Critique of Mental Health Welfare Law in Korea : Focusing on Involuntary Hospitalization Criteria / 신경정신의학

Under new mental health and welfare law, involuntary admission is allowed only for persons with mental illness based on the narrowed criteria of mental illness when they meet both need for treatment and danger to themselves and others. These stringent danger criteria along with narrowed definition of mental illness may prevent timely intervention for people with acute psychosis. It is claimed that the danger criteria is essential to keep up with international (UN, WHO) principles for legislation of mental health acts and laws of advanced countries. The international principles, however, do not necessarily call for stringent danger criteria for involuntary hospitalization. Danger criteria are not also prerequisites for involuntary hospitalization in many advanced countries. In countries with strict danger criteria, complementary measures seem to be taken for the drawback of danger criteria. As for the involuntary hospitalization by legal guardians, the complicated qualification for legal guardians may hinder prompt admission. The required number of legal guardians also needs to be changed from two to one person. Even in the situation where involuntary hospitalization is deemed urgent, there is no way to transport the patients to the hospital for assessment or temporary admission unless the police judges the patients to be dangerous to themselves or others. Outpatient treatment order can be an alternative to involuntary admission. However, it is rarely used since the order cannot be applied to those who do not have history of admission due to danger. For voluntary admission, status conversion to involuntary admission needs to be allowed in case of aggravation of symptoms to meet involuntary admission criteria. In addition, informal admission needs to be introduced to avoid unnecessary formal procedures for patients admitting voluntarily to open ward. In view of all these issues with new mental health and welfare law, entire revision of new mental health law is urgent to balance the rights to proper treatments and protection of human rights of persons with mental disorder.

Contemplation of Legal Criteria of Psychiatric Compulsory Admission: Including an Introduction of US Case Which Can be Referred to the Assessment of the Appropriateness of Hospitalization in Korea / 신경정신의학

The Korean Mental Health Act has been radically reformed recently in order to improve psychiatric patients' human rights by regulating the compulsory admission process. However, the expert group brought up questions about difficulties in practice and incoherence in its philosophy before the Act was implemented. There are already discussions concerning the next revision of the Act. In such a situation, lessons can be learned from the experiences of other countries. Articles on psychiatric compulsory admission were comprehensively reviewed with the focus on legal criteria, and found that current trends worldwide include a move towards broad diagnostic criteria, use of capacity and treatability test, and treatment in the interest of health rather than safety. In addition, we introduce the Whittington scale, an assessment tool for the appropriateness of hospitalization used in the Connecticut Mental Health Center, US, as a reference for the similar procedure being implemented soon in Korea.

Impacto de maloclusiones sobre la calidad de vida y necesidad de tratamiento ortodóntico en escolares de dos escuelas privadas Azogues - Ecuador, 2015 / Impact of malocclusions on quality of life and Need for Orthodontic Treatment in schoolchildren of two private schools Azogues - Ecuador, 2015

Objetivos: Evaluar el impacto de las condiciones orales atribuidas a maloclusiones sobre la calidad de vida a través del CS Child-OIDP y Necesidad De Tratamiento Ortodóntico a través del INTO en escolares de 11 a 12 años de dos escuelas privadas en Azogues-Ecuador, año 2015. Material y métodos: Esta investigacion evaluó a 170 escolares para determinar el impacto de las maloclusiones sobre la calidad de vida, mediante la versión peruana del Child-OIDP, utilizando únicamente. las condiciones atribuidas a maloclusiones, (CS Child-OIDP Posición de los dientes, espacios, tamaño y forma y deformidades cracenofaciales), sobre los desempeños diarios, y la Necesidad de Tratamiento De Ortodoncia mediante el Indice de Necesidad de Tratamiento de Ortodoncia (INTO) . Resultados: Las condiciones más prevalentes fueron: posición de los dientes (63,5%), y dientes separados (40,5%); los desempeños más afectados fueron comer (65,3%) y sonreír (51,8%); respecto de la necesidad de tratamiento ortodóntico según el componente estético, el 91,18% de los escolares no tuvieron necesidad de tratamiento y según el componente de salud dental, el 10%; al asociar las dos variables, se encontró diferencia estadísticamente significativa en el desempeño sonreír p=0,02; según el Componente de Salud Dental. Conclusiones: La condición más prevalente fue posición de los dientes, los desempeños diarios más afectados fueron comer y sonreír, al asociar Necesidad de Tratamiento y desempeños afectados en los dos componentes revelaron a los desempeños comer y sonreír como los más afectados, existiendo significancia estadística en el desempeño sonreír.

Objectives: To evaluate the impact of oral conditions attributed to malocclusions on quality of life through CS Child-OIDP and Need for Orthodontic Treatment through INTO in schoolchildren aged 11 to 12 from two private schools in Azogues-Ecuador, year 2015. Material and Methods: This study evaluated 170 schoolchildren to determine the impact of malocclusions on quality of life, using the Peruvian version of the Child-OIDP, but only using the conditions attributed to malocclusions, (CS Child-OIDP position of teeth, spaces, size And form and cracenofacial deformities), on daily performance, and the need for orthodontic treatment through the need for orthodontic treatment index (INTO). Results: The most prevalent conditions were Position of the teeth (63.5%), and Separated Teeth (40.5%); The most affected performances were eating (65.3%) and smiling (51.8); regarding the need for orthodontic treatment according to the aesthetic component, 91.18% of the students did not need treatment and according to the Dental Health Component 10%; when associating the two variables, we found statistically significant difference only in the performance smile p = 0.02 according to the Dental Health Component. Conclusions: The most prevalent condition was position of the teeth, the most affected daily performances were eating and smiling, when associating Treatment Need and affected performances in the two components revealed to eating and smiling performance as the most affected, there being statistical significance in performance smile.

Necesidad de tratamiento periodontal en embarazadas, Frutillar, Chile, 2015 / Periodontal treatment needs in pregnant women, Frutillar-Chile 2015

Objetivo Determinar la necesidad de tratamiento periodontal de embarazadas de la ciudad de Frutillar, Chile, durante el año 2015. Material y método Se realizó un estudio observacional descriptivo de corte transversal durante los meses de julio a octubre del año 2015. Se evaluó a 66 embarazadas, las cuales cumplieron con los criterios de inclusión. Fueron evaluadas mediante un examen clínico por 2 examinadores calibrados (kappa 0,86). Para determinar la necesidad de tratamiento, se utilizó el índice de necesidad de tratamiento periodontal de la comunidad. Se aplicó el test de la chi al cuadrado, asumiendo un nivel de significación estadística p < 0,05. Este estudio contó con la aprobación del Comité de Ética del Centro de Salud Familiar de Frutillar. Resultados Del total de las embarazadas evaluadas, el 97% presentó necesidad de tratamiento periodontal. El valor promedio ± desviación estándar del índice de necesidad de tratamiento periodontal de la comunidad fue 2,51 ± 1,48), no teniendo diferencias estadísticamente significativas entre grupo etario (p > 0,05). Conclusión La necesidad de tratamiento periodontal de embarazadas de la ciudad de Frutillar es alta. La detección de enfermedad periodontal debe ser una parte fundamental del examen dental integral de las embarazadas, para mantener un estado de salud y prevenir futuras complicaciones en su condición de embarazo.

Aim To determine the periodontal treatment needs of pregnant women in 2015 in the city of Frutillar, Chile. Material and method A descriptive observational cross-sectional study was conducted from July 2015 to October 2015 on a total of 66 pregnant women that satisfied the inclusion criteria. They were evaluated by a clinical examination by two trained examiners (Kappa 0.86). The Community Periodontal Index of Treatment Needs (CPITN) was used to determine their periodontal treatment needs. The Chi-squared statistic was used, assuming a statistical significance level of P<.05. This study was approved by the Ethics Committee of the Frutillar Family Health Centre. Results Of the total of pregnant woman evaluated, 97% need periodontal treatment. The mean value using the CPITN was 2.51 (SD 1.48), with no statistically significant differences between the age. Conclusion The periodontal treatment needs of pregnant women in the city of Frutillar are high. The detection of periodontal disease must be an essential part of the comprehensive dental examination of the pregnant woman, in order to maintain health and prevent further complications in their pregnancy condition.

Necesidad de tratamiento periodontal e higiene oral en adolescentes de 12 años de Llanquihue / Periodontal treatment needsand oral hygiene in adolescents 12 years old of Llanquihue

OBJETIVO: Determinar la necesidad de tratamiento periodontal e higiene oral de los adolescentes de 12 años, de la ciudad de Llanquihue, Chile. MATERIAL Y MÉTODOS: Se realizó un estudio observacional descriptivo de corte transversal, en adolescentes de 12 años de la ciudad de Llanquihue, Chile, entre los meses de marzo y junio del año 2013. Se evaluó una muestra de 90 adolescentes, los cuales cumplieron con los criterios de inclusión. Para determinar la necesidad de tratamiento, se utilizó el índice de necesidad de tratamiento periodontal de la comunidad y se evaluó la higiene oral mediante el índice de higiene oral simplificado. Se aplicó el T-test, asumiendo un nivel de significancia estadística p < 0,05. RESULTADOS: Del total de adolescentes examinados, el 56,7% eran de género masculino. El valor promedio del índice de necesidad de tratamiento periodontal de la comunidad fue 1,1 ± 0,9 y el del índice de higiene oral simplificado fue de 0,7± 0,5. Los promedios de índice de necesidad de tratamiento periodontal de la comunidad e índice de higiene oral simplificado no tuvieron diferencias estadísticamente significativas entre géneros (p < 0,05). CONCLUSIÓN: El 33,3% de los adolescentes de 12 años pertenecientes a la ciudad de Llanquihue tienen necesidad de tratamiento periodontal. La detección de enfermedad periodontal debe ser una parte fundamental del examen dental integral de los niños y adolescentes

OBJECTIVE: To determine the periodontal treatment needs and oral hygiene among 12 years old teenagers, living in Llanquihue, Chile. MATERIALS AND METHODS: A cross-sectional, descriptive, observational study was performed. It evaluated 12 years old teenagers registered in the selected schools in Llanquihue, Chile 2013 between march and june. The sample consisted of 90 teenagers, who met the inclusion criteria. To determine the treatment needs periodontal it was used the Community Periodontal IndexofTreatment Needs(CPITN) and the oral hygiene was evaluated by using theSimplified Oral Hygiene Index(OHI-S).Test T was applied assuming a statistical significance level p < 0,05. RESULTS: Of the total sample, 56,7% of the participants were males. The average values for the CPITN and OHI-S, were 1,1 ± 0,9 and 0,7 ± 0,5, respectively. There were no statistically significant differences between both genders (p < 0,05). CONCLUSION: 33,3% of adolescents aged 12 yearsold belonging tothe town ofLlanquihue, need periodontal treatment. Periodontal disease detection must be considered as an important part of the integral dental examination in children and adolescents