• Title/Summary/Keyword: Public Health Doctor

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Factors Predicting Fecal Occult Blood Testing among Residents of Bushehr, Iran, Based on the Health Belief Model

  • Dashdebi, Kamel Ghobadi;Noroozi, Azita;Tahmasebi, Rahim
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.17-22
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    • 2016
  • Colorectal cancer is a major cause of mortality worldwide. Fecal occult blood testing has proven a very effective screening tool for early detection and mortality reduction. The aim of this study was to determine predictors factors related to fecal occult blood testing using the Health Belief Model method among residents of Bushehr, Iran. A cross sectional study was performed on a sample of 600 men and women more than 50 years of age. The sample was selected by a convenience method from patients referred to public and private laboratories throughout the city. Each subject filled out a questionnaire which was designed and developed based on Health Belief Model constructs. Statistical analysis was conducted using ANOVA, T-test, chi-square test, and logistic regression. Fecal occult blood tests were performed on 179 (29.8%) out of 600 subjects, of which 95 patients (58.1%) did a periodic examination test and 84 patients (46.9%) had a doctor's advice for testing. According to the logistic regression model, the perceived barriers (P=0.0, Exp(B)= 0.3), perceived benefits (P<0.01, Exp(B)= 1.9) and self-efficacy (P<0.01, Exp(B)= 1.6) were predictive factors related to occult blood testing among subjects. The results showed that reducing people's perception of barriers to testing, increasing perceived benefits of screening, and reinforcing self efficacy can have major effect in increasing the rate of fecal occult blood screening for colorectal cancer prevention.

Survey on the Status of Utilization of mediate Moxibustion by Korean Medicine Doctor (한의사의 간접구 이용실태에 대한 조사 연구)

  • Lee, Eunkyoung;Han, Seungjun;Chong, Myongsoo
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.2
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    • pp.105-127
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    • 2013
  • Objectives : We examined the use of the moxibustion through survey on Korean Medicine Doctors (KMDs) on preparation of universal moxa product standard by fully reflecting opinions of practitioners and the industry. Methods : The questionnaire is composed of 25 questions including use of indirect moxa, side effects, complaints and improvements, general characteristics and so on, and were responded by 1,588 KMDs. For statistics, frequency analysis, chi-square analysis, T-test and ANOVA were conducted using SPSS 12.0 for windows, and the significance level was 0.05. Results : In this research, 91% of the responded KMDs was using moxibustion, and the proportion of using mediate moxibustion was shown as 63.2%. They used mediate moxibustion for side effects of direct moxa method such as risk of burn, ease of use, control of stimulation and so on. And it was mostly being conducted to women and 40 ages. Most respondents gave moxibustion treatments for the purpose of thermal stimulation on acupoint to musculoskeletal diseases. Most respondents were treating 1~2 pieces of moxibustion to patients by moxibustion points to those of 1~2 regions every time within 10 minutes. Regarding the frequency of side effects of mediate moxibustion, within 3% of respondents had experienced side effects, and the types were burn, flare and itchiness, odor and smoke. The dissatisfaction of mediate moxibustion products was moderate(2.00 out of 5 point scale), and went up public health doctors, the younger ages and the shorter clinical experience. Complaints on mediate moxibustion products were serious odor, poor attachment, risk of burn etc. Regarding ways to improve mediate moxibustion, the expansion of moxibustion's insurance cost carne out highest, followed by preparation of manual on efficacy, strengthening of training, acquiring evidence on efficacy, diversification of specifications, safety improvement, quality improvement of mediate moxibustion products. Conclusions: Many KMDs use for ease of use and give moxibustion treatments for thermal stimulation but they complain about safety, efficacy and quality of mediate moxibustion. After this it is considered that we have to elevate therapeutic effect through the improvement of mediate moxibustion products.

Japan's Policy and Implications for Expansion of Doctoral Manpower (일본의 의사인력 확충 정책과 시사점)

  • Kwon, Ju-Young
    • Journal of the Korea Convergence Society
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    • v.11 no.11
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    • pp.345-352
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    • 2020
  • Under "Emergency Doctor Security Act of 2007", Japanese government focuses on relocating doctors in medically underserved areas and matching supply and demand of manpower in order to resolve the ubiquity of specific treatment departments. Particularly, there are two alternatives to secure the number of local physicians and avoid the regional shortage of doctors in the short term. Firstly, the government attracts existing physicians to the region. Secondly, the government increases the capability of regional clinical training system to prevent the influx of doctors to the larger cities. Also, it seeks solutions from various perspectives, such as cultivating manpower to work in vulnerable areas through the regional frame system and autonomous medical college. This study introduces the case of Japan as a benchmark and suggests that policymakers should focus on the recent conflict between the government and the medical consultation. More specifically, this study provides policy implications on the alternative measures for securing the manpower of regional doctors.

Suggestion about Modernized Classification of Herbal Medicinal Preparations in Dual Medical Systems (이원화 체계 하에서의 현대적 한약제제 분류 방안 고찰)

  • Kim, Ji-Hoon;Cho, Sun-Young;Han, Sang-Yong;Park, Sun-Dong;Kim, Yun-Kyung
    • The Journal of Korean Medicine
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    • v.36 no.1
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    • pp.61-74
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    • 2015
  • Objectives: The main purpose of this study is to find a solution for modernized classification of herbal medicinal preparations in dual medical systems. Through this study, we expect to provide a reasonable foundation of herbal medicine for public health. Methods: We studied legal or technical terms of herbal medicinal preparations from the past regulations, and through this procedure, we could suggest clear definitions of terms for herbal medicinal preparations. We also investigated documents for approval of herbal medicinal preparation from US, EU(European union), The People's Republic of China, Japan, so that we can refer to them to revise regulation for appropriate use of herbal preparations. Results: In Korea pharmaceutical affairs act, any basis of 'Crude drugs' does not exist. But in some subordinary notifications, the way that they use the 'Natural product medicine' is used as a means of limiting basic rights of doctor or pharmacist of Korean medicine compared to doctor or pharmacist. At the same time, in subordinary notifications, provisions are vague and not enough for scientific evidence of Korean medicine. Thus, we re-categorized herbal medicinal preparations into new drugs, drugs made from herbal medicinal preparations and suggested requirements for drug approval. Conclusions: Instead of using the term 'Crude drug preparations', and we should use term 'Herbal medicinal preparations' in related act and notification. And also we suggest to amend subordinary regulations and documents for approval of herbal medicinal preparations. Through this, we can make herbal medicinal preparations be more industrialized.

A study on Medical Fee Information System Application based on XML Based on XML (XML 기반의 수가정보시스템 적용에 관한 연구)

  • Seong Kyoung
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.1051-1054
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    • 2006
  • Lots of information such as prescription transmitted to the drug store by the result of separation of medical activity from medicine one, EDI for billing medical charge to Health Care Public Cooperation and the returned opinion letter sent to doctor etc is scattered in the Web document made from XML. Especially information containing medical treatment charge is one of the materials that are revised frequently. It is the current situation that document is transmitted or form is made for distribution whenever this kinds of revision is occurred. In this thesis, DTD design and implementation for the information system regarding the rate of medical charge is studied based on XML which is used to calculate charges for the several activities including consulting and prescribing. Patient or patron as well as doctor, pharmacist and nurse are all interested in the information regarding the rate of medical charge. It aims everybody to easily obtain information about the rate of medical charge by querying it anytime, anywhere.

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Morbidity Pattern of Residents in Urban Poor Area by Health Screening (도시 영세지역 주민의 건강진단 결과)

  • Kim, Chang-Yoon;SaKong, Jun;Kim, Seok-Beom;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.150-157
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    • 1991
  • The purpose of the this study was to assess the morbidity pattern of urban residents in the poor area by health screening for the community diagnosis. The items of health screening were history taking and physical examination by medical doctor and hearing test, check blood pressure, test for hematocrit, liver function(sGOT, sGPT), urine sugar and protein, and chest X-ray. The examinee in health screening were 437 persons and they occupied 16.9% of total residents in the poor area. Male examinee were 129 persons(9.9% of total residents) and female examinee were 308 persons(23.9% of total residents). Age group of above sixty years old, 42.0% of total residents in the poor area were participated, but only 5.9% were participated in age group of 10 to 19 years old. Among the 437 examinee, 191 persons(43.7%) had one or more abnormal findings in health screening. In male 38.7% had abnormal findings, and some what lower than that of female(45.8%). Age group of above sixty years had most high rate of abnormal findings(69.8%), in contrast to age group of 10 to 19 years old (10.9%). Diseases of the digestive system was the most common and which occupies 23.7% of total abnormal findings. And diseases of the circulatory system occupied 19.7%. Low hematocrit(14.6% of total participants of 437 persons) occupies the most common abnormal findings for screening test(hematocrit, blood pressure, hearing test, sGOT/sGPT, urine protein and urine sugar, chest X-ray) and high blood pressure(10.1%) occupied second, third; hearing impairment (5.5%), fourth ; abnormal liver function (4.1%), fifth ; sugar in urine (2.3%), sixth ; protein in urine(1.4%) and lastly abnormal chest X-ray (0.9%). The positive rate of abnormal findings in health screening was very high compared with morbidity rate by health interview. It is supposed that some portion of this high rate is by selection bias in examinee in health screening specially high participating rate in older age, and the other portion is due to the low socioecomic status and bad environment of the residents of the poor area. These findings will be good information for the research and development of health care system in the urban poor area.

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Development of a Standard Tool for Pattern Identification of Gastroesophageal Reflux Disease (GERD) (위식도역류질환 변증도구 개발 연구)

  • Han, Ga-jin;Leem, Jung-tae;Lee, Na-la;Kim, Jin-sung;Park, Jae-woo;Lee, Jun-hee
    • The Journal of Internal Korean Medicine
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    • v.36 no.2
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    • pp.122-152
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    • 2015
  • Objectives: This study was designed to develop a standard tool for pattern identification of gastroesophageal reflux disease (GERD) patients. Methods: Korean and Chinese literature was selected that mentioned pattern identification of GERD. We gathered the pattern identification and their symptoms and a Chinese medical doctor proficient in Korean translated the Chinese characters into Korean. A Korean linguist then confirmed the translation results to develop a draft of the standard tool for pattern identification of gastroesophageal reflux disease (PIGERD). The final PIGERD was developed after assessment by an expert committee composed of professors from the Korean Medicine University, using the following items: inclusion of the pattern identification and its symptoms, importance of items, and validity of translation. Results: Six pattern identifications and 94 symptoms were selected from 45 references and translated into Korean. Four pattern identifications [pattern/syndrome of liver qi invading the stomach (肝胃不和), spleen-stomach weakness (脾胃虛弱), spleen-stomach dampness-heat (脾胃濕熱), and stomach yin deficiency (胃陰不足)] and 49 symptoms were then selected through the Delphi method by the expert committee. The final standard PIGERD tool was completed after the assessment of translation validity and reflection of individual opinions by the expert committee. This tool consists of 40 items including tongue and pulse diagnosis. The weighted value was also computed from assessment of the importance of items. Conclusions: We developed a standard tool for pattern identification of gastroesophageal reflux disease (PIGERD) to clarify the pattern identification of patients with gastroesophageal reflux disease for standardized diagnosis.

A Study on the Administrative Enhancement for Health Center Activities (보건소(保健所) 행정(行政)의 기선을 위(爲)한 연구(硏究))

  • Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.3 no.1
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    • pp.97-110
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    • 1970
  • This survey was conducted to evaluate not only the present status of health center directors-their personal histories, their will to private practice in the future, their responses to governmental policies, -but also the distribution of doctorless myons, budget and subsidy, and director's opinions to the enhancement of health center activities. This survey questioned 116 health center directors and 16 health personnel from August to October of 1970 and obtained the following results; 1) The average ages of directors of kun, city, and total health centers were $43.2{\pm}7.8,\;42.1{\pm}7.7,\;and\;42.9{\pm}10.3$ respectively. 2) The average family sizes of directors of kun, city, and total health centers were $5.6{\pm}2.7,\;5.6{\pm}2.1,\;and\;5.6{\pm}2.6$ respectively. 3) Directors holding M. D. degrees were 79.3%, those holding qualified M. D. degrees ('approved director') were 20.7%. 4) M. P. H., M. S., and Ph. D. holders were 6.0%, 6.1%, and 4.3% respectively. 5) The average duration of present directorship in kun and city were 30.2 months and 20.4 months respectively. 6) The majority of directors had been employed in related fields before assuming current position : directorship at other health center 26.7%, army 22.4%, health subcenter 21.6%, private practice 19.0%. 7) Average length of directorship is 41.8 months. Average length of public health career, including health subcenter and present position, is 56.5 months. 8) Both rural and urban experience in health centers for regular directors is 16.3% and for approved directors, 12,5%. A total of 15.5% of all survey directors had experience in both rural and urban health center. 9) A total of 70.7% of health center directorships were staffed by local doctors. 10) Nearly 40% wanted to quit the directorships within 3 years and 60.3% had already experienced private practice. 11) Of the regular directors 17.4% felt strongly about devoting their lives to public health fields, but only 4.1% of the approved approved directors felt so. 12) There wire 432 doctorless myons among 996 respondent myons and 4.5 doctorless myons per kun. 13) The percentage of doctorless myon by Province are as follows, Cholla buk-do 57.2%, Cholla nam-de 55.0%, Kyungsang nam-do 52.0%, Kyungsang buk-do 49.7%, Chungchong but-do 42.4%, Kyonggi-do 32.9%. Cheju-do 30.8%, Kangwon-do 25.8%. 14) Two thirds of health critters have experienced the abscence of the director for a certain period since 1966 and the average span of the abscence was 18.2 months. 15) The percentage of doctorless myons increased proportionally with the span of the director's abscence. 16) The average budgets of health centers, kun, city and ku, were $W15.03\;million{\pm}W4.5\;million,\;W22.03\;million{\pm}W17.80\;million,\;W13.10\;million{\pm}W7.9\;million$ respectively. 17) Chunju city had the highest health budget per capita(W344) while Pusan Seo ku had the lowest(W19). 18) Director's medical subsidies are W30,000-50,000 in kun, and roughly W20,000 in city. 19) The older of priority in health center activities is T.B. control(31.1%), Family Planning and M. C. H.(28.0%), prevention of acute communicable disease and endemic disease (18.2%) and clinical care of patients(14.3%). 20) Nearly 32% opposed in principle the governmental policy of prohibiting medical doctors from going abroad. 21) Suggestions for immediate enhancing the position of director of health centers and subcenters: (1) Raise the base subsidy (48.2%), (2) Provide more opportunities for promotion (20.7%), (3) Exemption from army services(12.1%), (4) Full scholarship to medical students for this purpose only (7.8%). 22) A newly established medical school was opposed by 56.9% of the directors, however 33.6% of them approved. 23) Pertaining to the division of labor in Medicine and Pharmacy, the largest portion (31.9%) urged the immediate partial division of antibiotics and some addictive drugs to be given only by prescription. 24) More than half wanted a W70,000 level for the director's medical subsidies, white 36.2% stated W50,000. 25) Urgently needed skills in the kun are clinical pathologist (38.6%) and doctor (health center director) (25.5%); while in the city nurse (37.1%), doctors(clinical)(31.4%) and health educators(14.4%) are needed. 26) Essential treatment for the better health center administration; raising the base subsidy (22.7%), obtaining the power of personal management (19.3%) and the establishment of a Board of Health (14.3%). etc.

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Factors Influencing Utilization of Medical Care Among Osteoarthritis Patients in Korea: Using 2005 Korean National Health and Nutrition Survey Data (우리나라 골관절염 환자의 의료이용과 관련된 요인: 2005년 국민건강영양조사 자료를 이용하여)

  • Kim, Min-Young;Park, Jong-Ku;Koh, Sang-Baek;Kim, Chun-Bae
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.6
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    • pp.513-522
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    • 2010
  • Objectives: The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. Methods: We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. Results: On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant association with medical utilization in men. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant association with medical utilization in women. Conclusions: The patients who tend to receive less care are those who suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.

Therapeutic Compliance for Calcium Supplements and Its Related Factors in Rural Osteoporotic Women (일부 농촌지역 여성 골다공증 환자의 칼슘보조제 치료순응도와 결정요인)

  • Chun, Byung-Yeol;Kam, Sin;Lee, Young-Ja;Lee, Sang-Won;Lee, Kyung-Eun;Lee, Young-Seok;Kim, Bong-Kee
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.111-132
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    • 2001
  • This study was conducted to examine the therapeutic compliance and its related factors in rural women with osteoporosis. A questionnaire survey was performed from April to May in 2000 for 140 osteoporotic patients who were diagnosed from April to June in 1999 through community health program. The study employed the health belief model for predicting and explaining sick role behavior. The analysis techniques employed included contingency table analysis and path analysis using LISREL. The major results of this study were as follows: Of the subjects, 12.1% were continuously complaint, 53.6% were intermittently compliant, and 34.3% were non- compliant to calcium supplement therapy. As the result of path analysis, the therapeutic compliance was significantly higher(${\mid}T{\mid}$ >2.0) as patients had higher perceived severity of disease, lower perceived barriers of treatment, and when patients thought their disease status as severe. As the patients had higher educational level, more experience of mass media contact or health education about osteoporosis, and when family had more concern for patient treatment, they had higher perceived susceptibility of complication(bone fracture)${\mid}T{\mid}$ >2.0). The patients had higher perceived severity(${\mid}T{\mid}$ >2.0) as they had more educational level, more advice for treatment from their doctors, and when family had more concern for their treatment. As the patients had more advice for treatment from their doctors and when family had more concern for their treatment, they had higher perceived benefit of treatment and lower perceived barriers to treatment(${\mid}T{\mid}$ >2.0). In order to improve the therapeutic compliance in rural osteoporotic women, it would be necessary that the patient should recognize their disease severity properly. And the perceived barriers should be removed through supportive environments for osteoporosis treatment such as doctor 's more advice and family 's more concern for treatment. In addition, effective and continuous management system for osteoporotic patients should be established.

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