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Review of 2019 Major Medical Decisions (2019년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Park, Noh Min;Jeong, Hye Seung;Lee, Dong Pil;Lee, Jung Sun;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.107-152
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    • 2020
  • During the main ruling in 2019, a number of rulings that were of interest or meaningful were handed down, such as just because the complication of medical practice has occurred, there is no presumption of negligence, a case involving a fall accident in which a lot of culpability has recently been made. the death of a well-known singer that caused a sensation, a case about damages caused by MERS in 2015, which is more meaningful in connection with damages caused by COVID-19, an infectious disease that has recently hit the world, including Korea. In preaching the principles of the law, just because there has been a complication caused by medical practice, there is no presumption of negligence, 'The scope of the complication without presumption of negligence' was determined differently by the court, the court was not able to specify the criteria. Specific circumstances were presented to limit the responsibility of the medical institution while acknowledging the malpractice of the medical institution in relation to the fall accident. In relation to the scope of damages, judgment was made on issues related to the calculation of lost profits of medical malpractice; criteria for determining celebrities' daily income, criteria for determining daily income in case of receiving survivor's pension due to medical accident, an incident in which the daily income is denied if the labor capacity is already lost at the time of a medical accident. But, it seems that judgments should be made based on clearer and more reasonable standards. Related to Medical Advertise, specific logic of judgment was presented as to whether it was interpreted as being in accordance with the specific prohibition listed in Article 27 paragraph 3 of the Medical Law, which is the criterion for violation of the Medical Law, or if it constitutes a significant harm to the order of the medical market. In response to the prohibition of operating the multiple medical institutions, the Constitutional Court decided that it was constitutional because it did not violate the regulations on excessive funding, and rationally limited the scope of the prohibited 'redundant operation'. The Supreme Court ruled for the first time that even a medical institution established and operated in violation of the Medical Service Act did not make it impossible to receive all medical care benefits implemented by a medical institution under the National Health Insurance Act. Significant rulings were finalized that recognized the existence of specific protection obligations for the people of the country in the management of infectious diseases.

Awareness regarding Safe Abortion among Adolescent Girls in Rural area of Mahottari district of Nepal

  • Singh, Jitendra Kumar;Sah, Poonam Kumari;Kushwaha, Shambhu Prasad;Bajgain, Bishnu Bahadur;Chaudhary, Sanjay
    • Journal of agricultural medicine and community health
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    • v.44 no.2
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    • pp.73-81
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    • 2019
  • This study aimed to assess the level of awareness on safe abortion among adolescent girls in rural area of Mahottari district of Nepal. A community based cross-sectional study was conducted in rural areas of Mahottari district of Southern Nepal between January and March 2019.A sample of 412 adolescent girls was selected using multi-stage cluster sampling. Multivariable logistic regression model was adapted to explore level of awareness among adolescent girls. This study found that 45.6% of adolescent girls had high awareness regarding safe abortion. The odds of awareness among the married adolescents was higher (AOR=2.16; 95% CI: 1.01-4.87) than unmarried adolescent whereas the odds of awareness among the adolescents who had education of secondary level and more had higher (AOR=2.21; 95%CI: 1.13-3.04) than those who had primary or lower secondary level of education. Similarly, the adolescents who had monthly family income of Nepalese Rupees (NRs.), 10,000-20,000 and more than NRs. 20,000 were respectively, 2.33 times (AOR = 2.33; 95% CI: 1.07-3.55) and 3.17 times (AOR = 3.17; 95% CI: 2.19-8.94) more likelihood to have high awareness regarding safe abortion than those their counterparts. The study showed that overall level of knowledge towards safe abortion was found low. Socio-demographic factors like marital status, level of education, and family income were the factors independently associated with level of awareness on safe abortion. Therefore, efforts should be exerted towards arising and improving the awareness of abortion care which may reduce unwanted pregnancy, abortion and other complications related to abortion.

Knowledge and Compliance Level of the Multi-drug resistant Organisms of ICU nurses (중환자실 간호사의 다제내성균 감염관리 지식과 이행도)

  • Shon, Joung-A;Park, Jin Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.280-292
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    • 2016
  • This descriptive survey assessed knowledge of intensive care unit (ICU) nurses regarding compliance with infection control for six kinds of multi-drug resistant organisms to assist in development of effective intervention strategies. Participants included 210 nurses working in the ICUs of general hospitals who completed a structured questionnaire. The results showed that the nurses' knowledge level and infection control compliance was 10.54 and 3.39 for MRSA; 11.25 and 3.69 for VRE; and 9.60 and 3.49 for CRGNB, respectively[ED highlight - consider providing additional information to describe what these values indicate.]. Knowledge regarding MRSA infection control differed significantly based on age, clinical experience, and experience as a trainee, while compliance with MRSA infection control differed based on age. Knowledge regarding VRE infection control was significantly different based on academic qualification level, experience as a trainee, and whether guidelines existed, while compliance with VRE infection control differed based on academic qualification level and the presence of an isolation environment. Knowledge regarding CRGNB infection control differed significantly based on academic qualification level and experience as a trainee, while compliance with CRGNB infection control differed based on the presence of an isolation environment. Thus, intervention strategies should include education programs for enhancing ICU nurse' knowledge regarding strategies for creating isolation environments.

The Health Status of Rural Farming Women (농촌여성(農村女性)의 건강실태(健康實態)에 관한 연구(硏究))

  • Park, Jung-Eun
    • Journal of agricultural medicine and community health
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    • v.15 no.2
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    • pp.97-106
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    • 1990
  • 1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

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A Study on Network Hospital and the Ban on Opening and Operating the Muliple Medical Institution (네트워크병원과 의료기관 복수 개설·운영 금지 제도에 관한 고찰)

  • KIM, JOON RAE
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.281-313
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    • 2016
  • Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution and one of them is to prohibit the operation of multiple medical institutions In the past, there was a provision stipulating the same purpose. But because the Supreme Court interpreted that several medical institutions could be opened if the medical treatment was not made at the additional medical instition which was opened in the another doctor,s license, multiple medical institutions could be opened and operated. However, some health care providers opened the several medical institutions to another doctor's license just by the excuse of the business management and then did illegal medical cares like the unfair luring of patients, overtreatment, and commition treatment for more profits. So, the health rights of the people came to be infringed on. Accordingly, lawmakers amended the Medical Law for medical personnel not to open and to operate more than one medical institution. As the amended medical law prohibited a medical personnel to open multiple medical institution, some medical personnels insisted that the amended medical law is unconstitutional under which they could not be able to open and operate medical institutions on based on free investment and bring out the benefits of network hospitals. But the regulation to prohibit multiple institutions does not apply only to a medical personnel. Many other experts like lawyer and pharmacist can open only one office under such a restriction. If the regulation goes out of force, the procedure that multiple medical institutions should be opened and operated in the capacity as a medical corporation or a non-profit corporation does not have to be followed. And we should keep in mind that the permission for medical personels to open multiple medical institutions could lead virtually to commercial hospital. If in the nation with a very low rate of public medical service, If only a few medical personnels with capital own many medical institutions and operate commercially them, this could cause a falling-off in quality of medical service, ultimately infringe on the health rights and the life right of the people.

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Surgical Site Infection Rates according to Patient Risk Index after General Surgery (일반외과 환자의 환자위험지수에 따른 수술창상감염 발생률)

  • Lee, Hye-Ryeong
    • Korean Journal of Occupational Health Nursing
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    • v.11 no.1
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    • pp.44-51
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    • 2002
  • Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

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Analysis of the effect of oral midazolam and triazolam premedication before general anesthesia in patients with disabilities with difficulty in cooperation

  • Lim, Seon Woo;So, Eunsun;Yun, Hye Joo;Karm, Myong-Hwan;Chang, Juhea;Lee, Hanbin;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.245-254
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    • 2018
  • Background: When performing dental treatment under general anesthesia in adult patients who have difficulty cooperating due to intellectual disabilities, anesthesia induction may be difficult as well. In particular, patients who refuse to come into the dental office or sit in the dental chair may have to be forced to do so. However, for adult patients with a large physique, physical restraint may be difficult, while oral sedatives as premedication may be helpful. Here, a retrospective analysis was performed to investigate the effect of oral sedatives. Methods: A hospital-based medical information database was searched for patients who were prescribed oral midazolam or triazolam between January 2009 and December 2017. Pre-anesthesia evaluation, anesthesia, and anesthesia recovery records of all patients were analyzed, and information on disability type, reason for prescribing oral sedatives, prescribed medication and dose, cooperation level during anesthesia induction, anesthesia duration, length of recovery room stay, and complications was retrieved. Results: A total of 97 patients were identified, of whom 50 and 47 received midazolam and triazolam, respectively. The major types of disability were intellectual disabilities, autism, Down syndrome, blindness, cerebral palsy, and epilepsy. Analyses of changes in cooperation levels after drug administration showed that anesthesia induction without physical restraint was possible in 56.0% of patients in the midazolam group and in 46.8% of patients in the triazolam group (P = 0.312). Conclusions: With administration of oral midazolam or triazolam, general anesthesia induction without any physical restraint was possible in approximately 50% of patients, with no difference between the drugs.

A Study on Analysis of Pilates-related Patent Information (필라테스 분야 특허 정보 분석에 관한 연구)

  • Chi, Dong-Cheol;Kim, Jong-Hyuck
    • Journal of the Korea Convergence Society
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    • v.13 no.4
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    • pp.513-519
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    • 2022
  • The 4th industrial revolution has made our life convenient, and the development of new technologies has brought affluent life. Considering that the 4th industrial revolution is a next-generation industrial revolution led by robot technology, life science, and artificial intelligence, the need for convergence research in sports field stimulated the continuous efforts for the academic foundation of sports. Recently, as interest in home training has increased due to the COVID-19 pandemic, the Pilates has also attracted much attentions demand for related supplies has increased. This is an demonstration that COVID-19 has had an impact on the sports industry ecosystem. The purpose of this study was, accordingly, to identify current trends through accurate patent information related to Pilates and to provide basic data for future studies on sports convergence industry and sports intellectual property. For the purpose, based on the data from Jan. 1 to Dec. 31, 2021 provided by KIPRIS (www.kipris.or.kr), the patent information search service provided by the Korean Intellectual Property Office, patent status analysis, international patent classification (IPC) patent analysis, and detailed patent analysis by classification were performed.

Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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Development and Validation of the Parental Role Responsibilities Scale (부모의 양육 역할 책임 척도 개발 및 타당화 연구)

  • Hwang, Ock-Kyeung;Jung, Youn-Ah;Song, Mi-Ryoung;Myung, Jun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.2
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    • pp.440-451
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    • 2021
  • The purpose of this study is to develop and validate the parental roles and responsibilities for young children. A survey was conducted on 301 parents with children attending preschools. The parental roles and responsibilities scale were determined from a total of 60 items and 11 sub-factors based on the criteria for goodness, validity, and reliability of items (i.e., factor load ≥ 0.5; AVE ≥ 0.5; CR ≥ 0.7; Cronbach's alpha ≥ 0.7). The parental roles and responsibilities scale include 'hygiene management' (4 items), 'physical activities' (6 items), 'survival and health care' (6 items), 'cognitive development' (5 items), 'emotional stability' (5 items), 'social skills' (6 items), 'social norms and values' (7 items), 'physical environment' (5 items), 'protection' (5 items), 'family community consciousness and family tradition' (4 items), and 'the role and responsibility of parents for childcare institutions' (7 items). It is significant that the indicators on the parental roles and responsibilities for young children were developed and verified to fit the situation in Korea. Findings will help identify the characteristics of parental role responsibilities and serve as a basis for efficient communication between parents and preschoolers.parental role responsibilities and serve as a basis for efficient communication between parents and preschools.