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A Study of Clinical Model for Radiation Therapy in Lung Cancer Patients of Busan and South Gyeongnam Province (부산, 경남지역 폐암 환자의 방사선치료 이용에 대한 임상 결정 모델 연구)

  • Son, Jongki;Kim, Yunjin;Jo, Deokyoung
    • Journal of the Korean Society of Radiology
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    • v.9 no.6
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    • pp.393-401
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    • 2015
  • Radiation therapy for lung cancer is an effective treatment during monotherapy or combination therapy. Studies have reported that the optimum utilization rate of radiation therapy is estimated at 61% to 74%. Radiation therapy in Korea has been investigated to be low; further studies are needed. This study was intended to assess the appropriateness of the use of radiation and to reveal the use of radiation therapy-related factors by examining radiation therapy in lung cancer patients of Busan and South Gyeongnam Province. This study was aimed at the population diagnosed with lung cancer in Busan and South Gyeongnam Province. To conduct the study, 1036 patients enrolled in two hospitals were collected and 897 appropriate as subjects were selected. We compared the optimum utilization rate and actual rate of radiation therapy, and revealed the adequacy and related factors for use of radiotherapy. Of 897 patients, 503 (56%) were treated with medical therapy and 394 (44%) were given radiotherapy. The radiotherapy utilization rate of all lung cancer patients was 42%. The proportion of non-small cell lung cancer by histologic type was 33% and that of small cell lung cancer was 90%. Factors related to radiation therapy used in cancer were age, histological type, clinical stage, doctor refereed to, and clinical examination. Compared to radiation utilization by region (site), curative chest therapy was 42%; palliative treatment was 26%. In the comparison of histologic types, utilization of small-cell lung cancer is lower; the lowest especially in the stage III. Utilization of radiation therapy in Busan and South Gyeongnam Province was lower than the reasonable one. Utilization difference could be explained by patient factors, tumor factors, and health service factors. To improve utilization,development ofoutreach service programs and activation of the multidisciplinary team are required.

Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

Assessment of the Effect of a Public Health Clinics' Home-Based Terminal Cancer Patient Management in Collaboration with a Regional Cancer Center (경남 지역 암센터와 보건소 재가암환자 관리 서비스와의 연계 사업)

  • Song, Haa-Na;Kang, Myoung Hee;Lee, Gyeong Won;Kim, Hoon Gu;Lee, Won Sup;Kang, Jung Hun;Kang, Yoon Sik;Eun, Young
    • Journal of Hospice and Palliative Care
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    • v.16 no.1
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    • pp.10-19
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    • 2013
  • Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.

A Study on Postconventional Christian Education for Intercultural Conflict Resolution (문화 간 갈등해소를 위한 탈인습적 기독교교육에 관한 연구)

  • Kim, Jinyoung
    • Journal of Christian Education in Korea
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    • v.62
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    • pp.257-283
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    • 2020
  • Our current society is experiencing a mass upheaval through globalization: mobility, hybridity, and cultural diversity are part of this world phenomenon. We can say that these changes are a result of people crossing borders due to international travel, immigration, emigration, studying abroad, labor, international marriages, fast and comfortable transportation, and the Internet. According to 2018 UNPD(Untied Nations Population Division)'s data, the international migrants have exceeded 258 million as of 2017. The increased number of migrants signifies that people with various backgrounds move from their own culture to a drastically different one. Interacting with different cultures can give people the chance to experience abundant lifestyles and improve life qualities. During that process, however, the differences between cultures can cause not only misunderstandings, conflicts, and violent collisions, but also xenophobia or radical nationalism. The current society is confronted with a problem: the people cannot stubbornly cling to a homogenous ethnicity anymore, which makes the coexistence between the citizens and immigrants necessary. Through these circumstances, I aim to suggest an educational model and a practical curriculum from a Christian perspective as the aim of this study. It seeks to encourage Christians to flexibly respond to these conflicts and collisions, and to fulfill their social responsibilities faithfully. For this reason, I will explore and seek sharing practical values through both shalom's communality as a theological approach and postconventionality in mature adults as a social-scientific approach. Consequently, I have few requests for the readers. First, approach with openness, understanding, and respect for other culture. Second, see this study as one step of confronting the global problem for coexistence and coprosperity of all social agents in the earth, a limited space. Third, notice that this study uses the interdisciplinary approach (theological and social scientific view) for a shareable, practical value that consistently leads the curriculum of my thesis, and a scientific method to eliminate bias. Lastly, understand that this study will eventually be used in educational practice, and as a result it prioritizes giving thought to the Christian educational environment. This study begins by exploring the conflicts and collisions between diverse cultures of our current society in international and national cases. Afterwards, I will reflect on how we can manage these conflicts and collisions by exploring the social-scientific view, postconventionality in mature adults, the theological view, and shalom's communality as a complement for the postconventionality's personal dimension. In conclusion, I suggest a curriculum that achieves peace as a practical value based on postventionality and shalom's communality for this study's goal.

Evaluation of Disaster Resilience Scorecard for the UN International Safety City Certification of Incheon Metropolitan City (인천시 UN 국제안전도시 인증을 위한 재난 복원력 스코어카드 평가)

  • Kim, Yong-Moon;Lee, Tae-Shik
    • Journal of Korean Society of Disaster and Security
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    • v.13 no.1
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    • pp.59-75
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    • 2020
  • This study is a case study that applied 'UNDRR's Urban Disaster Resilience Scorecard', an evaluation tool necessary for Incheon Metropolitan City to be certified as an international safe city. I would like to present an example that the results derived from this scorecard contributed to the Incheon Metropolitan City Disaster Reduction Plan. Of course, the Disaster Resilience Scorecard can't provide a way to improve the resilience of every disaster facing the city. However, it is to find the weakness of the resilience that the city faces, and to propose a solution to reduce the city's disaster risk. This is to help practitioners to recognize the disaster risks that Incheon Metropolitan City faces. In addition, the solution recommended by UNDRR was suggested to provide resilience in areas vulnerable to disasters. It was confirmed that this process can contribute to improving the disaster resilience of Incheon Metropolitan City. UNDRR has been spreading 'Climate Change, Disaster-resistant City Creation Campaign', aka MCR (Making Cities Resilient) Campaign, to cities all over the world since 2010 to reduce global cities' disasters. By applying the disaster relief guidelines adopted by UNDRR, governments, local governments, and neighboring cities are encouraged to collaborate. As a result of this study, Incheon Metropolitan city's UN Urban Resilience Scorecard was evaluated as a strong resilience field by obtaining scores of 4 or more (4.3~5.0) in 5 of 10 essentials; 1. Prepare organization for disaster resilience and prepare for implementation, 4. Strong resilience Urban development and design pursuit, 5. Preservation of natural cushions to enhance the protection provided by natural ecosystems, 9. Ensure effective disaster preparedness and response, 10. Rapid restoration and better reconstruction. On the other hand, in the other five fields, scores of less than 4 (3.20~3.85) were obtained and evaluated as weak resilience field; 2. Analyze, understand and utilize current and future risk scenarios, 3. Strengthen financial capacity for resilience, 6. Strengthen institutional capacity for resilience, 7. Understanding and strengthening social competence for resilience, 8. Strengthen resilience of infrastructure. In addition, through this study, the risk factors faced by Incheon Metropolitan City could be identified by priority, resilience improvement measures to minimize disaster risks, urban safety-based urban development plans, available disaster reduction resources, and integrated disasters. Measures were prepared.

Statistical Optimization of Culture Conditions of Probiotic Lactobacillus brevis SBB07 for Enhanced Cell Growth (프로바이오틱 Lactobacillus brevis SBB07의 균체량 증가를 위한 배양 조건 최적화)

  • Jeong, Su-Ji;Yang, Hee-Jong;Ryu, Myeong Seon;Seo, Ji Won;Jeong, Seong-Yeop;Jeong, Do-Youn
    • Journal of Life Science
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    • v.28 no.5
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    • pp.577-586
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    • 2018
  • We recently reported the potential probiotic properties of Lactobacillus brevis SBB07 isolated from blueberries. The present study investigates the effect of culture conditions such as temperature, initial pH, culture time, and medium constituent for industrial application. The ingredients of the medium to improve cell growth were selected by Plackett-Burman design (PBD) and central composite design (CCD) within a desirable range. The PBD was applied with 19 factors: seven carbon sources, six nitrogen sources, and six microelements. Protease peptone, corn steep powder (CSP), and yeast extract were found to be significant factors for the growth of SBB07. The CCD was then applied with three variables found from the PBD at five levels, and the optimum values were decided for the three variables: protease peptone, CSP, and yeast extract. In the case of the growth of SBB07, the proposed optimal media contained 2.0% protease peptone, 2.5% CSP, and 2.0% yeast extract, and the maximum dried-cell weight was predicted to be 2.93963 g/l. By the model verification, it was confirmed that the predicted and actual results are similar. Finally, the study investigated the effects of incubation temperature and initial pH at the optimized medium. It was confirmed that the dried-cell weight increased from $2.2933{\pm}0.0601g/l$ to $3.85{\pm}0.0265g/l$ when compared to the basal medium at $37^{\circ}C$ and initial pH 8.0. Establishing the optimal culture condition for SBB07 provides good potential for applications in probiotics and can serve as the foundation for the industrialization of materials.

The Modulation of Radiosensitivity by Combined Treatment of Selective COX-2 Inhibitor, NS 398 and EGF Receptor Blocker AG 1478 in HeLa Cell Line (선택적 COX-2 억제제 NS 398과 EGF 수용체 차단제 AG 1478의 복합투여가 HeLa 세포주의 방사선 감수성에 미치는 영향)

  • Youn Seon Min;Oh Young Kee;Kim Joo Heon;Park Mi Ja;Seong In Ock;Kang Kimun;Chai Gyuyong
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.51-60
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    • 2005
  • Purpose : Selective inhibition of multiple molecular targets may improve the antitumor activity of radiation. Two specific inhibitors of selective cyclooxygenase-2 (COX-2) and epidermal growth factor receptor (EGFR) were combined with radiation on the HeLa cell line. To investigate cooperative mechanism with selective COX-2 inhibitor and EGFR blocker, in vitro experiments were done. Materials and Methods : Antitumor effect was obtained by growth inhibition and apoptosis analysis by annexin V-Flous method. Radiation modulation effects were determined by the clonogenic cell survival assay. Surviving fractions at 2 Gy ($SF_2$) and dose enhancement ratio at a surviving fraction of 0.25 were evaluated. To investigate the mechanism of the modulation of radiosensitivity, the cell cycle analyses were done by flow cytometry. The bcl-2 and bax expressions were analyzed by western blot. Results : A cooperative effect were observed on the apoptosis of the HeLa ceil line when combination of the two drugs, AG 1478 and NS 398 with radiation at the lowest doses, apoptosis of $22.70\%$ compare with combination of the one drug with radiation, apoptosis of $8.49\%$. In cell cycle analysis, accumulation of cell on $G_0/G_l$ phase and decrement of S phase fraction was observed from 24 hours to 72 hours after treatment with radiation, AG 1478 and NS 398. The combination of NS 398 and AG 1478 enhanced radiosensitivity on a concentration-dependent manner in HeLa cells with dose enhancement ratios of 3.00 and $SF_2$ of 0.12 but the combination of one drug with radiation was not enhanced radlosensitivity with dose enhancement ratios of 1.12 and SF2 of 0.68 (p=0.005). The expression levels of bcl-2 and bax were reduced when combined with AG 1478 and NS 398. Conclusion : Our results indicate that the selective COX-2 inhibitor and EGFR blocker combined with radiation have potential additive or cooperative effects on radiation treatment and may act through various mechanisms including direct inhibition of tumor cell proliferation, suppression of tumor cell cycle progression and inhibition of anti-apoptotic proteins.

Initial results from spatially averaged coherency, frequency-wavenumber, and horizontal to vertical spectrum ratio microtremor survey methods for site hazard study at Launceston, Tasmania (Tasmania 의 Launceston 시의 위험 지역 분석을 위한 공간적 평균 일관성, 주파수-파수, 수평과 수직 스펙트럼의 비율을 이용한 상신 진동 탐사법의 일차적 결과)

  • Claprood, Maxime;Asten, Michael W.
    • Geophysics and Geophysical Exploration
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    • v.12 no.1
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    • pp.132-142
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    • 2009
  • The Tamar rift valley runs through the City of Launceston, Tasmania. Damage has occurred to city buildings due to earthquake activity in Bass Strait. The presence of the ancient valley, the Tamar valley, in-filled with soft sediments that vary rapidly in thickness from 0 to 250mover a few hundreds metres, is thought to induce a 2D resonance pattern, amplifying the surface motions over the valley and in Launceston. Spatially averaged coherency (SPAC), frequency-wavenumber (FK) and horizontal to vertical spectrum ratio (HVSR) microtremor survey methods are combined to identify and characterise site effects over the Tamar valley. Passive seismic array measurements acquired at seven selected sites were analysed with SPAC to estimate shear wave velocity (slowness) depth profiles. SPAC was then combined with HVSR to improve the resolution of these profiles in the sediments to an approximate depth of 125 m. Results show that sediments thicknesses vary significantly throughout Launceston. The top layer is composed of as much as 20m of very soft Quaternary alluvial sediments with a velocity from 50 m/s to 125 m/s. Shear-wave velocities in the deeper Tertiary sediment fill of the Tamar valley, with thicknesses from 0 to 250m vary from 400 m/s to 750 m/s. Results obtained using SPAC are presented at two selected sites (GUN and KPK) that agree well with dispersion curves interpreted with FK analysis. FK interpretation is, however, limited to a narrower range of frequencies than SPAC and seems to overestimate the shear wave velocity at lower frequencies. Observed HVSR are also compared with the results obtained by SPAC, assuming a layered earth model, and provide additional constraints on the shear wave slowness profiles at these sites. The combined SPAC and HVSR analysis confirms the hypothesis of a layered geology at the GUN site and indicates the presence of a 2D resonance pattern across the Tamar valley at the KPK site.

A Study on Nursing Students' Dental-Health Knowledge on and Attitude to the Major Oral Diseases Management (양대구강병 관리에 대한 간호과 학생의 구강보건 지식 및 태도에 관한 연구)

  • Choi, Bu-geun;Hwang, Yoon-sook
    • Journal of dental hygiene science
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    • v.1 no.1
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    • pp.21-27
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    • 2001
  • The purpose of this study was to explore some of the right directions for school dental-health education, by examining nursing students' knowledge on and attitude to the two major oral diseases in our country, dental caries and periodontal disease, as they will take charge of dental-health education and care for children in school dental-health center as sole expert health personnels after graduation. As a result of making an analysis of their knowledge and attitude, the following findings were acquired: (1) The students investigated perceived their oral cavity to tend to be healthy(36.8%) or in moderate situation(36.3%), although they had a subjective symptom for hot or cold food. (2) They thought dental caries is attributed to poor dental hygiene care(90.4%). Among them, 94.1% found toothbrushing effective for the prevention of dental caries, but just 40.2% agreed that toothbrush should be straight. (3) Those who considered fluoride effective for dental caries prevention thought the best way to use fluoride is taking fluoride-containing tap water(2.00). The second best way was fluoride mouth rinse(2.40), followed by the topical application of fluoride(2.70), use of fluoride dentifrice, and intake of fluoride(4.30) in the order named. (4) The regular examination and toothbrushing were mentioned as a way to prevent dental caries, but just toothbrushing was put in action for dental health. So their knowledge and actual attitude weren't the same. (5) They brushed their teeth for oral health(94.3%). Toothbrushing was done after breakfast(71.9%) or before bedtime(65.8%). Just 40.3% performed toothbrushing after lunch. That was implemented twice(35.7%) or three times(37.6%) a day. (6) Out of those who pointed out toothbrushing as a way to prevent periodontal diseases(84.7%), the effect of toothbrushing on the prevention of periodontitis wasn't supported by 7.1% of those who completed the course of study for the teaching profession and by 17.0% of the others who didn't. The two groups weren't of the same opinion. The above-mentioned findings suggest that the dental knowledge of the nursing students wasn't good enough to be properly responsible for school children's dental health care. In particular, there was a gap between knowledge and attitude. To improve children's poor dental health and help their oral cavity stay healthy, there is a need to activate school dental-health center, which is now in model operation, and to make the most of dental hygienists, who are educated to be a dental-health specialist, for more successful dental-health care for school children.

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Evaluation of Countermeasures Effectiveness in a Radioactively Contaminated Urban Area Using METRO-K : The Implementation of Scenarios Designed by the EMRAS II Urban Areas Working Group (METRO-K를 사용한 방사능으로 오염된 도시지역에서 대응행위효과 평가 : EMRAS II 도시오염평가분과 시나리오의 이행)

  • Hwang, Won-Tae;Jeong, Hae-Sun;Jeong, Hyo-Joon;Kim, Eun-Han;Han, Moon-Hee
    • Journal of Radiation Protection and Research
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    • v.37 no.3
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    • pp.108-115
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    • 2012
  • The Urban Areas Working Group within the EMRAS-2 ($\underline{E}$nvironmental $\underline{M}$odelling for $\underline{RA}$diation $\underline{S}$afety, Phase 2), which has been supported by the IAEA (International Atomic Energy Agency), has designed some types of accidental scenarios to test and improve the capabilities of models used for evaluation of radioactive contamination in urban areas. For the comparison of the results predicted from the different models, the absorbed doses in air were analyzed as a function of time following the accident with consideration of countermeasures to be taken. Two kinds of considerations were performed to find the dependency of the predicted results. One is the 'accidental season', i.e. summer and winter, in which an event of radioactive contamination takes place in a specified urban area. Likewise, the 'rainfall intensity' on the day of an event was also considered with the option of 1) no rain, 2) light rain, and 3) heavy rain. The results predicted using a domestic model of METRO-K have been submitted to the Urban Areas Working Group for the intercomparison with those of other models. In this study, as a part of these results using METRO-K, the countermeasures effectiveness in terms of dose reduction was analyzed and presented for the ground floor of a 24-story business building in a specified urban area. As a result, it was found that the countermeasures effectiveness is distinctly dependent on the rainfall intensity on the day of an event, and season when an event takes place. It is related to the different deposition amount of the radionuclides to the surfaces and different behavior on the surfaces following a deposition, and different effectiveness from countermeasures. In conclusion, a selection of appropriate countermeasures with consideration of various environmental conditions may be important to minimize and optimize the socio-economic costs as well as radiation-induced health detriments.