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Association between Socioeconomic Status and Altered Appearance Distress, Body Image, and Quality of Life Among Breast Cancer Patients

  • Chang, Oliver;Choi, Eun-Kyung;Kim, Im-Ryung;Nam, Seok-Jin;Lee, Jeong Eon;Lee, Se Kyung;Im, Young-Hyuck;Park, Yeon Hee;Cho, Juhee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8607-8612
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    • 2014
  • Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

Development of Highway Safety Evaluation Considering Design Consistency using Acceleration (가속도를 고려한 도로의 설계일관성 평가기법에 관한 연구)

  • 하태준;박제진;김유철
    • Journal of Korean Society of Transportation
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    • v.21 no.1
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    • pp.127-136
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    • 2003
  • Road safety is defined under the minimum design standard and design examination process is consisted of the standard according to current road design. However, road safety in practical way is correlative to not only all element of roads but also road shape, such as, between straight line and curved line and between curved lines. Also. it is related to alignments such as horizontal alignment and vertical alignment, and cross section. That is, the practical road design should be examined in both sides of 3 dimension and consecutiveness (consistency) as the actual road is a 3 - dimensional successive object. The paper presents a concept for acceleration to evaluate consistency of road considering actual road shape on 3-dimension. Acceleration of vehicle is influential to road consistency based on running state of vehicles and state of drivers. The magnitude of acceleration. especially, is a quite influential element to drivers. Based on above, the acceleration on each point on 3-D road can be calculated and then displacement can be done. Computation of acceleration means total calculation on each axis. Speed profile refers to “Development of a safety evaluation model for highway horizontal alignment based on running speed(Jeong, Jun-Hwa, 2001)” and then acceleration can be calculated by using the speed pronto. According to literature review, definition of acceleration on 3-D and g-g-g diagram are established. For example, as a result of the evaluation, if the acceleration is out of range, the road is out of consistency. The paper shows calculation for change of acceleration on imaginary road under minimum design standard and the change tried to be applied to consistency. However accurate acceleration is not shown because the speed forecasting model is limited and the paper did not consider state of vehicles (suspension, tires and model of vehicles). If speed pronto is defined exactly, acceleration is calculated on all road shapes, such as. compound curve and clothoid curve. and then it is appled to consistency evaluation. Unfortunately, speed forecasting model on 3 -D road and on compound curves have rarely presented. Speed forecasting model and speed profile model need to be established and standard of consistency evaluation need to developed and verified by experimental vehicles.

Evaluation of Approximate Exposure to Low-dose Ionizing Radiation from Medical Images using a Computed Radiography (CR) System (전산화 방사선촬영(CR) 시스템을 이용한 근사적 의료 피폭 선량 평가)

  • Yu, Minsun;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.6 no.6
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    • pp.455-464
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    • 2012
  • This study suggested evaluation of approximately exposure to low-dose ionization radiation from medical images using a computed radiography (CR) system in standard X-ray examination and experimental model can compare diagnostic reference level (DRL) will suggest on optimization condition of guard about medical radiation of low dose space. Entrance surface dose (ESD) cross-measuring by standard dosimeter and optically stimulated luminescence dosimeters (OSLDs) in experiment condition about tube voltage and current of X-ray generator. Also, Hounsfield unit (HU) scale measured about each experiment condition in CR system and after character relationship table and graph tabulate about ESD and HU scale, approximately radiation dose about head, neck, thoracic, abdomen, and pelvis draw a measurement. In result measuring head, neck, thoracic, abdomen, and pelvis, average of ESD is 2.10, 2.01, 1.13, 2.97, and 1.95 mGy, respectively. HU scale is $3,276{\pm}3.72$, $3,217{\pm}2.93$, $2,768{\pm}3.13$, $3,782{\pm}5.19$, and $2,318{\pm}4.64$, respectively, in CR image. At this moment, using characteristic relationship table and graph, ESD measured approximately 2.16, 2.06, 1.19, 3.05, and 2.07 mGy, respectively. Average error of measuring value and ESD measured approximately smaller than 3%, this have credibility cover all the bases radiology area of measurement 5%. In its final analysis, this study suggest new experimental model approximately can assess radiation dose of patient in standard X-ray examination and can apply to CR examination, digital radiography and even film-cassette system.

Flowering Patterns of Miscanthus Germplasms in Korea (국내 수집 억새 유전자원의 출수 특성)

  • An, Gi-Hong;Um, Kyoung-Ran;Lee, Jun-Hee;Jang, Yun-Hui;Lee, Ji-Eun;Yu, Gyeong-Dan;Cha, Young-Lok;Moon, Yun-Ho;Ahn, Jong-Woong
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.60 no.4
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    • pp.510-517
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    • 2015
  • Miscanthus has been considered as the most promising bioenergy crop for lignocellulosic biomass production. In Korea, M. sacchariflorus and M. sinensis can be found easily in all regions. It is a great advantage to utilize as important species with respect to genetic and cross-breeding programs materials for creation of novel hybrids. For successful breeding programs, it is important to precisely understand the variability of flowering traits among Miscanthus species as breeding parents materials. In this study, flowering traits were observed daily in 960 germplasms of two Miscanthus species (M. sacchariflorus and M. sinensis) for growing seasons over 2 years. The flowering process was divided into three stages. ST (sprouting time) was recorded when first leaf of the plant emerged on soil. FS1 (flowering stage 1) and FS2 (flowering stage 2) were recorded when flag leaf was firstly observed, and 1 cm of panicle was showing on at least one stem, respectively. For 2013 and 2014, the latest germplasms exerted flag leaf, i.e. September 30 (DOY of FS1 164.1) and September 4 (DOY of FS1 141.0) occurred M. sacchariflorus cv. Geodae 1 and M. sacchariflorus cv. Uram collected from Southern Korea (Jeollanam-do), while Miscanthus germplasms collected from northern Korea (Gyeonggi-do) which emerged the earliest flag leaf in July and August, significantly decreased DOY. For DOY from ST to FS2, M. sacchriflorus germplasms ranged from 140 to 190 days, and 110 to 170 days for 2013 and 2014. The highest frequency showed to 160 days for 2013, and 150 days for 2014. In M. sinensis germplasms, the highest frequency showed to 180 days for 2013, and 170 days for 2014. In the results of correlation between the day of years from ST to FS2 for 2013 and 2014, M. sacchriflorus and M. sinensis showed high coefficient of correlation (0.70 and 0.89). It can be supposed that flowering characteristics of Miscanthus are largely affected by the unique phenotypic characteristic of native habitat than environmental factors of the current planted site. This study for flowering traits of Miscanthus may provides an important information in order to expedite the introduction as breeding materials for creation of new hybrid.

Current Situation on Signing Advance Medical Directives and Actual Life-sustaining Treatment Given at a University Hospital (일개 대학병원의 연명치료 선택 및 사전의료의향서 작성 현황)

  • Yoon, Ho-Min;Choi, Youn-Seon;Hyun, Jong-Jin
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.91-100
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    • 2011
  • Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

A Study on the Successful Case of Brand Renewal through American National Brand 'C' Company's Marketing Strategy (미국(美國) 내셔널브랜드 C사(社)의 마케팅전략(戰略)을 통한 브랜드리뉴얼 성공사례(成功事例) 연구(硏究))

  • Koh, Hee-Sook
    • Journal of Fashion Business
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    • v.6 no.1
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    • pp.137-154
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    • 2002
  • It's not easy to renew old brand of over 50 years history to the tastes of new consumer of our time. Most of national brands that has a history of some 20 years in Korea have strove for continuation and growth of brand to no avails, which can be taken as a good example of current situation. For instance, C company, one of the National brand of US which has a history of 51 years, has made its position secure as a fashion group and based itself on a sound foundation by establishing new marketing strategy and completing successful brand renewal in the process of strategic M&A with Italian company. Those successful marketing strategies are as follows. 1) they regarded both market and consumer oriented marketing activity as company's highest priority strategy and put great emphasis upon concentration on target market and reestablishment of brand image of business casual wear. 2) Setting up and operating planning team composed of merchandizer alone in Milano, they set the direction of plan on the basis of concentrated research on potential item in market according to thorough market research done by buying office in Korea, branch office in Hong Kong and buyer in US prior to blueprint planning for season. 3) Great emphasis was placed on business which focused on intensive presentation of basic key item for apparel career women who are main consumer group in the midium-low prices market in US and on supplementation of size and color. they named this line 'collectibles' and helped their customer develop their own clothes plan without worrying about the change of color and fabric by supporting same fabric and color throughout the year and enabled them to add variation easily by supplementing new trend item. 4) Company set black as a main color that lots of apparel career women find easy to care and to express their own image and presented them with pebble which belongs to navy and beige and added fashion color such as wine and brown etc as season goes by. They constructed basic line in order for their customers to coordinate purchased item with new one or to add them to present collection, and to achieve efficient sale by setting up strategy which allows this cross coordination and changing pattern occasionally. 5) Though basic jacket for 99$, short slim skirt for 49$ are products within midium-low prices range, in the material planning stage aiming at production of item that has both resonable function appealing to consumer and is fashionable, synthetic material had to be used as a main source due to price competitiveness. Despite this situation, considering comfortable sense of fit and refined drape of silhouette that has no sign of cheap material, whole collectible line was divided into two items, which contributed to reduction of cost. In case of material that is composed of triacetate and polyester in 70 to 30 ratio, was used up to 4 million yard, which allowed drastic curtailment of cost accompanied by concentration. In case of 'collectibles' line, using Korean material mainly, C company chose to have their product sewed in Southeast Asian countries where transportation is well developed and both productivity and quality verified by operating global production system which aiming at cutdown of cost through outsourcing production from the country where labor cost is low and getting finished product. Polarization between present consumers telling us that consumers with the mind of middle classes in the past no longer exists between consumers who seek after only fine article of highest quality and wise consumers who are sensible enough to judge bubble on correlation between price and quality. To cope with this change in new consumer mind, apparel makes changing their policy so as to produce item that has reasonable quality and falls within affordable price range anywhere in the world. and they're striving to get out of difficult situation by operating global marketing strategy which stresses separation of planning, production and sale and sensibility of fashion shared worldwide. The marketing strategy of C company can be exemplified as a successful one.

Depression and Anxiety in Outpatients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 우울과 불안심리 평가)

  • Ryu, Yon Ju;Chun, Eun Mi;Sim, Yun Su;Lee, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.11-18
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    • 2007
  • Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

A Study on Forecasting Accuracy Improvement of Case Based Reasoning Approach Using Fuzzy Relation (퍼지 관계를 활용한 사례기반추론 예측 정확성 향상에 관한 연구)

  • Lee, In-Ho;Shin, Kyung-Shik
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.67-84
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    • 2010
  • In terms of business, forecasting is a work of what is expected to happen in the future to make managerial decisions and plans. Therefore, the accurate forecasting is very important for major managerial decision making and is the basis for making various strategies of business. But it is very difficult to make an unbiased and consistent estimate because of uncertainty and complexity in the future business environment. That is why we should use scientific forecasting model to support business decision making, and make an effort to minimize the model's forecasting error which is difference between observation and estimator. Nevertheless, minimizing the error is not an easy task. Case-based reasoning is a problem solving method that utilizes the past similar case to solve the current problem. To build the successful case-based reasoning models, retrieving the case not only the most similar case but also the most relevant case is very important. To retrieve the similar and relevant case from past cases, the measurement of similarities between cases is an important key factor. Especially, if the cases contain symbolic data, it is more difficult to measure the distances. The purpose of this study is to improve the forecasting accuracy of case-based reasoning approach using fuzzy relation and composition. Especially, two methods are adopted to measure the similarity between cases containing symbolic data. One is to deduct the similarity matrix following binary logic(the judgment of sameness between two symbolic data), the other is to deduct the similarity matrix following fuzzy relation and composition. This study is conducted in the following order; data gathering and preprocessing, model building and analysis, validation analysis, conclusion. First, in the progress of data gathering and preprocessing we collect data set including categorical dependent variables. Also, the data set gathered is cross-section data and independent variables of the data set include several qualitative variables expressed symbolic data. The research data consists of many financial ratios and the corresponding bond ratings of Korean companies. The ratings we employ in this study cover all bonds rated by one of the bond rating agencies in Korea. Our total sample includes 1,816 companies whose commercial papers have been rated in the period 1997~2000. Credit grades are defined as outputs and classified into 5 rating categories(A1, A2, A3, B, C) according to credit levels. Second, in the progress of model building and analysis we deduct the similarity matrix following binary logic and fuzzy composition to measure the similarity between cases containing symbolic data. In this process, the used types of fuzzy composition are max-min, max-product, max-average. And then, the analysis is carried out by case-based reasoning approach with the deducted similarity matrix. Third, in the progress of validation analysis we verify the validation of model through McNemar test based on hit ratio. Finally, we draw a conclusion from the study. As a result, the similarity measuring method using fuzzy relation and composition shows good forecasting performance compared to the similarity measuring method using binary logic for similarity measurement between two symbolic data. But the results of the analysis are not statistically significant in forecasting performance among the types of fuzzy composition. The contributions of this study are as follows. We propose another methodology that fuzzy relation and fuzzy composition could be applied for the similarity measurement between two symbolic data. That is the most important factor to build case-based reasoning model.

Effect of adhesive hydrophobicity on microtensile bond strength of low-shrinkage silorane resin to dentin (접착시스템의 소수성이 Low-shrinkage silorane resin과 상아질의 미세인장강도에 미치는 영향)

  • Cho, So-Yeun;Kang, Hyun-Young;Kim, Kyoung-A;Yu, Mi-Kyung;Lee, Kwang-Won
    • Restorative Dentistry and Endodontics
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    • v.36 no.4
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    • pp.280-289
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    • 2011
  • Objectives: The purpose of this study was to evaluate ${\mu}TBS$ (microtensile bond strength) of current dentin bonding adhesives which have different hydrophobicity with low-shrinkage silorane resin. Materials and Methods: Thirty-six human third molars were used. Middle dentin was exposed. The teeth were randomly assigned to nine experimental groups: Silorane self-etch adhesives (SS), SS + phosphoric acid etching (SS + pa), Adper easy bond (AE), AE + Silorane system bonding (AE + SSb), Clearfil SE bond (CSE), CSE + SSb, All-Bond 2 (AB2), AB2 + SSb, All-Bond 3 (AB3). After adhesive's were applied, the clinical crowns were restored with Filtek LS (3M ESPE). The 0.8 mm ${\times}$ 0.8 mm sticks were submitted to a tensile load using a Micro Tensile Tester (Bisco Inc.). Water sorption was measured to estimate hydrophobicity adhesives. Results: ${\mu}TBS$ of silorane resin to 5 adhesives: SS, 23.2 MPa; CSE, 19.4 MPa; AB3, 30.3 MPa; AB2 and AE, no bond. Additional layering of SSb: CSE + SSb, 26.2 MPa; AB2 + SSb, 33.9 MPa; AE + SSb, no bond. High value of ${\mu}TBS$ was related to cohesive failure. SS showed the lowest water sorption. AE showed the highest solubility. Conclusions: The hydrophobicity of adhesive increased, and silorane resin bond-strength was also increased. Additional hydrophobic adhesive layer did not increase the bond-strength to silorane resin except AB2 + SSb. All-Bond 3 showed similar ${\mu}TBS$ & water sorption with SS. By these facts, we could reach a conclusion that All-Bond 3 is a competitive adhesive which can replace the Silorane adhesive system.

Investigation of Microbial Contamination in Oenanthe javanica at Postharvest Environments (미나리(Oenanthe javanica) 수확 후 처리 환경에서의 위생지표세균 및 병원성 미생물 오염도 조사)

  • Kim, Yeon Rok;Lee, Kyoung Ah;Choi, In-Wook;Lee, Young-Ha;Kim, Se-Ri;Kim, Won-Il;Ryu, Song Hee;Lee, Hyo Sub;Ryu, Jae-Gee;Kim, Hwang-Yong
    • Journal of Food Hygiene and Safety
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    • v.29 no.4
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    • pp.268-277
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    • 2014
  • This study assessed microbiological hazards at postharvest stage of dropwort farms (A, B, C, D, E, F, G, H, I) located in 4 different areas in Korea. The samples were assessed for sanitary indication bacteria (total aerobic bacteria, coliform, and Escherichia coli) and pathogenic bacteria (Escherichia coli O157:H7, Listeria monocytogenes, Staphylococcus aureus and Bacillus cereus). Total aerobic bacteria and coliform in 9 dropwort farms were detected at the levels of 0~7.00 and 0~4.25 log CFU/g, mL, of $100cm^2$. In particular, microbial contamination in worker's hand showed higher than cultivation environment factors. Escherichia coli was detected in several farms of soil, irrigation water, washing water and worker's hand and also, dropwort in these farms was contaminated with E. coli (positive reaction). In case of pathogenic bacteria, B. cereus was detected at the highest levels in soil. S. aureus was detected qualitatively from only one sample of dropwort washed by water. E. coli O157:H7 and L. monocytogenes were not detected. Although dropwort pass through 2 process (trimming and washing), the microbial contamination was not differ significantly before and after which indicates that current washing system was not effect on reduction of microorganism. From these results, the postharvest environment and workers have been considered as cross-contamination factors. Thus, processing equipments and personal hygiene should be managed to reduce the microbial contamination of dropwort. Accordingly management system such as good agricultural practices (GAP) criteria is needed for the safety of dropwort