Risk of breast cancer is higher in upper 40-year women than in under 40-year women, in non-childbirth women than in childbirth women, in women who have the first children at 25 years old or more than in those who have the first children at lower than 25 years old. Breastfeeding women have lower risk of breast cancer than non-breastfeeding those. The women with history of chloroorganic insecticide exposure have higher risk of breast cancer than those without this history.
Breast Neoplasms ; Risk factors ; Rural Population ; women ; hospitals

We developed the Tele-PACS of radiology, which uses the communication network as asymmetric satellite data communication system. The asymmetric satellite data communication system uses receive-only satellite links for data delivery and PSTN(Public Switched Telephone Network) modem or N-ISDN(Narrow-band Integrate Services Digital Network) for communication. The satellite communication linking we implemented showed the very high-speed performance compared to the terrestrial linking such as 28.8 kbps modem linking or 56Kbps linking. The satellite linking was 5-10 times faster than the terrestrial linking on the average. We developed the down-link system of satellite and the medical collaborative tools and the Web-based Image-viewer. We concluded that 1) Satellite networking is currently the cheapest and fastest solution for internet access. 2) Web-based Image-Viewer enables small size hospitals in rural area to connect to the central PACS easily and to retrieve the image data reliably. 3) The suggested teleradiology system using satellite networking could be adequate to the fast telemedicine and telecare for rural hospitals especially located in geographically isolated areas such as islands.
Hospitals, Rural ; Internet ; Islands ; Modems ; Satellite Communications ; Telemedicine ; Telephone ; Teleradiology

We developed the Tele-PACS of radiology, which uses the communication network as asymmetric satellite data communication system. The asymmetric satellite data communication system uses receive-only satellite links for data delivery and PSTN(Public Switched Telephone Network) modem or N-ISDN(Narrow-band Integrate Services Digital Network) for communication. The satellite communication linking we implemented showed the very high-speed performance compared to the terrestrial linking such as 28.8 kbps modem linking or 56Kbps linking. The satellite linking was 5-10 times faster than the terrestrial linking on the average. We developed the down-link system of satellite and the medical collaborative tools and the Web-based Image-viewer. We concluded that 1) Satellite networking is currently the cheapest and fastest solution for internet access. 2) Web-based Image-Viewer enables small size hospitals in rural area to connect to the central PACS easily and to retrieve the image data reliably. 3) The suggested teleradiology system using satellite networking could be adequate to the fast telemedicine and telecare for rural hospitals especially located in geographically isolated areas such as islands.
Hospitals, Rural ; Internet ; Islands ; Modems ; Satellite Communications ; Telemedicine ; Telephone ; Teleradiology

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.
Education ; Growth and Development ; Hand ; Health Expenditures ; Health Facility Closure ; Hospitals, Community ; Hospitals, General ; Hospitals, Rural* ; Humans ; Inflation, Economic ; Models, Economic

To try to determine the type of medical service wanted by the rural population, in Chungnam Province, a survey amongst the populations of 6 counties was conducted; Within the 6 counties, 2 local communities, which had no access to local medical services, were surveyed. The 12 communities were actively involved in Sae-Maul activities, and total number of households surveyed, was 822. The survey was conducted over a 1 month period, from July 16th, 1976, thru August 20th, and the followings are the results, summarized. 1. The largest number of respondents desired a combination of Public Health Center and Country Hospital, followed in order by Private Clinic and Modern Medical Facility. 2. The respondents, aged under 40 years, desired the Private Clinic type medical service, whilst those over 40 years of age, wanted the County Hospital, and as the numbers in this age bracket, were larger, so the ratio was much higher. 3. Sex, educational background, and occupation did not play any particular emphasis in the decisions. 4. Monthly income affected the responses to the survey. These in the lower-income bracket, wanted the County Hospital, and the ratio was high. These in the high income bracket desired the Modern Medical Service, accordingly. Those with an income of 50,000 won or less, amongst the low-income bracket, favored the Public Health sub-center type of service. The ratio for this service was very high.
Chungcheongnam-do ; Surveys and Questionnaires ; Family Characteristics ; Hospitals, County ; Occupations ; Public Health ; Rural Population

A fully-automated biochemical analysis system is developed, intending for primary medical units. It features high reliability, high usability, strong adaptability, low operation cost, low maintenance cost, and low requirements for operators.
Automation ; instrumentation ; methods ; Biochemistry ; instrumentation ; methods ; Equipment Design ; Equipment and Supplies, Hospital ; Hospitals, Rural

BACKGROUND: Despite increasing the number of newly licensed nurses across Korea, shortages caused by geographical imbalances remains a significant concern. Therefore, understanding nursing students' attitudes to working and living, factors influencing where they first choose to work after graduation is useful in formulating appropriate interventions to retain nurses in regional areas. METHODS: A total of 329 senior nursing students from areas outside Metropolitan Seoul completed self-report questionnaires. Data were analyzed using t-test, chi-square test and multiple logistic regression analysis. RESULTS: Of the respondents, 57.8% reported that they planned to work in the region in which their school was located. The three factors ranked as having the greatest influence on their decision to work in non-metropolitan regions were: the cost of living, housing costs, and the proximity to family. Enjoyable aspects of rural life contributed positively to students' intentions to work in non-metropolitan regions, whereas isolation and socialization problems negatively affected their intentions to work in such areas. CONCLUSIONS: Greater consideration should be given to improving working conditions and housing environments in non-metropolitan regions.
Employment ; Hospitals, Rural ; Housing ; Humans ; Intention ; Korea ; Logistic Models ; Nursing ; Seoul ; Socialization ; Students, Nursing ; Surveys and Questionnaires

Haematogenous osteomyelitis, especially in its more common chronic stage, is an important cause of morbidity in children in the Southern Highlands Province. Hospital stays are lengthy and the incidence of fractures is high. While awaiting, or in the absence of, culture and sensitivity results, cloxacillin 200 mg/kg/day plus probenecid 40 mg/kg/day is an appropriate first choice antibiotic when it is available. Antibiotic therapy in chronic disease should be limited to the specific settings of associated soft tissue infection; pre- and post-sequestrectomy; and radiological signs of ongoing bone necrosis and systemic signs of active infection. Surgical drainage of subperiosteal pus and possibly the medullary canal is required in all but the very early (less than 48 hours) cases of acute osteomyelitis that sometimes respond to antibiotics alone. Sequestrectomy should be reserved for cases where a sequestrum and adequate involucrum can be seen on X-ray. Effective management of this disease is possible only if ongoing communication exists between hospital-based medical staff and the staff of health centres or subcentres, including the network of aid post orderlies and their supervisors. Since the majority of patients present to facilities other than hospitals, any campaign directed at improving management must involve co-workers in rural areas, namely the health extension officer, nurse and aid post orderly. Only in this way can we hope to achieve earlier appropriate treatment and more systematic long-term follow-up.
Adolescent ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Chronic Disease ; Hospitals, Rural ; Humans ; Osteomyelitis ; drug therapy ; microbiology ; surgery ; Papua New Guinea ; Rural Health

PURPOSE: The objective of this study was to evaluate the risk factors associated with agricultural machinery-related injuries, and to develop strategies to control and prevent such injuries. METHODS: The medical records of 148 patients who visited the emergency department of Chosun University Hospital with a history of agricultural machinery-related injuries from January 2005 to December 2006 were examined. Injury rates were categorized by age, sex, underlying disease, place and time of injury, mechanism of accident, kind of machine and final diagnosis, Injury severity was calculated by using TRISS method and compared. RESULTS: 148 cases of agricultural machinery-related injuries were identified. Most cases involved men(85.1%) and occurred between 4 p.m. and 8 p.m., with seasonal peaks in autumn and spring. The largest number of cases involved men in their sixties(33.2%) with a mean age of 57.5. Significant risk factors for injury were age over fifty, transferred patient, accident on main road , and patients of passenger seat or trunk when the accident occurred. Extremities were more vulnerable than other body areas, and injuries of the abdomen, head, and neck had higher fatality and mortality rate. The overall mortality rate was 12.8%. CONCLUSIONS: Agricultural machinery-related injuries have a high case fatality rate. Physicians must be able to make rapid, accurate assessments of the injured farmer, taking into account environmental factors that may cause additional problems, and active care of the injured farmer must be initiated at the rural hospital in order for optimal recovery to take place. There will be a need to develop strategies for prevention of these injuries and for educational programs.
Abdomen ; Agriculture ; Diagnosis ; Emergency Service, Hospital ; Extremities ; Head ; Hospitals, Rural ; Humans ; Male ; Medical Records ; Mortality ; Neck ; Risk Factors* ; Seasons

OBJECTIVETo investigate the secular trend of advanced maternal age woman (>or= 35 year-old) in our country.

METHODSData on maternal woman at different age were collected at surveillance hospital in Chinese Birth Defects Monitoring Network from 1996 to 2007 and retrospective analysis of the trend of advanced maternal women were carried out. Trend analysis of the advanced maternal age in urban and rural areas of west, middle and east areas was also conducted. Chi-square test was applied to test the differences and the fitting model analysis was also applied.

RESULTSA total of 6,308,594 parturient woman were monitored, included 354,511 woman (5.62%) of advanced maternal age. In 1996 and 2007, the proportion of the advanced maternal woman were 2.96% (12,508/422,486) and 8.56% (66,351/775,333), respectively. It showed an increasing trend for the national woman proportion of advanced maternal age from 1996 to 2007 (chi(2) = 45 376.16, P < 0.01). In city, the proportion of advanced maternal age woman were 2.95% (8755/296,975) and 7.69% (40,197/522,596) in 1996 and 2007, respectively. In rural region, the proportion of advanced maternal age woman were 2.99% (3753/125,511) and 10.35% (26,154/252,737) in 1996 and 2007, respectively. It showed increasing both in city and rural areas (chi(2)(city) = 24,152.86, P < 0.01; chi(2)(rural) = 20,809.79, P < 0.01). And the proportions in urban area and rural area were 5.13% (221,655/4,317,533) and 6.67% (132,856/1,991,061), the proportions difference was significant in statistics (chi(2) = 1536.260, P < 0.01). An Exponential model was established, ln(Y) = ln(2.52) + (0.103 x t). In east areas, the proportion were 3.90%and 8.81% in 1996 and 2007, respectively, in middle areas the respective proportions were 2.49% and 8.56%, in west areas were 2.11% and 8.21%. They all showed increasing trend in proportion of advanced maternal age from 1996 to 2007 year in east areas, middle areas and west areas (chi(2)(east) = 11,746.87, P < 0.01; chi(2)(middle) = 17,350.21, P < 0.01; chi(2)(west) = 16,432.68, P < 0.01). But the proportions of city and rural were different in those areas.

CONCLUSIONThe proportion of advanced maternal woman had secular increasing trend and the rates were lower in city than in rural areas.

Adult ; Age Distribution ; China ; Female ; Hospitals, Maternity ; Humans ; Maternal Age ; Middle Aged ; Pregnancy ; Retrospective Studies ; Rural Population ; Urban Population