• Title/Summary/Keyword: Regional Medical Center

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Perceptions of Residents in Relation to Smartphone Applications to Promote Understanding of Radiation Exposure after the Fukushima Accident: A Cross-Sectional Study within and outside Fukushima Prefecture

  • Kuroda, Yujiro;Goto, Jun;Yoshida, Hiroko;Takahashi, Takeshi
    • Journal of Radiation Protection and Research
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    • v.47 no.2
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    • pp.67-76
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    • 2022
  • Background: We conducted a cross-sectional study of residents within and outside Fukushima Prefecture to clarify their perceptions of the need for smartphone applications (apps) for explaining exposure doses. The results will lead to more effective methods for identifying target groups for future app development by researchers and municipalities, which will promote residents' understanding of radiological situations. Materials and Methods: In November 2019, 400 people in Fukushima Prefecture and 400 people outside were surveyed via a web-based questionnaire. In addition to basic characteristics, survey items included concerns about radiation levels and intention to use a smartphone app to keep track of exposure. The analysis was conducted by stratifying responses in each region and then cross-tabulating responses to concerns about radiation levels and intention to use an app by demographic variables. The intention to use an app was analyzed by binomial logistic regression analysis. Text-mining analyses were conducted in KH Coder software. Results and Discussion: Outside Fukushima Prefecture, concerns about the medical exposure of women to radiation exceeded 30%. Within the prefecture, the medical exposure of women, purchasing food products, and consumption of own-grown food were the main concerns. Within the prefecture, having children under the age of 18, the experience of measurement, and having experience of evacuation were significantly related to the intention to use an app. Conclusion: Regional and individual differences were evident. Since respondents differ, it is necessary to develop and promote app use in accordance with their needs and with phases of reconstruction. We expect that a suitable app will not only collect data but also connect local service providers and residents, while protecting personal information.

A Study on Characteristics of Core Projects Described in 3rd Community Health Plans (제3기 지역보건의료계획서에 기술된 핵심사업의 특성에 관한 연구)

  • Kim, Dong-Moon;Lee, Weon-Young;Moon, Ok-Ryun;Kim, Chang-Yup
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.1
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    • pp.88-98
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    • 2004
  • Objectives : The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. Methods : Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k>0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. Results : The survey was used by 59.8 % of samples as a core project decision-making method. The partici- pants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. Conclusions : The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health

Analysis on the utilization Pattern of a General Hospital - With Cases of General Hospital Inpatients in the Provincial Area - (종합병원 이용형태에 관한 분석 - 지방소재 종합병원 입원환자 중심 -)

  • Jung, Yong-Mo;Jun, Sun-Kyong;Lee, Yong-Chul
    • The Korean Journal of Health Service Management
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    • v.3 no.1
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    • pp.14-24
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    • 2009
  • This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.

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TI-201 Redistribution SPECT and N-13 Ammonia PET Images in Patients with Old Myocardial Infarction and Left Ventricular Dysfunction: Segmental Comparison and Discordance Analysis (좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 TI-201 재분포 SPECT와 휴식기 N-13 Ammonia PET: 분절 비교 및 불일치 분석)

  • Choi, Joon-Young;Lee, Kyung-Han;Kim, Young-Hwan;Lee, Eun-Jeong;Chung, Hyun-Woo;Lee, Su-Jin;Lee, Sang-Hoon;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.218-224
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    • 2004
  • We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between PET and SPECT images and analyze the discordant pattern. Materials and Methods: Rest N-13 ammonia and F-18 FDG PET were performed on 18 patients with old myocardial infarction and left ventricular dysfunction whose dipyridamole - 4hr redistribution TI-201 SPECT showed one or more severe fixed defects. Regional perfusion and metabolism were evaluated visually and quantitatively with 5-segment myocardial model. Results: There were high concordant rate in uptake pattern (80/90 segments, 88.9%) and high correlation coefficient on quantitative analysis (R=0.81, p<0.001) between redistribution TI-201 SPECT and N-13 ammonia PET images. Nine of 18 patients had SPECT-PET concordant pattern (Group I). Ten segments (9 in inferior wall, 1 in apex) from the remaining 9 patients showed SPECT-PET discordant pattern with abnormal TI-201 defect and near normal N-13 ammonia uptake (Group II). The diastolic and systolic left ventricular dimensions were significantly increased in Group II compared to those of Group I. When attenuation uncorrected N-13 ammonia PET images were reconstructed in Group II, it resulted in PET images with severe inferior wall defects nearly identical to those seen in redistribution TI-201 SPECT images. Conclusion: Redistribution TI-201 SPECT images showed high concordant rate and correlation with rest N-13 ammonia PET images. Most of discordant segments had fixed thallium defects in inferior wall with nearly normal N-13 ammonia uptake, which may result from severe left ventricular dilatation and attenuation by the left hemidiaphragm and cardiac blood pool.

Intraoperative Measurement and Analysis of Coronary Artery Bypass Graft Flow (수술중 측정한 관상동맥 우회도관 혈류량의 분석)

  • Park, Kye-Hyun;Chae, Hurn;Yun, Yang-Ku;Lee, Jae-Woong;Kim, Kwhan-Mien;Jun, Tae-Gook;Kim, Jhin-Gook;Shim, Young-Mog;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.760-769
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    • 1997
  • This study aimed to determine factors that influence blood flow through coronary bypass grafts and to analyze relationship between the graft flow and postoperative outcome. Blood flow through 146 bypass grafts(GBF) was measured with transit-time ultrasound flowmeter during coronary artery bypass grafting operations in 50 patients. Single and multiple regression analyses were done for relationships between the GBF and four variables: internal diameter of recipient coronary artery, myocardial value of bypassed branch(es), type of graft, and finding of preoperative myocardial perfusion scan. The relationship between GBF and postoperative scan finding was also analyzed. 1. The mean GBF was significantly higher in sequential grafts than in single vein grafts or in internal thoracic artery grafts(61.5 vs. 46.9 and 42.5 ml/min). 2. Myocardial value and recipient artery diameter were found to be the factors determining GBF. There was no correlation between GHF and presence of perfusion defect in the preoperative scan. 3. Myocardial value was found to be more important than recipient artery diameter in determinintg GBF. 4. Reversible perfusion defects were more frequently found in the areas upplied by grafts with low GBP. But this fact had only mild statistical significance. These results suggest that blood flow through a bypass graft is more determined by the size of its supplyinf: myocardium than by the size of recipient artery. So, we can expect effective improvement in myocardial flow reserve after grafting of small(1~1.5mm) coronary arteries, if they supply substantial area of myocardium.

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Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Anti-inflammatory and Tyrosinase Inhibition Effects of Amaranth (Amaranthus spp L.) Seed Extract (아마란스 씨앗 추출물의 항염 및 Tyrosinase 억제 효과)

  • Yi, Mi-Ran;Kang, Chang-Hee;Bu, Hee-Jung
    • Korean Journal of Plant Resources
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    • v.30 no.2
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    • pp.144-151
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    • 2017
  • This study examined the anti-inflammatory and whitening effects of Amaranth (Amaranthus spp L.) seed extract. Amaranthus spp L. seeds were extracted using 70% ethanol and then fractionated sequentially with n-hexane, dichloromethan, ethyl acetate and butanol. For the study of anti-inflammatory activity in RAW 264.7 cells, EtOAc fraction of Amaranthus spp L. seeds significantly inhibited nitrogen oxide production as well as the protein level of iNOS. Furthermore, EtOAc fraction of Amaranthus spp L. seeds inhibited expression of $TNF-{\alpha}$, PGE2 and the protein level of COX-2 in a dose-dependent manner. Inaddition, the tyrosinase inhibitory activities of the Amaranthus spp L. seed 70% ethanol extract and subfractions were also measured to see if these extracts can be used as an ingredient for whitening cosmetics. Tyrosinase is an oxidase that is a rate-limiting enzyme for controlling the production of melanin. Therefore, tyrosinase inhibitors have become increasingly important in cosmetics and medical products with regards to hyperpigmentation. EtOAc fraction of Amaranthus spp L. seeds showed mushroom tyrosinase inhibitory activity in a dose-dependent manner. This activity was more potent than that of a positive control cynandione A. These results suggest that Amaranthus spp L. seeds may be a valuable natural ingredient for the food and cosmetics industries.

An indicator for managing the regional variations in approval rates of long-term care (LTC) service (지역별 장기요양 인정의 차이 관리지표 개발)

  • Han, Eun-Jeong;Lee, JungSuk;Park, Seyoung;Jang, Soomok;Jung, Inkyung
    • The Korean Journal of Applied Statistics
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    • v.30 no.3
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    • pp.391-401
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    • 2017
  • This study develops an indicator to manage regional variations of approval rates for long-term care (LTC) service. We used LTC insurance data for grade assessment that include 433,155 applicants from 227 LTC centers across Korea in 2015. The approval rate for each center was defined as the proportion of the numbers of approved applicants out of all applicants. We assumed that the approval rates depended on the characteristics of applicants. We estimated the 'standard' approval rates from a multiple linear regression analysis using the characteristics of applicants as independent variables. The difference between the observed and the standard rates was then defined as an indicator for deviation. A center having a large difference could be considered as a center with a potential error in grade assessment. We also examined if the characteristics of investigators affected the approval rates. We found that the socio-demographic characteristics of applicants and reapplication rate for LTC grade were independent factors affecting the approval rates. Centers having the management indicator values falling outside the middle 95% of the distribution were identified as centers with an error in grading. We expect that this study will contribute to enhancing reliability and equity in LTC grading.

Effect of LI4-LI11 Electro-acupuncture on Regional Cerebral Blood Flow in Healthy Human - Evaluated by $^{99m}Tc-ECD$ Brain SPECT - (합곡-곡지 전침치료가 정상인의 뇌혈류에 미치는 영향 - Brain SPECT와 SPM을 이용하여 -)

  • Ryu Jong-Man;Kim Young-Suk;Park Sung-Uk;Jung Woo-Sang;Ko Chang-Nam;Cho Ki-Ho;Bae Hyung-Sup;Kim Deok-Yoon;Moon Sang-Kwan
    • The Journal of Korean Medicine
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    • v.27 no.2 s.66
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    • pp.36-43
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    • 2006
  • Objectives : Acupuncture has been widely applied to rehabilitation after stroke by Oriental medical doctors in Korea. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. In addition, a correlation between activation of specific areas of brain cortices and corresponding acupuncture stimulation at the therapeutic points had been well illustrated. rill now, however, there were few studies which evaluated a correlation between activation of specific areas of brain and frequently-used acupuncture therapy for stroke, such as LI4-LI11 electro-acupuncture (EA) for paresis after stroke. This study was undertaken to evaluate the effect of LI4-LI11 EA on regional cerebral blood flow (rCBF) in normal volunteers using Single Photon Emission Computed Tomography (SPECT). Methods : In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (8 males, 2 females, mean age $25.6{\pm}2.3$years; age range from 24 to 31 years). 7 days after the resting examination, 15 minutes of electro-acupuncture were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by Statistical parametric mapping with a threshold of p=0.001, uncorrected (extent threshold: k=100 voxels). Results : EA applied at right LI4-LI11 increased rCBF in right frontopolar area (Brodmann area 10) and left middle frontal area (Brodmann area 46). Interestingly, all the areas showing increased rCBF corresponded to the territories of both anterior cerebral arteries. However, LI4-11 EA decreased rCBF in the left occipital lobe (peristriate area, Brodmann area 19). Conclusions : The results demonstrated a correlation between LI4-11 EA and rCBF increase in the frontal lobes. It is also suggested that there may be a correlation between LI meridian and the territory of the anterior cerebral arterties.

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The Possibility of Regional Health Insurance Data in Blueprinting the Local Community Health Plan (지역보건의료계획 수립에 있어 지역의료보험자료의 활용가능성)

  • Lee, Sang-Yi;Kim, Chul-Woung;Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.870-883
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    • 1997
  • The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.

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