The authors, in this paper, addressed a variety of problems and difficulties which Korean psychiatrists should cope with. The surprising development of neurosciences, splitting of neuropsychiatry into neurology and psychiatry, easygoing attitude of psychiatrists, changes in the delivery system of health care and ill-balanced education of psychiatry were listed as causes of or contributors to them. Social bias to psychiatry and regulations from outside are also considered as contributors. Psychiatric education, including medical school, residency training, continuing medical education and psychiatric textbooks, need to be changed in order to enlarge the boundary of psychiatry. Reestablishment of identity of psychiatry and psychiatrist is unavoidable, considering far-reaching new knowledge of neuroscience and gradually invisible borderzone between neurology and psychiatry. The other ways worth while to consider are : the expansion of psychiatrists' activities, development of medical behavioral science to a clinical specialty, creation of new psychiatric subspecialties, and additional training of psychiatric residencies in the primary medical care.
Journal of Korea Entertainment Industry Association
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v.13
no.3
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pp.279-290
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2019
The purpose of this study is to analyze the relationship between the family relationship and the awareness of child abuse of parents with elementary and middle school children. This study also examines the mediating effect of parenting stress between the family relationship and awareness of child abuse. For this purpose, a questionnaire survey was conducted to school parents living in A metropolitan area and the 389 data were used for analysis. As a result of the analysis, their child abuse awareness showed that family relationship effected their awareness of child abuse positively and on parenting stress negatively. In addition, the partial mediating effect of parenting stress was proved between the family relationship and child abuse awareness. The results of this analysis signify that the family relationship is the important independent variable and parenting stress is the main mediating variable between the two variables. According to these analysis results, this study suggested that it is necessary to enhance family relations enhancement programs, child abuse prevention manual, and various parenting support services and strengthen the function of Health Family Support Center as a delivery system of family welfare services.
For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.
This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha County. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visiting and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located in myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. MCH workers and MPW I spend much time for manipulating main function. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinary area. MPW II distributes their time evenly in performing MCH program, T.B. Program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve the variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.
Kim, Jung-Hyun;Chae, Sang Yeup;Ko, Min-Jung;Jo, Min-Gi;Jang, Jun-Yeong;Kim, Jun Yeon;Kim, Ha-Na;Park, Kyeong Ju;Hwang, Ji-Min;Goo, Bonhyuk;Park, Yeon-Cheol;Baek, Yong-Hyeon;Nam, Sang-Soo;Seo, Byung-Kwan
The Journal of Korean Medicine
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v.42
no.3
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pp.1-8
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2021
Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.
Renewable energy (RE) is essential to comprise sustainable societies, especially, in rural villages of developing countries. Furthermore, application of off-grid RE systems to health care can improve the quality of life. In this research, a RE-based vaccination supply management system was constructed to enlarge the cold-chain in developing countries for the safe storage and delivery of vaccines. The system was comprised of the construction of RE plants and development of vaccine carriers. RE plants were constructed and connected to health posts in local villages. The cooling mechanism of vaccine carriers was improved and monitoring devices were installed. The effect of the system on vaccine cold-chain was evaluated from the field test and topographical analysis in the southern village of Nepal. RE plants were normally operated for the vaccine refrigerator in the health post. The modified vaccine carriers had a longer operation time and better temperature control via monitoring and RE-based recharging functionality. The topographical analysis estimated that the system can cover larger region. The system prototype showed great potential regarding the possibility of a sustainable and enlarged cold-chain. Thus, RE-based vaccine supply management is expected to facilitate vaccine availability while minimizing waste in the supply chain.
Purpose: The purpose of this study was to investigate the status of emotional labor of nursing personnel working in comprehensive nursing service ward and to suggest the way service improvement can be achieved. Methods: A total of 28 nurses working in comprehensive nursing service ward were divided into four groups to conduct focus group interview. All interviews were recorded and transcribed after the interview to perform data analysis in the order of data classification, topic categorization, and keyword derivation. Results: The five categories of subjects and relating keywords drawn from the focus group interviews are as follows: 1) Emotional labor experience: suppressing emotions, expressing emotions or actions that are different from reality, 2) Situations of emotional labor: verbal abuse and assault, sexual harassment, personal needs and errands, 3) Responses to emotional labor: responding directly, responding directly, receiving senior's help, using the organizational system, persevering, 4) Problems caused by emotional labor: work exhaustion, job change intention, job stress, 5) Protection plan against emotional labor: manual or education for nurses, education for patients and carers, compensation, tough sanctions though system strengthening. Conclusion: This study shows that although nurses working in comprehensive nursing service ward generally experience high levels of emotional labor, the problem solving of them relies mainly on personal response. Therefore, it is necessary to develop various measures to protect nurses in an organizational level response, thus to improve the comprehensive nursing service system.
The purpose of this study was to establish a classification systems of sport culture contents for enhancing cultural competitiveness. The main research method for this was the Delphi survey based on the literature. Through a literature review, the definition of sport cultural contents and the classification system of major industrial countries were analyzed. The Delphi survey by a panel of 25 was conducted over a two-round. The results were as follows: first, the sport culture contents includes an artistic creativity, which have a working form that enables delivery to the public and organizing sports activities, and classify as a technology for high value-added content and services. Second, the 'culture' for the large category item, which include the cultural heritage and culture art. The 'media' recognize the importance of temporal concepts with traditional media and it was classified as new media. In the case of items in the large category 'events' are classified as national and international sporting events and festivals, the 'services' main category item is divided into social, care, educational services. Finally, the 'others' includes such as copyrighted items.
The beneficial effects of total parenteral nutrition (TPN) in improving the nutritional status of malnourished patients during hospital stays have been well established. However, recent randomized trials and meta-analyses have reported an increased rate of TPN-associated complications and mortality in critically ill patients. The increased risk of complications during TPN therapy has been linked to the development of hyperglycemia, especially during the first few days of TPN therapy. This retrospective study was conducted to determine whether the amount of dextrose from TPN in the 1st week in the intensive care unit (ICU) was related to the development of hyperglycemia and the clinical outcome. We included 88 non-diabetic critically ill patients who stayed in the medical ICU for more than two days. The subjects were 65 ${\pm}$ 16 years old, and the mean APACHE (Acute Physiology and Chronic Health Evaluation) II score upon admission was 20.9${\pm}$7.1. The subjects received 2.3${\pm}$1.4 g/kg/day of dextrose intravenously. We divided the subjects into two groups according to the mean blood glucose (BG) level during the 1st week of ICU stay: <140 mg/dl vs ${\geq}$ 140 mg/dl. Baseline BG and the amount of dextrose delivered via TPN were significantly higher in the hyperglycemia group than those in the normoglycemia group. Mortality was higher in the hyperglycemia group than in the normoglycemia group (42.4% vs 12.8%, P=0.008). The amount of dextrose from TPN was the only significant variable in the multiple linear regression analysis, which included age, APACHE II score, baseline blood glucose concentration and dextrose delivery via TPN as independent variables. We concluded that the amount of dextrose delivered via TPN might be associated with the development of hyperglycemia in critically ill patients without a history of diabetes mellitus. The amount of dextrose in TPN should be decided and adapted carefully to maintain blood glucose within the target range.
Journal of Information Technology Applications and Management
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v.28
no.3
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pp.49-58
/
2021
Due to the increasing interest in wellness aroused by the aging population and the pursuing feature of active old age, Korean elderly set importance on long life with their healthy condition. Following the change in the paradigm of the medical delivery system from hospital-oriented, treatment-oriented to personal-centered and self-care, Service design application of Smart Healthcare for the elderly became valuable. Smart Healthcare is a healthcare service provided through the fusion of ICT technologies including mobile/wearable devices, IoT, big data, and information technology, and it is utilized to prevent diseases managing abundant health information and living habits. As a methodology for delivering such Smart Healthcare to the elderly, Service design can be adopted. Therefore, this study would like to present the perquisites of Smart Healthcare design for the elderly through analyzing the results from in-depth interview methods between the elderly and medical staff. As a result of this study, guidelines for Service design application of health vulnerability management for the elderly utilizing smart phones were presented. Therefore, this study presented four prerequisites composed of 'high level of supplementation and ethical decision making', 'improvement of inequality in accessibility and experience', 'resolving problems in policy implementation' and 'user-friendliness' for the Smart Healthcare service design for the elderly. Overall, Service design is expected to play an innovative role in improving the quality of life for the elderly through the process of collecting and delivering information on Smart Healthcare centered on the experience of the elderly.
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