Affairs Coordination pursuant to the Law on the Establishment, Operation and Promotion of State-Sponsored Organizations (Law 5733). Annually it conducts approximately 50 short- and long-term research projects to accumulate a wide range of research experience. Also it studies and evaluates the primary issues of national health services, health and medical industries, social insurance, social security, family welfare, and population. it conducts joint research projects and active information exchange programs with related domestic and international organizations through seminars and conferences. It executes specific research and development projects according to the government's requests. it educates and trains people domestically and abroad by disseminating a wide-range of information on health and social affairs. it conducts national household surveys on areas of fertility, health and medical care of the disabled, the elderly, and low-income earners. The mid- and long-term research goals of KIHASA should be established and managed systematically. A new organization such as 'Center for Policy Evaluation' is needed to enhance research abilities and experiences. Able research personnels should be recruited and current researchers should try to develop their abilities.