The Decision No 37/CP date June 20th, 1996 issued the strategy for the activities of the people protection and care during 1996-2000. It aimed to assure that 40% of communal health stations (CHS) had midwife or nurse of gynecological - pediatrical profession and 100% of villages and hamlets had health staffs. In order to obtain above mentioned objectives, this study introduced 7 solutions for sending the medical doctor to the CHS, 4 conditions for training the medical doctor for local level, 7 solutions for sending the midwives to CHS, 4 solutions for health staffs in the local level, 3 solutions for health staffs of the traditional medicine, 4 solutions for developing the health staffs of the traditional medicine, 4 solutions for developing the health staff network for village level and 14 solution for sending the health staffs to the lower levels.
Personnel Selection ; Medical Staff ; Solutions

Humans ; Occupational Health Physicians ; organization & administration ; Personnel Selection

The concept of personalized medicine for disease diagnosis, treatment, and management, considering individual variability, including susceptibility, clinical manifestations, and drug responsiveness, is a global emerging trend in medicine, which is also inevitable. However, clinical applications of personalized medicine in the real-world practice have been limited to certain cancers so far. Furthermore, this new concept to the diagnosis and treatment of adult asthma has not been applied to clinical use. Asthma is a multifactorial and heterogeneous disease. It seems to encompass a broad spectrum of clinical manifestations with different underlying pathophysiological mechanisms. Thus, it is not easy to categorize by their clinical features alone. Endotypical categorization that considering specific pathophysiological mechanisms will be more helpful in applying the concept of personalized medicine. The success of personalized medicine depends on patient selection for precise prescription of asthma medications. In the recent years, many investigators and physicians have devoted a lot of effort to the discovery of reliable biomarkers in asthmatic patients, which will be able to actualize the personalized medicine in near future. Despite such great efforts toward investigation of good biomarkers, few things have turned out to be practical in the clinic. Easily interpretable biomarkers of asthma are necessary to assess early detection, determination of treatment, prognosis prediction, and monitoring of exacerbation. Herein, we review recent studies regarding disease classifications and biomarkers of asthma.
Adult* ; Asthma* ; Biomarkers* ; Classification ; Diagnosis ; Humans ; Precision Medicine* ; Patient Selection ; Phenotype ; Prescriptions ; Prognosis ; Research Personnel

The difficulty in the participant recruitment is the common question in acupuncture clinical trial study. The existing recruitment of clinical trial is most applicable for the clinical trial of medicines. Because the intervention of acupuncture clinical trial is different from that of medicines, characterized as the specialties in "theory, principle, acupoints, technique", it is very necessary to develop the strategy on the participant recruitment in acupuncture clinical trial. The free community medical consultation is one of the important means of recruitment. In the paper, by taking the participant recruitment of acupuncture clinical trial on chronic stable angina pectoris as the example, the discussion is given on the strategy on the recruitment of free community medical consultation in the aspects of feasible investigation of recruitment approach, recruitment plan, participant screening, etc. The revisiting after the free community medical consultation is the important approach to the improvement of successful recruitment. This strategy on the recruitment of free community medical consultation is highly practical and improves the successful rate and compliance of the participant recruitment. Hence, this strategy deserves to be promoted.
Acupuncture Therapy ; Clinical Trials as Topic ; standards ; Humans ; Personnel Selection ; standards ; Research Design ; standards

The cohort study is an observational epidemiological study which selects the specific study population attempting to study the relatiqnship between an exposure to the purported cause and the subsequent risk of developing disease in accordance of time direction. Since Doll and Hill had studied the association between lung cancer and smoking behavior among the British medical doctors in the years of the last fifties, the defined group cohort studies analysing the relationship between an exposure and the occurence of a disease have become very popular. Cohort studies can be classified as either prospective or retrospective, depending on the temporal relationship between the initiation of the study and the occurence of the disease. Cohort studies are admitted as the very valuable studies for demonstrating the association between an exposure and a disease because it is possible to drive relative and attributable risks and often incidence measures. They can even examine multiple effects of a single exposure. However, they are usually expensive to carry out and large cohorts are required for rare diseases in addition to the time consum ing works. There are also very significant problems associated with selection of appropriate groups to be studied as far as complete ascertainment of disease occurence in them. Usually it is necessary that we must compromise to provide the opportunity for various types of bias such as selection bias, follow-up bias, information bias or misclassification, confounding bias and post hoc bias to occur which can result in incorrect conclusions. Only the success of a cohort study would be expected when the investigator pay the deep care in recognizing and correcting for these biases.
Bias (Epidemiology) ; Cohort Studies* ; Humans ; Incidence ; Lung Neoplasms ; Rare Diseases ; Research Personnel ; Selection Bias ; Smoke ; Smoking

Neuromuscular electrical stimulation (NMES) is a relatively new therapeutic approach for dysphagia, involving the application of electrical current across the skin to excite the nerve or muscle tissue. Recently, investigators are trying to establish a scientific basis for NMES, but there is still debate over the effect of NMES in dysphagia rehabilitation. Moreover, there is a paucity of evidence about patient selection, electrode placement, stimulation parameters, and application duration. This paper is aimed to review recent evidence of NMES for dysphagia management.
Deglutition Disorders ; Deglutition* ; Electric Stimulation* ; Electrodes ; Humans ; Patient Selection ; Rehabilitation ; Research Personnel ; Skin

BACKGROUND AND PURPOSE: The presence of dysphagia and aspiration in stroke patients is associated with increased mortality and morbidity. Early recognition and management of these two conditions via reliable, minimally invasive bedside procedures before complications arise remains challenging in everyday clinical practice. This study reviews the available bedside screening tools for detecting swallowing status and aspiration risk in acute stroke by qualitatively observing reference population study design, clinical flexibility, reliability and applicability to acute-care settings. METHODS: The primary search was conducted using the PubMed, Embase, and Cochrane Library databases. The search was limited to papers on humans written in English and published from 1991 to 2016. Eligibility criteria included the consecutive enrollment of acute-stroke inpatients and the development of a protocol for screening aspiration risk during oral feeding in this population. RESULTS: Of the 652 sources identified, 75 articles were reviewed in full however, only 12 fulfilled the selection criteria. Notable deficiencies in most of the bedside screening protocols included poor methodological designs and inadequate predictive values for aspiration risk which render clinicians to be more conservative in making dietary recommendations. CONCLUSIONS: The literature is dense with screening methods for assessing the presence of dysphagia but with low predictive value for aspiration risk after acute stroke. A standard, practical, and cost-effective screening tool that can be applied at the bedside and interpreted by a wide range of hospital personnel remains to be developed. This need is highlighted in settings where neither trained personnel in evaluating dysphagia nor clinical instrumentation procedures are available.
Deglutition Disorders ; Deglutition* ; Humans ; Inpatients ; Mass Screening* ; Mortality ; Patient Selection ; Personnel, Hospital ; Pliability ; Stroke

Since 2016, the pediatric emergency centers (PECs) have been selected by the Korean Ministry of Health and Welfare, but there are still many problems in their designation and operation. The authors, affiliated with the policy research team in the Korean Society of Pediatric Emergency Medicine, sought to identify the current status and plans for improvement of PECs in Korea. The problems in the designation and operation are the disproportionate regional distribution of the PECs, financial difficulties in meeting the designation criteria, and recruitment of dedicated pediatric emergency specialists. To improve this, it is necessary to designate additional PECs and analyze the appropriateness of insurance cost, to strengthen the role other than the community practice, and to reinforce back-up treatment by pediatric sub-specialists in PECs.
Community Health Services ; Emergencies* ; Emergency Medicine ; Financial Support ; Geography, Medical ; Insurance ; Korea* ; Local Government ; Personnel Selection ; Specialization

Since 2016, the pediatric emergency centers (PECs) have been selected by the Korean Ministry of Health and Welfare, but there are still many problems in their designation and operation. The authors, affiliated with the policy research team in the Korean Society of Pediatric Emergency Medicine, sought to identify the current status and plans for improvement of PECs in Korea. The problems in the designation and operation are the disproportionate regional distribution of the PECs, financial difficulties in meeting the designation criteria, and recruitment of dedicated pediatric emergency specialists. To improve this, it is necessary to designate additional PECs and analyze the appropriateness of insurance cost, to strengthen the role other than the community practice, and to reinforce back-up treatment by pediatric sub-specialists in PECs.
Community Health Services ; Emergencies* ; Emergency Medicine ; Financial Support ; Geography, Medical ; Insurance ; Korea* ; Local Government ; Personnel Selection ; Specialization

Considerable effort has been made to address the issue of occupational health and environmental exposure to mercury. This review reports on the current literature of mercury exposure and health impacts on dental personnel. Citations were searched using four comprehensive electronic databases for articles published between 2002 and 2015. All original articles that evaluated an association between the use of dental amalgam and occupational mercury exposure in dental personnel were included. Fifteen publications from nine different countries met the selection criteria. The design and quality of the studies showed significant variation, particularly in the choice of biomarkers as an indicator of mercury exposure. In several countries, dental personnel had higher mercury levels in biological fluids and tissues than in control groups; some work practices increased mercury exposure but the exposure levels remained below recommended guidelines. Dental personnel reported more health conditions, often involving the central nervous system, than the control groups. Clinical symptoms reported by dental professionals may be associated with low-level, long-term exposure to occupational mercury, but may also be due to the effects of aging, occupational overuse, and stress. It is important that dental personnel, researchers, and educators continue to encourage and monitor good work practices by dental professionals.
Aging ; Biomarkers ; Central Nervous System ; Dental Amalgam ; Environmental Exposure ; Humans ; Occupational Diseases ; Occupational Health ; Patient Selection ; Research Personnel