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Ethnosientific Approach of Health Practice in Korea (한국인의 건강관행에 대한 민속과학적 접근)

  • 김귀분;최연희
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.396-417
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    • 1991
  • In order that nursing care an essential quality of nursing practice be acceptable and satisfying, it is necessary that client's culture be respected and that nursing practice be appropriate to that culture. Since cultural elements are an important influence on health practices and life patterns related to medical treatment, recovery from and prevention of disease, nurses need to have an understanding and knowledge of social and cultural phenomena to aid in the planning of nursing interventions. To understand the health practices surrounding health and illness, the health beliefs and practices of both folk and professional healing systems should be ascertained. Cultural data are required to provide care of high quality to clients and to reduce possible conflict between the client and the nurse. It is nursing's goal to provide clients from various cultures with quality nursing care which is satisfying and valuable. The problem addressed by this study was to identify Korean health practices which would contribute to the planning of professional caring practice with the culture : ultimately this study was intended to make a contribution to the development of the science of nursing. The concrete objectives of this study were ; 1) to identify Korean health practices, 2) to interpret the identitial health practices through traditional cultural thought, and 3) to compare the Korean health practices with those of other cultures. The investigator used the ethnosceintific approach outlined by spradly in a qualitative study. To discover ancestral wisdom and knowledge related to traditional health practeces, the subjects of this study were selected from residents of a small rural mountain village in south west Korea, a place considered to be maintaining and transmitting the traditional culture in a relatively well -preserved state because of being isolated from the modern world. The number of subjects was 18, aged 71 to 89. Research data were collected from January 8 to March 31, 1990. Five categories of health practices were identified : “Manage one's own mind”, “Moderation in all thing”, “Live in accord with nature”, “Live in mutuality with others”, and “Live to the best of one's ability”. Values derived from these ways of thinking from Confucianism, Taoism and Buddhism help fashion a traditional way of life, examplified by the saying “Benifience to all”. Korean thought and philosophy is influenced primerily by Confucianism, Confucian principles of ethics, embedded deeply in the peoples' minds, form the idea that “heaven and human being are intimately united” based on concept that “heaven is, so to speak, reason”. Twoe Gae's theory of existential subjectivity develops the concept of self which is the basis of the spirit of reverence in modern Confucian philosophy. The human md is granted from heaven out of the idea of matter, and what control the mind is the spirit of reverence. Hence the idea of “The primacy of the mind" and provided that one should control one's own mind. The precepts of duty to parents, respect for elders and worship of ancestors, and moderation in all behavior put a restraint on life which directed that one live earnestly according to Nature's laws with their neighbors. Not only Confucianism, but also Buddism and Taoism have had an important effect upon these patterns of ideas. When compared with western culture, Korean health practices tend to be more inclusive, abstract and intuitive while westerner health practices found to be mere concrete, practical and personal. Values and beliefs based and pragmatism and existentialism infuence western civilization, Ethical values may be founded on utilitarianism, which considers what is good for the persons in their circumstances as the basis of conduct and takes a serious view of their practical lives including human aspirations rather than an absolute truth. These philosophical and ethical ideas are foundations for health practices related to active, practical and progressive attitudes. This study should be enable nursing not only to understand clients as reflections of the traditional culture when planning nursing practice, but to dovelop health education corresponding to cultural requiments for the purpose of protection against disease and improvement of health, and thus promote sound health practice. Eventually it is hoped that through these processes quality nursing care as the central idea of the science of nursing will be achieved.

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Decreased Neutrophil Apoptosis in Patients with Sepsis is Related to the Activation of NF-κB (패혈증 환자에서 NF-κB 활성화에 의한 호중구 아포프토시스의 억제)

  • Kwon, Sung Youn;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.5
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    • pp.495-509
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    • 2003
  • Background : Neutrophil-mediated inflammation is usually self-limiting, because neutrophils have a remarkably short life span. Prolonged neutrophil survival, which is caused by decreased spontaneous apoptosis, leads to persistent inflammation in sepsis. Because many inflammatory cytokines, which generate signals that delay apoptosis, are regulated by nuclear factor-${\kappa}B$ transcription factor, we hypothesized that nuclear factor-${\kappa}B$ might be related to the reduced neutrophil apoptosis observed in sepsis. Methods : Neutrophils of healthy volunteers and sepsis patients were freshly isolated from venous blood. Neutrophil apoptosis was assayed with two approaches : by counting apoptotic cells under a microscope and by flow cytometry using Annexin V. The activity of nuclear factor-${\kappa}B$ was assessed by immunofluorescent staining or electrophoretic mobility shift assay. Expression of X-linked inhibitor of apoptosis was measured by western blot assay. Results : We confirmed reduced spontaneous neutrophil apoptosis in patients with sepsis. The number of apoptotic neutrophils in patients with sepsis increased to the level of that in healthy controls after cycloheximide treatment, suggesting that decreased spontaneous neutrophil apoptosis is dependent on de novo protein synthesis. In patients with sepsis, basal neutrophil nuclear factor-${\kappa}B$ was activated compared to the level in healthy controls. Moreover, a blockade of nuclear factor-${\kappa}B$ activity reversed the decreased spontaneous neutrophil apoptosis in sepsis patients. Meanwhile, X-linked inhibition of apoptosis expression, which is regulated by nuclear factor-${\kappa}B$, decreased 24 hours after incubation in healthy persons, but persisted for 24 hours in patients with sepsis. Conclusion : These observations suggest that the reduced spontaneous neutrophil apoptosis observed in patients with sepsis may be related to the induction of survival protein by nuclear factor-${\kappa}B$.

A Study on the Effect of Aroma Therapy on Anxiety and Pain Before and After Tooth Extraction (향기흡입법이 발치 전·후에 미치는 불안과 통증에 관한 연구)

  • Jeong, Mi-Ae
    • Journal of Korean society of Dental Hygiene
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    • v.4 no.1
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    • pp.105-117
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    • 2004
  • The purpose of this study was to examine the effect of aroma therapy on anxiety and pain before and after tooth extraction. The subjects in this study were 60 patients who felt severe anxiety and pain due to tooth extraction. The experiment was conducted from January through March, 2004, by organizing an experimental group and a control group with 30 patients each. The experimental group was asked to keep wearing lavender-containing necklaces from two days before tooth extraction to inhale lavender, and no such an action was taken to the control group. The collected data were analyzed with SPSS 10.0 program to obtain statistical data. and ${\times}2$ test and t-test were implemented. The findings of this study were as follows: 1. Regarding whether or not the experimental and control groups were homogeneous, men outnumbered women, and the largest number of the patients were in their 30s. Those who were married were more than the others who were unmarried in number, and those who lived with their spouses under the same roof together outnumbered the others who didn't, as the rate of the former stood at 65 percent in the experimental group and 86.4 percent in the control group. They expressed high satisfaction at their spouses, since 45 percent of the experimental group and 31 percent of the control group did it, but the difference between them and those who were unsatisfied was insignificant (pE0.347). By occupation, the largest number of people in the experimental group, which numbered 16.7 percent, were self-employed, and lots of patients in the control group were government workers. As for blood type, type A was most prevailing, which recorded 43.3 percent. By religion, 43 percent of the experimental group had no religion, whereas 36.7 percent of the control group were Christian. The most common monthly income ranged from 2 million to 2.5 million won. 2. There was little disparity in past pain experience between the two groups before aroma therapy was applied. The experimental group underwent more pain (6.15) than the control group (5.78), but the difference wasn't significant. The experimental group (90%) experienced more anxiety and fear than the control group(83%), but the difference was insignificant. This fact showed that there was little gap between the two groups in anxiety and fear caused by tooth extraction. Contrary to earlier expectation that pre-anxiety might not be the same. little significant difference was found. 3. After aroma therapy was applied, 50 percent of the experimental group and 23.3 percent of the control group suffered significantly less anxiety and fear about tooth extraction(${\times}2$=4.59, pE.05). And the experimental group exposed to aroma therapy was less nervous(3.0) than the control group(4.39), and the gap between the two was significant (t=13.37, pE.001). Therefore, aroma therapy had a good effect on alleviating their anxiety. During tooth extraction. 73.3 percent of the experimental group and 93.3 percent of the control group felt pain. The former group suffered Significantly less pain(${\times}2$=4.32, PE.05). Concerning the extent of pain, the experimental group(2.53) found it less painful to have their teeth extracted than the control group(5.50), and the gap between the two was significant(t=5.89, PE.05). 4. As to the effect of aroma therapy on alleviating anxiety or fear, the experimental group(33.3%) felt that aroma therapy let them more relieved. Every member of that group was willing to use aroma therapy again in the future, and 86.7 percent of that group perceived that aroma therapy made a difference to dental treatment. The experimental group responded to aroma therapy favorably, as every member of it had an intention to advise others to use that therapy.

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EFFECT OF ACID-TREATMENT ON DENTIN BONDING (산 처리가 상아질 접착에 미치는 영향)

  • Kim, Young-Kyong;Kim, Sung-Kyo;Park, Jin-Hoon
    • Restorative Dentistry and Endodontics
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    • v.18 no.1
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    • pp.73-83
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    • 1993
  • The purpose of this study was to evaluate the effect of various acid treatments on dentin bonding. Freshly extracted human teeth were uprightly embedded in self curing acrylic resin, and their occlusal surfaces were grinded to expose flat dentin surfaces. The specimens were divided into 4 groups. Specimens of one group were not treated so as to be a control and those of the other three groups were threated with 10% polyacrylic acid, 10% phosphoric acid, and 10-3 solution(10% citric acid/3% ferric chloride) respectively. Primer, bonding resin and composite resin were applied over the treated dentin surfaces sequentially. All specimens were stored in $37^{\circ}C$ distilled water for 24 hours, then the tensile bond strength was measured and the treated dentin surfaces and fracured dentin surfaces were examined under a scanning electron microscope. The results were as follows: Bond strengths of acid-treated groups were higher than those of the untreated group. In the acid-treated groups, bond strength was found to be the highest in the 10-3 solution group followed by the 10% phosphoric acid group and the 10% polyacrylic acid group(P<0.01). On SEM examination of dentin surfaces, the untreated dentin surface showed a remaining smear layer and closed dentinal tubules. Dentin surfaces treated with 10 % polyacrylic acid showed a clean dentin surface without the smear layer, but showed remaining smear plugs in dentinal tubules. A dentin surface treated with 10% phosphoric acid or 10-3 solution showed open dentinal tubules without the smear layer or smear plugs. On SEM observation of the fractured dentin-resin interface, the untreated group showed that failure occurred in the smear layer. The group treated with 10% polyacrylic acid showed no resin tag remained in the dentinal tubules, but resin tags in the dentinal tubules were observed in the group treated with the 10% phosphoric acid or the 10-3 solution. On the failure mode examination, the higher the bond strength of the group, the higher the frequency of cohesive failure. The coefficient between bond strength and cohesive failure rate was 0.71.

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Studies on Pathogenicity of Nosema bombycis Naegeli to Parents and Hybrid in the Silkworm (Bombyx mori L.) (원종 및 교잡종에 대한 미립자의 병원성에 관한 연구)

  • 김종수;김문협;채수군;임종성
    • Journal of Sericultural and Entomological Science
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    • v.14 no.2
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    • pp.81-92
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    • 1972
  • Studies on Pathogenicity of Nosema bombycis Naegeli are summarized as follows: 1. The mortality of the parents, Jam 103 and Jam 104, is remarkbly higher than that of the hybrid, Jam 103$\times$Jam 104, whereas there is no difference in the mortality between the parents. 3. In the mortality of the pathogen-concentration, it is increased in order of the following concentrations inoculated, 10$^{8}$ , 10$^{7}$ , 10$^{8}$ and 10$^{5}$ /ml. 3. In the mortality of each instar, it is high in order of 5th, 4th, 3rd, and 2nd instar. 4. In the interaction between the mortalities of the varieties and the concentrations, 1) The mortality shows no differences between the parents and the hybrid in the high concentration of 10$^{8}$ /ml. 2) The mortality of the hybrid is lower than that of the parents in the low concentration of 10$^{5}$ /ml, whereas no difference is found between the parents. 3) The interaction appears at the same level in the middle concentration of 10$^{6}$ /ml to the parents and of 10$^{7}$ /ml to the hybrid. 5. It was pointed out that active immunity depends upon the volume of antigen injection, immunizing period, and injection intervals. In this experiment, it is noticed that the optimum volume of injection is above 20ml and D is the best one of the four treatment (A.B.C.D.). 6. The immune sera indicate such a 12,800 high titer in the indirect method can be obtained from the D immunizing method. Silkworm tissues and N. bombycis spores show self-fluorescence, but it is able to distinguish it from the F.I.T.C. by using the U.V. filter. 7. The midgut epithelium is examined to be the first site of the tissues which are penetrated into and multiplied by the inoculation of the pathogen per os.

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Preparation and Measures for Elderly with Dementia in Korea : Focus on National Strategies and Action Plan against Dementia (한국의 치매에 대한 대응과 대책 : 국가 전략과 활동계획)

  • Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.44 no.1
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    • pp.11-27
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    • 2019
  • Dementia is major epidemic disease of the 21st century in the world. Dementia is one of the major issues in public health globally. Also in Korea, the estimated prevalence of dementia was 8.7%(0.47 million) in 2010, the number will reach the 1 million mark in 2024, it will become a 15.1%(2.71 million) by 2050. Among Koreans aged 65 or older, 725,000 are estimated to be suffering from dementia in 2017. Against dementia, Korea developed three National Dementia Plans in 2008, 2012, and 2016. The 1st plan was came into effect in 2008 and focused on prevention, early diagnostic, development and coordination of infrastructures and management, and improving awareness. The 2nd plan was launched in 2012, addressed the same priorities but had a stronger focus on supporting family members. In 2012 the Dementia Management Act established a statutory basis for organization of the National Dementia Plans. Under the Dementia Management Act, the government is required to produce a comprehensive plan for dementia every 5 years. The Act also orders that the government should register the dementia patients and collect statistics on epidemiology and the management of the dementia conditions. The Dementia Management Act of Korea required the operation of the National Institute of Dementia and Metropolitan/Provincial Dementia Centers to make and carry out dementia management plans throughout the nation. The Act also mandate to establish Dementia Counselling Centers in every public health center and the National Dementia Helpline. The 3rd National Dementia Plan of 2016 aims to build a dementia friendly community to ensure people with dementia and their carer live well. This plan focus on community-based prevention and management of dementia, convenient and safe diagnosis, treatment, and care for people with dementia, the reduction of the care burden for family care-givers of people with dementia, and support for dementia research through research, statistics and technology. In 2017, Moon's government will introduce the "National Dementia Responsibility System," which guarantees most of the burden caused by dementia. This plan include that the introduction of a ceiling on self-pay for dementia diseases, expansion of the application of dementia care standards through alleviating the support criteria for long-term care insurance for mild dementia, expansion of dementia support centers, expansion of national and public dementia care facilities. In the meantime, Korea has accomplished many accomplishments by establishing many measures related to dementia and promoting related projects in a short time, but there are still many challenges.

The Trend of Cigarette Design and Tobacco Flavor System Development

  • Wu, Jimmy Z.
    • Journal of the Korean Society of Tobacco Science
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    • v.24 no.1
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    • pp.67-73
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    • 2002
  • In light of addressing consumer health concern, coping with anti-tobacco movement, and promoting new product, tobacco industry is actively pursuing to make a new generation of cigarettes with low tar and nicotine deliveries, and less harmful substances. Low tar and low nicotine cigarettes increases their market shares dramatically world wide, especially in KT&G, multinational tobacco companies, EU countries, even in China regulated by CNTC to set up yearly target to lower tar and nicotine deliveries. On the other hand, to design a new cigarette with reduced harmful substances begins to gain speed. The "modified Hoffmann list" publishes thirty plus substances in tobacco leaf and main smoke stream, which is the prime suspect causing health problems. Various ways and means are developed to reduce such components including new tobacco breeds, new curing method, tobacco leaf treatment before processing, selected filtration system, innovated casing system to reduce free radicals, as well as some non conventional cigarette products. In TSRC held this year, the main topic is related to reduce tobacco specific nitrosamines in tobacco leaf. The new generation of cigarette is in the horizon. It still needs a lot help to produce commercial products with satisfied taste and aroma characters. The flavor industry is not regulated by many governments demanding which ingredients might or might not be for tobacco use. However, most of the cigarette companies self impose a list of ingredients to guide flavor suppliers to design flavors. Unfortunately, the number of ingredients in those lists is getting shorter every year. It is understandable that the health is not the only reason. Some cigarette companies are playing safe to protect the company from potential lawsuit, while others are just copying from their competitors. Moreover, it is obvious that it needs more assistance from casings and flavors to design new generation of cigarettes with missing certain flavor components in tobacco leaf and main smoke stream. These flavor components are either non-existed or at lower level at new form of cured tobacco leaf or filtered in the main smoke stream along with reduced harmful substances. The use of carbon filters and other selected filtration system poses another tough task for flavor system design. Specific flavor components are missing from the smoke analysis data, which brings a notion of "carbon taste" and "dryness" of mouth feel. It is ever more demanded by cigarette industry to flavor suppliers to produce flavors as body enhancer, tobacco notes, salivating agents, harshness reducer, and various of aromatic notes provided they are safe to use. Another trend is that water based flavor or flavor with reduced ethanol as solvent is gaining popularity. It is preferred by some cigarette companies that the flavor is compounded with all natural ingredients or all ingredients should he GMO free. The new generation of cigarettes demands many ways of new thinking process. It is also vital for tobacco industry. It reflects the real needs for the consumers that the cigarette product should be safe to use as well as bearing the taste and aroma characters smokers always enjoyed. An effective tobacco flavor system is definitely a part of the equation. The global trend of tobacco industry is like trends of any other industries lead by consumer needs, benefited with new technology availability, affected by the global economy, and subjected for various rules and regulations. Anti-tobacco organizations and media exceptionally scrutinize cigarette, as a legal commercial product. Cigarette is probably the most studied commercial product for its composition, structure, deliveries, effects, as well as its new developmental trend. Therefore, any new trend of cigarette development would be within these boundaries. This paper is trying to point out what it would be like for tobacco industry in the next few yews and what concerns the tobacco industry. It focuses mostly on the efforts to produce safer cigarettes. It is such a vital task for the tobacco industry and its affiliate industries such as cigarette papers, filters, flavors, and other materials. The facts and knowledge presented in this paper might be well known for the public. Some of the comments and predictions are very much personal opinion for a further discussion.

Association between seafood intake and depression in Korean adults: analysis of data from the 2014-2020 Korea National Health and Nutrition Examination Survey (한국 성인의 수산물 섭취와 우울증과의 상관성 연구: 2014-2020년도 국민건강영양조사 자료를 이용하여)

  • Hyemin Shin;Won Jang;Yangha Kim
    • Journal of Nutrition and Health
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    • v.56 no.6
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    • pp.702-713
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    • 2023
  • Purpose: Depression is a prevalent mental health concern globally including South Korea. Given the growing interest in the relationship between diet and mental health, this study aimed to investigate the association between seafood consumption and depression among Korean adults. Methods: A cross-sectional analysis was conducted using data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2014-2020). The study included 18,149 participants (7,541 men and 10,608 women) aged 19 years and older who completed the Patient Health Questionnaire (PHQ-9). Seafood intake levels were assessed using a oneday 24-hour dietary recall, and participants were categorized into three tertiles by gender. Depression status was determined using the PHQ-9 scores and the self-report of the doctor's diagnosis and treatment. Multivariable logistic regression analysis was performed to assess the association between seafood consumption and depression in both genders. Results: Participants with a higher seafood intake had a significantly lower nutritional density of total fat, while the nutritional density of omega-3 polyunsaturated fatty acids was significantly higher. The prevalence of depression was significantly lower in the highest tertile of seafood consumption compared to the lowest tertile in both men (p < 0.001) and women (p < 0.001). After adjusting for confounding factors, the highest tertile of seafood consumption demonstrated a decreased risk of depression compared to the lowest tertile in men (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.51-0.99; p-trend = 0.020) and women (OR, 0.73; 95% CI, 0.59-0.91; p-trend = 0.004). Conclusion: The findings of this study suggest that consuming seafood rich in omega-3 fatty acids may potentially reduce the risk of depression in the adult population.

A Study on the Job Performance of Dental Coordinators and Their Perception (치과코디네이터의 업무수행 및 인식도에 관한 조사연구)

  • Kwon, Soon-Bok;Kim, Young-Nam;Moon, Hee-Jung;Shin, Myung-Suk;Han, Gyeong-Soon;Han, Su-Jin
    • Journal of dental hygiene science
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    • v.5 no.4
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    • pp.211-220
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    • 2005
  • The purpose of this study was to examine the job performance of dental coordinators and their perception of their job to lay the groundwork for utilizing dental personnels more efficiently. The subjects in this study were dental coordinators who worked at selected dental hospitals and clinics in Seoul, Gyeonggi province and Incheon. A survey was conducted to gather data from May 1 to August 8, 2005 and answer sheets from 108 respondents were analyzed. The findings of the study were as follows: 1. As for the length of service, 43.5 percent of the dental coordinators investigated had worked at dental institutes for five years or more, which was followed by less than two years(19.5%) and three years to less than five years(19.4%). Concerning the length of service as dental coordinators, 39.8 percent had served for less than two years, and 19.4 percent had worked for two years to less than three years and for five years or more respectively. Regarding the name of position, 38 percent were called team leaders, and 30.6 percent were called coordinators. As to duties, the largest group of them that stood at 30.6 percent were in charge of receiving, and in regard to department, the largest group, 57.4 percent, belonged to the treatment backup department. 2. Concerning education, the greatest number of them, 45.4 percent, had received education at private institutes, and 73.1 percent found it necessary for dental coordinators to take an authorized qualification test. 43.5 percent, the largest group, looked upon the central government as the best organization to authorize their qualifications and 70.8 percent believed that what they learned enabled them to perform their job successfully. As to the necessity of follow-up education as a means to improve job performance, 96.3 percent consented to it. As for the reason, 63.9 percent considered that necessary to enhance their own ability and 22.2 percent were in want of systematic education. Regarding educational expenses, 29.6 percent were subsidized by the dental institutes where they had worked and 25.9 percent had totally been responsible for that. Regarding a required course, medical service and marketing was most widely pointed out(66.7%), followed by theory and practice(65.7%) and introduction to dentistry(57.4%). As to what sort of education they wanted to receive more, dental service and marketing was selected the most, followed by practical health insurance(35.2%). 3. In regard to what type of job they performed as dental coordinators, 88.9 percent were in charge of appointment in the field of customer service, and 87.9 percent paid attention to having good manners as service providers in the area of self-management. In the field of hospital affairs, 81.3 percent were in charge of receiving. 4. As to their awareness of dental coordinator job, the largest group took pride in the job they performed ($3.99{\pm}0.76$), and the second largest group believed that dental coordinators made a great contribution to hospital management ($3.92{\pm}0.70$). The third largest group gave a great weight to their own job ($3.91{\pm}0.84$) in light of overall dental duties and the fourth largest group found themselves to get along with other employees regardless of position ($3.86{\pm}0.74$). The fifth largest group believed their job was of great use for promoting the oral health of patients ($3.76{\pm}0.75$), and the sixth largest group thought the future of dental coordinators was promising($3.74{\pm}0.86$). 5. In regard to their perception by age group, those who were older had a better opinion on every item of their job in general. Their age made a statistically significant difference to their view of the weight of dental coordinator job(P < 0.001) in light of overall dental duties, of being approved and trusted by managers(P < 0.01), of social awareness of dental coordinator, and of being understood and approved by other employees and dentists. Their pride in current job and their satisfaction with the name of their position were statistically significantly different according to their age as well. Besides, their age made a statistically significant difference to their opinion about whether or not there was an age limit to their occupation and about their contribution to hospital management (P < 0.05). 6. As for their perception by type of job, the dental hygienists were generally most satisfied with their job, followed by nursing aids and others. There was a statistically significant gap among their opinions about whether to make a job-related decision on their own(P < 0.001). the weight of their job in terms of overall dental duties, whether their job improved their ability, whether their job made a great contribution to enhancing the oral health of patients, whether their job was understood and approved by other employees(P < 0.01), social awareness of their job, whether they conflicted with other employees during job performance, and whether dental hospitals or clinics offered a self-development opportunity for them to take their ability to another level(P < 0.05). And their satisfaction with current pay was statistically significantly different as well.

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The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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