• Title/Summary/Keyword: US health system

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The United States CHES Program: The Role and Development of the Modern Health Educator (미국의 CHES 프로그램: 현대 보건교육사의 역할과 제도의 발전)

  • Sohn, Ae-Ree;Burzo, Jamie
    • Korean Journal of Health Education and Promotion
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    • v.27 no.5
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    • pp.63-71
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    • 2010
  • Objectives: The field of health education is still relatively new and is therefore evolving and developing rapidly throughout the world. Many countries' certification programs are still being created. This paper will discuss on the US CHES system of regulation, accreditation, and implementation for the future development of international health education programs. Methods: This article focuses on the United States CHES credentialing program, specifically on its historical development and the roles, employment settings and socioeconomic demographics of current CHES professionals through literature review. Results: The roles and skills required vary by employment setting, with seven universally recognized responsibilities of health educators. There are also 35 key competencies which are crucial to the role of the health educator, with 163 sub-competencies performed by all health educators. The employment of health educators will increase from 62,000 in 2006 to 78,000 in 2016. As the costs of healthcare increase, employers are projected to hire more health educators to decrease healthcare costs through prevention and early detection of chronic illnesses. Community health non-profit agencies, academia, healthcare (hospital/clinic), schools, government/government contracting, and businesses are some of the most widespread employment settings for health educators in the United States. Conclusion: Better understanding of this longstanding and successful program will benefit countries developing their own certification system. The variety and specificity of the information on the US CHES program may be of value as South Korea continues to develop its Korean CHES program.

Gateway RFP-Fusion Vectors for High Throughput Functional Analysis of Genes

  • Park, Jae-Yong;Hwang, Eun Mi;Park, Nammi;Kim, Eunju;Kim, Dong-Gyu;Kang, Dawon;Han, Jaehee;Choi, Wan Sung;Ryu, Pan-Dong;Hong, Seong-Geun
    • Molecules and Cells
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    • v.23 no.3
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    • pp.357-362
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    • 2007
  • There is an increasing demand for high throughput (HTP) methods for gene analysis on a genome-wide scale. However, the current repertoire of HTP detection methodologies allows only a limited range of cellular phenotypes to be studied. We have constructed two HTP-optimized expression vectors generated from the red fluorescent reporter protein (RFP) gene. These vectors produce RFP-tagged target proteins in a multiple expression system using gateway cloning technology (GCT). The RFP tag was fused with the cloned genes, thereby allowing us localize the expressed proteins in mammalian cells. The effectiveness of the vectors was evaluated using an HTP-screening system. Sixty representative human C2 domains were tagged with RFP and overexpressed in HiB5 neuronal progenitor cells, and we studied in detail two C2 domains that promoted the neuronal differentiation of HiB5 cells. Our results show that the two vectors developed in this study are useful for functional gene analysis using an HTP-screening system on a genome-wide scale.

Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh

  • Mahumud, Rashidul Alam;Sarker, Abdur Razzaque;Sultana, Marufa;Islam, Ziaul;Khan, Jahangir;Morton, Alec
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.2
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    • pp.91-99
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    • 2017
  • Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

Reviewing the Operation of the Navy Safety Management System and Its Direction (해군 안전관리체계 운영에 대한 검토 및 발전 방향 고찰)

  • Jeongwoo Han;Kijae Kim;Wonyoung Lee;Kyoshik Park
    • Journal of the Society of Disaster Information
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    • v.19 no.4
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    • pp.859-868
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    • 2023
  • Purpose: In order to enhance safety, the Korea Navy is making efforts to introduce a safety and health management system and to develop a risk assessment system, while safety accidents keeps occurring. A development plan was proposed through an inspection of the Safety Management System(SMS). Method: To diagnose the Korea Navy's safety management system, changes in the safety environment, documentation system, and safety and health management system operation were reviewed, points to be improved were found, and improvement directions were derived. Result: There is a need for an SMS standard that can present the Korea Navy's safety policy and safety management direction, and a safety program that provides guidelines for implementing it in a standardized manner. To this end, we were able to confirm the feasibility of linking the requirements of the US Navy's SMS and the international standard ISO 45001 standard together with the Korea Navy's safety management system. Conclusion: The Korea Navy's safety management system needs to clearly present safety policies and standards, and have public confidence and effectiveness in safety work through a standard program that can implement them, and for this, the development of a Navy SMS is necessary.

Usefulness of $^{99m}Tc$-labeled RBC Scan and SPECT in the Diagnosis of Head and Neck Hemangiomas (두경부 혈관종 진단시 $^{99m}Tc$-RBC Scan and SPECT 검사의 유용성)

  • Oh, Shin-Hyun;Roh, Dong-Wook;Ahn, Sha-Ron;Park, Hoon-Hee;Lee, Seung-Jae;Kang, Chun-Goo;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.39-43
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    • 2008
  • Purpose: There are various methods to diagnose hemangioma, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine. However, by development of SPECT imaging, the blood-pool scan using $^{99m}Tc$-labeled red blood cell has been used, because it was non-invasive and the most economical method. Therefore, in this study, we proposed that the usefulness of $^{99m}Tc$-RBC scan and SPECT of the head and neck to diagnose unlocated hemangiomas. Materials and Methods: $^{99m}Tc$-RBC scan and SPECT was performed on 6 patients with doubtful hemangioma (4 person, head; 1 person, neck; 1 person, another). We labeled radiopharmaceutical using modified in vivo method and then, centrifuged it to remove plasma. After a bolus injection of tracer, dynamic perfusion flow images were acquired. Then, anterior, posterior, both lateral static blood-pool images were obtained as early and 4 hours delayed. SPECT was progressed 64 projections per 30 seconds. Each image was interpreted by physicians, Nuclear medicine specialist, and technologist blinded to patient's data. Results: In 5 patients of all the radioactivity of doubtful site didn't change in flow images, but, in blood-pool, delayed and SPECT images, it was increased. So, it was a typical hemangioma finding. The size of lesion was over 2 cm, and it could discriminate as comparing to the delayed and SPECT imaging. On the other hand, in 1 patient, the radioactivity was increased in blood-pool images, but, not in delayed and SPECT images, so, it was proved no hemangioma. Conclusion: Using $^{99m}Tc$-RBC Scan and SPECT, we could diagnose the hemangiomas in head and neck, as well as, liver, more non-invasive, economical, and easy. Therefore, it considered that $^{99m}Tc$-RBC scan and SPECT would offer more useful information for diagnosis of hemangioma, rather than otherimaging such as US, CT, MRI.

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Socioeconomic Disparities in Breast Cancer Screening among US Women: Trends from 2000 to 2005

  • Kim, Jae-Young;Jang, Soong-Nang
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.3
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    • pp.186-194
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    • 2008
  • Objectives : This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. Methods : Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. Results : Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. Conclusions : These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. Continued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.

Comprehensive Review of Standard Occupational Classification (SOC) as used in the Occupational Safety and Health Field (산업안전보건분야에서 표준직업분류(Standard Occupational Classification, SOC) 활용 사례 고찰 및 향후 국내 도입 방안 제언)

  • Park, Donguk;Choi, Sangjun;Byun, Hyaejeong;Kim, Yangho;Kim, Soogeon;Ha, Kwonchul;Kang, Taesun
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.23 no.1
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    • pp.11-19
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    • 2013
  • Backgrounds: Occupations are grouped on the basis of similarity in tasks and duties performed. Standard occupational classification (SOC) is a tool for organizing all professions into a clearly defined set of groups according to the tasks and duties undertaken in the respective jobs. Objectives: The major objective of this study is to comprehensively review how a SOC system is used in occupational and safety fields such as surveillance, exposure monitoring, occupational epidemiological study, management of carcinogens and analysis of occupational accidents. Methods: We summarized the cases, policies and regulations used in SOC systems in advanced countries and as they appear in articles Results: We found that SOC systems have been widely used in various areas of occupational safety and health in the US, the UK, Finland, and the EU. In general, it is highly common to use SOC in the analysis of occupational accidents and diseases and to identify factors causing those accidents. The SOC system is also used not only for surveillance of exposure to hazardous agents and occupational health, but to manage carcinogens. In order to adjust the effects of a particular job, SOC is used in the general population health area. The Ministry of Employment and Labor (MOEL) has never used or introduced an SOC system. There have been no cases of the application of a SOC system to either the occupational safety and health field or to health surveillance for the general population in Korea. Conclusions: We suggested a need to introduce an SOC system in several occupational safety and health activities, such as work environment measurement, analysis of occupational accidents, specific physical examination and surveillance systems, etc.

The Legal Consideration in Emergency Medical Service System (의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로-)

  • Kang, Byung Woo
    • The Korean Journal of Emergency Medical Services
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    • v.3 no.1
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    • pp.91-101
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    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

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Sensor enriched infrastructure system

  • Wang, Ming L.;Yim, Jinsuk
    • Smart Structures and Systems
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    • v.6 no.3
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    • pp.309-333
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    • 2010
  • Civil infrastructure, in both its construction and maintenance, represents the largest societal investment in this country, outside of the health care industry. Despite being the lifeline of US commerce, civil infrastructure has scarcely benefited from the latest sensor technological advances. Our future should focus on harnessing these technologies to enhance the robustness, longevity and economic viability of this vast, societal investment, in light of inherent uncertainties and their exposure to service and even extreme loadings. One of the principal means of insuring the robustness and longevity of infrastructure is to strategically deploy smart sensors in them. Therefore, the objective is to develop novel, durable, smart sensors that are especially applicable to major infrastructure and the facilities to validate their reliability and long-term functionality. In some cases, this implies the development of new sensing elements themselves, while in other cases involves innovative packaging and use of existing sensor technologies. In either case, a parallel focus will be the integration and networking of these smart sensing elements for reliable data acquisition, transmission, and fusion, within a decision-making framework targeting efficient management and maintenance of infrastructure systems. In this paper, prudent and viable sensor and health monitoring technologies have been developed and used in several large structural systems. Discussion will also include several practical bridge health monitoring applications including their design, construction, and operation of the systems.

Economic Evaluation and Budget Impact Analysis of the Surveillance Program for Hepatocellular Carcinoma in Thai Chronic Hepatitis B Patients

  • Sangmala, Pannapa;Chaikledkaew, Usa;Tanwandee, Tawesak;Pongchareonsuk, Petcharat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8993-9004
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    • 2014
  • Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.