• 제목/요약/키워드: medical and welfare

검색결과 1,359건 처리시간 0.028초

호스피스의료와 간호윤리 (Hospice Medicine and Nursing Ethics)

  • 문성제
    • 의료법학
    • /
    • 제9권1호
    • /
    • pp.385-411
    • /
    • 2008
  • The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

  • PDF

저소득층 장애인 의료비에 대한 정부부담금 추계 (A Short-Term Projection of the Government Budget in Medical Expenditures using for the Low-income Handicapped)

  • 이선자;김미주;장숙랑;이효영
    • 보건행정학회지
    • /
    • 제13권2호
    • /
    • pp.125-143
    • /
    • 2003
  • This study was conducted to estimate the future government budget in medical expenditures using for the low-income handicapped, because medical expenditures to the low-income handicapped is escalating in these days. It became a big problem not only to the central-government but also to the district-government because they have to subsidize a part of co-payment. This study was designed to project the future government budget using structural model. For the short-term projection, the structural model is stronger than the regression model. The data used for this study were the population projection data based on National Census Data(2000) of the National Statistical Office, the data of Ministry of Health & Welfare, and the data of National Health Insurance Corporation from November 2m to June 2001. The results of the study are summarized as follows: The future government budget in medical expenditures using to the low-income handicapped will be 15-18 billion Won in the year 2003, 16-23 billion Won in 2004, 18-30 billion Won in 2005, 19-38 billion Won in 2006 and 21-49 billion Won in 2007. It is predicted that they would be increasing rapidly. Therefore, the government budget in medical expenditures using for the low-income handicapped must be enlarged.

Trichomonas vaginalis Adhesion Protein 33: A Useful Target for Diagnosis of T. vaginalis

  • Joo Kyung Bok;Rho Pyong-Ui;Park Seung Kyu;Kim Jae Won;Lee Kyu Jae;Ryang Yong Suk
    • 대한의생명과학회지
    • /
    • 제11권1호
    • /
    • pp.15-22
    • /
    • 2005
  • Trichomoniasis is a sexually transmitted disease induced by Trichomonas vaginalis, a parasitic protozoan. The symptoms of trichomoniasis are rarely appeared that the infections are distributed worldwide from underdeveloped to developed countries. The diagnosis of trichomoniasis is mainly taken by wet smear following microscopic examination, of which the diagnostic accuracies are poor and varies with the clinicians' experiences. Therefore, more exact and convenient diagnostic methods for T. vaginalis are required. Here, we cloned and expressed recombinant T. vaginalis adhesion protein 33 (rTvAP33) using an E. coli expression system. rTvAP33 was then immunized to rabbit and BALB/c mice for the production of anti-rTvAP33 antibodies. Sandwich ELISA using these antibodies detected T. vaginalis cultured in TYM broth supplemented with ferrous ions. Vagina-parasitizing microorganisms showed low cross-reactivities in this system. These results suggest that Tv AP33 is a good diagnostic target for the detection of TvAP33-expressing T. vaginalis.

  • PDF

Effectiveness of Mass Drug Administration on Neglected Tropical Diseases in Schoolchildren in Zanzibar, Tanzania

  • Kim, Ju Yeong;Sim, Seobo;Chung, Eun Joo;Rim, Han-Jong;Chai, Jong-Yil;Min, Duk-Young;Eom, Keeseon S.;Mohammed, Khalfan A.;Khamis, Iddi S.;Yong, Tai-Soon
    • Parasites, Hosts and Diseases
    • /
    • 제58권2호
    • /
    • pp.109-119
    • /
    • 2020
  • Soil-transmitted helminths and Schistosoma haematobium affect more than 3 billion people globally and mainly occur in sub-Saharan Africa. The present study assessed the overall infection status of a 1716-student cohort of schoolchildren in Zanzibar and applied mass drug administration (MDA) to the cohort from 2007 to 2009. Schools in Pemba, Zanzibar, had a much higher prevalence of soil-transmitted helminth infections than those in Unguja, and the Chaani, Ghana, and Machui schools of Unguja exhibited high S. haematobium infection rates. The MDA program only partially controlled parasite infections, owing to high rates of re-infection. The infection rate of S. haematobium across all 10 schools, for example, was only reduced by 1.8%, and even this change not significant, even though the S. haematobium infection rates of the Chaani and Mzambarauni schools were significantly reduced from 64.4 and 23.4%, respectively, at the first screening, to 7.3 and 2.3% at the last screening. The overall infection rate of Ascaris lumbricoides was reduced from 36.0% at the first screening to 22.6% at the last screening. However, the infection rates for both Trichuris trichiura and hookworm were generally unaffected by MDA. In the future, parasite control programs should involve strategically designed MDA schedules and holistic intervention (e.g., sanitation improvement, hygiene behavior changes, and control of intermediated hosts).

우리나라 의사양성체제의 관점에서 본 의과대학 교육의 문제점과 개선방향 (Current Issues and Future Considerations in Undergraduate Medical Education from the Perspective of the Korean Medical Doctor Development System)

  • 한재진
    • 의학교육논단
    • /
    • 제20권2호
    • /
    • pp.72-77
    • /
    • 2018
  • Observation of the current Korean medical education and training system shows that certain negative traits of unchangeable solidification engraft themselves so deeply into the overarching system that they are now hampering the state of the national health welfare. Focusing only on undergraduate medical education, we can point out some glaring side-effects that should be of concern to any stakeholder. For instance, a graduate can legally begin his career as an independent practitioner immediately after passing the licensing exam and return to the old stuck school-year system of 2-year-premedical and 4-year-medical programs where outcome-based and integrated curricula are incomplete and unsatisfactory. In terms of learning opportunities, the balance between patient care and public health, as well as that between in-hospital highly specialized practice and community-based general practice, has worsened. Every stakeholder should be aware of these considerations in order to obtain the insight to forge a new direction. Moreover, our medical schools must prepare our students to take on the global roles of patient care within the Fourth Industrial Revolution, health advocacy for the imminent super-aged society, and education and research in the bio-health industry, by building and applying the concept of academic medicine. We will need to invest more resources, including educational specialists, into the current undergraduate medical education system in order to produce proper outcomes, smart curriculum, innovative methods of teaching and learning, and valid and reliable monitoring and evaluation. The improved quality of undergraduate medical education is the starting point for the success of the national system for public health and medical care as a whole, and therefore its urgency and significance should be emphasized to the public. The medical society should go beyond fixing what is broken and usher in a new era of cooperation and collaboration that invites other health professionals, governmental partners, law-makers, opinion leaders, and the general public in its steps toward the future.

Expression Analysis of Two Cancer-testis Genes, FBXO39 and TDRD4, in Breast Cancer Tissues and Cell Lines

  • Seifi-Alan, Mahnaz;Shamsi, Roshanak;Ghafouri-Fard, Soudeh;Mirfakhraie, Reza;Zare-Abdollahi, Davood;Movafagh, Abolfazl;Modarressi, Mohammad Hossein;Kazemi, Golnesa;Geranpayeh, Lobat;Najafi-Ashtiani, Mitra
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권11호
    • /
    • pp.6625-6629
    • /
    • 2013
  • Breast cancer accounts for one third of new cancer cases among women. The need for biomarkers for early detection is the stimulus to researchers to evaluate altered expression of genes in tumours. Cancer-testis (CT) genes are a group with limited expression in normal tissues except testis but up-regulation in a wide variety of cancers. We here evaluated expression of two CT genes named FBXO39 and TDRD4 in 32 invasive ductal carcinoma samples, 10 fibroadenomas and 6 normal breast tissue samples, in addition to two breast cancer cell lines, MCF-7 and MDA-MB-231, by the means of quantitative real time RT-PCR. FBXO39 showed significant up-regulation in invasive ductal carcinoma samples in comparison with normal samples. It also was expressed in both cell lines and after RHOXF1 gene knock down it was down-regulated in MCF-7 but up-regulated in the MDA-MB-231 cell line. TDRD4 was not expressed in the MCF-7 cell line and any of the tissue samples except testis. However, it was expressed in MDA-MB-231 and was up-regulated after RHOXF1 gene knock down. Our results show that FBXO39 but not TDRD4 can be used for cancer detection and if proved to be immunogenic, might be a putative candidate for breast cancer immunotherapy.

대학(대학원) 졸업 후 의사 수련교육 거버넌스 고찰 (Review the Governance of Graduate Medical Education)

  • 박혜경;박윤형
    • 보건행정학회지
    • /
    • 제29권4호
    • /
    • pp.394-398
    • /
    • 2019
  • Education on the physician continues with undergraduate medical education, graduate medical education, and continuous medical education. The countries such as the United States, Japan, the United Kingdom, German, and others are required to undergo training in the clinical field for 2 years after completing the national medical examination, and to become doctors after passing the clinical practice license test. Korea can obtain a medical license and become a clinical doctor at the same time if it passes written and practical tests after completing 6 years of undergraduate medical education or 4 years of graduate school. About 90% of medical school graduates replace clinical practice with 4-5 years of training to acquire professional qualifications, but this is an option for individual doctors rather than an extension of the licensing system under law. The medical professional qualification system is implemented by the Ministry of Health and Welfare on the regulation. In fact, under the supervision of the government, the Korean Hospital Association, the Korean Medical Association, and the Korean Academy of Medical Sciences progress most procedures. After training and becoming a specialist, the only thing that is given to a specialist is the right to mark him or her as a specialist in marking a medical institution and advertising. The government's guidelines for professional training are too restrictive, such as the recruitment method of residents, annual training courses of residents, dispatch rule of the residents, and the quota of residents of training hospitals. Although professional training systems are operated in the United States, the United Kingdom, France, and Germany, most of them are organized and operated by public professional organizations and widely recognize the autonomy of academic institutions and hospitals. Korea should also introduce a compulsory education system after graduating from medical education and organize and initiate by autonomic public professional organization that meets global standards.

노인에게 발생하는 안전사고에 관한 연구 (A Study on Accidents for the Aged)

  • 박상섭
    • 한국응급구조학회지
    • /
    • 제10권1호
    • /
    • pp.41-49
    • /
    • 2006
  • Purpose: It can be said that the aged belong to the group vulnerable to safety accidents. The purpose of this study was to investigate safety accidents to old people and provide basic data to prevent them from being in a safety accident. Result : 1. The number of the aged of traffic accident fatalities per 100,000 persons was 57.8, which was significantly higher than other OECD countries. 2. trauma for the aged, falling accounted for 60.6%, which was relatively higher than other wounds, probably because of decreased capacity of movement and reduced faculty of sensation. 3. accidents to the aged at home, 43.9% occurred in a room, which shows great risk of safety accidents to the aged in a room. 4. the aged generally showed negative awareness of social safety. Suggestion : 1. it is necessary to provide regular education about accidents through the mass media and at social welfare facilities in order for aged people to consolidate safety consciousness repeatedly. 2. it is necessary to make a brief and clear guide to prevention of accidents. 3. the Ministry of Construction and Transportation and the Ministry of Health and Welfare should give priority to designing a building for aged people and authorize construction according to the standards for establishing safety facilities for the aged. 4. it is necessary to change social consciousness. since transportation accidents can be caused not by aged people's insufficient safety consciousness but by that of all the people, it is necessary to provide society-wide education programs against dangerous driving in order to guarantee aged people's safety. 5. legal procedure to secure aged people's safety should be strengthened to reinforce legal protection for them.

  • PDF

녹내장 환자의 의료이용에 대한 5년간(2008-2012)의 변화추이 -한국의료패널 자료를 활용하여- (Trend of Medical Care Utilization in Glaucoma Patients over 5 Years(2008-2012) -Korea Health Panel Data-)

  • 이중형;김효진
    • 한국융합학회논문지
    • /
    • 제9권10호
    • /
    • pp.433-439
    • /
    • 2018
  • 본 연구는 20세 이상의 남녀를 대상으로 녹내장 환자의 5년간의 안과 외래이용을 분석하여 한국인에서 녹내장 발병에 대한 변화추이를 조사하고자 시행하였다. 연구 자료는 한국의료패널의 2008년부터 2012년도의 연간자료를 활용하여 의료이용에 대한 빈도와 교차분석을 실시하였다. 녹내장환자의 안과외래 이용은 2008년 0.43%, 2009년 0.47%, 2010년 0.49%, 2011년 0.61%, 2012년 0.75%로 매년 유의하게 증가하였다(p<0.001). 안과외래를 이용한 녹내장 환자는 20대에서 70대까지 고 연령층으로 갈수록 더 높은 이용률을 보였고(p<0.001), 각 연령대에서 매년 증가하는 경향을 보였다(p<0.001). 이와 같은 결과에서 한국인에서 녹내장으로 인한 최근 의료이용은 매년 증가추세를 보여 각 연령대에 맞는 조기발견과 관리가 중요한 과제임을 알 수 있다.

교육전담간호사 제도 시범사업 적용에 따른 일 의료기관에서의 성과 (Application and Evaluation of the Pilot Program for the Education Nurse System in a Medical Institution)

  • 심원희;박지선;임효민;김은혜;김진현
    • 임상간호연구
    • /
    • 제28권3호
    • /
    • pp.242-250
    • /
    • 2022
  • Purpose: This study was conducted to evaluate the performance following the application of the pilot program for the education nurse system of the Ministry of Health and Welfare in a medical institution. Methods: This study was employed a non-homogeneous comparative group design by comparing new nurses who entered the medical institution after the pilot project from December 2019 to April 2020 with new nurses who entered before the pilot project during the same period. Satisfaction, academic achievement, job adaptation, personal turnover within one year, and patient safety incident rate were investigated as performance indicators. Results: After the pilot project, the overall satisfaction among new nurses, preceptors, and fellow nurses increased, but there were no significant changes in academic achievement and job adaptation in new nurses. The personal turnover rate decreased from 15.6% to 9.1%, and the patient safety incident rate also decreased from 26.3% to 15.7%. Also, the preceptor overtime also decreased from 3.67 to 0.66 hours. Conclusion: The performance of the pilot project for the education nurse system was related to improvements in satisfaction, turnover rate of new nurses, patient safety incident rate, and preceptor overtime. Above all long-term monitoring of each performance indicator is necessary through the continuation of the education nurse system of the Ministry of Health and Welfare.