• Title/Summary/Keyword: rural health service

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Knowledge, Barriers and Attitudes Towards Breast Cancer Mammography Screening in Jordan

  • Abu-Helalah, Munir Ahmad;Alshraideh, Hussam Ahmad;Al-Serhan, Ala-Aldeen Ahmad;Kawaleet, Mariana;Nesheiwat, Adel Issa
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3981-3990
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    • 2015
  • Background: Breast cancer is the most common type of cancer in Jordan. Current efforts are focused on annual campaigns aimed at increasing awareness about breast cancer and encouraging women to conduct mammogram screening. In the absence of regular systematic screening for breast cancer in Jordan, there is a need to evaluate current mammography screening uptake and its predictors, assess women's knowledge and attitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service. Materials and Methods: This cross-sectional study was conducted in six governorates in Jordan through face-to-face interviews on a random sample of women aged 40 to 69 years. Results: A total of 507 participants with mean age of $46.8{\pm}7.8$ years were interviewed. There was low participation rate in early detection of breast cancer practices. Breast self-examination, doctor examination and periodic mammography screening were reported by 34.9%, 16.8% and 8.6% of study participants, respectively. Additionally 3.8% underwent breast cancer screening at least once but not periodically, while 87.6% had never undergone mammography screening. Reported reasons for conducting the screening were: perceived benefit (50%); family history of breast cancer (23.1%); perceived severity (21.2%); and advice from friend or family member (5.8%). City residents have shown higher probability of undergoing mammogram than those who live in towns or villages. Results revealed negative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening. The most commonly reported barriers for women who never underwent screening were: fear of results (63.8%); no support from surrounding environment (59.7); cost of the test (53.4%); and religious belief, i.e. Qadaa Wa Qadar (51.1%). Conclusions: In the absence of regular systematic screening for breast cancer in Jordan, the uptake of this preventive service is very low. It is essential for the country of Jordan to work on applying regular systematic mammography screening for breast cancer. Additionally, there is a need for improvement in the current health promotion programmes targeting breast cancer screening. Other areas that could be targeted in future initiatives in this field include access to screening in rural areas and removal of current barriers.

Population Strategy for Physical Activity in Korea (우리나라 신체활동 및 운동사업에서의 인구집단 전략)

  • Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.227-240
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    • 2005
  • Health promotion has more comprehensive approaches in recent years. Nevertheless we accept the concept of health promotion differently, we are agree on that community is the most important field in health promotion which includes population at the aspect of health policy, individual skill and, environment. And there are a number of different approaches to health promotion. In them, 'population approaches' and 'high -risk group approaches' has the most different characteristics. 'Population approaches' is equally important or more important than 'individual approaches' for maintaining and promoting population health. Almost part of this article contents is the summary of the guideline and population strategy of health promotion in Korea, 1999 - 2005. Community based health promotion program should be reinforced, integrated, comprehensive, collaborative through efficiently utilizing community resources. Recent new orientation of community health program is integrated health program, we can find this orientation at Ottawa charter 1986. Comprehensive approaches with the determinant factors for health are essential task. Physical activity is a key health determinant. The population-health approach suggests that educating people about physical activity is not enough. Individual behavior changes are important too, but need to be balanced with strategies for environmental change. Population strategy with physical activity for health promotion should be developed through improving social and physical supportive environment, linking and integrating community resources between public and private sectors in national, regional and local level. Continuous public education and social marketing should be provided through collaborating with community physical activity organization, facilities, work-places and school for increasing concern of all the people of community about physical activity. Governments, agencies and citizens should held and participate to building movement. And the strategy that various 'active for life' program should be developed, delivered, maintained and reinforced continuously. Basically, adequate and sufficient financing, developing human resources, policies and legislation would be provided and supported fully too. At last, research development and knowledge exchange are required domestically and internationally. In Korea, we had classified the category of strategic priority of physical activity programs by environmental support, life-course approach, high-risk group approach and disease group approach for physical activity program based on community health center. Community based core programs for physical activity that includes infrastructure building and establishment of supporting environment, community campaign, health promotion education and public service announcement, physical activity programs for elderly and obesity, exercise prescription program.

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The Medical Doctors' Opinion of Public Health Center on the Development and Supply of Medical Doctor for Public Health Sector (공공보건분야 의사 인력 양성과 개발에 대한 보건소 근무 의사들의 인식)

  • Lee, Kyeong-Soo;Lee, Jung-Jeung;Kim, Jin-Sam;Hwang, Tae-Yoon;Son, Hyo-Kyung;Kim, Chun-Bae
    • Journal of agricultural medicine and community health
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    • v.34 no.3
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    • pp.303-315
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    • 2009
  • Objectives: This study, as for activating measures for capable medical physicians to penetrate into the public health sector, is to provide a basic informations which are used for the enlargement of human resources of physicians in the public health sector, by investigating the perception of physicians, who are now working in the public health center, on the training and development of physicians in the public health sector. Methods: The subjects of this study were 126 individuals. The data was analyzed by frequency analysis using SPSS ver. 17.0K. Results: According to the investigation of 'how to support physicians in public health sector', the necessity of almost questions is considered to be important. Especially, regarding to investigation on 'obstacles of physicians' entrance to public health sector', 'relatively low salary' and 'lack of promotion chances' were thought to be considerable. The most significant education programs to work for public health sector is to improve the ability of health administration planning and service performance. Conclusions: The important methods to reinforce and easily obtain the human resources of physicians in public health sector are not only to improve the penetration of physicians to public health sector, but also to enhance the ability of present physicians, even though sufficient recruitment of physicians is essential.

The Experience and Competence of Physicians Who Provide Emergency Health Care at Public Health Sub-Centers on Remote Islands in Korea (도서지역 보건지소 공중보건의사의 응급의료 경험 및 대처능력 고찰)

  • Seo, Je-Hyun;Lee, Su-Jin;Ha, Jeong-Hoon;Kwon, Duck-Geun;Kim, Jung-Ho;Lee, Jae-Hyuk;Na, Baeg-Ju;Kang, Yoon-Hwa
    • Journal of agricultural medicine and community health
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    • v.36 no.1
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    • pp.36-46
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    • 2011
  • Objectives: To investigate the experience and competence of physicians providing emergency medical services at public health sub-centers on remote Korean islands. Methods: This study enrolled 79 doctors who work at public health sub-centers on remote Korean islands. Data were collected in December 2009 via self-administered e-mail questionnaires. The response rate was 44.3%. Results: Emergent situations occurred at most (58.68%) of the public health sub-centers that were surveyed in December 2009. An average of 1.92 cases required treatment by public health physicians. Only 20.25% of the physicians were specialists in emergency medicine, while the remainder were general practitioners (GPs) without clinical experience as emergency doctors. We also found that the physicians we surveyed had insufficient knowledge of emergency medical care. At some health centers only one doctor was available, and there was no medical team in holiday, although most of the physicians indicated that the ideal number of doctors per center was two or three. In cases of emergency, patients were often sent to the mainland by ship without receiving first-aid treatment. The public health sub-centers lacked the necessary medical equipment to save lives in emergencies and lacked escort systems for emergency patients. Conclusions: The Korean government should address the importance of providing emergency care in remote areas. Health administrators should provide suitable manpower, medical equipment, guidelines for emergency medicine, and education for public health physicians on remote islands.

A Study on the Family Planning Status of an Urban Slum Population (일부도시영세민의 가족계획 실태에 관한 연구)

  • 노순영
    • Journal of Korean Academy of Nursing
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    • v.3 no.3
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    • pp.50-61
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    • 1973
  • Despite the intensive family Planning program of the government, which has reduced the :average population growth to 2.0 percent in 1970, the continuing high fertility rates and poor family planning services in urban slum areas has been continually pointed out by various evaluation seminars. Thus, it was felt that a study of the current status of family planning in an urban slum population was needed. The aims of the study were to: (1) delineate the general characteristics of the urban slum population (2) discover the knowledge, attitudes, and practice of family planing. (3) determine what was felt to be the ideal number of children. (4) determine the status of induced abortion. A random stratified sample of 200 women was selected from a population of 3, 118 married women, 20-49 years of age, living in the Yonsei Community Health Project area and registered at the Yonhee Community Health Service Institute. The respondents were interviewed by the investigates, using a pretested questionary, from the period of October 1 to October 30, 1972. The findings of the Study were as follows: 1. Afore than half of the respondents were in the high fertility age group (25-34): of lower educational level (under primary School) : from rural areas: and with unstable sources of income. 2. The average respondent had 3.6 living children. 3. Most of the respondents had knowledge of contraceptive methods such as the Loop(78, 5%) and Oral pill (87.0%). 4. Seventy seven percent of the respondents recognized the Health Center as an available source for family planning. 5. About seventy percent of the respondents approved of family planning. 6. Eighty four point five percent of all the respondents answered that using contraceptives is harmful to maternal health. 7. Currently, 21.0 percent of the respondents were using contraceptives, while 40.0 percent of the respondents were current users or had used contraceptives. 5. Of the respondents who had ever stopped using contraceptives, 78.0 percent gave side effects as the reason they discontinued the method. 9. The average number of ideal children reported by the respondents was 3.5. 10. If they had only 2 daughters, 85.5 Percent of the respondents thought they must have more children. 11. Sixty nine point five percent of the respondents approved of induced abortion for unwanted pregnancies, while 34.5 percent of the respondents had experienced induced abortion for unwanted pregnancies. The mean number of induced abortion for unwanted pregnancies was 0.7. 12. The result of this study showed that such urban slum population would be one of the most important target of the family planning services, therefore further social-psychological researches with technical development on this area are recommended.

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A Study on the Status of Physical Exercise of Community People in City Area (도시지역주민의 운동실태와 관련요인)

  • 한중호;남철현
    • Korean Journal of Health Education and Promotion
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    • v.8 no.1
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    • pp.68-86
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    • 1991
  • This study was carried out to investigate consciousness level of physical exercise and analyze factors affection to the practice of exercise. The main purpose of the study was to give basic and necessary data in developing of program regarding to the physical exercise of the people and social athletics. This study was conducted by trained surveyers, for dweller in three cities(Seoul, Taegu and Ulsan) during January 4. 1990 to January 24. 1990. The results of this study can be summarized as follows 1. The subject of criticism an investigation for general charactristic be conducted in Seoul, Taegu and Ulsan city area an objective 417 person, 432 person and 366 person was among those comparatively little more by male was higher rate than female. Those in classification was adopted by age group 20 years old adult 41.3% of most higher rate, age group evaluation, were 24.9% and other group were 18.4% comprehensively appearanced by adult group has most many value rate. 2. An objective of investigation survey was made to personnel were comparative an educated level significantly higher such as college graduated 48.8% this rate of value has most higher, High school graduated ; 30.1% and middle School gratuated were 11.7%. In addition the native comes from large city, Farming and fishing villages an rural area rate were shown as 29.6%, 28.4% and 19.9% each other. There by classification of occupational job was shown by students has 27.4% are most higher significantly, also there sales and service field job appearanced 15.1% and expert technical job is 9.0% Although nonreligion person rate were 37.3%, buddist, Christianity, Roman Catholicism all them each other shown 33.6%, 16.7% and 12.4%. An evaluation in economic situation value rate was appearanced by middle class level 61.7% and higher and low level are 14.4% and 23.9% with each other and married were 59.2%. 3. The people resident in cities area has pratice of health development by exercise person were 43.5% and value of rate for male has exercise practice is 52.5%, was significantly higher than female has by age group 10 years old and age group 50 years old is 52.6% and 47.3% was comparative higher rate also age group 30 is 35.1% of low factor was indicated. Although evaluated an economic situation rate was higher level get more taken the practice of health develop exercise(higher level 60.0% and low level is 32.9%). Although by higher level of educated were more taken pratice of their proper physical exercise(college graduated rate ; 52.2% of most higher and high school graduted ; 39.7% and then middle school graduated is 19.1%) unmarried taken exercise rate ; 48.4% is significantly higher than married person rate ; 40.8%. Although objective of native area of exercise rate of Urban area cities ; 52.5% are significantly higher farming and fishing native person rate ; 40.4% shown is most low.

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Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia over three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Powell, Kate;Eckert, Marion;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2431-2440
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

Oral Health and Related Factors for the Elderly (Structural Equation Modeling을 통한 노인(老人)의 구강건강(口腔健康) 관련요인(關聯要因) 분석(分析))

  • Seung, Jeung-Hee
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.91-95
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    • 2004
  • This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

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An Analysis of Single-person Households' Expenditure Pattern (1인가구의 품목별 소비지출 분석)

  • Park, Moon-Soo;Chong, Hogun;Kim, Hwa-Nyeon;Koh, Dae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.2
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    • pp.987-994
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    • 2015
  • This study examines how single-person household expenditure patterns are different with respect to age and income groups using Tobit model. The expenditure data of the national household survey from 2006 to 2012 were used. The results show that income elasticities of all items are greater than 1 except for food & beverage, housing, water, electricity & gas, and Communication. Income elasticities are significantly different among consuming items. Additionally the income elasticities are also different between various age and income groups of single-person households. Therefore governments and businesses have to take this into account when devising their policies or strategies regarding single-person households. Especially, businesses need to adopt a strategy targeted at single-person households with high income and buying power such as unmarried professional people. As the number of single-person household increases the proportion of expenditures on necessities such as beverage, food, and energy is expected to decrease while that on services increases. Consequently policy responses are required to prepare for the expansion of service industries such as health, hospital, and housekeeping services.

The Nature of Patient's Disagreement with Doctors among Some Rural Residents (일부 농촌주민에서 의사에 대한 환자의 의견불일치)

  • Lee, Moo-Sik;Cho, Hyong-Won;Kim, Eun-Young;Chun, Byung-Chul;Shin, Dong-Hoon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.315-329
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    • 1999
  • Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

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