Purpose: The aim of this study was to evaluate the effects of oral health care programs in 3 school-based oral health care center among primary schoolchildren. Methods: School-based oral health care programs included fluoride mouth rinsing, pit and fissure sealing for permanent premolars and molars, fluoride gel application and chewing of xylitol candy. All of the programs were carried out by one dental hygienist among 'D' primary schoolchildren in Daegu city under the supervision of a dentist. Baseline dental examinations were completed and preventive care was implemented for 544 children during one year. All of the children visited a school-based oral health care center every three months for a regular check-up. The final oral examination was conducted from March 15 to April 1, 2004. The data analysis data was made on the basis of SAS 8.01. Mean differences between 2003 and 2004 data were compared by paired t-test. Corresponding p-values were considered significant at values less than 0.05. Results: The DMF rate and DFT index were reduced to 8.0% and 8.4% during one year respectively, but there were no statistically significant differences. The DMF rate was significantly reduced (16.3%) after a one year program of school-based oral health care practice. The DMFT(Decay Missing Filling Tooth) index was also reduced compared to 2003 throughout the entire grade. Conclusion: School-based oral health care programs can reduce the prevalence of dental caries prevalence among schoolchildren during one year. This program also improved the oral health capacity of schoolchildren. It is recommend that the school-based oral health care program should be extended to every primary school in Korea.
Purpose: The purpose of this study was to provide a survey of patients with dementia registered and managed by primary health care posts. Method: Computation of 2016 dementia data registered in Health Care Center programs of 14 municipalities in ChoongNam province was analyzed. Data collection was done based on a pretest for dementia prevention and general management of registered dementia patients. Results: Results showed; Screening tests for dementia, 40% of population 60 or over, average number of cases, 174, average number of dementia registrants, 3.1, programs for prevention, approximately 70% special policy measures and 28% cognitive rehabilitation programs, counseling and education operating well overall, average number of dementia registrants/clinic 11.8, with women accounting for 70%, elders with less than 3 years of education, 75%, residence type cohabitation by married couples, 41%, and elders with Alzheimer type dementia, 64%. Conclusion: During early detection of dementia and follow-up examinations, high-risk groups (women, elders) should receive a dementia examination. In management of dementia there is a need to develop various programs including physical, economic, and emotional support not only for patients, but also for families. Health care managers also need systematic education to give them expert knowledge of dementia and management of dementia.
Jo, Sun-Jin;Yim, Hyeon Woo;Jeong, Hyunsuk;Song, Hoo Rim;Ju, Sang Yhun;Kim, Jong Lyul;Jun, Tae-Youn
Journal of Preventive Medicine and Public Health
/
제48권5호
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pp.257-263
/
2015
Objectives: Although the prevalence of depressive disorders in South Korea's general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities. Methods: Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated. Results: The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2), with major depressive disorder 5.4% (95% CI, 2.1 to 8.7), dysthymia 1.1% (95% CI, 0.0 to 2.6), and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5). Among the 26 patients with depressive disorder, 19 patients were newly diagnosed. Conclusions: As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.
The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.
Background: We here examined the awareness of female health employees (doctors, nurses, midwives) working in primary health care service about cervical cancer and its risk factors. Additionally attitude and behavior for gynecologic examination and pap smear screening wwere researched. Materials and Methods: This cross-sectional, descriptive study con cerned female health employees working at primary health care services in two southern cities of Turkey, over a four month period in 2013. Participants were recently or previously sexually active research was explained and verbal informed consent was obtained face to face. The questionnaire consisted of two parts; socio-demographic characteristics and level of knowledge about cervical cancer and its risk factors. Results: The average age of the participants (midwives 43.7%, n=143; nurses 40.4%, n=132; doctors 6.4%, n=21; emergency medical technicians and others, 9.5%, n=31; total, n=327) was $30.9{\pm}6.41$ years. 64.2% (n=210) were working in Diyarbakir and 35.8% (n=117) in Batman. A large proportion reported low knowledge and inadequate screening practice Conclusions: Health employees should be better informed about the importance of screening for cancers, given their preventive roles for the general population.
Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.
Demand for appropriate health care has gradually increased in Korea. In addition, developments of community- and school-based oral health programs have also focused oral health care for the oral health promotion. Especially, school-based oral health programs are the underpinnings of promoting oral health and preventing oral diseases among schoolchildren. School-based oral health programs have had three major components: oral health education, oral health services, and a healthful environments. These included oral health education(one-to-one communication, group communication, and use of mass communication), oral examination, fluoride mouthrinsing, pit-and-fissure sealants, fluoride gel application, mechanical plaque control, and chewing xylitol candy. In this study, we evaluate the effects of oral health programs among primary schoolchildren by comparing the oral health knowledge, oral health behaviors, and perception of caries prevention procedures. Data for this study were obtained from 699 primary schoolchildren at the two primary school in Daegu, Korea. One is experimental group, N primary school, that was established school-based oral health center under supervision of Nam-gu Public Health Center, the other is control group, N' primary school, that was yet to establish school-based oral health center. We surveyed children's oral health knowledge and behaviors, and perception of caries prevention procedures using self-administrated questionnaire and then analyzed differences of each item among two groups. The brief findings of this study were summarized as follows. There are several advantage to a comprehensive school-based oral health program. (1) School-based oral health programs facilitate and increase the effectiveness of teaching oral health subjects. (2) Schoolchildren are available for prevention or treatment procedure. (3) School-based oral health center may be less threating than private dental clinic. (4) With comprehensive school-based oral health programs the decayed, missing, and filled teeth(DMFT) of schoolchildren should demonstrate a substantial and steady decrease over time(Choi et al, 2004). In conclusion, treatment is not the answer to solving children's oral health programs; rather primary prevention is the key. Many countries and communities are focusing on hoe millions of underprivileged children can be provided with health care. Schoolchildren gain the knowledge and behaviors to attain and maintain good oral health in schools. For these reasons, the role of school-based oral health center is not only important but also a necessity.
The objective of this study was to analyze the status of health examination, and the health care management of industries in Seoul. This will provide effective industrial health care services. 46 industries were selected as a sample, and were given self administered questionnaire developed by the academic affairs of community health nursing. The results of this study are as follows: (1) The general characteristics of industries: The greater part of the industries were manu facturing companies, 300-900 workers, in a one shift system. (2) The general characteristics of health man ager: 96% of the companies had industrial nurses and the larger industries had comprehensive health managers. 90% of the industrial nurses were full-time employees and 77% of the industrial physician were part time employees. 80% of the industrial physician were age 50 or older, while 59% of the industrial nurses were 25-29 years of age. (3) Health examination and follow up care: The proportions of the workers who took general health examination was 94%. Of those, 12% took secondary examinations. In secondary examinations, 36% were evaluated at the C-grade, 20% were evaluated at the D-grade. The proportion of the workers who were required to take special examination were 29% and of that, the proportion of the workers who actually took the examination was 88%. 85% of the workers who were recommended for follow up cares were given follow up care while working. The physical agents among the special examination were done the most frequently to detect the examination effects. (4) Health care services: Industrial nurses performed health examination most frequently and health education was done the least. There were significant differences in health care services according to the size of the industries. Companies with 300 workers or less had higher health care services than other groups. The three primary reasons of health care management and examinations of workers are: First, industrial nurses are requires to accumulate professional knowledge and experience through continuos' activities. Second, systematic and concert examination for industrial workers should be performed periodically. Third, it needs developing health education strategies that are important workers for health promotion in industries.
Background: Primary myelodysplastic syndrome (MDS) is an acquired clonal disorder of myeloid progenitor cells, characterized by peripheral cytopenias in the presence of hypercellular marrow with dysplastic features. Our aim was to study the demographical and clinicopathological features of adult Pakistani patients with MDS at disease presentation. Materials and Methods: This single centre study was conducted at Liaquat National Hospital and Medical College, extending from January 2010 to December 2014. Data were retrieved from the patient archives. Results: Overall 45 patients were diagnosed at our institution with de novo MDS during the study period. There were 28 males and 17 females. Age ranged between 18 and 95 years with a mean age of $57.6{\pm}17.4years$ and median of 64 years. The male to female ratio was 1.7:1. The main presenting complaints were generalized fatigue (60%), fever (33.3%), dyspnea (15.5%), bleeding (13.3%) and weight loss (11.1%). Examination was unremarkable in 42.2% of patients. Physical examination revealed pallor in 37.7%, followed by petechial and purpuric rashes in 20%. The commonest laboratory finding was anemia (hemoglobin < 10 g/dl in 41 (91.1%) patients. Out of these, 27 (60%) patients had normocytic anemia, followed by macrocytic (22.2%) and microcytic (8.8%). Conclusions: Primary MDS in Pakistani patients demonstrates a male preponderance. The proportion of anemic patients was high in our series with predominance of normocytic anemia. However, other clinico-hematological features appear comparable to published data.
Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.
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