The neuropsychiatric sequelae of traumatic brain unjury(TBI) are effects on complex aspect of behavior, cognition and emotional expression. They include psychiatric disorders such as depression, psychosis, personality change, dementia, and postconcussion syndrome. The damage is done not only to the cortex of the brain but also to subcortical and axial structures. The diffuse degeneration of cerebral white mailer is axonal damage that is caused by mechanical forces shearing the neuronal fiber at the moment of impact(diffuse axonal injury, DAI). The DAI and the changed receptor-agonist mechanism ore the most important mechanisms in genesis of neuropsychiatric sequalae by mild TBI. The most important instrument for diagnosis of neuropsychiatric sequalae of TBI is a physician or psychiatrist with experience and knowledge. The most effective therapeutic tool is a professional who understands the nature of the problem.
Objectives: The purpose of this study was to identify resources put into clinical. activities and identify a new RBRVS for oriental medical services in the Korean National Health Insurance. Methods: Based on a survey of physician's time, physical effort & technical skill, mental effort & judgment, and stress that were used for patient treatments, relative input values for the relevant clinical activities were estimated and rearranged in a way to be compared. with the current values in health insurance. Results: We found the actual resource-based relative values for oriental medical services statistically different from the current values, with a narrower variation in value distribution. Conclusions: The findings suggest the C\lrrent RBRVS should be revised to reflect the actual input resources into physicians activities and to avoid a distortion of physicians behavior.
Purpose: Core competencies for becoming a good physician have been the focus of recent discussion. Understanding students' state of mind should be included in this analysis. Thus, the purpose of this study was to review recent research papers on subjective well-being in medical education and propose some suggestions. Methods: A selective search was conducted of the literature that has been published since 2000 in the Medline, Riss4U, ERIC, and KoreaMed databases using the search terms "happiness", "subjective well-being", "satisfaction", and "stress". Thirty seven studies were included in this review. Each was categorized according to 3 subjects (satisfaction, positive affect, negative affect). Results: Most studies showed relatively high levels of distress in medical students, which was related to academic worries. Although medical students were under a great deal of distress, they regarded help-seeking behavior for their distress as weakness or something negative. Conclusion: To decrease medical students' distress and sustain their well-being, there should be a change in students' awareness through curriculum, teaching methods, and coping strategies in medical education.
The purpose of this study was to evaluate the information searching behavior of consumer by type of medical institution. A questionnaire survey was conducted of 1,507 persons who were selected through a multi-stage stratified area cluster sampling in nationwide level, excluding Jeju-Do. Personal survey was conducted through door-to door survey from 27 July to 10 August 1999. The main results of this research was as following; 1. The proportion of information searching of respondents ranged from 91.5-95.2%. Even though the proportion of user in university hospital was slightly high, there was not significant statistically by type of medical institution. In terms of information source, personal informer was most common information source in all type of medical institution. Public informers were more frequently used in university hospital visitors and professional informer in general and university hospital visitors. 2. Comparing to searching intensity, user informer and professional informer's influences were more powerful, but not statistically significant. In analysis of unit influence for information source, written informer or public informer was more powerful in clinic visitor, professional informer and written informer in university hospital visitor. 3. Information which consumer want to know mostly were about on special potential and career of physician. The clinic visitor wanted to know about institutional location and kindness of medical personnel. The university hospital visitor also wanted to know about facilities and convenience of process. Comparing to institution selection criteria of consumers at 1991, quality related criteria were recognized more importantly in outpatient and dental services. But in case of inpatient services, convenience factor was recognized more importantly. In conclusion, the effort for specific marketing plan by type of medical institution should be needed. And more concern on information searching behavior of consumer will be needed.
Purpose: The coronavirus disease 2019 (COVID-19) pandemic has influenced the lives of people worldwide. Little is known about the effects of the COVID-19 pandemic on the behavior and fears of pediatric patients with inflammatory bowel disease (IBD) and their families. We conducted a survey to determine the COVID-19 exposure, related perceptions, and information sources; medication compliance; and patients' and parents' behaviors, fears, and physician contact. Methods: An anonymous cross-sectional survey of pediatric patients with IBD and their parents at one pediatric gastroenterology unit of a university medical center was performed. Results: A total of 46 pediatric patients with IBD and 44 parents completed the survey. Parents of pediatric patients with IBD had high fear of their children becoming infected with severe acute respiratory syndrome coronavirus 2. They perceived schools as the most hazardous environment, whereas the children did not. Half the pediatric patients with IBD feared infection. Patients and parents felt sufficiently informed about COVID-19. The primary source of guidance for pediatric patients was their parents (43%), followed by television and social media, whereas the parents mainly consulted internet news websites (52.2%), television, and public health institutes. Pediatric patients with IBD adhered to their prescribed medication. They also showed cautious behavior by enhancing hand hygiene (84%) and leaving the house less frequently than before. However, in-person medical visits remained favored over video consultations. Conclusion: Although parents expressed overprotective concerns, both parents and pediatric patients with IBD are coping well with the COVID-19 pandemic. IBD-relevant information should be actively conveyed.
Kim, Yong-Ik;Kim, Chang-Yup;Shin, Young-Soo;Lee, Kun-Sei
Journal of Preventive Medicine and Public Health
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v.34
no.4
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pp.379-388
/
2001
Background : Cervix cancer is the most common form of cancer among Korea women. in spite of proof that cervical cancer screening could reduce death rates substantially, the screening rates reported by previous Korean studies remain stubbornly very low. Behavioral studies to increase the cervix cancer screening rate are essential in order to develop the cancer screening program. Objective : To evaluate the factors which are related to the intention and behavior for cervix cancer screening using the Theory of Planned Behavior (TPB) and the Theory of Reasoned Action (TRA). Methods : The survey was conducted from July 21 st to 26th in 1998. Of 3,218 women, 303(12.2%) between 30 and 55 years old, voluntarily participated in the survey in the 3 Myeons in Choongju city. Charge-free cervix cancer screening was provided for the subjects 3 months later. Results : The R-square of both TPB and TRA to the intention (30% and 42%, respectively) was greater than the actual behavior (21% and 13%, respectively. TPB and TRA were found to provide an appropriate framework for the study of cervix cancer screening behavior. However, TRA was more powerful in explaining the intention, not only because the perceived behavioral control component exhibited lower reliability and validity than other components(altitude and subjective norm), but also because there may have been a few limitations in this study design. Consequently, the use of TRA is preferred in attempting to explain intention and actual behavior in this study. Conclusions : This study suggests that a successful intervention program should focus on changing attitudes and reducing psychologic barriers, rather than on just providing information. Physician recommendations, and the support of family members and friends are also very important factors in cervix cancer program participation. Physicians, friends, family members, and opinion leaders in rural areas, all of whom could affect the individual subjective norm, may all have the potential to play great roles as facilitators.
The Journal of the Convergence on Culture Technology
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v.9
no.3
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pp.67-74
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2023
The purpose of this study is to find relationships between the moral distress of nursing college students and career maturity, and between the moral distress of them and career preparation behavior by using a descriptive correlation methodology. Analysis is done using t-test, ANOVA, Pearson correlation coefficient, and Multiple regression with IBM SPSS WIN/22.0. According to the general characteristics, the there is a significant difference in the subjects with an outgoing personality (F=-2.82, p=.001), who suffered from moral distress at an older age (F=.4.85, p=.029). There is a significant difference in career maturity among subjects with an extroverted personality (F=3.63, p=.001). The average score of the subjects' moral distress is 72.51±53.75, and by sub-area, futile care was the highest with 23.36±19.04, and the lowest with 7.61±8.56 in physician practice. The average of career maturity was 3.74(±.56), and by sub-area, career attitude was the highest with 3.98±.54, and the lowest with 3.61±.43 in professionalism. The average of career preparation behavior was 2.67(±.60). In this study, it was confirmed that the moral stress of nursing students is a factor affecting career maturity (r=-.510, p=.000) and career preparation behavior (r=-.353, p=.001). Therefore, It can be seen that it is necessary to develop an intervention program that can positively enhance the career maturity and career preparation behavior of nursing students through intervention for the moral anguish experienced by nursing students.
Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.
Pain, an adaptive but unpleasant sensation, is the most common symptom of numerous diseases in humans and animals. Although animal patients express this symptom frequently, a lack of communication abilities hinders its recognition by veterinary physicians, thereby leading to unsatisfactory management of the symptom. On the other hand, pain itself has its own neurological mechanisms, regardless of the disease that causes it. Thus, a physician may need to know the mechanisms underlying pain development in order to properly manage the symptom in a particular disease. In this review, we attempt to provide a brief introduction to the anatomical, physiological, and neurological basis of pain transmission and sensation. Although most knowledge about these mechanisms comes from studies in humans and laboratory animals, it is generally applicable to pet, farm, or zoo animals. In addition, we summarize pain behavior in several pet, farm, and laboratory animals for its proper identification. This information will help to identify and manage pain, and thus improve welfare, in animals.
Plat, Marie-Christine J.;Frings-Dresen, Monique H.W.;Sluiter, Judith K.
Safety and Health at Work
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v.2
no.3
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pp.218-228
/
2011
Objectives: The objective of this study was to test the feasibility and acceptability of a new workers' health surveillance (WHS) for fire fighters in a Dutch pilot-implementation project. Methods: In three fire departments, between November 2007 and February 2009, feasibility was tested with respect to i) worker intent to change health and behavior; ii) the quality of instructions for testing teams; iii) the planned procedure in the field; and iv) future WHS organisation. Acceptability involved i) satisfaction with WHS and ii) verification of the job-specificity of the content of two physical tests of WHS. Fire fighters were surveyed after completing WHS, three testing teams were interviewed, and the content of the two tests was studied by experts. Results: Feasibility: nearly all of the 275 fire fighters intended to improve their health when recommended by the occupational physician. The testing teams found the instructions to be clear, and they were mostly positive about the organisation of WHS. Acceptability: the fire fighters rated WHS at eight points (out of a maximum of ten). The experts also reached a consensus about the optimal job-specific content of the future functional physical tests. Conclusion: Overall, it is feasible and acceptable to implement WHS in a definitive form in the Dutch fire-fighting sector.
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