Effects of Public Health Service Impartiality on Subjective Health Happiness: Mediated Effect of Public Health Service Quality / 보건행정학회지

BACKGROUND: The purpose of this study is to analyze the effect of impartiality in providing public health services on subjective health happiness and the mediated effects of public health service quality. Based on this, this study intends to present policy implications to improve public health services. METHODS: The research method is multiple linear regression analysis. The analysis of the mediating effects is performed by Baron & Kenny's test, Sobel-Goodman's test, and Bootstrap. RESULTS: The impartiality of public health services and the quality of public health services are shown to have a statistically significant effect on subjective health happiness. Quality of public health service appears to be mediating the relationship between impartiality in providing public health care and subjective health happiness. CONCLUSION: To promote people's subjective health happiness, it is necessary to secure impartiality in providing public health services in the first place and improve the quality of public health services.

Endocrown restorations for extensively damaged posterior teeth: clinical performance of three cases

The restoration of endodontically treated teeth (ETT) with more than one cusp missing and thin remaining walls is challenging for the general practitioner. The use of posts combined with full coverage restorations is a well-established approach, yet not following the minimal invasive principles of adhesive dentistry. Endocrowns are indirect monoblock restorations that use the pulp chamber of the ETT for retention. In this study the fabrication of 4 endocrowns and their clinical performance will be discussed. Two clinical cases include computer-aided design/computer-aided manufacturing manufactured molar endocrowns (one feldspathic ceramic and one hybrid composite-ceramic restoration) and the other two are dental laboratory manufactured resin composite premolar endocrown restorations. The modified United States Public Health Service criteria were used to assess the clinical behavior of the restorations at different follow up periods. Endocrown restorations present a satisfactory clinical alternative, either by the use of resin composite or glass ceramic and hybrid materials. Specific guidelines with minimal alterations should be followed for an endocrown restoration to be successful. Due to limited evidence regarding the long term evaluation of this restorative technique, a careful selection of cases should be applied.

Historical Origins of the Tuskegee Experiment: The Dilemma of Public Health in the United States / 의사학

The Tuskegee Study of Untreated Syphilis in the Negro Male was an observational study on African-American males in Tuskegee, Alabama between 1932 and 1972. The U. S. Public Health Service ran this study on more than 300 people without notifying the participants about their disease nor treating them even after the introduction of penicillin. The study included recording the progress of disease and performing an autopsy on the deaths. This paper explores historical backgrounds enabled this infamous study, and discusses three driving forces behind the Tuskegee Study. First, it is important to understand that the Public Health Service was established in the U. S. Surgeon General's office and was operated as a military organization. Amidst the development of an imperial agenda of the U.S. in the late 19th and early 20th centuries, the PHS was responsible for protecting hygiene and the superiority of “the American race” against infectious foreign elements from the borders. The U.S. Army's experience of medical experiments in colonies and abroad was imported back to the country and formed a crucial part of the attitude and philosophy on public health. Secondly, the growing influence of eugenics and racial pathology at the time reinforced discriminative views on minorities. Progressivism was realized in the form of domestic reform and imperial pursuit at the same time. Major medical journals argued that blacks were inclined to have certain defects, especially sexually transmitted diseases like syphilis, because of their prodigal behavior and lack of hygiene. This kind of racial ideas were shared by the PHS officials who were in charge of the Tuskegee Study. Lastly, the PHS officials believed in continuing the experiment regardless of various social changes. They considered that black participants were not only poor but also ignorant of and even unwilling to undergo the treatment. When the exposure of the experiment led to the Senate investigation in 1973, the participating doctors of the PHS maintained that their study offered valuable contribution to the medical research. This paper argues that the combination of the efficiency of military medicine, progressive and imperial racial ideology, and discrimination on African-Americans resulted in the Tuskegee Syphilis Experiment.

Cobertura de serviços públicos de saúde para gastos com medicamentos e vacinas na população com diabetes mellitus / Coverage by the public health services of medication and vaccines for the population with diabetes mellitus

O estudo analisou a cobertura do serviço público de saúde para gastos com medicamentos e vacinas para a população adulta do município de São Paulo que referiu ter diabetes mellitus em 2003 e as implicações dos programas de acesso a medicamentos e campanhas vacinais. Dados coletados pelo Inquérito Multicêntrico de Saúde de São Paulo. O SUS foi o mais utilizado pela população para a vacinação contra a gripe e pneumonia e na cobertura do gasto com medicamentos houve participação significativa do setor privado, sendo a cobertura SUS estimada em 38%. Não foram observadas diferenças significativas na prevalência de utilização do serviço público para vacinação entre as categorias das variáveis pesquisadas, o que sugere uma distribuição universal da vacinação pelo serviço público de saúde. Diferente da vacinação, a cobertura do gasto com medicamentos pelo serviço público de saúde em 2003 era recente, o que pode explicar a menor cobertura. A análise da cobertura dos gastos com medicamento e vacinas pelo serviço de saúde em 2003 pode contribuir para embasar políticas que visem ampliar o acesso da população ao serviço de saúde.

This study analyzed the coverage by the public health service of expenses with medication and vaccines for the adult population of São Paulo with self-reported diabetes mellitus in 2003 and the implications for access to medicines and vaccination campaigns programs. Data were collected by the Multicenter Health Survey of São Paulo. The Unified Health System (SUS) was widely used by the population for vaccination against influenza and pneumonia and there was significant private sector participation for coverage of expenses with medication, with an estimated coverage of 38% by SUS. There were no significant differences in the prevalence of use of public services for vaccination among the categories of variables studied, suggesting a universal distribution of vaccination by the public health service. Unlike vaccinations, in 2003 the coverage of medication expenses by the public health service was recent in Brazil, which may explain the low level of coverage. An analysis of coverage of vaccination and medication expenses in diabetes mellitus population since 2003 may contribute to be the basis for policies to broaden access of the population to health services.

Research on constitution of Chinese medicine and implementation of translational medicine / 中国结合医学杂志

Translational medicine is a new concept presented in recent decades, the core of which is to build a bridge between basic medical research and clinical application. From the beginning of constitution of Chinese medicine, clinical application has been given priority. Therefore, the idea of translational medicine is fully demonstrated in the research into the three key scientific problems of "classification of constitution of Chinese medicine", "relationship between constitution and disease" and "adjustment of constitution". Under its guidance, not only was the systematic theory of constitution of Chinese medicine established, but also the Constitution of Chinese Medicine Scale and the Standards of Classification and determination of Constitution of Chinese Medicine were developed, which translates methods of classifying the nine constitutional types into guidance for prevention of disease, management of health and clinical application. The research findings of constitution of Chinese medicine have been applied in clinical practice and public health, establishing the diagnosis and treatment model of constitution-disease-syndrome differentiation. The nationwide application of constitution differentiation has shown good effect. In the future, constitution of Chinese medicine should strengthen the evidence-based research and multi-disciplinary cooperation, and establish a research team on comprehensive constitution of Chinese medicine and translational medicine, to translate the findings into clinical practice and public health more accurately and quickly.

Desempenho clínico de laminados cerâmicos / Clinical performance of porcelain laminate veneers

A busca por um sorriso perfeito tem se tornado exigência comum na prática clínica, uma vez que um belo sorriso é fator importante para o bem-estar pessoal e social. Para o presente trabalho, foram confeccionados 63 laminados cerâmicos, sendo 34 em pacientes do sexo feminino e 06 do sexo masculino. Os laminados cerâmicos cimentado foram avaliados nos períodos inicial, seis e 12 meses, mediante doze critérios de performance clínica (USPHS). Assim, este estudo tem como objetivo avaliar o desempenho clínico do laminado cerâmico, a fim de contribuir para a prática clínica de sua utilização.

The search for a perfect smile is becoming an increasing concern in daily practice, because a beautiful smile is an important factor for personal and social well-being. For this article, it was fabricated 63 porcelain laminate veneers (and 34 females and 6 males). The porcelain laminates were evaluated after cementation at the following periods: baseline, 6 and 12 months, using twelve criteria of clinical performance (USPHS). The aim of this study was to evaluate the clinical performance of porcelain laminate veneers, in order to encourage their use in routine clinical practice.

The effect of clinical performance on the survival estimates of direct restorations

OBJECTIVES: In most retrospective studies, the clinical performance of restorations had not been considered in survival analysis. This study investigated the effect of including the clinically unacceptable cases according to modified United States Public Health Service (USPHS) criteria into the failed data on the survival analysis of direct restorations as to the longevity and prognostic variables. MATERIALS AND METHODS: Nine hundred and sixty-seven direct restorations were evaluated. The data of 204 retreated restorations were collected from the records, and clinical performance of 763 restorations in function was evaluated according to modified USPHS criteria by two observers. The longevity and prognostic variables of the restorations were compared with a factor of involving clinically unacceptable cases into the failures using Kaplan-Meier survival analysis and Cox proportional hazard model. RESULTS: The median survival times of amalgam, composite resin and glass ionomer were 11.8, 11.0 and 6.8 years, respectively. Glass ionomer showed significantly lower longevity than composite resin and amalgam. When clinically unacceptable restorations were included into the failure, the median survival times of them decreased to 8.9, 9.7 and 6.4 years, respectively. CONCLUSIONS: After considering the clinical performance, composite resin was the only material that showed a difference in the longevity (p < 0.05) and the significantly higher relative risk of student group than professor group disappeared in operator groups. Even in the design of retrospective study, clinical evaluation needs to be included.

A Survey of Role Perception and Function Performance Related to Public Health Service among the Medical Staff in a National Hospital / 農村醫學 地域保健

OBJECTIVES: While there have recently been efforts to improve public health service at a governmental level, there is actually insufficient research on awareness of the roles related to public health service among hospital employees. This study examined role perception and function performance related to public health service among the medical staff in a national hospital. METHODS: 15% were randomly sampled from each type of occupation among the medical staff in a national university hospital, a survey was conducted in 323 persons, and there were a total of 265 participants (80.2%): 103 doctors(38.9%), 98 nurses (37.0%), and 64 others (24.1%). RESULTS: The hospital employees had insufficient awareness of their roles as public health service providers in terms of six required items for public health service: 1) services for supporting establishment, implementation, and assessment of public health service policies, 2) participation in the health service activities and support services by central or local governments, 3) technological support and educational services for private health service institutions, 4) health service for unprivileged brackets, 5) health service that requires association with other areas dealing with geriatric, disabled, and mentally-disordered people, and 6) health service for children and mothers. CONCLUSIONS: In general, since the hospital employees had insufficient awareness of their roles and responsibilities as public health service providers, it is necessary to secure manpower exclusively in charge of public health service and provide education about strategic public health service.

Clinical performance and failures of zirconia-based fixed partial dentures: a review literature

PURPOSE: Zirconia has been used in clinical dentistry for approximately a decade, and there have been several reports regarding the clinical performance and survival rates of zirconia-based restorations. The aim of this article was to review the literatures published from 2000 to 2010 regarding the clinical performance and the causes of failure of zirconia fixed partial dentures (FPDs). MATERIALS AND METHODS: An electronic search of English peer-reviewed dental literatures was performed through PubMed to obtain all the clinical studies focused on the performance of the zirconia FPDs. The electronic search was supplemented by manual searching through the references of the selected articles for possible inclusion of some articles. Randomized controlled clinical trials, longitudinal prospective and retrospective cohort studies were the focuses of this review. Articles that did not focus on the restoration of teeth using zirconia-based restorations were excluded from this review. RESULTS: There have been three studies for the study of zirconia single crowns. The clinical outcome was satisfactory (acceptable) according to the CDA evaluation. There have been 14 studies for the study of zirconia FPDs. The survival rates of zirconia anterior and posterior FPDs ranged between 73.9% - 100% after 2 - 5 years. The causes of failure were veneer fracture, ceramic core fracture, abutment tooth fracture, secondary caries, and restoration dislodgment. CONCLUSION: The overall performance of zirconia FPDs was satisfactory according to either USPHS criteria or CDA evaluations. Fracture resistance of core and veneering ceramics, bonding between core and veneering materials, and marginal discrepancy of zirconia-based restorations were discussed as the causes of failure. Because of its repeated occurrence in many studies, future researches are essentially required to clarify this problem and to reduce the fracture incident.

Avaliação clínica de restaurações de resina composta em dentes posteriores / Clinical evaluation of composite restorations in posterior teeth

Este estudo avalia o comportamento clínico de restaurações diretas de resina composta em dentes posteriores. Para tanto, toma uma série de casos de acompanhamento longitudinal, com a realização de 55 restaurações de classe I e II. Os operadores são alunos de Odontologia do Centro Universitário Franciscano (Unifra, RS). A avaliação foi feita seis meses após a confecção das restaurações, e foi utilizado o critério United States Public Health Service (USPHS) modificado: forma anatômica, estabilidade da cor, descoloração marginal, integridade marginal e lesão de cárie secundária. Foram avaliadas 54 (98,2%) restaurações, delas, duas falharam, e o índice de sobrevivência foi de 91,78%. Conclui que o desempenho clínico das restaurações é aceitável.

This article aims to evaluate the clinical performance of direct composite resin restorations in posterior teeth. Methods: Case series of longitudinal, with the completion of 55 restorations, class I and II. The operators were dental students from Franciscan University Center (Unifra) RS, Brazil. The evaluation was conducted six months after making these, and criterion was utilized United States Public Health Service (USPHS) modified: anatomical form, color stability, marginal discoloration, marginal integrity and caries secondary. A total of 54 (98.2%) restorations, of whom two failed, and the survival rate was 91.78%. In conclusion, it finds that the clinical performance of the restorations was acceptable.

Current Status of Home-Based Cancer Patients Management in Jeju / 한국호스피스완화의료학회지

PURPOSE: As a part of analysis of home-based cancer patients management of public health centers, regional cancer center, and hospice institution in Jeju, this study was undertaken to establish their role. METHODS: We investigated current status of hospice palliative care, especially home-based cancer patients management and summary demand of public health centers. RESULTS: Services provided through the home-based cancer patients management project included physical, emotional, spiritual and education/informative services, even though there was little difference between them. The result showed that in the view of patients there was little relationship between public health centers, regional cancer center and hospice palliative institution. CONCLUSION: The relationship between home-based cancer patients management and institutions should be reinforced. Patients in acute state and difficulty care of patients should be referred to regional cancer center whereas maintenance state of patients should be referred to public health center.

Clinical Features, Disability and Socioeconomic Status of Patients With Muscular Dystrophy in Korea

BACKGROUND: Since 2001, the Ministry of Health and Welfare in Korea has designated muscular dystrophy (MD) to be a rare and intractable disease, and has ensured that patients with this condition obtain support from the National Health Insurance Corporation for their medical expenditure. However, the health-related and socioeconomic status of Korean patients with MD has yet to be established. METHODS: We selected 441 patients with MD who received medical services at 17 neuromuscular centers during 2005. The medical records of selected patients were analyzed, and the subtype of MD was classified by its clinical course and diagnostic tests. A total of 95 patients or their family members participated in this health-related and socioeconomic status survey. RESULTS: Medical record analysis showed similar clinical and diagnostic characteristic data to those published previously in other countries: male predominance, being young at onset, and muscular weakness of the extremities as a predominant symptom in most patients. The diagnostic tests for MD were based on laboratory and electrophysiological studies. The most frequent form of MD among our cohort was Duchenne/Becker muscular dystrophy (42%). Our survey revealed the effect of the patients' profound disability on their activities of daily living. One-half of the patients were dissatisfied with the medical expenditure support service that was made available to them, and most patients suffered from a financial burden. The most important medical services to be developed in the future are expansion of the public health service or development of a rehabilitation hospital. CONCLUSIONS: This is the first multicenter-based epidemiologic study on the health-related and socioeconomic status of patients with MD in Korea. The findings indicate that medical coverage and public health service are currently inadequate and hence should be expanded in the future.

A Study on Yangsaeng for Health Promotion of Aged Women in Rural Area

PURPOSE: The purpose of this study was to explore the yangsaeng level in a health management way of an aged women in rural area, and to offer basic material for the development of community's public health service. METHODS: The subjects were 144 aged women who participated voluntarily in the questionnaire. The data were collected from January to February, 2008 with a self-administered questionnaire. Data were analyzed by SPSS 13.0 win program for finding frequency, percentage, mean, standard deviation, ANOVA and Tukey. RESULTS: The average age of workers was 72. Total yangsaeng level was 3.08+/-.33, highest yangsaeng factor was Activity & Rest Yangsaeng of 3.55+/-.46 and lowest yangsaeng factor was Season Yangsaeng of 2.43+/-.75. The total Yangsaeng level was the significant difference in monthly incomes(F=4.046, p=.047). CONCLUSION: Considering the results above, the yangsaeng level of aged women is affected by the age, education level, a monthly income etc. Therefore, for health promotion plan of aged women, consider that their age, educational level, economic level ect, and systematic education for promotion of health is necessary.

The Business Analysis on the Chronic Disease Management in PublicHealth Centers for the Electronic Health Records System / 대한의료정보학회지

OBJECTIVE: This study analyzes the chronic disease management, which is a core business of the public health centers, and grasps the functions of the information system that users need. METHODS: It is conducted by analyzing work flows in two public health centers that using two different health information systems, Posdata system and Daeryun systems. We also performed detailed interview and discussion to formulate the functionality for the information system in the future. RESULTS: Both two health information systems currently used at public health centers emphasized hypertension, diabetes mellitus and hyperlipidemia as major target disease. They used information systems as a tool of case registration, assessment, reporting, consultation and education and patient care. But functionality of current systems supports only a part of the whole system and manual data input using excel program was still applied. The current information system is just inputting the data of manual works in computer and many of the functions are not used and still there are many duplicate and manual works. Two major problems of information systems in Korean public health centers are lack of standardization in the business process and reporting, and the current system does not support current functionalities. CONCLUSION: We found that management of the chronic disease is to be more important work for the public health centers in the future. The future direction of the work process of the management of chronic disease would be upgrading the current functionality as well as new functionalities. Better linkage with direct care system and interoperability with national electronic health records system are new demands.

Weight loss program using $\beta$3-adrenergic receptor gene polymorphism / 日本農村医学会雑誌

Obesity is a major risk factor for lifestyle-related diseases and its prevention is essential in terms of public health. Body weight is influenced by a genetic predisposition as well as food intake, and exercise. In about 30% of the Japanese, a specific mutation [codon 64 TGG (Trp) →CGG (Arg)] of β3-adrenergic receptor gene is observed. The basal metabolic rate is about 200 kcal/day lower in the individuals with this type of mutation than in those without. We conducted a weight loss program which included analysis of β3-adrenergic receptor gene polymorphism, monitoring of eating behavior, and promotion for lifestyle modifications by public health nurses. The subjects for analyses were 39 Japanese men (mean age 37.8±8.6 years) and six Japanese women (46.8±6.4 years), with body mass index (BMI) over 24. They had not been receiving medical treatment for lifestyle-related diseases. The ratio of the normal group (no mutation at the specific site of β3-adrenergic receptor gene) to the mutation group were 73% to 27%. After we explained the results of the genetic testing to the participants, public health nurses encouraged them to change their lifestyle and provided dietary guidance. After 3 and 8 months intervention, reductions in BMI were observed 75% and 57% of the subjects in the normal group, and 92% and 67% of the subjects in the mutation group, respectively. At any time point, the changes were not statistically significant between the normal and mutation groups. Behavior modification was observed 49% of the subjects in the normal group and 75% in the mutation group. More than 80% of the participants were of the opinion that the genetic testing had been useful for them to reconsider their health status.

Survey of Public Health Service Needs of Live-Alone Elders in Urban Area

BACKGROUND: The number and proportion of live-alone elders in Korea have been increasing dramatically. We tried to identify the physical health status of live-alone elders in community and their needs for public health service in order to provide basic data for effective public health service to promote health and quality of life. METHODS: The subjects for this study were 38 nurses who provide visit-nursing service to live-alone elders in Seoul and Kyunggi Province. Data were collected by semi-structured questionnaires. RESULTS: The half of live-alone elders had disease, but only half of them took appropriate treatment. Barrier to treatment were difficulty to access to medical center, immobility, lack of drive and also poor insight. CONCLUSION: To solve the problems related to the elderly living alone in community, the instillation of public health policy that encompass professional medical service and comprehensive team approach are needed.

The Recent National Hansen Programme in Some Countries / 나학회지

Prevalence of Hansen's disease is reduced about 90% all over the world 20 years by the active efforts of World Health Organization and every country government. As a result, Hansen's disease remains as the public-health problem in only 10 countries after 2003. Recently, patients ware converged in 5 countries such as India, Brazil, Mozambique, Nepal, Madagascar, prevalence of these country 83% of all patients in the world, 88% of new patients of the world. Recently the general society-interests about Hansen's disease are fallen because of the reducing the importance in the public health service and the decreasing of the occurrence of the new patients of Hansen's disease. And the special workers about Hansen's disease and the supports from the government and international organization were reduced. So many workers are worried about the reducing of the quality of Hansen programme, delayed diagnosis and possibility of disability. And Hansen's disease is not actually the main concerns of public-health problem all over the world, but recently the Hansen's disease is known as the major cause of neuropathy and blindness among the infectious disease. For the use of the references of decisionmaking of the national Hansen programme I have reviewed and compared the national Hansen programme in some countries.

Prospective clinical evaluation of three different bonding systems in class V resin restorations with or without mechanical retention / 대한치과보존학회지

The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty-nine healthy adults who had at least 2 NCCLs in their premolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups: (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St. Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves; (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves; (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin, Denfil (Vericom Co., Anyang, Gyeonggido, Korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United States Public Health Service) criteria. Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpha ratings, there was no significant difference among the 3 adhesive systems (p > 0.05). There was also no significant difference between the groups with or without mechanical retention (p > 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves.

4275 and counting: telling stories about STDs on Daru

This paper applies a qualitative perspective and method to a highly quantitative dataset. Data on 4275 consecutive patients with sexually transmitted diseases (STDs) who reported to the Daru General Hospital STD Clinic between 1980 and 1992 are critically examined. Prevailing public health approaches to the epidemiology of STDs presume a linguistic, social, cognitive and geographical fixity to both STDs and the people whom they afflict in ways that are empirically unsound. Some of the problems of and some of the problems with the presentation and treatment of gonorrhoea, syphilis and donovanosis are discussed. Because Daru is characterized by high levels of sexual violence, low levels of condom usage and a deeply entrenched sex industry, this total of 4275 is surely a dramatic under-accounting. In particular it misses the embodied, highly gendered nature of disease. Male and female STD Clinic patients appear to think about, feel and report their problems in greatly different ways.

The Content Evaluation of Tobacco Cessation Information on Internet Web-Sites in Korea / 대한의료정보학회지

In this study, quality of tobacco cessation information provided through Internet web sites was evaluated in terms of clarity of objectives, suitability, accuracy, reliability and usability. This study limited to those internet web sites developed and delivered by Korean public health service organizations or their related institutions or associations. This study analyzed 8 internet web sites and evaluation criteria developed by Chung, Yong Chul and Park, Hyeoun Ae (2000) were used. Study results indicated that objectives of those sites were not described or not clear; the types of audiences of those sites were not evident; Sources of the information were not clearly documented; sponsored institutions or organizations were not clearly identified; authors/editors credentials were not clearly stated. The development of guidelines for standardized health information on Internet web sites is necessary.