• Title/Summary/Keyword: Preventive consulting

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It Was Possible to Reduce the Pain of the Victims of Humidifier Disinfectant (가습기살균제 피해자의 아픔을 줄일 수 있었다)

  • Kim, Pangyi;Choi, Yoon-Hyeong;Park, YeongChul;Park, Tae-Hyun;Leem, JongHan
    • Journal of Environmental Health Sciences
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    • v.48 no.1
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    • pp.1-8
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    • 2022
  • Objectives: The purpose of this study is to reveal the circumstances under which the cases of harm to health caused by humidifier disinfectant were neglected and show the points where the number of victims and the degree of damage could have been reduced. In addition, it attempts to describe how damage management proceeded immediately after the incident and actually exacerbated the damage. Finally, it explores the unfortunate aspects of the recent trial. By doing so, it attempts to take this as an opportunity to consider whether a tragic event such as the humidifier disinfectant incident could occur in the future. Methods: This study collected and analyzed data on chemical material characteristics related to humidifier disinfectants, data on health effect characteristics, data on related laws and regulations from the Ministry of Environment, data related to the damage investigation by the Korea Environmental Industry and Technology Institute, and current contents. Results: The lack of related systems and laws is the area where the greatest responsibility for the cause of the humidifier disinfectant disaster falls, so it is difficult for the government to escape this responsibility. Establishing a dedicated department to identify the prevalence of certain diseases within the functions of the Health Insurance Review and Assessment Service to monitor health can greatly contribute to the prevention and management of diseases through early detection and management of group outbreaks caused by harmful factors. Humidifier disinfectant damage relief should have been expanded earlier beyond HDLI (humidifier disinfectant lung injury) to include non-specific diseases such as asthma, pneumonia, and interstitial pneumonia. The scope of relief benefits should have also been expanded earlier to include the payment of disability benefits. Fortunately, with the 2020 revision of the Special Act, the conditions for estimating causal relations were eased and individual screening systems such as health impact assessment were reorganized along with the introduction of a rapid screening system. Conclusions: The management system for chemical substances in a country is clearly of paramount importance, and the ministry in charge must have a response system in case of damage to health effects. Administration that looks at the victims' situation from their point of view is needed, and technical countermeasures are required to quickly recognize the prevalence of certain diseases.

Economic Value of the Sirolimus Eluting Stent($CYPHER^{TM}$) in Treating Acute Coronary Heart Disease (관상동맥질환 치료를 위한 시롤리무스 방출 스텐트 ($CYPHER^{TM}$)의 경제성 분석)

  • Lee, Hoo-Yeon;Park, Eun-Cheol;Park, Ki-Dong;Park, Ji-Eun;Kim, Young;Lee, Sang-Soo;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.339-348
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    • 2003
  • Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

Overview of Legal Measures for Managing Workplace COVID-19 Infection Risk in Several Asia-Pacific Countries

  • Derek, Miller;Tsai, Feng-Jen;Kim, Jiwon;Tejamaya, Mila;Putri, Vilandi;Muto, Go;Reginald, Alex;Phanprasit, Wantanee;Granadillos, Nelia;Farid, Marina Bt Zainal;Capule, Carmela Q.;Lin, Yu-Wen;Park, Jihoon;Chen, Ruey-Yu;Lee, Kyong Hui;Park, Jeongim;Hashimoto, Haruo;Yoon, Chungsik;Padungtod, Chantana;Park, Dong-Uk
    • Safety and Health at Work
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    • v.12 no.4
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    • pp.530-535
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    • 2021
  • Background: Despite the lack of official COVID-19 statistics, various workplaces and occupations have been at the center of COVID-19 outbreaks. We aimed to compare legal measures and governance established for managing COVID-19 infection risks at workplaces in nine Asia and Pacific countries and to recommend key administrative measures. Methods: We collected information on legal measures and governance from both general citizens and workers regarding infection risks such as COVID-19 from industrial hygiene professionals in nine countries (Indonesia, India, Japan, Malaysia, New Zealand, Republic of the Philippines, Republic of Korea, Taiwan, and Thailand) using a structured questionnaire. Results: A governmental body overseeing public health and welfare was in charge of containing the spread and occurrence of infectious diseases under an infectious disease control and prevention act or another special act, although the name of the pertinent organizations and legislation vary among countries. Unlike in the case of other traditional hazards, there have been no specific articles or clauses describing the means of mitigating virus risk in the workplace that are legally required of employers, making it difficult to define the responsibilities of the employer. Each country maintains own legal systems regarding access to the duration, administration, and financing of paid sick leave. Many workers may not have access to paid sick leave even if it is legally guaranteed.

Delphi Survey for COVID-19 Vaccination in Korean Children Between 5 and 11 Years Old (국내 5-11세 소아의 코로나19 백신 접종에 대한 델파이 연구)

  • Choe, Young June;Lee, Young Hwa;Choi, Jae Hong
    • Pediatric Infection and Vaccine
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    • v.29 no.1
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    • pp.37-45
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    • 2022
  • Purpose: During the coronavirus disease 2019 (COVID-19) pandemic, we conducted a Delphi survey that included the experts from the field of COVID-19 immunization in children aged 5-11 years. The aim was to organize collective expert opinions on COVID-19 vaccination in young children in the Republic of Korea, and so thus assist the vaccination policy. Methods: The panels included pediatric infectious disease specialists, preventive medicine experts, infectious disease physicians, and COVID-19 vaccine experts consulting the Ministry of Health and Welfare. The Delphi survey was conducted online using a questionnaire from February 14 to February 27, 2022. Results: The Delphi panels agreed that children were vulnerable to COVID-19, and the severity of illness was modest. Furthermore the panels reported that children with chronic illness were more susceptible to a worsening clinical course. There were generally positive opinions on the effectiveness of COVID-19 vaccination in children aged 5-11 years, and experts gathered a slightly positive opinion that the adverse events of pediatric COVID-19 were not numerous. The benefits of COVID-19 vaccination were evaluated at a level similar to the potential risks in children. Currently, the only approved mRNA platform vaccine in children seemed to be sustainable; however, the recombinant protein platform COVID-19 vaccines were evaluated as better options. Conclusions: Due to the surge of the Omicron variant and an increase in pediatric cases, the COVID-19 vaccination in young children may have to be considered. Panels had neutral opinions regarding the COVID-19 vaccination in children aged 5-11 years. Thus monitoring of the epidemiology and the data about the safety of COVID-19 vaccination should be continued.

On Pattern of Birth and Death in Seoul City (서울시인구(市人口)의 출생(出生).사망(死亡) 양상(樣相)에 관(關)한 연구(硏究))

  • Kwon, E-Hyock;Kim, Tae-Ryong;Park, Hyung-Jong;Koo, Do-Suo;Lee, Yong-Wook;Park, Soon-Young
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.9-23
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    • 1968
  • A survey was conducted by the staff of the College of Medicine and School of Public Health, Seoul National University in cooperation with Seoul Special City from 1 December 1967 through 28 February 1968, on such events as delivery, death, abortion and pregnancy. The survey directed to a total population of 47,811 residing in 9,157 households led us to the following findings: 1. Two year averages of crude birth rate, crude death rate and natural increase rate were 30.1, 5.6 and 24.5, respectively. 2. Of all deliveries, home and hospital deliveries constituted 61.1 per cent and 35.5 per cent, respectively. 3. Deliveries other than hospital deliveries were found to be attended more often by mother-in-laws (26.5 per cent) than by doctors or midwives(23.4 per cent). 4. About 51 per cent of all women having experiences in pregnancy during the last two years had an experience of consulting a doctor at least one time throughout whole period of pregnancy. 5. In most cases scissors were used to cut umbilical cords, of which 71.0 per cent were not sterilized and only 20.3 per cent sterilized. 6. In many cases placenta was incinerated(48.2 per cent) and on many other occasions it was thrown away into water(28.3 per cent). 7. Cement bags(37.4 per cent), gauze and absorbent cotton(29.8 per cent) were found to be most frequently used to receive new-born babies. 8. In 1966 8. 8 per cent of the women had at least one abortion induced and in 1967 the percentage was 9.2 per cent. 9. Nearly all(95.8 per cent) of the induced abortions reportedly were done at doctor's clinics. 10. Of all the abortions induced 65.3 per cent were done by specialists in obstetrics, 30.3 per cent by general practitioners and 2.7 per cent by midwives. 11. Those who experienced spontaneous abortions were 1.9 per cent of all women both in 1966 and 1967. 12. About 9.2 per cent of women investigated were found to be currently pregnant. 13. Age specific death rate turned out to be highest among those under 1 year of age. 14. Ten major causes of death in their order of frequency were: 15. Places of death can be classified into homes(75.3 per cent) and hospitals(13.2 per cent). 16. Method of disposing of corpses comprised burials(54.2 per cent) and cremations(44.6 per cent). 17. Infant, neonatal and hebdomadal mortality rates have been computed at 32.2, 18.9 and 13.7, respectively. 18. Infants were found to have died either at homes(81.5 per cent) or at hospitals(18.5 per cent). 19. Birth registrations had been done for about 18.5 per cent of the dead infants.

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Perceptions of Caregivers and Medical Staff toward DNR and AD (Do Not Resuscitate (DNR)와 Advance Directives (AD)에 대한 환자 보호자와 의료인의 인식)

  • Lee, Sun Ra;Shin, Dong-Soo;Choi, Yong-Jun
    • Journal of Hospice and Palliative Care
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    • v.17 no.2
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    • pp.66-74
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    • 2014
  • Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

Difference of perception of the duties of dental hygienist between dentists and dental hygiene students in an area (일개 지역 치과의사와 치위생학과 학생 간 치과위생사의 업무에 대한 인식의 차이)

  • Hwang, Soo-Jeong;Koong, Hwa-Soo;Lee, Sang-Hoon
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.1-12
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    • 2017
  • Although dental hygienists have performed chair-side assisting and other dental cares as well as preventive dental cares in Korea, medical technician law confines duties of dental hygienists as closed narrative. The aim of this study was to investigate difference in perception of duties of dental hygienists in dental clinic between dentists and dental hygiene students. A total of 245 copies of questionnaires were distributed to dentists and students by post-mail. Only 42 dentists and 30 students in an area replied these questionnaires about the present and future duties of dental hygienists after providing written consent. Both groups agreed that intra and extra oral X-ray taking, education about oral health behavior, instruction after dental treatment, chair-side assisting, consulting for patients, scaling, initial impression taking, management of dental materials and equipment, sterilization of equipment, and receiving dental bills are duties of dental hygienists. However, they had different perceptions about various dental treatments as duties of dental hygienists even if they were under instructions of a dentist, including infiltration anesthesia, filling in cavity, intramuscular injection, FC change, canal irrigation, orthodontic treatment including separating, ligature bracket bonding and removing, setting crown and bridge, making individual, removing implant screw, and so on. These findings demonstrated that there were different perceptions about duties of dental hygienists between dentists and dental hygiene students, especially on dental treatment.