• Title/Summary/Keyword: cost of illness

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CHANGES IN WATER USE AND MANAGEMENT OVER TIME AND SIGNIFICANCE FOR AUSTRALIA AND SOUTH-EAST ASIA

  • Knight, Michael J.
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 1997.11a
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    • pp.3-31
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    • 1997
  • Water has always played a significant role in the lives of people. In urbanised Rome, with its million people. sophisticated supply systems developed and then fled with the empire. only to be rediscovered later But it was the industrial Revolution commencing in the eighteenth century that ushered in major paradigm shifts In use and altitudes towards water. Rapid and concentrated urbanisation brought problems of expanded demands for drinking supplies, waste management and disease. The strategy of using water from local streams, springs and village wells collapsed under the onslaughts of rising urban demands and pollution due to poor waste disposal practices. Expanding travel (railways. and steamships) aided the spread of disease. In England. public health crises peaks, related to water-borne typhoid and the three major cholera outbreaks occurred in the late eighteenth and early nineteenth century respectively. Technological, engineering and institutional responses were successful in solving the public health problem. it is generally accepted that the putting of water into pipe networks both for a clean drinking supply, as well as using it as a transport medium for removal of human and other wastes, played a significant role in towering death rates due to waterborne diseases such as cholera and typhoid towards the end of the nineteenth century. Today, similar principles apply. A recent World Bank report Indicates that there can be upto 76% reduction in illness when major water and sanitation improvements occur in developing countries. Water management, technology and thinking in Australia were relatively stable in the twentieth century up to the mid to late 1970s. Groundwater sources were investigated and developed for towns and agriculture. Dams were built, and pipe networks extended both for supply and waste water management. The management paradigms in Australia were essentially extensions of European strategies with the minor adaptions due to climate and hydrogeology. During the 1970s and 1980s in Australia, it was realised increasingly that a knowledge of groundwater and hydrogeological processes were critical to pollution prevention, the development of sound waste management and the problems of salinity. Many millions of dollars have been both saved and generated as a consequence. This is especially in relation to domestic waste management and the disposal of aluminium refinery waste in New South Wales. Major institutional changes in public sector water management are occurring in Australia. Upheveals and change have now reached ail states in Australia with various approaches being followed. Market thinking, corporatisation, privatisation, internationalisation, downsizing and environmental pressures are all playing their role in this paradigm shift. One casualty of this turmoil is the progressive erosion of the public sector skillbase and this may become a serious issue should a public health crisis occur such as a water borne disease. Such crises have arisen over recent times. A complete rethink of the urban water cycle is going on right now in Australia both at the State and Federal level. We are on the threshold of significant change in how we use and manage water, both as a supply and a waste transporter in Urban environments especially. Substantial replacement of the pipe system will be needed in 25 to 30 years time and this will cost billions of dollars. The competition for water between imgation needs and environmental requirements in Australia and overseas will continue to be an issue in rural areas. This will be especially heightened by the rising demand for irrigation produced food as the world's population grows. Rapid urbanisation and industrialisation in the emerging S.E Asian countries are currently producing considerable demands for water management skills and Infrastructure development. This trend e expected to grow. There are also severe water shortages in the Middle East to such an extent that wars may be fought over water issues. Environmental public health crises and shortages will help drive the trends.

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An Analysis of the National Suicide Rate in Korea during 2005 (2005년 전국 자살실태 분석)

  • Kim, Gi-Jeong;Kwak, Jyung-Sik
    • Journal of forensic and investigative science
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    • v.2 no.1
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    • pp.5-22
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    • 2007
  • From the numerous social problems generated by the unbalanced social development and the social trend of belittling life overall, we found the causes of suicide getting worse in its seriousness day by day. In reality, the problem has been approached in a collateral level in contrast with other social problems. There have been an active involvement in studying the definition, causes and ways of prevention of suicide theoretically until now. However, different from other social problems, it is almost impossible to treat or fix the problem of suicide. Only ways to treat or fix the problem is when the suicide has ended in failure. Thus, this study intends to examine the suicide rate among the total accidents during the year 2005, perform the analyses on the actual causes according to the relations such as the means of suicide, occupation, age group, educational background, etc. In order to present a solution to the issue of suicide becoming serious each day. Among the total accidents in 2005, the suicide rate came out to be approximately 52.4%. Among the result, 52.4%, male with 69% resulted higher than female with 31%, which appears to be related to the social functions. While men tends to take more active(80%) means of suicide like jumping off, poison, hanging, etc., women tends to take more passive(60%) means of suicide like sleeping pills, slitting wrist, etc. In terms of the cause, pessimism, illness, denial, mental disorder, etc resulted more than 75%, and there were many cases of suicide after exhibiting the signs of depression. Also there were higher suicide rate of the unemployed engaged in direct labor with educational background lower than college level related to the pessimism regarding the family living cost. We were able to determine the recent increase in the suicidal tendency of the educated people higher than the college level and the retired people with depression caused by the sudden change in social status. Overall there are several reasons for suicide, however, in most cases the signs of depression were exhibited until the final suicide, which tells us the serious psychological problem of suicide. Assuming that the current development of suicide will continue in future, the result of this study will guide the corresponding social policies, be utilized in preparing the insurance or management at the national level dealing with the real social problems that are not just a conflict of an individual, but could spread like a fad and become much bigger than the present by the continuous support at the environmental, social and political levels, and be utilized as the basic data to establish the research plan.

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Factors Associated with Care Burden among Family Caregivers of Terminally Ill Cancer Patients (말기암환자 가족 간병인의 간병 부담과 관련된 요인)

  • Lee, Jee Hye;Park, Hyun Kyung;Hwang, In Cheol;Kim, Hyo Min;Koh, Su-Jin;Kim, Young Sung;Lee, Yong Joo;Choi, Youn Seon;Hwang, Sun Wook;Ahn, Hong Yup
    • Journal of Hospice and Palliative Care
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    • v.19 no.1
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    • pp.61-69
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    • 2016
  • Purpose: It is important to alleviate care burden for terminal cancer patients and their families. This study investigated the factors associated with care burden among family caregivers (FCs) of terminally ill cancer patients. Methods: We analyzed data from 289 FCs of terminal cancer patients who were admitted to palliative care units of seven medical centers in Korea. Care burden was assessed using the Korean version of Caregiver Reaction Assessment (CRA) scale which comprises five domains. A multivariate logistic regression model with stepwise variable selection was used to identify factors associated with care burden. Results: Diverse associating factors were identified in each CRA domain. Emotional factors had broad influence on care burden. FCs with emotional distress were more likely to experience changes to their daily routine (adjusted odds ratio (aOR), 2.54; 95% confidence interval (CI), 1.29~5.02), lack of family support (aOR, 2.27; 95% CI, 1.04~4.97) and health issues (aOR, 5.44; 2.50~11.88). Family functionality clearly reflected a lack of support, and severe family dysfunction was linked to financial issues as well. FCs without religion or comorbid conditions felt more burdened. The caregiving duration and daily caregiving hours significantly predicted FCs' lifestyle changes and physical burden. FCs who were employed, had weak social support or could not visit frequently, had a low self-esteem. Conclusion: This study indicates that it is helpful to understand FCs' emotional status and family functions to assess their care burden. Thus, efforts are needed to lessen their financial burden through social support systems.

The Utilization Pattern of a Rural Health Subcenter among Suburban Farmhouse Members (일 도시근교 농가구원의 보건지소 이용양상)

  • Sohn, Seok-Joon;Kwon, Sun-Seok;Kim, Sang-Won;Byun, Ju-Nam;Nam, Hae-Sung;Son, Myung-Ho
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.65-77
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    • 1999
  • In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the farmhouse members in a suburban area, a questionnaire survey was carried out for objects of 696 population. The results observed were as follows: The annual utilization rate of rural health subcenter for a basic health service unit was 25.0 per 100 persons, and annual mean visiting times was 0.22 times. And the most frequent disease by annual health subcenter utilization illness was musculoskeletal disease(30.6%), and the next was respiratory disease(14.1%), gastrointestinal disease(13.9%) by order. Favorite reason for community health subcenter utilization were near distance from living place(49.6%), lower disease severity(18.9%) and lower medical cost(18.1%) by order. But disfavoring reasons for it were absence of specialist(20.2%), non effective treatment(19.2%) and insufficient equipment(14.7%) by order. And insufficient items about community health subcenter utilization were restriction of treatment limit(40.7%), lower reliance(22.5%) and difficulty in traffic(13.4%) by order. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization was educational level. The desirable works for the health subcenter in a suburban area were disease control of elderly and disease preventing service. These results suggested that to increase the utilization of rural health subcenter in a suburban area and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, improvement of medical quality and change of priority about health subcenter's works.

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The Change of Health Service before and after the Unification of two Health Subcenters in a Rural Area (한 농촌지역 2개면 보건지소 통합전후 보건의료사업 변화 연구)

  • Sul, Sue-Jeong;Park, Hyang;Sohn, Seok-Joon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.427-440
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    • 2000
  • A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

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