• The Korean Journal of Pain
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• v.35 no.1
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• pp.14-21
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• 2022

The coronavirus disease 2019 (COVID-19) pandemic, which has been rampant since the end of 2019, has evidently affected pain management in clinical practice. Fortunately, a COVID-19 vaccination program is currently in progress worldwide. There is an ongoing discussion that pain management using steroid injections can decrease COVID-19 vaccine efficacy, although currently there is no direct evidence to support this statement. As such, the feeling of pain in patients is doubled in addition to the co-existing ill-effects of social isolation associated with the pandemic. Thus, in the COVID-19 era, it has become necessary that physicians be able to provide high quality pain management without negatively impacting COVID-19 vaccine efficacy. Steroids can alter the entire process involved in the generation of adaptive immunity after vaccination. The period of hypophysis-pituitary-adrenal axis suppression is known to be 1 to 4 weeks after steroid injection, and although the exact timing for peak efficacy of COVID-19 vaccines is slightly different for each vaccine, the average is approximately 2 weeks. It is suggested to avoid steroid injections for a total of 4 weeks (1 week before and after the two vaccine doses) for the double-shot vaccines, and for 2 weeks in total (1 week before and after vaccination) for a single-shot vaccine. This review focuses on the basic concepts of the various COVID-19 vaccines, the effect of steroid injections on vaccine efficacy, and suggestions regarding an appropriate interval between the administration of steroid injections and the COVID-19 vaccine.

• Korean Journal of Poultry Science
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• v.8 no.2
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• pp.77-89
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• 1981

The experimental study was undertaken to confirm the effect of vaccination of birds with Newcastle disease (ND) vaccines on the Market by use of th. various vaccination programs. Sixteen groups of birds varying from 2 to f days of age, which were originated from hyper-immunised hens against ND were immunised by three different ways, a live vaccine only, a killed vaccine only, and the combination of a live and killed vaccine according to the each schedule of employed programs. In the administration of a live vaccine only, birds were immunized by one of following methods, the combination of intranasal and intraocular inoculation, intramuscular inoculation, via drinking water and the double inoculation by spray and drinking water application. Except for the double application, all the birds were vaccinated 2,3 or 4 times with two volumes of the virus dose (drinking water application) instructed by the commercial vaccine laboratory, until 21, 28 or 30 days of age, and all the immunized birds 19, 21 or 28 days postvaccination were challenged intramuscularly with 1.0$m\ell$ of 10,000 MLD per $m\ell$ of a virulent ND virus. In the administration of the combination of a live and killed vaccine, birds were immunized 2 or 3 times intranasally at first until 14 or 28 days of age with the same dose of the above experiment of a live vaccine, and then inoculated intramuscularly 1 or 2 times until 60 days of age with 1.0 $m\ell$ of a killed vaccine. And all immunized birds 11 days postvaccination were challenged with the same procedure of the above experiment. In the administration of a killed vaccine only, birds were immunized 3 times intramuscularly until 28 days of age with varied dose (0.2-0.5 $m\ell$) of a killed vaccine and all immunized birds 33 days postvaccination were challenged with the same procedure of the above experiment. The results obtained are summerised as follows: All birds vaccinated by using the combination of a live and killed vaccine program or a killed vaccin only appeared to be refractory. without any sign of illness, to the challenge exposure with 1.0$m\ell$ of 10,000 MLD per $m\ell$ of a virulent ND virus. On the other hand, the survival rates of birds of live vaccine groups immunized by a number of vaccine program such as Salsbury's day old program, 3-3-3 program, the Institute of Veterinary Reserch program and Multiple inoculation program, were 39.58%, 43.7%, 43.75% and 47.80%, respectively. And the survival rates of birds vaccinated with a live vaccine by 4 different ways of administration, i.e., double inoculation by water and aerosol application, intramuscular injection, intranasal instillation and via 4.inking water were 87.50%, 64.06%, 42.18% and 25.00%, respectively.

• Korean Journal of Poultry Science
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• v.8 no.1
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• pp.15-24
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• 1981

A study was conducted to determine whether the vaccination programs for the control of New castle disease (ND) would affect the immune status of birds against the disease. Twenty-six poultry flocks in the epizootic area of ND were surveyed to investigate the level of urn antibody against ND virus and the programs used for the vaccination of birds. The mortality rates and vaccination status of birds during the epizootic of ND were also examined in the infected poultry flocks to elucidate the immune effect against the epizootic with particular regard to various vaccination programs used in the field. The results obtained are summerized as follows: 1. Of 26 poultry flocks investigated, 22 flocks were immunized with live and killed vaccines, their haemagglutination-inhibition (HI) antibody titer being 146 and 50, respectively. Among 22 farms using live and killed vaccines two flocks which showed the lowest HI titer of 10 and 23 had the disease later on. However, no cases of ND were recorded in the killed vaccine groups, although their HI titers were in the range of 38 to 64. 2. Of 14 infected flecks, one flock was not vaccmated against ND while all the remaining 13 flocks were vaccinated against the disease, of which 8 flocks were vaccinated with live vaccine only and the other 5 flocks with both live and killed vaccines. The mortality rate of 8 infected flocks which had been vaccinated with only live vaccine was as high as 32.5% while that of 5 flocks with both live and killed vaccines was as low as 5.1%. 3. It was found that in majority of flocks B$_1$vaccine was used via drinking water and in a few flocks the vaccine was administered via intramuscular route or method of dipping mouth, nose and eye of birds into vaccine solution.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7459-7466
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• 2013

Background: Some 60 years after introduction of the Papanicolaou smear worldwide, cervical cancer remains a burden in developing countries where >85% of world new cases and deaths occur, suggesting a failure to establish comprehensive cervical-cancer control programs. Effective interventions are available to control cervical cancer but are not all affordable in low-income settings. Disease awareness saves lives by risk-reduction as witnessed in reducing mortality of HIV/AIDS and smoking-related cancers. Subjects and Methods: We initiated a community-based awareness program on cervical cancer in two low-income Muslim Uyghur townships in Kashi (Kashgar) Prefecture, Xinjiang, China in 2008. The education involved more than 5,000 women from two rural townships and awareness was then evaluated in 2010 and 2011, respectively, using a questionnaire with 10 basic knowledge questions on cervical cancer. Demographic information was also collected and included in an EpiData database. A 10-point scoring system was used to score the awareness. Results: The effectiveness and feasibility of the program were evaluated among 4,475 women aged 19-70 years, of whom >92% lived on/below US$1.00/day. Women without prior education showed a poor average awareness rate of 6.4% (164/2,559). A onetime education intervention, however, sharply raised the awareness rate by 4-fold to 25.5% (493/1,916). Importantly, low income and illiteracy were two reliable factors affecting awareness before or after education intervention. Conclusions: Education intervention can significantly raise the awareness of cervical cancer in low-income women. Economic development and compulsory education are two important solutions in raising general disease awareness. We propose that implementing community-based awareness programs against cervical cancer is realistic, locally affordable and sustainable in low-income countries, which may save many lives over time and, importantly, will facilitate the integration of comprehensive programs when feasible. In this context, adopting this strategy may provide one good example of how to achieve "good health at low cost".

• Child Health Nursing Research
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• v.19 no.3
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• pp.216-227
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• 2013

Purpose: Despite the well-known public health benefits of vaccination, increasing public concern about the safety of childhood vaccinations has led some parents to refuse or hesitate having their children immunized. The purpose of this study was to identify the subjectivity of parents toward refusal of childhood vaccination. Methods: Q-methodology, in which subjective viewpoints are explored and analyzed using a combination of quantitative and qualitative techniques, was used. Thirty-five participants were asked to rank 42 statements on diverse issues of childhood vaccination according to a continuous 9-point scale ranging from -4 for strongly disagree to +4 for strongly agree. Collected data was analyzed using the PC-QUANAL program. Results: The results revealed three discrete groups of parents in the refusal of children's immunization: type I, distrust; type II, concern about side effects, and type III, belief that vaccinations are unnecessary. Conclusion: Special nurse counselors who can provide correct information about vaccination based on the three types should be part of the government policy. Customized education programs to shift viewpoints should be also redeveloped according to the results in this study.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.7-15
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• 2017

Purpose: Influenza vaccination coverage in adolescents is an important goal of informed vaccination policies and programs. This study aimed to estimate the influenza vaccination coverage rate and investigate the factors influencing influenza vaccination coverage in Korean adolescents. Methods: The study population consisted of 5,213 adolescents (aged 12 to 18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2007 to 2014 (except for 2013). We analyzed influenza vaccination coverage in relation to the demographics, lifestyle, and medical characteristics of the participants. Results: The influenza vaccination coverage rate, during the study period, was 23.2% (range, 21.1% to 24.7%). Logistic regression analysis revealed that factors influencing influenza vaccination were elementary school age (odds ratio [OR], 1.706; 95% confidence interval [CI], 1.526 to 1.906), good self-rated health status (OR, 1.192; 95% CI, 1.057 to 1.344), a drinking status of non-drinker (OR, 1.769; 95% CI, 1.474 to 2.122), a smoking status of non-smoker (OR, 1.459; 95% CI, 1.144 to 1.860), and a past diagnosis of pneumonia (OR, 1.469; 95% CI, 1.076 to 2.006). Conclusions: Influenza vaccination coverage in Korean adolescents is relatively low. Special efforts are needed to increase vaccination coverage for adolescent groups with low vaccination rates including adolescent smokers and drinkers, middle and high school age adolescents, and adolescents with a poor self-rated health status.

• Journal of Korean Academy of Nursing
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• v.22 no.2
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• pp.207-226
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• 1992

This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

• Health Policy and Management
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• v.8 no.2
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• pp.125-148
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• 1998

Accurate vital statistics are essential for a national health planning and evaluation. Among various vital statistics, birth and death rates, and infant and matemal mortality rates together with the causes of death are the very basic ones for above purposes as well as for the maternal and child health management. These statistics are based on the birth and death reports. It is required by law to report every birth and death within one month after its occurrence. However, in case of a neonatal death occurring prior to the birth report, most of the birth and death are not reported. Thus accurate infant and maternal mortality rates are not available yet in Korea. The main objective of this study is to develop a birth and infant death reporting system via computer network. We designed a new birth report form based on the current form and data from the analysis of medical record forms of 14 hospitals. A new form is basically addition of essential medical information to the current birth report form. Since a revision of the rules and regulations related wtih the birth report is necessary to use a new form, we kept the current from intact to make it acceptable to the government office for a field trial. We also developed computer programs for data input for birth and death reports at a medical faciltiy, data processing for production of maternal and child health indices at a health center, and management of maternal and child health services including immunization and postantal care at health center. The birth certificate and birth report can be printed out at a medical facility. The computer packages were programmed by Borland Delphi 3.0 and can be run under Windows 95 system. We proposed a new birth and death reporting system via computer network after a field trial for data input, transmission, and processing. The medical and demographic data o birth and death at medical facilities will be sent to health centers directly via computer network. The health center will retain the medical data for analysis and forward only the data for birth and death reports required by current regulations to the Dong, Up, or Myun Office. Once the birth or death is reported via computer network to the Dong Office, then the Dong Office will notify the baby's mother of the birth report and request to submit the baby's name by mail. When the baby's name its submitted. the Dong Office will forward the birth reports to the Common Court and Statistics Agency in the same way as the current system, Upon the completion of birth registration of the Common Court, the court will issue the birth certificate to mother which will be used in lieu of the family record. The advantages of proposed birth and death reporting system via computer network ar as follows ; I) The accuracy, timing, and completeness of reporting will be improved and more accurate maternal and child health indices can be obtained, ii) The maternal and child health services of health center will be obtained, iii) Epidemiologic data for pregnancy and birth can be obtained, iv) Manpower for birth and death reporting will be saved.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.167-174
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• 2009

Purpose : Pertussis was very common in the past, but reported cases have dramatically decreased. The improvement of vaccination programs and unreadiness of laboratory confirmation seems to have developed this situation. This study investigated the frequency of pertussis among infants with a paroxysmal cough and compared the clinical characteristics between infants with and without pertussis. Methods : Between June and November 2006, 27 infants admitted to the hospital that were 15-90 days old with a history of a cough for more than seven days were enrolled. The cough was described as: paroxysmal, whooping, and post-tussive vomiting. PCR and cultures for Bordetella pertussis with nasopharyngeal aspirates were obtained. The patients were divided into two groups: (1) the pertussis group that had positive results by PCR or culture; (2) the control group that had negative results by PCR and culture. Clinical and laboratory characteristics were compared between the two groups. Results : Among the 27 cases, five (18.5%) were finally diagnosed with pertussis. Only one out of the five pertussis cases was initially diagnosed with a pertussis-like syndrome on admission. Compared to the group without pertussis, the pertussis group had a significantly higher frequency of: no fever (P =0.043), a paroxysmal cough (P =0.040), cyanosis (P =0.001), non-immunized status for DTaP (P =0.047), normal auscultation (P =0.028), normal chest X-ray findings (P =0.027), high absolute lymphocyte count (P =0.039), and low CRP (P =0.046). The patients with the diagnosis of pertussis had a significantly longer duration of coughing (27.2${\pm}$10.6 vs. 12.6${\pm}$5.6 days, P =0.039). Conclusion : Pertussis should be suspected in any infant with typical symptoms of pertussis in addition to: a persistent cough without fever, accompanied by paroxysms or cyanosis prior to the age of DTaP immunization. Active laboratory confirmation should be carried out to confirm more cases with pertussis.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.