• 제목/요약/키워드: Preventive Perspective

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강북구 148 마을 건강주민운동사업의 성과와 한계 (Performances and Limitations of the Health Community Organization Project in 148 Village, Gangbuk-gu)

  • 홍종원;박웅섭;김상아;김남준
    • 농촌의학ㆍ지역보건
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    • 제42권3호
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    • pp.155-167
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    • 2017
  • 이 연구는 서울시 강북구 건강마을 사업에 대한 문헌고찰과 운영주체를 대상으로 한 심층면접을 통해 주민운동의 관점에서 사업의 성과와 한계를 살펴보고, 기존 건강증진 사업과의 차별성을 찾아 향후 건강증진 사업의 새로운 방향성을 모색하는 것을 목적으로 하였다. 연구 결과 빈곤층의 비율이 높고, 물리적 환경이 열악한 지역사회 주민들의 건강불평등을 완화하기 위한 건강친화 마을 만들기 사업은 주민조직화의 원리를 적용한 것으로 기존 건강증진사업과 다음과 같은 방법론적 차별성과 성과가 있었다. 첫째, 주민 스스로 지역보건의료 계획을 수립하고 주민의 성장을 통한 건강증진사업이 이루어졌다. 둘째, 기존 건강증진사업에서는 볼 수 없었던 주민활동가가 팀을 이루어 보건소 및 전문가, 주민 간 긴밀한 협력을 위해 매개자로 활동하였다. 셋째, 병의원이나 보건소가 아닌 대안적 주민참여 건강증진 공간인 건강카페를 통한 건강증진 구심점이 마련되어 다양한 프로그램이 활성화되었다. 넷째, 건강의 사회적 결정요인을 고려한 접근을 통한 건강증진 프로그램이 활성화 되었다. 따라서 향후 건강친화 마을 만들기와 같은 지역사회 건강불평등 완화를 위한 사업을 실시할 때 이 연구에서와 같은 방법론적 접근을 고려해볼 필요가 있다. 하지만 다양한 사업주체들이 모인만큼 이해관계와 역할분담과 관련된 어려움이 발생한 점과 시범사업의 성과와 한계를 사전에 명확히 예상하기 못해 갈등이 유발되었던 점 등의 한계가 있었던 만큼 향후 유사한 사업의 계획 시 이 연구에서 나타난 한계점 등을 고려한 내용이 반영되어야 할 것이다. 주민건강운동의 관점에서 건강마을사업 확산 된다면 사회 전체에 건강증진 효과를 만들 것이다.

한국에 있어서의 학교급식개선을 위한 연구 II. 자활급식 2년간의 관찰 (A study on improvement of school lunch program in a demon-stration school (II))

  • 김명호;이원덕;김영옥;김문식
    • Journal of Preventive Medicine and Public Health
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    • 제9권1호
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    • pp.95-108
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    • 1976
  • It is obvious that adequate nutrition is essential for growth and development of school children, and many elementary schools in this country have already practiced it. Therefore, it would seem apparent that the school feeding program would have a significant effect on the growth and development of school children. This paper presents a two-year experimental school-feeding program from 1973 to 1974, and attempts to evaluate its effects by before-and-after nutrition surveys conducted in two elementary schools, one experimental and the other as a control. The two schools are both located in the same county (Yongin-Kun, Kyunggi-Do), and the families of their students are presumed to share the same socio-economic level. To assess the effect of school-feeding, we measured height, weight, chest circumference and grasping power. Physical examination was done foresigns of nutritional deficiency. A stool examination for parasites and blood examinations for hemoglobin, hematocrit and serum protein were included. Analyses were done for 150 students selected randomly at the beginning of the program. These students attended the school throughout the program period. Results are as follows: 1. The amount of increase of height, weight, chest cirumference and grasping power were greater in the experimental school than in the control school, but the differences are not statistically significant. 2. Signs of vitamin deficiency decreased in both experimental and control schools during the two-year program period. 3. At the time of the 1974 post-survey, values of Hb. & Hct. revealed no significant differences between the two schools, but serum protein level was a little higher than that of general Korean rural children of the same age. 4. Infestation rate of parasites had increased in both schools during the two-year program period. 5. Each student of the two schools was classified into three major classes, according to the level of economic condition of his or her parents, namely higher, middle and lower. The results of each class of the experimental school was compared with that of the corresponding class of the control school, expecting the relative magnitude of change largest in the lower economic class of the experimental school. However, change was greatest in the middle class, still not being statistically significant. Finally, the authors concluded that the two-year period for such a program is not sufficiently long for its beneficial effects to be demonstrated and measured. As long as the growth and development of children are concerned, planning with a more distant perspective is required, as well as the development of new methods of evaluation.

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S병원 성과평가지표 개발에 관한 연구 (Development of Performance Measurement Indicators in S Hospital)

  • 이희원;유승흠;이해종;박창일
    • 한국병원경영학회지
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    • 제5권1호
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    • pp.1-23
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    • 2000
  • This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.

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Alcohol as a Risk Factor for Cancer: Existing Evidence in a Global Perspective

  • Roswall, Nina;Weiderpass, Elisabete
    • Journal of Preventive Medicine and Public Health
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    • 제48권1호
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    • pp.1-9
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    • 2015
  • The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

노인요양보장체계의 효율화에 대한 소고 (Reviewing Efficiency Strategy of Long-term Care System)

  • 신의철;임금자;이은환;이윤환
    • 보건행정학회지
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    • 제21권1호
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    • pp.115-131
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    • 2011
  • Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

Viral Hepatitis and Liver Cancer in Korea: an Epidemiological Perspective

  • Yeo, Yohwan;Gwack, Jin;Kang, Seokin;Koo, Boyeon;Jung, Sun Jae;Dhamala, Prakash;Ko, Kwang-Pil;Lim, Young-Khi;Yoo, Keun-Young
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6227-6231
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    • 2013
  • In the past, hepatitis B virus (HBV) infection was endemic in the general Korean population. The association of HBV infection with the occurrence of liver cancer has been well demonstrated in several epidemiologic studies. While the mortality rates of liver cancer in Korea have decreased steadily over the last decade, the presence of hepatitis B surface antigen (HBsAg) in mothers remains high at 3-4%, and 25.5% of these HBsAg positive mothers are positive for hepatitis B e antigen (HBeAg). HBV infection caused almost a quarter of hepatocellular carcinoma (HCC) cases and one-third of deaths from HCC. These aspects of HBV infection prompted the Korean government to create a vaccination program against HBV in the early 1980s. In 1995, the Communicable Disease Prevention Act (CDPA) was reformed, and the government increased the number of HBV vaccines in the National Immunization Program (NIP), driving the vaccination rate up to 95%. In 2000, the National Health Insurance Act (NHIA) was enacted, which provided increased resources for the prevention of perinatal HBV infection. Then in 2002, the Korean government, in conjunction with the Korean Medical Association (KMA), launched an HBV perinatal transmission prevention program. The prevalence of HBsAg in children had been high (4-5%) in the early 1980s, but had dropped to below 1% in 1995, and finally reached 0.2% in 2006 after the NIP had been implemented. After the success of the NIP, Korea finally obtained its first certification of achievement from the Western Pacific Regional Office of the World Health Organization (WPRO-WHO) for reaching its goal for HBV control. An age-period-cohort analysis showed a significant reduction in the liver cancer mortality rate in children and adolescents after the NIP had been implemented. In addition to its vaccination efforts, Korea launched the National Cancer Screening Program (NCSP) for 5 leading sites of cancer, including the liver, in 1999. As a consequence of this program, the 5-year liver cancer survival rate increased from 13.2% (1996-2000) to 23.3% (2003-2008). The development of both the primary and secondary prevention for liver cancer including HBV immunization and cancer screening has been of critical importance.

Application of visual decision making process in the development of business process reengineering vision and implementation plan

  • Kim, Jae-Kyeong;Sung, Tae-Kyung
    • 경영과학
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    • 제14권2호
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    • pp.185-198
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    • 1997
  • Business process reengineering(BPR) aims at a radical redesign of our business processes in order to achieve dramatic improvements in their performance. However, the fact that many BPR projects have failed hesitates the companies who have started to use BPR or who are planning to do so. Implementing a radical plan from a cross-functional perspective needs a more careful consideration of process vision, preventive measures and contigency plan. Our research suggests to use a visual decision making process (VDMP) in the development of a process vision and implementation plan. A BPR project of Carlaon School of Mnagement (CSOM) at the University of Minnesota is illustrated to show our suggested methodology.

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클레임코스트를 고려한 프로젝트의 시간-비용 혼합정수계획모형 (Considering Claim Costs in Project Time-Cost Mixed Integer Programming Model)

  • 김종열;강창욱;황인극
    • 산업경영시스템학회지
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    • 제34권3호
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    • pp.97-105
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    • 2011
  • Previous researches have focused on the efficiency of project execution and the satisfaction of internal customers In view of the fact that a project is successful if any defects are not found in the short-term performance test of the project final outcome. To execute a project that both internal customer and external customer are satisfied in terms of longer-term benefit perspective, the project claim costs (PCC) which may occur for the warranty period of the project final outcome should be considered. We propose a model included PCC to the linear programming between time and cost to expedite a project and perform the validity test by applying the model to an example project. This model and related procedure will contribute to overall project activities' cost reduction by taking preventive actions for PCC.

A UNANI PERSPECTIVE OF MASSAGE: DALAK

  • Abbasi, Hana;Kabir, Hifzul
    • 셀메드
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    • 제9권3호
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    • pp.6.1-6.5
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    • 2019
  • Unani system of medicine provides comprehension about the state of human body while in health and during turn down of health. Unani system strives to find the best methods to leads a healthy life with minimal or zero risk of any sickness additionally, the treatment is not only done through unani formulations but also by the regimenal therapies (Tadabeer) like Cupping (Hijamah), Leeching (Taleeq), Venesection (Fasd), Massage (Dalak), Exercise (Riyazat) etc. Massage (Dalak) is widely practiced regimens, which are used for restrorative, preventive as well as for therapeutic purposes. Almost all the civilizations having evidences about the use of massage in their manuscripts to improve impure blood or impurities from the body. Massage (Dalak) found to be effective in treatment of neurological and musculoskeletal disorders. Ibn Rushd stated that Massage (Dalak) is a type of exercise used for the removal of toxins or waste metabolites from the body. According to the disease, Massage (dalak) should be done in different parts of body and with different types of oils (roganiyat) and single drugs (mufrid advia).

건축물 유지관리점검 체계화를 위한 제도 개선방안 (A Study on the Improvement of Inspection System for Building Maintenance)

  • 유광흠;김민지
    • 대한건축학회논문집:계획계
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    • 제34권10호
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    • pp.63-73
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    • 2018
  • As the life cycle of buildings is expected to increase, new constructions will decrease and the proportion of remodeling and repair will increase. Therefore, there is an increasing need for overall performance management of old buildings. In 2020, the proportion of buildings over 30 years old is expected to reach a half. As a result, the demand for securing and improving the performance in the stage of using the building is increasing due to the change in the demand for the building, such as the decrease in the construction permit and the increase in the use of the existing building. From this perspective, the study sought to consider institutional measures to organize the preventive and conservative maintenance of buildings. For this purpose, the conceptual goals of inspection for building maintenance were set through a literature review, and the status and problems associated with building maintenance were analyzed to suggest ways to improve the inspection system for building maintenance.