• The Journal of Korean Society for Radiation Therapy
• /
• v.23 no.1
• /
• pp.51-58
• /
• 2011

Purpose: In this study, we tried to check the usefulness of two Linear Accelerators, Clinac IX and 21EX (Varian, Palo Alto, CA), which are equipped in Ajou Medical Center. From 2008 to 2010, we evaluated the error range of Absolute Dose based on the daily output, which was measured by CHECKMATE$^{TM}$ (Sun Nuclear, Melbourne, FL). Materials and Methods: For Daily Q.A, photon beams of two linear accelerators, 21EX and IX (6 MV and 10 MV, respectively) were measured daily by using CHECKMATE$^{TM}$ just before the treatment began, while the absolute dose was measured biweekly by using water phantom. We analyzed the data of measured values from the daily Q.A and the absolute dose from 2008 to 2010 for 21EX, and from 2009 to 2010 for IX. We utilized Excel 2007 (Microsoft, USA) to evaluate Average, Standard deviation and Confidence level of the data. Furthermore, in order to check the measured values of CHECKMATE$^{TM}$ and the significance of absolute dose, each error value was compared and analyzed. Results: During the observation period, the output of two equipment's absolute dose increased in process of time and in both 6 MV and 10 MV, there was a similar increasing trend. In addition, the error rate of the measured value of CHECKMATE$^{TM}$ and the value of absolute dose were under 0.34, which means that there is a similarity relationship between the two measured values. After checking that the measured value of CHECKMATE$^{TM}$ increased, We measured the absolute dose to adjust that. When the error range was close to 2~3%, the number of changing the output was four for 21EX and three for IX. Conclusion: As a result of measuring and analyzing the daily output changes for two years by using CHECKMATE$^{TM}$, we could find that there is a significance between the output which we should obey during Q.A, and the measured value of absolute dose within the error tolerance of 2~3%. Thus, the use of CHECKMATE$^{TM}$ can be positively considered for more efficient and reliable daily output verification of linear accelerator. It can also be a good standard for other medical centers to understand the trends of linear accelerator and to refer to for the correction of each output.

• Journal of Home Health Care Nursing
• /
• v.6
• /
• pp.46-58
• /
• 1999

The purpose of this research was to find out the state of the nursing performance of the home care nurses in Seoul in order to provide the data for the practical work guide. The data were collected from fifty home care nurses working in 22 institutions located in Seoul. The research tool used for this research was modified and tested by Song Jong-Rye(1999) which was originally modified the standard tool of American Nurses Association (1998) and was partly supplement and adjusted for this research. The reliability of this tool was Cronbach's $\alpha$=.0982. The collected data were statistically processed using SAS for t-test, ANOVA. $Scheff\'{e}$ test. Among the surveyees, 50% have been working as a home care nurse more than three years and 74.0% of them were married. And 52% have B.S degree with certification of home care nurse from the certification program for Home Care Nurses affiliated at nursing schools. Half of the home care nursing organizations were based on the general hospitals, and most(78%) of the responsible senior personnels of those organizations were nurses. The following results are drawn from this research. 1) The level of nursing performance by the task sectors General performance level of home care nurses was relatively high in grade of 3.06 from total 4.00. Among the task sectors. the ethical field scored the highest points, and the next were nursing intervention, professional training, and data gathering, and the research sector scored the lowest point. 2) The level of nursing performance by general features of home care nurses Statistically relevant correlation between performance according to the duration of working experience as a nurse(p=0.8951) and performance according to the duration of working as home care nurse(p=0.2263) did not emerge. Also, performance by marriage status(p=0.2218), education(p=0.5733), and taking the certification program for home card nurse(p =0.1560) has no statistically meaningful correlation. 3) The level of nursing performance by the type of home care nursing organizations There exists a significant difference(p=0.002) between performances by the types of organizations. Most of the responsible senior personnels of the home care nursing organization were nurses. The level of nursing performance of the home care nursing organization under nurse management was relatively higher than that of home care nursing organizations led by medical doctors or non-medical professional, but this was not proved as statistically meaningful(p =0.3617). 4) The level of nursing performance by task sectors according to the characteristic of home care nursing service organization There exists a significant difference between nursing performances by task sectors according to the characteristics of home care nursing organization(p=0.002). In case of model research center of one College of Nursing, the nursing performance in the sectors of organization, theory, and data gathering were lower than that of in hospital based home care nursing service. And in case of local home care centers, performances in sectors of organization, theory, data gathering, nursing intervention. professional training, and research sectors were significantly low. Based on the obtained results, overall performance of home care nurses can be appraised as relatively good. Especially, performances in sectors of the nursing intervention, nursing plan. and data gathering including the in direct nursing were recorded high scores. From this, it can be concluded that high quality of nursing is relatively practicing for home patients at these days. Since the high quality of nursing for patients was directly related to the level of nursing performances of home care nurses, it is required to improve practical performance level of them by making constant evaluation and running continual education program and supplementing curriculum for the sectors with low scores.

• Progress in Medical Physics
• /
• v.26 no.4
• /
• pp.250-257
• /
• 2015

Multi-leaf collimator (MLC) systems are frequently used to deliver photon-based radiation, and allow conformal shaping of treatment beams. Many proton beam centers currently make use of aperture and snout systems, which involve use of a snout to shape and focus the proton beam, a brass aperture to modify field shape, and an acrylic compensator to modulate depth. However, it needs a lot of time and cost of preparing treatment, therefore, we developed the manual MLC for solving this problem. This study was carried out with the intent of designing an MLC system as an alternative to an aperture block system. Radio-activation and dose due to primary proton beam leakage and the presence of secondary neutrons were taken into account during these iterations. Analytical calculations were used to study the effects of leaf material on activation. We have fabricated tray model for adoption with a wobbling snout ($30{\times}40cm^2$) system which used uniform scanning beam. We designed the manual MLC and tray and can reduce the cost and time for treatment. After leakage test of new tray, we upgrade the tray with brass and made the safety tool. First, we have tested the radio-activation with usually brass and new brass for new manual MLC. It shows similar behavior and decay trend. In addition, we have measured the leakage test of a gantry with new tray and MLC tray, while we exposed the high energy with full modulation process on film dosimetry. The radiation leakage is less than 1%. From these results, we have developed the design of the tray and upgrade for safety. Through the radio-activation behavior, we figure out the proton beam leakage level of safety, where there detects the secondary particle, including neutron. After developing new design of the tray, it will be able to reduce the time and cost of proton treatment. Finally, we have applied in clinic test with original brass aperture and manual MLC and calculated the gamma index, 99.74% between them.

• Journal of agricultural medicine and community health
• /
• v.27 no.1
• /
• pp.165-181
• /
• 2002

The purpose of this survey was to assess the nutritional status of preschool children a county of Jeju Island. This study used health examinations results for preschool aged children, performed by the public health center of Pukjeju-gun in Jeju-do for over three years from 1999 to 2001, of children in kindergartens and children homes. The target children totaled 5,990 from the ages three to six. For a control group, 316 children from the nearby Jeju-city areas were included as well. The items of this research included height, weight, and hemoglobin values. 1. The average height of boys from ages three to six were 96.35cm, 102.14cm, 109.94cm, 111.00cm respectively, and girls were 94.96cm, 100.93cm, 108.33cm, 110.54cm respectively. The average weights of boys from ages three to six were 15.42kg, 16.93kg, 19.65kg, 19.67kg respectively, and the weight of girls were 14.90kg, 16.45kg, 18.88kg, 19.50kg respectively. 2. The percentages of children who did not reach 90% of the Korean standard height were 4.3% in boys 4.1% in girls. The percentages of children with less than 80% of the Korean standard weight were 7.6% in boys and 6.8% girls. The percentages of children over 120% of Korean standard weight were 10.4% in boys and 11.4% in girls. 3. As for the obesity level, the percentage of boys under-weighed(under 10% for standard weight for height) were 11.6% and girls, 9.5%, and the percentages of boys and girls with obesity($\geq$20%) were 3.6% and 4.4% respectively. 4. The mean hemoglobin value of boys were 11.83g/$d\ell$ and girls, 11.83g/$d\ell$. These were lower than the value of average normal Korean children (12.5g/$d\ell$). The mena hemoglobin values of the children in Pukjeju-gun were considerably lower than that of the children living in Jeju-city(12.3g/$d\ell$) as well. Anemia of Children of Pukjeju-gun were estimated at 38.1%(male) and 37.2%(female), by using Hemoglobin level(<11.5g/$d\ell$ 5. The rates of children included within the normal range of obesity level in Jeju-city and Pukjeju- gun were boys 80.2%, 71.6% in boys, and 77.4%, 72.4% in girls. The percentage of children living in PukJeju-gun included within the normal range were considerably low. 6. There were no changes in the Body Mass Index (BMI) during the three years from 1999 to 2001, but the percentage of children with anemia significantly increased. Health care for preschool aged children, especially in the rural areas, is very important. Centering on public health centers, it is necessary to systematically promote health care in the rural areas.

• Journal of dental hygiene science
• /
• v.17 no.4
• /
• pp.323-332
• /
• 2017

This study aimed to investigate the factors influencing the decision on whether to receive regular oral check-ups among the national health insurance beneficiaries with income and aged over 20 years in Korea. This was a cross-sectional study, using the data from the 2014 6th Korea National Health and Nutrition Examination Survey (KNHANES VI-2), conducted by the Korea Centers for Disease Control and Prevention. The final sample included 2,843 subjects who participated in the health examination survey and oral check-ups. The IBM SPSS Statistics ver. 20.0 was used for the statistical analysis, based on the complex sampling design. The Rao-Scott chi-square test was used to verify the difference in the distribution of independent variables with regard to oral check-ups. The binary logistic regression analysis was used to determine the influencing factors. The ratio of beneficiaries who received oral check-ups was less than half of those who received medical examinations. The Rao-Scott chi-square test, revealed significant differences in the age group (p<0.05) of the predisposing factors, toothache within a year (p<0.001), untreated dental caries (p<0.001) of the need factors, personal income level (p<0.001), educational level (p<0.001), type of medical insurance (p<0.001), and private health insurance (p<0.01) of the enabling factors. In the binary logistic regression analysis, factors influencing oral check-ups were age group, personal income level, educational level, toothache within a year, and untreated dental caries. These findings show a variety of factors influencing the utilization of regular oral check-ups.

• Journal of Hospice and Palliative Care
• /
• v.13 no.2
• /
• pp.109-119
• /
• 2010

Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

• Progress in Medical Physics
• /
• v.16 no.2
• /
• pp.62-69
• /
• 2005

The purpose of this study has been performed to investigate the possibility of external audit program using thermoluminescence dosimetry for electron beam in korea. The TLD system consists of LiF powder, type TLD-700 read with a PCL 3 reader. In order to determine a calibration coefficient of the TLD system, the reference dosimeters are irradiated to 2 Gy in a $^{60}CO$ beam at the KFDA The irradiation is performed under reference conditions is water phantom using the IAEA standard holder for TLD of electron beam. The energy correction factor is determined for LiF powder irradiated of dose to water 2 Gy in electron beams of 6, 9, 12, 16 and 20 MeV (Varian CL 2100C). The dose is determined according to the IAEA TRS-398 and by measurement with a PTW Roos type plane-parallel chamber. The TLD for each electron energy are positioned in water at reference depth. In this study, to verify of the accuracy of dose determination by the TLD system are performed through a 'blind' TLD irradiation. The results of blind test are $2.98\%,\;3.39\%\;and\;0.01\%(1\sigma)$ at 9, 16, 20 MeV, respectively. The value generally agrees within the acceptance level of $5\%$ for electron beam. The results of this study prove the possibility of the TLD quality assurance program for electron beams. It has contributed to the improvement of clinical electron dosimetry in radiotherapy centers.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.8
• /
• pp.654-661
• /
• 2016

This study was conducted to investigate treatment tendency and dental caries occurrence after receiving insurance coverage for pit and fissure sealing. Data were obtained from statements for insurance payments received by the Daejeon branch health insurance review and assessment service from December 2009 until December 31 2014. As to the Pit and Fissure Sealing current state by year, there was most a lot of the number of examinee and the treatment number of teeth in 2010. The per capita average treatment number of teeth was highest (3.39) in 2013. As to the result that it analyze the first molar Pit and Fissure Sealing in 2010 according to the general feature, man was high than the woman, it showed up by age in the age of 7 most highly, and the summer was the highest among by season. The upper jaw left first molar was the most common location, although the upper jaw on the right side first molar, lower jaw right side first molar, and lower jaw left first molar were also affected. In 2010, the procedure was conducted more in the upper jaw right side first molar and enforces the recharge since 2011 to 2014, men were treated more than women, the recharge which is the most abundant in the age of 7 was performed by age, and the procedure was performed more during summer than in other seasons. It is forecasted that at August, 2015 most high demand shows according to the result that it predicts the tooth treatment number until December 2015 based upon the treatment number of teeth from December 2009 until November 2014 and be reduced in comparison with the year 2014. Thus, tooth brushing alone is not sufficient to prevent dental caries. Indeed, conducting pit and fissure sealing in infants and toddlers, as well as elementary middle and high school oral health centers is expected to be effective at preventing dental caries.

• Science of Emotion and Sensibility
• /
• v.9 no.2
• /
• pp.111-118
• /
• 2006

The purpose of the study is to examine the effects of the positive menial stress, eustress, on autonomic nervous system(ANS) and human health. For this, we analyzed heart rate variability(HRV) parameters, the most promising markers of ANS function to assess the changes of emotional and physiological states of human body. We measured HRV Signal of World Cup group(281 male subjects: $29.8{\pm}5.6yr$., 187 female subjects: $29.0{\pm}5.4yr$.) in two stadiums at least an hour before the game during '2002 FIFA World Cup Korea/Japan' event. We also measured control group's(331 male subjects: $30.9{\pm}4.7 yr$., 344 female subjects: $30.2{\pm}5.2 yr$.) in the health promotion centers in two university hospitals at least a month before and after the world cup event period. Considering physiological differences between males and females, the data analysis was applied to 'male group' and 'female group' separately. As a result, some tendency was observed that is different from what we have known as the stress reaction. In general, all parameter values except that of mean heart rate tend to decrease under stressed condition. However, under eustressed condition, both heart rate and standard deviation of the Normal to Normal intervals(SDNN) were higher then those of normal condition(p<0.05). Especially, in case of female group, contrary to distressed condition, every frequency-domain powers showed tile higher value(p<0.05, p<0.001). Considering that decrease of HRV indicates the loss of one's health, the increase of SDNN and frequency parameters means that homeostasis control mechanism of ANS is functioning positively. Accordingly, induction of eustress from international sports event may affect positively to the people's health.

• Child Health Nursing Research
• /
• v.2 no.2
• /
• pp.45-57
• /
• 1996

A serious disease in a family influences the entire family member given the fact that the members closely interact with each other. Especially in terms of pediatric nursing, study on family gains importance as the need to care of families whose children with developmental disabilities and chronic disease This study was done based on The Resiliency Model of Family Adjustment and Adaptation(McCubbin, 1991) is intended to examine the stress of parents whose children suffer from cleft lip or /and cleft palate. It also helps them to cope with the stress and analyze the relationship between the stress and coping This study used Family Inventory of Life Events and Changes (FILE) and Coping Health Inventory for Parents(CHIP) for measuring family stress and coping. The two instruments are revised to fit the social and cultural environment of Korean culture. Data collection was done from April 18, 1996 to May 18, 1996 at 8 University medical centers located in Seoul. Those who answered questionnaires were 84 parents whose children have cleft lip or /and cleft palate. SPSS PC+ was used to analyze the data collotted. Programs used for data analysis were t-test, ANOVA, Pearson correlation coefficient. The study is summarized as follows .1. The average score of family stress is 10.46(percentage of the full score 24.90) and 'finance and business strains'(3.25), and 'intrafamily strains'(2.65) ranked the highest. The average score of family's coping is 1.93, which is close to the answer of' moderately helpful' and they are measured to put their utmost efforts to' intergration and cooperation of family and optimistic definition on the situation'. 2. There is no significant statistical correlation between the family stress and coping. 3. Mothers show more stress than fathers in the parts of 'illness and family care strains' and 'losses'(t〓-2.34, t〓-2.32, p<.05). 4. Fathers show more willingness to cope with the stress than mothers do in the parts of' seeking social support','self-esteem','emotional comfort' 5. Mothers are more stress than fathers in the parts of family stress and its coping with it by usual traits(t〓-2.78, p<.05). Parents with religion are measured to cope more willingly than those who are not 6. Income of a family shows positive correlationship with family coping (r〓.28, p<.05). The study shows that gender difference is significant variable in studying on family stress and coping. Mothers get more stress than fathers, which has much to do with the fact that they are in charge of raising children and keeping houseworks. Accordingly, managing family crisis and its survival can be induced by giving support for the mothers, studying fathers including the rest of the family members and giving nursing care and arbitration ; religious background is also considered to be one of the important factors in family stress , judging from the relationship between family income and family's coping, caring given to suffering children is needed on societal levels. The above considerations bring up the need to have a longitudinal study of children with congenital anomaly including cleft lip or /and cleft palate and their families about family stress and coping. Resiliency programs on family system and their effectiveness and the relationship between the enlarged families with social and cultural values reflecting Korean tradition are also needed to be studied.