• The Korean Journal of Pain
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• 제30권4호
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• pp.287-295
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• 2017

Background: Recently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals. Methods: We conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital. Results: Among the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05). Conclusions: Instruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management.

• 여성건강간호학회지
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• 제5권3호
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• pp.379-388
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• 1999

Breastfeeding is an excellent way of feeding infants and continues to be an important source of nutrition and antibodies for infants. Although breast-feeding is believed to be important, the rate of breastfeeding among Korean women is very low. One reason for the low breastfeeding rate is that the health professionals in the past have given little practical help couples to overcome difficulties encountered during breastfeeding. The promotion of breastfeeding has recently become a high priority among health professionals because of the undisputed physiological, psychological, social, economic, and nutritional benefits. Fathers have been found to influence the course of breastfeeding, but no one has conducted a systematic investigation into in and included fathers perspectives of breastfeeding in Korea. It is important to find strategies to solve the problems by assessing the knowledge, attitude and practice of breastfeeding with fathers as well as mothers. The purpose of this research is to find ways to promote primiparous(first child) couples's breastfeeding by assessing their general knowledge, attitude and practice of it. More specifically its purposes is to identify the relationship between knowledge, attitude, practice and the background factors of breastfeeding of primiparous couples in order to promote and support breastfeeding. The data will help health professionals to guide first-pregnancy couples to prepare and overcome any difficulties encountered during breastfeeding. Data were collected through a questionnaire which included both structured and open-ended questions. The questionnaire was composed referencing earlier literature, studies and surveys. This survey was made postpartum 2-3days after childbirth on 96 couples. The numbers of subjects for data analysis were selected 51 couples through pilot screening test. Data were coded and analyzed using the Statistical Package for Social Sciences : Cronbach's alpha coefficient, T-test, ANOVA, Stepwise pearson's correlation coefficient. The relations between the variables of breastfeeding were examined using a Pearson's correlation coefficient. This study showed that, the internal validity of the instrument was tested by Cronbach's alpha. The result was : mother knowledge 0.72, mother attitude 0.88, and father knowledge 0.70, father attitude 0.92, practice 0.76 and planning of breast feeding 0.95. The average age of mothers in the sample was 28.9 years old, and the average age of fathers in the sample was 31.3 years old. The other descriptive informations available included. the study also found that fathers were more important than doctors or nurses. However results of the study indicate that there were no differences between father and mother knowledge of breastfeeding(t=-0.39, p=0.698), and father attitude was statistically significant higher than mother attitude of breastfeeding (t=2.24, p=0.030). In analysis, the variable 'practice' with breastfeeding was the relationship with mother knowledge (p=0.031) and mother attitude(p=0.015). In this study, the correlation between one couple' knowledge and attitude was not significant. Primiparous couples surveyed in the postpartum period regarding knowledge, attitude and practice about breastfeeding might be affected by recall bias, the effects of the euphoria of the first 24-48 hours postpartum, but these variables were not examined. This study results add to the body of knowledge about nursing care for breastfeeding mothers and fathers. This indicates that a need for education about breastfeeding and, that fathers be included in it as well as mothers.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2465-2472
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• 2015

Background: The Quality Audit (BQA) program of the Breast Surgeons of Australia and New Zealand (NZ) collects data on early female breast cancer and its treatment. BQA data covered approximately half all early breast cancers diagnosed in NZ during roll-out of the BQA program in 1998-2010. Coverage increased progressively to about 80% by 2008. This is the biggest NZ breast cancer database outside the NZ Cancer Registry and it includes cancer and clinical management data not collected by the Registry. We used these BQA data to compare socio-demographic and cancer characteristics and survivals by ethnicity. Materials and Methods: BQA data for 1998-2010 diagnoses were linked to NZ death records using the National Health Index (NHI) for linking. Live cases were followed up to December $31^{st}$ 2010. Socio-demographic and invasive cancer characteristics and disease-specific survivals were compared by ethnicity. Results: Five-year survivals were 87% for Maori, 84% for Pacific, 91% for other NZ cases and 90% overall. This compared with the 86% survival reported for all female breast cases covered by the NZ Cancer Registry which also included more advanced stages. Patterns of survival by clinical risk factors accorded with patterns expected from the scientific literature. Compared with Other cases, Maori and Pacific women were younger, came from more deprived areas, and had larger cancers with more ductal and fewer lobular histology types. Their cancers were also less likely to have a triple negative phenotype. More of the Pacific women had vascular invasion. Maori women were more likely to reside in areas more remote from regional cancer centres, whereas Pacific women generally lived closer to these centres than Other NZ cases. Conclusions: NZ BQA data indicate previously unreported differences in breast cancer biology by ethnicity. Maori and Pacific women had reduced breast cancer survival compared with Other NZ women, after adjusting for socio-demographic and cancer characteristics. The potential contributions to survival differences of variations in service access, timeliness and quality of care, need to be examined, along with effects of comorbidity and biological factors.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2597-2606
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• 2014

Background: There is a scarcity of information about the proportion of the adult Saudi population that meet the recommended guidelines of physical activity (PA) to reduce cancer risk. Moreover, their awareness about the role of PA in cancer prevention is unclear. Objectives: This cross-sectional study aimed at estimating the proportion of adult Saudis meeting the PA guidelines, specifically those recommended by American Cancer Society (ACS) for cancer prevention, and to assess the public awareness about the role of PA in cancer prevention. Materials and Methods: Using a multistage sampling method, 2,127 adult Saudis of both genders were recruited from 6 urban and 4 rural primary health care centers in Al Hassa, Saudi Arabia. Participants were personally interviewed to gather information about their sociodemographic characteristics, searching activity about PA and cancer, and the time spent in leisure time PA (moderate and vigorous)/week using the Global Physical Activity Questionnaire with show cards. Finally, items about the role of PA in cancer risk reduction were inquired. Results: Of the included participants, 11.6% met the recommendations for cancer prevention (${\geq}45$ minutes of moderate-vigorous PA activity/${\geq}5$ days/week or 225 minutes/week). Multivariate regression showed that being male (AOR=1.49, CI=1.09-2.06), <20 years of age (AOR=3.11, CI=2.03-4.76), and unemployed (AOR=2.22, CI=1.57-3.18) were significant predictors for meeting PA recommendations for cancer prevention. Only 11.4% of the sample indicated correctly the frequency and duration of PA required for an average adult to be physically active and while >70% of them indicated the role of PA in prevention of hypertension, coronary heart disease and lowering elevated blood cholesterol, only 18.6% and 21.7% correctly mentioned the role of PA in reducing colon and breast cancer risk, respectively. Poor knowledge was found among those with less than college education and aged ${\geq}50$ years. The level of knowledge was significantly positively correlated with total leisure time PA of the participants. Conclusions: A minority of adult Saudis in Al Hassa was aware about the role of PA in cancer prevention and engaged in sufficient LTPA for cancer risk reduction benefits, highlighting the need for public health actions to include policies and programs that address factors deterring their participation in LTPA and increasing their awareness with remedies to manage the prevalent misconceptions.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2547-2554
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• 2014

Background: To evaluate the perception of cancer patients toward treatment services and influencing factors and to inquire about the use of complementary alternative medicine (CAM). Materials and Methods: Information was obtained through pre-tested structured questionnaires completed by cancer patients during treatment at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Results: Of 242 patients, 137 (64.6%) accepted to enter this study. Most were Saudi (n=93, 68%), female (n=80, 58%), educated at university (n=71, 52%), married (n=97, 72%) and with breast cancer (n=36, 26%). One-hundred (73%) patients were satisfied with the services provided; 61% were Saudi. Ninety-four (68%) respondents were satisfied with the explanation of their cancer. Twenty-eight (21.6%) patients received CAM, of them 54.0% received herbal followed by rakia (21.0%), nutritional supplements/vitamins (7.0%) and Zamam water (18.0%), with significant differences among them (p =0.004). Seven (5%) patients believed this therapy could be used alone; 34 (25%) patients believed it could be used with other treatments, regardless of whether they themselves used this therapy. Fifty-three (53%) satisfied patients felt they received enough support; 31 (58%) patients received support from family and friends; 22 (41.6%) patients received support from the health-care team. Patients who received information about their disease from their physicians and those who felt they had enough support were more satisfied. The patients who took alternative treatment were older age, mostly female and highly educated but values did not reach significance. Conclusions: We stress enhancing the educational and supportive aspects of cancer-patient services to improve their treatment satisfaction and emphasize the need for increasing the educational and awareness programs offered to these patients.

• 정신신체의학
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• 제20권2호
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• pp.82-90
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• 2012

연구목적 : 위암은 국내에서 매우 빈번하게 발생하는 암이지만, 위암과 디스트레스 간의 관련성을 규명한 연구는 거의 없었다. 본 연구에서는 위암 환자의 디스트레스의 유병률을 조사하고 관련 위험인자를 알아보고자 한다. 방 법 : 일 종합병원 암센터에 입원한 274명의 위암 환자가 본 연구에 참여하였다. 모든 참여자에게 디스트레스를 평가하는 병원 불안 우울 척도가 시행되었으며, 사회인구학적 및 암 관련 임상 자료가 조사되었다. 결 과 : 153명(55.8%)의 위암 환자가 유의한 디스트레스를 나타내었다. 로지스틱 회귀분석에서 음주 경험이 있는 경우[오즈비(OR)=2.10, p=0.034]와 수행능력이 저하된 경우(OR=2.40, p=0.002)가 위암 환자의 디스트레스에 유의한 영향을 미치는 요인으로 밝혀졌다. 결 론 : 본 연구에서 약 반 수 이상의 위암 환자가 디스트레스를 겪고 있으며, 음주 경험과 낮은 수행 능력이 관련 위험 인자로 나타났다. 본 연구의 결과로 위암 환자의 디스트레스에 대한 선별 평가 및 심리사회적 중재의 필요성을 확인하였다.

• 한국안광학회지
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• 제5권1호
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• pp.165-171
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• 2000

본 조사는 경북 농촌지역의 백내장 분포를 알아보기 위하여 실시하였다. 백내장은 전 세계적으로 설명과 시력장애의 주원인일 뿐 아니라 노인인구의 증가로 인해 백내장 환자의 수는 현저하게 증가하였다. 이러한 추세에도 불구하고 백내장으로 인해 심하게 시기능이 저하된 상태에 있으면서도 안과적 진단 기회를 얻지 못하고 있는 환자들이 아직도 많이 있다. 이런 환자들의 선별과 분포조사를 위해 경북 칠곡과 문경 지역에서 일반 건강검진을 희망한 50세 이상 주민 636명(1272안)을 대상으로 최근 일본 Kanazawa 의과대학의 Sasaki 등이 제안한 간편한 백내장 일차선별검사를 적용하여 다음과 같은 결과를 얻었다. 전체 조사대상자 중 시력장애를 호소한 사람은 모두 493명(77.5%)이었다. 제1단계 선별검사로 448명(90.9%), 제2단계 선별검사로 308명(48.4%)의 백내장이 의심되는 시력불량군을 분류하였고, 제1, 2단계일차 선별검사에 의해 최종적으로 백내장으로 분류된 사람의 수는 421명(66.2%)이었다. 연령에 따른 유병율은 50대 27.5%, 60대 62.5%, 70대 86.1%, 80세 이상 94.3%이었다. 따라서 백내장이 실명과 시력장애의 주원인 일 뿐 아니라 국내에서도 공중보건분야의 중요한 문제인 만큼 적절한 관리와 안보건 대책이 요구되며 특히 안보건을 위한 의료활동이 농촌지역에까지 확대되어야 할 것으로 사료되었다.

• 무역상무연구
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• 제46권
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• pp.29-60
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• 2010

The incentive and reasons to publish FIDIC Conditions of Contract for Design, Build and Operate Projects(DBO Form) are manifold. It is partly a response to the increasing need for sophisticated project delivery methods in both the public and private sectors and the already widespread use of the FIDIC Yellow Book with operation and maintenance obligations and partly a response to the challenge to decrease maintenance cost to a minimum by means of a new procurement route. As a result, FIDIC has developed a new model form to meet this market place requirement. On the other hand, FIDIC did not simply adapt the Yellow Book but has developed a new form from it, whilst preserving the style of the already known FIDIC Forms and maintaining the wording where it was not necessary to change it for the purposes of a DBO Form. Moreover DBO Form fills up supposed gaps in other FIDIC Forms and ameliorates the claim management and dispute management framework. FIDIC DBO approach may be shortly summarized as follows. First, DBO Form provides for single project responsibility. Second, DBO Form has the clear objective of ensuring the use of a most reliable and efficient technology at the lowest life-cycle cost. Third, DBO Form is intended to operate as an effective quality increase in the design and construction of projects. Fourth, DBO Form is intended to provide significant benefits with regard to system integration and reduction of risks. Fifth, DBO Form accelerates and enhances completion schedule compliance. Sixth, DBO takes care of all three supporting pillars of sustainability(including economical, environmental and social elements). DBO Form is obviously a good starting point for negotiations and the preparation of calls for tenders, thus saving the parties time and money. However, existing cultural and legal differences, particular local conditions and the particular needs of some branches of the industry may require the form to be adapted according to the particular needs of a project. And Civil law practitioners are strongly recommended to verify carefully the underlying legal concepts and background of each clause of the General Conditions in order to avoid unnecessary and sometimes unnatural changes and amendments being made. Note that when preparing the Particular Conditions ensure that terminology is consistent and that existing inherent concepts should not be ignored.

• 한국콘텐츠학회논문지
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• 제16권5호
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• pp.351-360
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• 2016

본 연구는 부위마취로 수술을 받는 노인환자의 간호요구를 파악하기 위한 서술적 조사연구이다. 연구대상자는 일개 종합병원과 일개 준 종합병원에 입원하고 있는 60세 이상의 척추마취, 경막외마취, 신경차단하에 수술을 받은 126명으로 구조화된 설문지를 이용하여 2012년 10월 1일부터 10월 30일까지 자료를 수집하였다. 수집된 자료는 기술통계, t-test와 ANOVA, $Scheff{\acute{e}}$ test로 분석하였으며 연구결과는 다음과 같다. 노인환자의 부위마취 수술 중 간호요구의 평균은 $3.08{\pm}0.38$점이었고, 영역별로는 교육적($3.47{\pm}0.50$점), 영적($3.37{\pm}0.78$점), 신체적($3.31{\pm}0.46$점), 정서적($2.72{\pm}0.50$점), 환경적($2.51{\pm}0.47$점) 간호요구의 순으로 나타났다. 일반적인 특성에 따른 간호 요구는 성별, 종교, 배우자 유무에서 유의한 차이를 보였고, 수술관련 특성에 따른 간호 요구는 수술과, 수술시간, ASA 신체분류에서 유의한 차이를 보였다. 본 연구결과 부위마취 수술 노인 환자에게 수술과 마취에 대한 교육을 제공하는 것이 필요하며, 연구결과를 토대로 부위마취 수술 노인환자의 간호요구를 충족시키기 위한 교육지침 및 중재프로그램을 개발하고 평가하는 연구를 제언한다.

• Journal of Nutrition and Health
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• 제14권4호
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• pp.190-199
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• 1981

A survey of nutrition and incidence of parasites was conducted from January 23 to 31 and February 14 to 18, 1981, to determine the nutritional status of young children under the age of 6 years, in one of the rural family health project areas: Whaseoung-gun, Kyunggi-do, Korea. This study covered a total of 233 children. The results are summarised as follows: Approximately one-half of these families had an annual income between \1,000,000 and \2,500,000. Nearly 84% of the households were involved in farming. Energy intake of children met 70.6% of the requirement: carhohydrates provided 77%, protein provided 11%, and fat provided 12% of the total energy intake. Low intake of iron; calcium; and vitamins, excluding thiamin, was also found. Mean hemoglobin value was $10.6{\pm}1.0gm/100ml.;\;42%$ of subjects were categorized as low group, 22% were in the deficient group, and only 36% were at an acceptable level as indicated by O'Neal. Thus, 22% of the subjects were proven to be anemic by the hemoglobin criteria. Mean hematocrit value was $30.1{\pm}2.8%$, and 80 of 208 children, or 38.4% of subjects, were below 30% of the standard established by O'Neal. The positive prevalence of parasitic infection was 20% , significantly higher than that observed in the Yowido compound (5.5%) in 1980. Hematologic findings had no significant correlation to parasitic infection. The majority, 95.2% of the subjects, met or surpassed 90% of the KlST's standard of height:whtile 28. 6% of the subjects were below 90% of the KIST's standard of weight. The ratio of weight to height for boys 4 to 6 years old was 15.8 to 17.5, in contrast to 16.3 to 16.9 for boys of KHDI project areas, and also in contrast to 17.7 to 17.9 for boys of the same age group from the Yowido apartment compound in Seoul. According to the results of the assessments, the authors found a clear difference in growth values, hematologic findings and dietary patterns between rural areas and advantaged urban areas of Seoul. Our results suggest the need to develop the nutrition and parasite control training of village women for better nutritional care of their young children.