• 의료법학
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• 제18권1호
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• pp.143-169
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• 2017

아동학대범죄의 처벌 등에 대한 특례법은 아동학대에 '범죄'라는 개념을 도입하고 신고의무자를 정함으로서, 아동학대 신고를 활성화하고자 하는 의도로 제정되었다. 동법 제10조는 의료인을 아동학대 신고의무자로 정하는데, 학대 피해 아동의 발견율이 0.5% 남짓인 현실을 고려한다면, 특정한 의학적 소견으로 비교적 명확하게 아동학대의 사실을 알 수 있는 의료인에게 신고의무를 부과한 입법적 조치는 타당하다. 향후 의료인에 의한 신고가 활성화되도록 하기 위한 제도를 마련하기 위하여 본 논문에서는 크게 세가지 제안을 한다. 첫 번째, 예비의료인과 의료인에게 아동학대 신고의무에 관한 교육을 꾸준하게 실시하는 것이다. 신고의무의 구체적인 내용 및 절차와 더불어, 의료인이 판단하기에 아동학대가 확실한 경우 뿐 아니라 "의심"되는 경우에도 신고의무가 있음을 주지시켜 아동학대를 조기에 발견하고 신고할 수 있도록 하는 것이 바람직하다. 두 번째, 신고 의료인 및 의료기관에 대한 보호 장치를 마련하여 한다. 현행법이 신고자의 보호를 위하여 필요한 조항들을 포함하고 있기는 하지만, 여기서 한발 더 나아가 의료인의 상황에 맞게 신고인을 보호할 수 있는 구체적인 지침을 마련하고, 그러한 지침에 대한 교육을 실시하여야 한다. 신고의료인에 대한 철저한 보호장치를 마련하는 것이 미신고의료인에 대한 면허 박탈 등의 처벌 조치를 강화하는 것보다 더 효과적인 신고의 유인을 제공할 것이다. 세 번째, 의료인이 모든 영유아의 건강상태를 주기적으로 모니터링할 수 있는 영유아건강검진제도를 학대아동 발견의 기회로 활용할 수 있도록 협진 체계를 마련하고, 영유아건강검진을 실시하는 의료인에 대하여 아동학대에 대한 체계적인 교육을 실시하는 것이 바람직하다.

• 대한세포병리학회지
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• 제12권1호
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• pp.1-15
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• 2001

The Bethesda System (TBS) was first developed in 1988 for the need to enhance the communication of the cytopathologic findings to the referring physician in unambiguous diagnostic terms. The terminology used in this reporting system should reflect current understanding of the pathogenesis of cervical/vaginal disease so the framework of the reporting system should be flexible enough to accommodate advances in medicine including virology, molecular biology, and pathology. Three years after the Introduction of TBS, the second Bethesda workshop was held to set or amend diagnostic criteria for each categories of TBS. TBS 1991 is now widely used. The third Bethesda workshop, The Bethesda System 2001 Workshop, was held in National Cancer institute Bethesda, Maryland from April 30 to May 2, 2001. Again, the goals of this workshop were to promote effective communication and to clarify in reporting cervical cytopathology results to clinicians and to provide with the information to make appropriate decisions about diagnosis and treatment. Nine forum groups were made and there were Web-based bulletin board discussions between October, 2000 and the first week of April, 2001. On the basis of bulletin board comments and discussions, the forum moderators recommended revised terminologies in the Workshop. Hot discussions were followed after the presentation by forum moderators during the workshop. Terminologies confusing clinicians and providing no additional informations regarding patient management were deleted in the workshop to clarify the cervicovaginal cytology results. Any informations related to the patient management were encouraged to add. So 'Satisfactory for evaluation but limited by...' of 'Specimen Adequacy' catergory was deleted. Terminology of 'Unsatisfactory' was further specified as 'Specimen rejected' and 'Specimen processed and examined, but unsatisfactory'. Terminologies of 'Benign Cellular Change' and 'Within Normal Limits' were combined and terminology was changed to 'Negative for intraepithelial lesion or malignancy'. In General categorization, category 'Other' was newly inserted and the presence of 'Endometrial cells' in women over 40 years old can be checked. Although the category 'Benign Cellular Change' was deleted, the organisms or reactive changes of this category can be listed in the descriptive diagnoses. Terminologies of ASCUS and AGUS were changed to atypical squamous cell and atypical glandular cell, respectively. Diagnostic term of 'Adenocarcinoma in situ', which is highly reproducible with reliable diagnostic criteria, was newly Inserted. The category of hormonal evaluation was deleted. Criteria for liquid-based specimen were discussed. Reporting by computer-assisted cytology was discussed and terminology for automated review was newly inserted. This is not the final edition of Bethesda 2001. The final document can be prepared before the ASCCP meeting in which Consensus Guidelines for the Management on Cytology Abnormalities and Cervical Precursors will develop in September 2001.

• 한국의학물리학회지:의학물리
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• 제27권3호
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• pp.139-145
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• 2016

With the development in field of industry and medicine, new machines and techniques are being launched. Moreover, the complexity of the techniques is associated to an increasing risk of incident. Especially, a small error in radiotherapy can lead to a serious patient-related incident, risk management is necessary in radiotherapy in order to reduce the risk of incident. However, in field of radiotherapy, there are no legally binding clauses for risk management and there is an absence of risk management systems at an institutional level. Therefore, we analyzed institutional status of risk management, reporting & classification systems, and risk assessment & analysis in 31 countries. For risk management and reporting systems, 65% of countries investigated had legislation or regulations; however, only 35% of countries used classification systems. It was found that 43% more countries had legislation for risk management in healthcare than those for radiotherapy; 19% more countries had reporting systems for healthcare than those for radiotherapy. For classification systems, 60% more countries had legislation, recommendation, and guidelines in the field of radiotherapy than those for healthcare. Recently, international institutes have published several reports for risk management and patient safety in radiotherapy, owing to which, countries adopting risk management for radiotherapy will gradually increase. Before adopting risk management in Korea, we should precisely understand the procedures and functions of risk management, in order to increase efficiency of risk management because classification & reporting system and risk assessment & analysis are connected organically, and institutional management is needed for high quality of risk management in Korea.

• Korean Journal of Radiology
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• 제23권11호
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• pp.1102-1111
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• 2022

Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

• The Journal of Asian Finance, Economics and Business
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• 제8권9호
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• pp.53-66
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• 2021

The global financial crisis in 2008 eroded trust towards the banking industry overall. To make such institutions more transparent, the International Accounting Standard Board developed the International Financial Reporting Standard 9 (IFRS 9). After the announcement of IFRS 9, academic research has primarily focused on examining the stability of banks due to early loan-loss recognition guidelines under the new system. There appears to be a lack of understanding of how IFRS 9 has influenced institutional depositors' opinions of bank trustworthiness. Hence the goal of this study is to determine how the adoption of IFRS 9 by banks has impacted perceptions of transparency, trust, and skepticism, from the perspective of large institutional depositors. This research was conducted in the context of Malaysian banks that follow the IFRS 9 guidelines. A framework is proposed using the signaling theory, leading to the development of a set of hypotheses. The hypotheses are tested with data collected from 654 financial analysts working in Malaysian companies that are large institutional depositors. The results indicate that the adoption of IFRS 9 has led to higher levels of perceptions of bank transparency and trust, and lower levels of skepticism towards such banks.

• The Journal of Asian Finance, Economics and Business
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• 제9권6호
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• pp.313-324
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• 2022

The goal of this research is to see how closely accounting programs in Saudi Arabian colleges comply with the International Accounting Education Standards (IESs). Further, it aims to assess the level of awareness and knowledge of IESs among accounting academics and to examine the possible explanatory factors for their variation. A structured questionnaire was sent to accounting faculty members at 37 Saudi universities. Out of 541 distributed questionnaires, a total of 102 usable responses were received from 26 universities. The findings show that accounting programs in Saudi universities are partially compliant with the guidelines of IESs and accounting academics in those universities are moderately aware of IESs. High variation in the level of academics' knowledge of IESs was detected and was significantly influenced by industry work experience, academic ranks, and professional qualification. The findings of this study suggest that Saudi Universities should work closely with the local and international accounting professional bodies, i.e. the Saudi Organization for Chartered and Professional Accountants (SOCPA) and the International Federation of Accountants (IFAC) to improve accounting programs based on the guidelines of IESs to cope with the recent changes in the capital market of the kingdom and the adoption of the International Financial Reporting Standards.

• 한국발생생물학회지:발생과생식
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• 제27권1호
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• pp.47-56
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• 2023

Despite the commercialization of Next generation sequencing (NGS) gene testing, only a few studies have addressed the various ethical and legal problems associated with NGS testing in Korea Here, we reviewed the normative issues that emerged at each stage of the wet analysis and bioinformatics analysis of NGS gene testing. In particular, it was in mind to apply various international guidelines and the principles of bioethics to actual clinical practice. Considering the characteristics of NGS testing, wet analysis of additional testing can be justified if presumptive consent is recognized. Furthermore, the medical relationship between diseases needs to be established and it should be clear that the patient would have given consent if the patient had been aware of the correlation between genes. At the stage of bioinformatics analysis, the question of unsolicited findings arises. In case of unsolicited and relevant findings, according to American College of Medical Genetics and Genomics (ACMG), a recognized relationship between genes and diseases needs to be established. In case of unsolicited and not-relevant findings, it is almost impossible to determine whether knowing or not knowing the findings is more beneficial to the patient. However, it seems to be certain that the psychological harm an individual may suffer from such information is likely to be greater if the disease is severe and if there is no cure. The list of genes for which the ACMG guidelines impose reporting obligations is a good reference for judgment.

• 대한불안의학회지
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• 제19권2호
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• pp.61-68
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• 2023

Objective : The purpose of this study was to investigate the associations between psychosocial factors and the mask-wearing behavior after deregulation of COVID-19 quarantine guidelines among adults in Korea. Methods : We collected data (345 subjects) from online questionnaire survey. The questionnaire included the Korean version of the Patient Health Questionnaire-9, the Korean version of fear of COVID-19 Scale, the Korean version of the Patient Health Questionnaire-15, Korean versions of the Perceived Stress Scale, and measurement tools adapted from previous studies for COVID-19 risk perception, social stigma, and appearance interest of subjects. We analysed data using SPSS version 23.0 for descriptive statistics, chi-square test, and logistic regression analysis. Results : People with cohabitant or mask-wearing tendency before COVID-19 pandemic had a higher rate of mask-wearing than those who were not. Subjects reporting higher level of social stigma (OR=1.154, 95% CI 1.049-1.270) and COVID-19 anxiety (OR=1.072, 95% CI 1.007-1.141) were more likely to report maskwearing behavior. Conclusion : From the results, appropriate intervention to those who fear social stigma and are anxious to the infectious diseases will be needed. Additionally, providing policies and guidelines that consider cohabitants and offering continuous education with information of disease to the public are also expected to helpful for recovery of daily life from infectious diseases.

• 한국산학기술학회논문지
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• 제15권12호
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• pp.7179-7186
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• 2014

이 연구는 감염병 발생자료와 감염병 관리사업 평가지표와의 관계를 실증적으로 분석함으로써 감염병 관리사업의 평가지표의 타당성을 실증적으로 분석함을 목적으로 하였다. 자료는 2004년과 2005년 2개년간의 시군구(보건소) 감염병 환자 발생 수 합계와 2005년도 감염병관리사업 평가지표 등 이었다. 자료의 분석은 빈도분석, 분산분석, 다중회귀분석 등을 이용하였다. 보건소 유형 및 법정감염병 각 군별로 각기 상이한 지표들이 도출되었으며, 각 군로도 특이한 지표 보다는 다양한 분야의 지표들이 혼재되어 있는 양상으로 도출되었다. 특히, 교육실적 등이 발생건수와 유의한 관계를 보이는 경우가 많아 발생건수는 신고건수 즉, 사업의 성과의 결과로 판단하는 것이 더욱 타당할 것으로 판단된다. 전체적인 지표의 개선이 필요하거나 사업의 투입시간 및 추이를 본 후 재평가가 필요할 것으로 생각되며, 각 사업별로 분리하여 특이한 평가지표를 생산할 필요가 있어 보인다. 감염병관리사업의 평가지표 개발은 기초자치단체별 감염병관리사업 종합평가체계를 구축하는데 핵심적인 역할을 할 것이며, 감염병관련업무 표준화를 촉진하고 관련지침을 개정에 활용될 것이며, 향후 보건사업 및 보건의료조직의 계량적인 성과 평가에 활용될 것이다. 또한 시군구 보건소에서 수행한 성공적인 감염병 관리 사업의 사례를 발굴, 제시함으로써 보다 성공적인 감염병관시업의 접근이 가능케 할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3123-3129
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• 2016

Background: Cancer is the fourth leading cause of death in Sabah Malaysia with a reported age-standardized incidence rate was 104.9 per 100,000 in 2007. The incidence rate depends on non-mandatory notification in the registry. Under-reporting will provide the false picture of cancer control program effectiveness. The present study was to evaluate the performance of the cancer registry system in terms of representativeness, data quality, simplicity, acceptability and timeliness and provision of recommendations for improvement. Materials and Methods: The evaluation was conducted among key informants in the National Cancer Registry (NCR) and reporting facilities from Feb-May 2012 and was based on US CDC guidelines. Representativeness was assessed by matching cancer case in the Health Information System (HIS) and state pathology records with those in NCR. Data quality was measured through case finding and re-abstracting of medical records by independent auditors. The re-abstracting portion comprised 15 data items. Self-administered questionnaires were used to assess simplicity and acceptability. Timeliness was measured from date of diagnosis to date of notification received and data dissemination. Results: Of 4613 cancer cases reported in HIS, 83.3% were matched with cancer registry. In the state pathology centre, 99.8% was notified to registry. Duplication of notification was 3%. Data completeness calculated for 104 samples was 63.4%. Registrars perceived simplicity in coding diagnosis as moderate. Notification process was moderately acceptable. Median duration of interval 1 was 5.7 months. Conclusions: The performances of registry's attributes are fairly positive in terms of simplicity, case reporting sensitivity, and predictive value positive. It is moderately acceptable, data completeness and inflexible. The usefulness of registry is the area of concern to achieve registry objectives. Timeliness of reporting is within international standard, whereas timeliness to data dissemination was longer up to 4 years. Integration between existing HIS and national registration department will improve data quality.