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Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis (사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로-)

  • Cho, Tong Ran;Kim, Hwa Joong
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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A Study of well-being in Caregivers Caring for Chronically Ill Family Members (만성 질환자 가족의 부담감에 관한 연구)

  • 서미혜;오가실
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.467-486
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    • 1993
  • Today, more chronically ill and handicapped people are being cared for at home by a family member caregiver. The task of caring for a family momber may mean that the caregiver has less time and money and more work which may result in increased fatigue and symptoms of illness. This study was done to examine the well-being of family caregivers. Fifty three family caregivers were interviewed. Concepts were measured using existing tools and included : Burden(25 item 5 point scale), Social sup-port (21 item 7 point scale), Health status defined by a symptom checklist(48 item S point scale), and Well -being defined by a quality of life scale (14 item 7 point scale) and caregiving activities. Data collection was done by interview and Q-sort. Social support and well - being were positively correlated as were symptoms and burden. Symptoms and burden were negatively correlated with social support and well-being. Items on the quality of life scale had a mean score range from 3.09 to 4.96. Quality of life related to income was lowest (3.09) but the desire to use more money for the patient was rated 2.90 on the burden scale where the item means ranged from 0.73 to 3.55. The high mean of 3.55 was for obligation to give care and the low 0.73 was (or not feeling that this was helping the patient. Mean scores for symptoms ranged from 0.26 to 2.15 with the 2.15 being for “worry about all the things that have to be done.” Over half of the patients were dependent for help with some activities of daily living. The caregivers reported doing an average of 3.40 out of five patient care activities including bathing (77.4%), shampooing (67.9%), and washing face and hands (49.1%), and 3.74 out of seven home maintenance activities including laundry (98.1%), cooking (83.0%), and arranging bed-ding(75.5%). The caregivers reported their spouse as one of the main sources of social support, including in times of loneliness and anger The mean score for loneliness as burden was 2.15 and ranked fourth and 31 (58.5%) of the sample reported being lonely recently and not being satisfied with the support received. Similarly anger caused by the patient was given a mean score of 2.13, and anger was reported to have been present recently by 38 (71.7%) of the sample and satis-faction with the support given was low. Having someone to help deal with anger ranked twelfth out of 21 items on the social support scale and had a mean score of 3.98 (range 3.49 to 5.98). Spouses were reported as a major source of social support but the fact that 50% of the caregivers were caring for a spouse, may account for the quality of this source of social support having been affected. These caregivers faced the same problems as others at the same stage of life. but because of the situation, there was a strain on their resources, particularly financial and social. In conclusion it was found that burden is correlated negatively to quality of life and positively to symptoms, but in this sample, symptoms and bur-den were scored relatively low. Does this indicate that the caregivers accept caregiving as part of their destiny and accept the quality of their lives with burden and symptoms just being a part of caregiving\ulcorner Does the correlation between the bur-den and symptoms indicate they are a measure of the same phenomenon or that the sample was of a more mobile, less burdened group of caregivers\ulcorner Quality of life was the one variable that was significant in explaining the varience on burden. Further study is needed to validate the conclusions found in this study but they indicate a need for nurses to ap-proach these caregivers with a plan tailored to each individual situation and to give consideration to interventions directed at improving quality of life and expanding social support networks for those caring for spouses.

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Effects of Risk Generation Factors Perceived by Fire Service Officers on a Public Service Motivation and a Vocational Calling (소방공무원이 지각하는 위험유발요인이 공공서비스동기, 직업소명에 미치는 영향)

  • Kim, Hee-Dong;Kim, Jhong Yun
    • Fire Science and Engineering
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    • v.32 no.2
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    • pp.102-109
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    • 2018
  • This study examined the effects of the risk generation factors on the public service motivation and a vocational calling of fire service officers during their work. This is based on the assumption that the risk generation factors of firefighters in their organization should be related to the effectiveness of the organization by affecting the psychological capital of the individual. For this study, the survey was conducted on fire service officers who participated the official training session in Kyuunggi and Seoul area and analyzed the data collected by the regression analysis and t-test analysis. As a result, the higher the perception of generation factors, the higher the level of public service motivation and vocational calling. In addition, there was a significant difference between a high risk generation factor perception group and low risk group regarding the perception level of public service motivations and vocational callings. These results show that there is a need to provide more field-based training opportunities for firefighters who can recognize the risk generation factors better.

Current Status of Dental Hygiene and Comparison of Some Curriculums in Korea and Japan (한.일 치위생(학)과 현황과 일부 대학의 교육 과정 비교 -일부 한국 학생 요구도를 중심으로-)

  • Jeong, Hyun-Ja;Aiko, Hujiwara
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.12
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    • pp.4896-4906
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    • 2010
  • This study was conducted in order to promote students' interest in overseas employment and to present methods of improving education that suits globalization and internalization. From responses to individual written survey questionnaires answered by $3^{rd}$grade 200 students who are studying dental hygiene at colleges in Daegu. They had most interested in Japan (60.3%), and they want to work abroad if they are given the changes (38.1%), which indicate that the dental hygiene majors have much interest and positive attitude in overseas employment. In Japan, there are 158 schools had department of dental hygiene (51 to 2 years, 101 to 3 years, 6 to 4 years). Especially, Kanto area has 25 private schools. When compared Korea and Japan, they similar were curriculum, 39 at 3 years, 44 at 4 years, respectively. The current national board dental hygiene examination system was 200 in total score, and 19 in total subjects. The 9 basic clinical courses including oral anatomy have 100 scores, and the 8 subjects including preclinical course have 50 scores, one dental assistant course have 50 scores. In Japan, 4 years pre-dental hygiene curriculum content provide certificate of dental hygiene after graduation. They provide additionally 'social worker' in Tokyo University, 'teacher in nursing' in Hirosima University. They scheduled the various foundational knowledge and skill such as competencies to communicate effectively, to participate community health program, and to make decisions regarding dental hygiene service.

Concept Analysis of Health Inequalities using Hybrid Model (혼종 모형을 이용한 건강 불평등 개념분석)

  • Lee, Ha-na
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.3
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    • pp.520-534
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    • 2018
  • This study was conducted to understand the conceptual definition and characteristics of health inequality. To accomplish this, we analyzed data collected from 14 participants as well as from available literature regarding health inequality using the hybrid model introduced by Schwartz-Barcott and Kim. We categorized health inequality into nine attributes in three dimensions. These dimensions included "target", "precede", and "result," corresponding to the target, cause and consequence of health inequality, respectively. Specifically, we define health inequality as individuals, families, communities, socio-economic, or geographically distinct demographic groups that are treated unfairly and result in several problems such as loss of quality of life, reduction of survival rate, or aggravation of a disease due to (i) poor treatment by a hospital (ii) irregular meals, (iii) desperate need for work (for money), (iv) expensive medical care costs, (v) qualitative differences in medical care by regional groups (vi) the lack of knowledge regarding disease (vii) and inadequate health care because of lack of time. As a result of this unfair treatment, human rights violation occurs. The major contribution from this paper is that we provide a guideline for establishing strategies to reduce health inequality by identifying the concept of health inequality. Based on this study, we recommend development of an educational program to reduce health inequalities.

Oral health knowledge level on oral care and elder oral hygiene care of the nursing home staff in long-term care facilities (노인요양시설 요양보호사의 구강관리 및 노인구강위생관리에 따른 구강보건지식 수준)

  • Kim, Kyung-Min;Park, Young-Nam;Lee, Min-Kyung;Lee, Jung-Hwa;Yoon, Hyun-Seo;Jin, Hye-Jung;Kim, Hye-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.5
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    • pp.723-730
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    • 2014
  • Objectives : This research was conducted to investigate geriatric care workers' oral care, and the oral care conditions of residents of elder care facilities in relation to workers' knowledge of oral care. Methods : A survey was conducted from November 2011 to February 2012 with geriatric-care workers in elder care facilities located in Busan and other areas of Gyeongsangnam-do. Results : With regard to their oral self-care practices, 52.5% of the geriatric workers "brushed their teeth from top to bottom" and 58.1% brushed their teeth 3 times a day. Further, 52.0% did not use any oral care products, while 36.5% used Mouthrinese. The workers who brushed their teeth in their own ways or from top to bottom had significantly higher oral care knowledge scores than those who brushed from left to right (p<.05). Concerning oral hygiene care for residents, 72.6% of the geriatric workers recommended that elders visit dentists for oral care, 96.6% helped elders oral wash their teeth every day, and 54.7% used oral care products for the elders. The workers who did not recommend visits to dental clinics scored slightly higher than those who did (p<.05). Additionally, those who did not help elders oral wash their teeth scored significantly higher than those who did (p<.05). Except for oral wash to recuperated old man and recommendation of visiting the dentist, relation between oral care and knowledge about oral health and oral hygiene care is plus mutual relation. Conclusions : To manage the accuracy and quality of oral care work performed by geriatric care workers in elder care facilities, enhancing standard training and education on oral care is necessary. Providing systematic, regular education on such knowledge and practices would also be essential.

The Effects of Married Nurses' Parenting Stress and Job Involvement on Retention Intention (기혼간호사의 양육스트레스와 직무몰입이 재직의도에 미치는 영향)

  • Nam, In Suk;Kim, Seonho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.155-164
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    • 2017
  • The purpose of this study is to identify correlations among married nurses' parenting stress, job involvement and intent to stay, as well as to clarify factors that affect nurses' intent to stay. This is a descriptive study conducted based on evaluation of 174 married nurses from one university hospital and two general hospitals (200 beds or above) located in C region, all of who had at least one child <6 years of age. Data were collected from Aug 20 until Sep 15, 2016, after which data were analyzed by aT-test, ANOVA, Pearson's coefficient, and stepwise multiple regression. The mean score of parenting stress was $2.67{\pm}0.54$ out of 4, while that of job involvement was $3.11{\pm}0.58$ out of 5, and intent to stay was $3.56{\pm}0.79$ out of 5. Intent to stay was significantly negatively correlated with parenting stress(r=-0.186, p=0.014), while it was positively correlated with job involvement(r=0.345, p<0.001). Factors influencing intent to stay were education level(${\beta}=0.28$, p=0.042), job satisfaction(${\beta}=0.60$, p<0.001), weekend work(${\beta}=0.20$, p=0.042), job involvement(${\beta}=0.31$, p<0.001) and parenting stress(${\beta}=-0.22$, p=0.038). These factors explained 36.8% of intent to stay(F=21.18, p<0.001). Overall, the results indicate that intervention strategies may be necessary to increase intent to stay by reducing parenting stress and enhancing job involvement.

Construction and Characterization of Vitreoscilla Hemoglobin (VHb) with Enhanced Peroxidase Activity for Efficient Degradation of Textile Dye

  • Zhang, Zidong;Li, Wei;Li, Haichao;Zhang, Jing;Zhang, Yuebin;Cao, Yufeng;Ma, Jianzhang;Li, Zhengqiang
    • Journal of Microbiology and Biotechnology
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    • v.25 no.9
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    • pp.1433-1441
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    • 2015
  • Pollution resulting from the discharge of textile dyes into water systems has become a major global concern. Because peroxidases are known for their ability to decolorize and detoxify textile dyes, the peroxidase activity of Vitreoscilla hemoglobin (VHb) has recently been studied. It is found that VHb and variants of this enzyme show great promise for enzymatic decolorization of dyes and may play a role in achieving their successful removal from industrial wastewater. The level of VHb peroxidase activity correlates with two amino acid residues present within the conserved distal pocket, at positions 53 and 54. In this work, sitedirected mutagenesis of these residues was performed and resulted in improved VHb peroxidase activity. The double mutant, Q53H/P54C, shows the highest dye decolorization and removal efficiency, with 70% removal efficiency within 5 min. UV spectral studies of Q53H/P54C reveals a more compact structure and an altered porphyrin environment (λSoret = 413 nm) relative to that of wild-type VHb (λSoret = 406), and differential scanning calorimetry data indicate that the VHb variant protein structure is more stable. In addition, circular dichroism spectroscopic studies indicate that this variant's increased protein structural stability is due to an increase in helical structure, as deduced from the melting temperature, which is higher than 90℃. Therefore, the VHb variant Q53H/P54C shows promise as an excellent peroxidase, with excellent dye decolorization activity and a more stable structure than wild-type VHb under high-temperature conditions.

Recent Advances in Amino Acid and Energy Nutrition of Prolific Sows - Review -

  • Boyd, R.D.;Touchette, K.J.;Castro, G.C.;Johnston, M.E.;Lee, K.U.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.11
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    • pp.1638-1652
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    • 2000
  • Prolific females require better nutrition and feeding practice because of larger litter size and the substantial decline in body fat. Life-time pig output will be compromised if body protein and fat are not properly managed. First litter females are especially vulnerable because they can loose ${\geq}15%$ of whole-body protein. Conservation of body protein mass during first lactation minimizes wean to estrus interval and increases second litter size (up to 1.2 pigs). The ability to influence litter-size by amino acid nutrition is a new dimension in our understanding. A P2 fat depth below 12 mm at farrow and below 10 mm at wean compromised wean to estrus interval (>2 d) and next litter size (0.5 to 1.5 pigs) in sows. It is now clear that a 'modest' excess of feed during the first 72 h of pregnancy decreases embryo viability so that the potential for an increased litter size at birth is not realized. The capacity for milk production by prolific young sows is 25% higher than the standard used previously (NRC, 1988). First litter females averaged 9.82 kg milk/d for a 21 d lactation. Second and third litter counterparts averaged 10.35 kg/d. Milk production was 95% of peak by 10 d of lactation and sows were in greatest negative energy and lysine balance during the first 6 d. Nearly 45% of the total loss in body protein occurred within the first 6 d, but this could reduced to 30-35% by using a more aggressive feeding strategy after parturition. There appear to be 2 phases in lactation for lysine need (d 2-12 vs 12-21). Feeding to the higher level alleviates the second litter size decline. The lysine requirement for lactation can be predicted with accuracy, but we are not able to predict the second limiting amino acid. Mammary uptake of valine relative to lysine and recent work with practical diets suggest that the recent NRC (1998) pattern is realistic and that threonine and valine could be co-limiting for corn-soy diets for prolific sows nursing 10-11 pigs. Empirical studies are needed to refine the ideal pattern so that synthetic lysine can be used with more confidence. Milk fat output for the elite sow is extraordinary and poses an unnecessarily high energetic cost. Methods that reduce mammary fat synthesis will benefit the sow and may enhance piglet growth.

Sexual Behaviors and Sexual Experience of Adolescents in Korea (한국 청소년의 성 행태와 성 경험)

  • Lee, Gyuyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.71-80
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    • 2016
  • Purpose: The aim of this study was to identify sexual experiences and associated factors among middle and high school students in Korea. Methods: Data were analyzed from 74,186 participants who completed the 2012 Korea Youth Risk Behavior Web-based Survey. Descriptive statistics were used to identify the condition of sexual behavior, and a complex sample logistic regression was used to examine the factors related to sexual behavior. Results: Data showed that 4.3% of adolescents had engaged in sexual intercourse (5.9% of males and 2.6% of females). According to the logistic regression analysis for complex samples, the school level, socioeconomic status, experience of part time work, and living with parents, were all factors associated with the decision to engage in sexual intercourse among boys and girls. In particular, sex education in schools was associated with a reduced risk of sexual intercourse. Conclusion: The results of this study highlight the importance of developing a program that focuses on enhancing sex education and promoting refusal and better decision-making skills in order to effectively reduce the likelihood of sexual experience among adolescents in Korea.