• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.135-152
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• 1983

Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.59-104
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• 2023

This essay attempts to analyze the public health welfare conception within the text of the Beveridge Report and its realization via the NHS in Great Britain. Once referring to the influence of the Report to create the foundations of the 20th-century welfare system, the quest to scrutinize the original intentions of the Report and its succession to the NHS is certainly intriguing. Furthermore, when regarding the significance of public health policy for a modern state, the effort to engage in Beveridge's conception and its realization is more than timely. In light of such a premise, this paper indulges in its study by the following methods. First, the historical background of the Report - namely, the role of the spirit of the age and the experience of the Emergency Medical Service are to be analyzed to identify the origins of the welfare policies proposed by Beveridge. Furthermore, the public health welfare conception of the Report conceived from its time is reflected upon by engaging on the goal towards social welfare and public health scheme. Lastly, the aims of the NHS and its management, treatment classification, and rehabilitation program are reviewed for comparative analysis with the Report to survey the realization of Beveridge's design. In this process, this paper not only takes into account the original text of the Report - but also other essential works of law and public policy, including the NHS Constitution for England and the National Health Service Act of 1946. The intentions of this study are not bound by merely coinciding with the Report, but resonate significance via reflecting upon the Beveridgian legacy on the modern welfare state from the current perspective. The structured analysis to research the aims and policies of the Report and to compare them to the reality of the NHS may provide an opportunity to confirm the realization of Beveridge's scheme in British society. In addition, this essay is part of an academic endeavor to critically assess the past and the present of the welfare institution in the public health sector. As such, it is hopeful that the essay sheds light on further studies concerning the constructive remedies of the Korean welfare system as well.

• Journal of the Korea Safety Management & Science
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• v.12 no.1
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• pp.19-25
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• 2010

To investigate acute drug intoxication trends in the elderly visited Emergency Medical Centers, Data was collected from the records of poisoning patients visited Five different Hospitals from January 1. 2007 to December 31. 2007. The analysis was conducted by using 135 cases of 624 cases. When considering only the elderly and making comparisons between the urban areas and the rural areas the following data was produced. In regard to patients with acute drug intoxication, the main substance of choice was pesticides. Cases of acute drug intoxication are definitely higher for those categorized as the rural elderly (75.0%) when compared with those categorized as the urban elderly (44.1%). The male to female ratio, those living together as a family, past suicide attempts, mental state and sobriety condition when they came, monthly distribution etc. between the two groups did not demonstrate a difference between them. In regard to reasons given for acute drug intoxication, suicide was the highest at 60.7% of the cases. When comparing accidental reasons for poisoning, the urban elderly, at 34.2% of their cases, were higher than in the rural elderly, at 23.7%. After first aid was administered, the admission rate was higher for the rural elderly (47.4%) than for the urban elderly (33.9%). This shows that the rural elderly have a more severe acute drug intoxication poisoning problem than the urban elderly do.

• Parasites, Hosts and Diseases
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• v.53 no.6
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• pp.699-703
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• 2015

Cystic echinococcosis (CE) is one of the most widespread zoonotic helminthiases, which can last an asymptomatic infection for several years. The purpose of this study was to demonstrate serum antibody prevalence of CE among asymptomatic people in Uzbekistan using ELISA. A total of 2,547 serum samples were collected, 66 from confirmed CE patients and 2,481 of patients with other diseases than CE at a hospital in Tashkent, Uzbekistan. The serum samples were screened for CE specific IgG antibodies by ELISA using cystic fluid antigen obtained from sheep. The serum antibody positive rate was 89.4% (59/66) in CE and 3.6% (89/2,481) in other disease patients. The present ELISA recognized 89.4% sensitivity and 96.4% specificity. The ELISA absorbance of positive samples was distributed 0.271-0.971 for CE and 0.273-0.887 for other disease patients. The other disease patients with high absorbance over 0.3 were 50 (2.0%) who were presumed to be active CE patients. The patients in their 40s showed the highest positive rate of 5.2% (P=0.181), and women were 4.4% while men were 3.1% positive (P=0.136). The data confirmed that there are many asymptomatic patients of CE in Tashkent. It is indicated that CE is an endemic disease of public health importance in Uzbekistan.

• Parasites, Hosts and Diseases
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• v.57 no.6
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• pp.587-593
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• 2019

Excavation (2008-2014) carried out under the Uffizi Gallery (Florence, Italy) led to the discovery of 75 individuals, mostly buried in multiple graves. Based on Roman minted coins, the graves were preliminarily dated between the second half of the 4th and the beginning of the 5th centuries CE. Taphonomy showed that this was an emergency burial site associated with a catastrophic event, possibly an epidemic of unknown etiology with high mortality rates. In this perspective, paleoparasitological investigations were performed on 18 individuals exhumed from 9 multiple graves to assess the burden of gastrointestinal parasitism. Five out of eighteen individuals (27.7%) tested positive for ascarid-type remains; these are considered as "decorticated" Ascaris eggs, which have lost their outer mammillated coat. Roundworms (genus Ascaris) commonly infest human populations under dire sanitary conditions. Archaeological and historical evidence indicates that Florentia suffered a period of economic crisis between the end of 4th and the beginning of the 5th centuries CE, and that the aqueduct was severely damaged at the beginning of the 4th century CE, possibly during the siege of the Goths (406 CE). It is more than plausible that the epidemic, possibly coupled with the disruption of the aqueduct, deeply affected the living conditions of these individuals. A 27.7% frequency suggests that ascariasis was widespread in this population. This investigation exemplifies how paleoparasitological information can be retrieved from the analysis of sediments sampled in cemeteries, thus allowing a better assessment of the varying frequency of parasitic infections among ancient populations.

• Journal of Korea Multimedia Society
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• v.22 no.5
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• pp.613-625
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• 2019

The rise of the Internet of Things (IoT) devices have greatly influenced many industries and one of them is healthcare where wearable devices started to track all your daily activities for better health monitoring accuracy and even down to tracking daily food intake in some cases. With the amounts of data that are being tracked and shared between from these devices, questions were raised on how to uphold user's data privacy when data is shared between these IoT devices and third party. With the blockchain platforms started to mature since its inception, the technology can be implemented according to a variety of use case scenarios. In this paper, we present a system architecture based on the healthcare system and IoT network by leveraging on multiple blockchain networks as the medium in between that should enable users to have direct authority on data accessibility of their shared data. We provide proof of concept implementation and highlight the results from our testing to show how the efficiency and scalability of the healthcare system improved without having a significant impact on the performance of the Electronic Medical Record (EMR) that mostly affected by the previous solution since these solutions directly connected to a public blockchain network and which resulted in significant delays and high cost of operation when a large amount of data or complicated functions are involved.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8115-8119
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• 2014

Background: Breast cancer continues to be the most common type of cancer afflicting many women worldwide. Presently, educational campaigns and research target only women as if men have no role in the management of this disease. The study examined the willingness of male partners to assist in early female breast cancer detection as well as their awareness and knowledge levels. Materials and Methods: Using a semi-structured questionnaire, data was collected from 500 public servants within the Tamale Metropolis and analyzed in SPSS. Results: The level of awareness of breast cancer was very high (98.8%) but there was a low level of knowledge of breast cancer among the male population. Marital status and religion had no effect on attitude, but increasing educational status significantly increased knowledge and positive attitude towards breast cancer examination (${\chi}^2$=4.255, p=0.0391). The majority (92.0%) agreed that men can assist in early breast cancer detection and 96.2% were willing to be provided with breast examination skills. Conclusions: Although level of awareness on female breast cancers among the men was high, they generally lack knowledge of the disease. Majority of male partners want to assist in early breast cancer detection if provided with the necessary skills.

• Journal of the Mineralogical Society of Korea
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• v.27 no.4
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• pp.235-242
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• 2014

Uranium can be released into the water environment from natural sources and human activities. The natural source of uranium is dominant in the Korean soil and groundwater environments. Uranium has both of radioactive and chemical toxic properties. Therefore, a drinking water contaminated with uranium has a high health risk. This study was conducted to determine the uranium concentration of water systems including small village drinking water system, groundwater for drinking water purpose, spring water, groundwater monitoring well, and emergency water suppling system. The uranium concentration was compared with domestic and other countries' standard. The contamination level was also evaluated on the basis of geological characteristics of the area. Among total 803 samples, 6 exceeded the Korean standard, $30{\mu}g/{\ell}$ and this was about 0.7% of the total sample. On the basis of geology, uranium concentration appeared to be increased in order of biotite granodiorite > biotite granite > gneissoid granite. The highest level of uranium was 12.4 in average.

• Korean Journal of Clinical Pharmacy
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• v.23 no.3
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• pp.269-277
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• 2013

Objectives: The purpose of this study was to identify the factors which affect risk perception and attitude on government risk management over medications containing asbestos among parents of elementary school students. Methods: This research design was cross-sectional study using self-administered questionnaire. The survey subjects were parents of elementary school students in Seoul, total of 1,051 subjects. The survey period was from June through July of 2011. The collected data were analyzed using the SPSS 20.0. Results: The subjects perceived high risk regarding medications containing asbestos. About 83.6% of the subjects perceived that the result taking of medications containing asbestos was fatal, 82.8% felt that medications containing asbestos was a very serious social problem, 79.5% agreed that medications containing asbestos was a new type of threat. The risk perception for medications containing asbestos was related to political affiliation, attitudes of dealing medicines, main use of media, and personal communication credibility. Those who did not believe that the current government policy was correct and the government was working toward the public's benefit and not its own had the higher level of negative attitudes towards the government's risk management over the case of medications containing asbestos. Conclusion: In implementing government policy, all information should be efficiently and accurately communicated through a transparent implementation process. Also, the government must have plans for countermeasures in case of an emergency and respond efficiently in order to maintain their credibility. Moreover, this highlights the need for health authorities to exert more effort in increasing public education/awareness, especially those concerning drug and dug-taking behavior, in order to harness positive attitude and trust towards the government's policy. For a more effective risk communication, the media, health experts, government representatives, and related industries should work together.

• Journal of Korean Public Health Nursing
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• v.11 no.2
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• pp.180-193
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• 1997

This study was designed to set up more developed curriculum in Nursing department of a junior college. The sample for the study were fifteen curriculums of fifteen selected junior colleges in Seoul and Kyunggi area. The credits and hours of each curriculum were analyzed into means and compared with the one of the example college. The data were categorized into seven sections; cultural subject, basic medical science, major subjects such as Nursing, Fundamental Nursing, electives, teaching and non-teaching subjects, and clinical practice. The data were analyzed by means of descriptive statistics. The results of the study were as follows; 1. Credit hours of Cultural subjects of each college ranges from $5.8\%\;to\;25.7\%$ of the total graduate credit hours; most commonaly lectured subjects are English 05 colleges), Korean (11 colleges), psychology (10 colleges), and computer (10 colleges). 2. In the case of the example college, Anatomy and Psychology were jointed as one subject, Basic Nursing Science, and some more study in depth should be made to develop more of this type of conjunction among related subjects on basic medical science. 3. As for the mendatory subjects of the example college, subjects on Adult Nursing was fourteen credits (14 hours), which was higher than the average 12.9 hours of other colleges compared. 4. Credit hours of Basic Nursing Laboratory were eight to ten credits (12-18 hours), which was higher than actual class hours. As more and more hospitals test clinical aptitude when recruiting nurses, more emphasis should be paid to the clinical practice. 5. Among fifteen sample curriculums six to twelve electives were offered with twelve to twenty-three credits. Most commonly opened subjects were Physical Examination (5), Nursing English (14). and Geriatrics Nursing (13). Nursing English are considered to be more important in the view of clinical practice. and Oriental Nursing, Nursing Information and Health Insurance Management should be considered as specialized subjects. 6. Teaching and Non-teaching subjects In case of the example school. Clinical Emergency Medicine, Introduction to Emergency Medicine were offered for these non-teaching class students so they could prepare for the qualification examination. 7. Clinical Practice The average credit hours for clinical practice of the sample college were 20.9 credit hours $(66.5\%)$ and the example school offered twenty credit hours which was slightly lower than the other forteen.