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Self-perception of the Amount of Medical Aid Use of Outpatient Overusers in Korea (의료급여 외래 과다이용자의 의료이용량에 대한 자기인식)

  • Shin, Sun-Mi;Kim, Eui-Sook;Lee, Hee-Woo
    • Health Policy and Management
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    • v.19 no.2
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    • pp.21-35
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    • 2009
  • Limited studies examined Medical Aid recipients' perception for amount of medical use. This study aimed to identify self-perception(optimal, under and overutilization) for amount, and real amount of medical use, and to determine factors associated with the perception. Subjects were 2,489 Medical Aid recipients among top 2% overusers in 2005. 200 case managers(CM) managing them conducted survey. CM interviewed them using 2005 medical claiming data from the Health Insurance Review & Assessment Service and structured questionnaire. Despite of overusers, perception of overutilization was only 26.9% and 23.6% in Class I and Class II, and that of underutilization was 21.4% and 18.7% respectively. In Class I, monthly total outpatient cost per capita of overutilization perception in 2006 was 206 thousand won higher than 150 thousand won of optimal utilization. Amounts of outpatient visit-days and prescribed cases of overutilization perception were higher than those of optimal and underutilization(p <0.0001). In Class II, overutilization perception had more prescribed cases(p 0.004). After adjustment of confounding factors including age and sex, the associated factors(odds ratio) with overutilization perception were hypertension(1.25), arthritis(1.32), depression(1.66), visit of multi medical institutions(3.09), and those of the underutilization were female(1.34), disabled(1.27), no family support(1.49), living in medium and small city(1.48), experience of unabled-visit to medical institution(2.54), frequent visit-recommendation from physician (1.36). In conclusion, education and consult are needed for subjects to improve the reasonable decision of medical use, and the self-care ability to manage diseases and symptoms. We suggest reinforcing the alternative service in community instead of costly medical institution.

Comparative volumetric and clinical evaluation of peri-implant sulcular fluid and gingival crevicular fluid

  • Bhardwaj, Smiti;Prabhuji, Munivenkatappa Lakshmaiah Venkatesh
    • Journal of Periodontal and Implant Science
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    • v.43 no.5
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    • pp.233-242
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    • 2013
  • Purpose: Peri-implant sulcular fluid (PISF) has a production mechanism similar to gingival crevicular fluid (GCF). However, limited research has been performed comparing their behavior in response to inflammation. Hence, the aim of the present study was to comparatively evaluate PISF and GCF volume with varying degrees of clinical inflammatory parameters. Methods: Screening of patients was conducted. Based on the perimucosal inflammatory status, 39 loaded implant sites were selected from 24 patients, with equal numbers of sites in healthy, peri-implant mucositis, and peri-implantitis subgroups. GCF collection was done from age- and sex-matched dentate patients, selected with gingival inflammatory status corresponding to the implant sites. Assessment of the inflammatory status for dental/implant sites was performed using probing depth (PD), plaque index/modified plaque index (PI/mPI), gingival index/simplified gingival index (GI/sGI), and modified sulcular bleeding index (BI). Sample collection was done using standardized absorbent paper strips with volumetric evaluation performed via an electronic volume quantification device. Results: Positive correlation of the PISF and GCF volume was seen with increasing PD and clinical inflammatory parameters. A higher correlation of GCF with PD (0.843) was found when compared to PISF (0.771). PISF expressed a higher covariation with increasing grades of sGI (0.885), BI (0.841), and mPI (0.734), while GCF established a moderately positive correlation with GI (0.694), BI (0.696), and PI (0.729). Conclusions: Within the limitations of this study, except for minor fluctuations, GCF and PISF volumes demonstrated a similar nature and volumetric pattern through increasing grades of inflammation, with PISF showing better correlation with the clinical parameters.

A rare duodichogamous flowering system in monoecious Toona sinensis (Meliaceae)

  • Lee, Hakbong;Kang, Hyesoon;Park, Wan-Geun
    • Journal of Ecology and Environment
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    • v.42 no.2
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    • pp.50-59
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    • 2018
  • Background: Duodichogamy is the rarest form of dichogamy in angiosperms, which is characterized by flowering in the sequence of male${\rightarrow}$female${\rightarrow}$male. Disentangling factors promoting duodichogamy require the discovery of more duodichogamous species in angiosperms. However, extremely limited information on duodichogamous species makes it difficult to make general conclusions. Given the inflorescence morphology and flowering characteristics, the Meliaceae family is highly likely to contain duodichogamous species. Methods: We selected 48 individuals from 20 populations in Korea and investigated their flower morphology, arrangement of flowers by sexual condition within inflorescences, and flowering phases and duration of male and female flowers of Toona sinensis (Meliaceae) for 5 years (2011-2015) to determine if the species shows duodichogamous flowering. Results: Toona sinensis belonging to Meliaceae possessed functionally unisexual flowers with rudimentary parts of the opposite sex. The floral organs in male were larger than those in female, except for ovary length and width. In dichasium, male flowers were observed on primary or lateral branches, whereas female flowers were borne only on lateral branches. Overall, individuals from six different populations flowered in the male${\rightarrow}$female${\rightarrow}$male sequence, thereby male is blooming far longer than female flowers at the level of individual trees (male vs. female = 17-20 days vs. 2-4 days). Conclusions: This is the first study to report a duodichogamously flowering species, T. sinensis, within Meliaceae. Several flowering characteristics observed from T. sinensis may be important clues used to discover additional duodichogamous Meliaceae species. Short flowering period and relatively small number of female flowers, which is analogous to reduced ovule numbers observed in other duodichogamous species, may intensify male-male competition in T. sinensis. This study contributed to narrowing down potential candidates of duodichogamy based on their geographic distributions and flowering time.

Clinico-Epidemiologic Patterns of Laryngeal Cancer: 5-year Results from a Regional Cancer Centre in Northeastern India

  • Nallathambi, Chandran;Yumkhaibam, Sobita Devi;Singh, Laishram Jaichand;Singh, Thaodem Tomcha;Singh, Indibor Yengkhom;Daniel, Nithinraj
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2439-2443
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    • 2016
  • Purpose: To determine the risk factors, clinical symptoms and patterns of spread in laryngeal cancer. Materials and Methods: A cross sectional study was carried out in the Regional Cancer Centre, Imphal, Manipur, India. One hundred and sixteen patients with laryngeal cancer were retrospectively reviewed for epidemiological data and descriptive statistics were reported for various variables. Results: Median age at presentation was 65 years and 32.8% were undernourished at presentation. The male to female ratio was 5.4:1. Heavy smoking and tobacco chewing was associated in 91.4% and 33.6% of patients respectively. Tracheostomy was required in 21.5% leading to diagnosis of laryngeal cancer. Almost all were squamous cell carcinoma with neuroendocrine and verrucous carcinoma accounting for less than 2%. Supraglottic, glottic and trans-glottic tumors were 56.9%, 36.3% and 6.9% respectively. Nodal metastases were seen in 81.8% of supraglottic cancers and 31.6% of glottic cancers with supraglottic involvement. Level II neck nodes were the commonest site followed by level III. Distant metastases (only liver) were apparent in 1.7% at presentation. Including these liver metastases, unresectable cases were limited to 6% of the patients. Conclusions: Tobacco use is implicated in almost all of the cases and the sex ratio has also decreased due to increased female smokers. The supraglottis remains the commonest site and incidence of nodal metastases is higher than in other countries. There is also a higher requirement for tracheostomy at presentation in this region.

Evolution of a Productive Bivoltine Hybrid of Silkworm Bombyx mori L.(SD7${\times}$SD12) with Shorter Larval Duration

  • Rao, P.Sudhakara;Basavaraja, H.K.;Kalpana, G.V.;Naik, V.Nishitha;Mahalingappa, K.C.;Pallavi, S.N.
    • International Journal of Industrial Entomology and Biomaterials
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    • v.8 no.1
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    • pp.27-32
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    • 2004
  • With an objective of evolving quantitatively and qualitatively superior bivolitine silkworm hybrid of Bombyxmori L. for tropics with shorter larval duration without compromising on productivity traits, a breeding programme was initiated at this institute during 1997 by utilizing breeding resource material from the institutes Germplasm collection. The breed SD7 is characterized with plain larvae spinning white oval cocoons and SD12 is characterized by sex-limited larval markings spinning white dumb-bell cocoons. After fixation, these breeds along with other newly evolved breeds were subjected for hybrid evaluation in the laboratory. Based on the hybrid studies, the hybrid SD7${\times}$SD12 was selected and evaluated for one year comprising three major sea- sons (6 trials) of tropics viz., Pre-monsoon (characterized by high temperature, low humidity and without any rain fall), Monsoon (characterized by moderate temperature, heavy rain fall with high humidity) and post-monsoon season (characterized by low temperature and low humidity with frequent rain fall) to know the fluctuations in the larval duration. The evaluation studies indicated that the hybrid is having shorter larval duration with productive merits. The hybrid SD7${\times}$SD12 recorded survival percent of 92.74, shell weight of 46.7 cg, shell ratio % of 24.0 and filament length of 1,200 meters with a shorter larval duration of 24 hrs; when compared to productive hybrid CSR2${\times}$CSR5(control). The breeding methodologies and hybrids usefulness for tropics were discussed.

Health Promoting Lifestyles of Korean Employees (근로자의 건강증진 생활양식 실천에 관한 연구)

  • Cho, Tong Ran;Park, Eun Ok
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.1
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    • pp.33-46
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    • 1998
  • Introduction : In Korea, national attention to the workplace health promotion programs (HPP) for employees began in early 1990s. Governmental supports for the HPP and education programs have given to the employees. The purpose of this study is to find the performance degree of employees' health promoting lifestyle(HPL). Subjects and Methods : For this study, 615 employees who attended governmental educations were selected as research samples. The tool for measuring HPL used in this study was developed for Korean by In-Sook Park in 1995. It is composed of 4-point scaled 60 items and divided into 11 subcategories. The data were collected by self reporting questionnaires from June to December in 1997. Those data were analyzed percentile, mean, standard deviation, ANOVA, t-test with SAS program. Major findings are as follows; 1. The total mean score of the employees' HPL performance was 2.66. The average scores of 'harmonious relationships' category were the highest as 3.11, whereas the one of 'professional health maintenance' were the lowest as 2.02. The remains were 'sanitary life'(2.90), 'emotional support(2.85), 'regular diet'(2.84), 'self achievement'(2.78), 'healthy diet'(2.56), 'rest and sleep'(2.56), 'exercise and activity'(2.54), 'diet control'(2.53), 'self-control'(2.52). 2. The factors affecting HLP were category of industries and sex, age, marital status, education level, major, educational experience of health promotion, among personal characteristics. The employees of service industries, female, older age, married, nurse, educated for health promotion, graduated from junior college performed HLP more than the others. 3. The participation rates of employees for HPP were 12.4%, because of limited time and facilities and equipments. Recommendations; 1. The regulation for performing the health promotion programs in the industries is essential for activating industrial health promoting movement. 2. More governmental supports for educations and services for health promotion programs in the industries are needed. 3. For behavioral changes of the employees, the contents of educations have to consist of exercise and activity, rest and sleep, diet and smoking habits. 4. The evaluating studies for ready made health promotion programs in the industries are expected.

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Extended Indications of Bilhaut-Cloquet Procedure for Type III and IV of Duplicated Thumb (무지 다지증 III, IV형의 치료에 Bilhaut-Cloquet 방법의 적극적 이용)

  • Lim, Young-Bin;Seul, Jung-Hyun;Nam, Hyun-Jae;Woo, Sang-Hyun
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.821-828
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    • 2011
  • Purpose: The authors applied Bilhaut-Cloquet procedure to Wassel type III and IV duplicated thumb, which was limited to patients with Wassel type I, II. This procedure was applied in order to improve the growth potential, range of joint motion, joint stability and cosmetic outcome. Methods: Sixteen patients received Bilhaut-Cloquet procedures to correct duplicated thumbs from May, 2005 to December, 2010. Seven patients were Wassel type III, nine patients were type IV. This procedure was applied not only to balanced type, but also unbalanced type or convergent type. Five patients were balanced type and eleven patients were unbalanced type. Convergent type of Wassel type IV was three. Sex ratio was the same, mean age at the operation was 20.1 months old (8~52 months old). Angular deformity, joint stability and range of joint motion and cosmetic outcome were considered together and estimated in Tada score. Also, postoperative subjective satisfaction score of the parents was evaluated by a 100-points scale. Results: Mean subjective satisfaction scored 75 points at 28 months after the operation. Radiologic study showed bony union of proximal phalangeal bone and stable joint in all patients. Range of motion was mean 20 degrees in interphalangeal joint and mean 73 degrees in metacarpophalangeal joint. Tada score showed 'good' in eleven patients (68.8%), 'fair' in three patients (18.7%) and 'poor' in two patients (12.5%). In seven patients those who were able to follow up for a long term showed no significant difference in length of proximal and distal phalangeal bones compared to the opposite thumb. Conclusion: Bilhaut-Cloquet procedure can be applied not only to balanced type of Wassel type III, IV duplicated thumb, but also to unbalanced type or convergent type that focused on functional reconstruction and cosmetic improvement.

Organizational Effectiveness of Police Officers for the Maintenance of Public Order (사회질서 유지를 위한 경찰공무원의 조직효과성)

  • Jo, Ho-Dae;Cho, Min-Sang
    • The Journal of the Korea Contents Association
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    • v.11 no.12
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    • pp.764-773
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    • 2011
  • Modern police activity is achieved than individual achievement by police officers through member's interaction. It is police's goal which protect citizen's life and body, property and is public order maintenance and to achieve this, suitable police official's selection and public official upgrading the quality and capacity strengthening are important element. But, polices organization has characteristic that do activity by team, and therefore, mutual cooperation of police officers is important first of all for public order preservation. Therefore, this study limited as patrol police officers and investigated realization difference about organizational effectiveness for public order maintenance. Analysis result, realization of organizational effectiveness appeared difference according to sex, age, area, police departments, class, period.

Effects of Sexual Rehabilitation Using the PLISSIT Model on Quality of Sexual Life and Sexual Functioning in Post-Mastectomy Breast Cancer Survivors

  • Faghani, Safieh;Ghaffari, Fatemeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4845-4851
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    • 2016
  • Background and Objectives: As one of the most common treatments for breast cancer, mastectomy has adverse effects on the quality of sexual life and sexual functioning in the impacted women. Various strategies have therefore been proposed to resolve their sexual problems. The present study was conducted to determine the effect of sexual rehabilitation using the PLISSIT model in post-mastectomy breast cancer survivors. Materials and Methods: The present quasi-experimental study was conducted on a population of post-mastectomy breast cancer survivors and their husbands. Sample size was calculated as 50 each for intervention and non-intervention groups. The former received sexual counseling based on the PLISSIT model consisting of four levels of intervention: permission, limited information, specific suggestion and intensive therapy, presented in four 90-minute sessions. Data were collected using the Sexual Quality of Life-Female (SQOL-F) questionnaire and the Female Sexual Function Index (FSFI). Results: No significant differences were observed in the mean quality of sexual life scores between the intervention and control groups (P>0.05) before the intervention; however, a significant difference emerged between the groups after the intervention (P<0.01). Thus the mean score for sexual functioning in the intervention group was $26.3{\pm}3.76$ before and $30.0{\pm}4.38$ after the intervention (P<0.0001). In the control group, however, the difference between the pre- and post-intervention mean scores was not statistically significant (P=0.713). Conclusion: The present study showed that nurses can use the PLISSIT model in conjunction with chemotherapy and radiotherapy to teach coping and problem-solving skills to women with breast cancer and their husbands and to encourage their participation in group programs for expressing their feelings and attitudes about their current sex life and thus help enhance quality of sexual life and sexual functioning in this group.

Clinical predictors of chest radiographic abnormalities in young children hospitalized with bronchiolitis: a single center study

  • Kim, Ga Ram;Na, Min Sun;Baek, Kyung Suk;Lee, Seung Jin;Lee, Kyung Suk;Jung, Young Ho;Jee, Hye Mi;Kwon, Tae Hee;Han, Man Yong;Sheen, Youn Ho
    • Clinical and Experimental Pediatrics
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    • v.59 no.12
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    • pp.471-476
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    • 2016
  • Purpose: Chest radiography is often performed on patients hospitalized with typical clinical manifestations of bronchiolitis. We aimed to determine the proportion of subjects with pathologic chest radiographic findings and the clinical predictors associated with pathologic chest radiographic findings in young children admitted with the typical presentation of bronchiolitis. Methods: We obtained the following data at admission: sex, age, neonatal history, past history of hospitalization for respiratory illnesses, heart rate, respiratory rate, the presence of fever, total duration of fever, oxygen saturation, laboratory parameters (i.e., complete blood cell count, high-sensitivity C-reactive protein [hs-CRP], etc.), and chest radiography. Results: The study comprised 279 young children. Of these, 26 had a chest radiograph revealing opacity (n=24) or atelectasis (n=2). Multivariate logistic regression analysis showed that after adjustment for confounding factors, the clinical predictors associated with pathologic chest radiographic findings in young children admitted with bronchiolitis were elevated hs-CRP level (>0.3 mg/dL) and past history of hospitalization for respiratory illnesses (all P<0.05). Conclusion: The current study suggests that chest radiographs in young children with typical clinical manifestations of bronchiolitis have limited value. Nonetheless, young children with clinical factors such as high hs-CRP levels at admission or past history of hospitalization for respiratory illnesses may be more likely to have pathologic chest radiographic findings.