• 여성건강간호학회지
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• 제17권5호
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• pp.463-473
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• 2011

Purpose: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire. Methods: A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion. Results: Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability. Conclusion: The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.

• 보건행정학회지
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• 제29권3호
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• pp.357-367
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• 2019

Background: This study evaluated the cost-effectiveness of 21 different national dyslipidemia screening strategies according to total cholesterol (TC) cutoff and screening interval among 40 years or more for the primary prevention of coronary heart disease over a lifetime in Korea, from a societal perspective. Methods: A decision tree was used to estimate disease detection with the 21 different screening strategies, while a Markov model was used to model disease progression until death, quality-adjusted life years (QALYs) and costs from a Korea societal perspective. Results: The results showed that the strategy with TC 200 mg/dL and 4-year interval cost \4,625,446 for 16.65105 QALYs per person and strategy with TC 200 mg/dL and 3-year interval cost \4,691,771 for 16.65164 QALYs compared with \3,061,371 for 16.59877 QALYs for strategy with no screening. The incremental cost-effectiveness ratio of strategy with TC 200 mg/dL and 4-year interval versus strategy with no screening was \29,916,271/QALY. At a Korea willingness-to-pay threshold of \30,500,000/QALY, strategy with TC 200 mg/dL and 4-year interval is cost-effective compared with strategy with no screening. Sensitivity analyses showed that results were robust to reasonable variations in model parameters. Conclusion: In this study, revised national dyslipidemia screening strategy with TC 200 mg/dL and 4-year interval could be a cost-effective option. A better understanding of the Korean dyslipidemia population may be necessary to aid in future efforts to improve dyslipidemia diagnosis and management.

• Journal of Preventive Medicine and Public Health
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• 제43권1호
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• pp.62-72
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• 2010

Objectives: To identify factors associated with cancer screening intention using the Theory of Planned Behavior (TPB). Methods: Among 55,920 eligible persons for National Cancer Screening Program (NCSP) in J city, 1,100 individuals were contacted. Of these, 797 were interviewed using a structured questionnaire. Thirty-six responses were excluded due to incomplete data. The remaining 761 completed questionnaires were analyzed to find factors associated with cancer screening intention. Results: Cancer screening intention was significantly associated with behavioral attitude (p<0.01) and subjective norm (p<0.01), but not with perceived behavioral control (p=0.29) in the TPB model. These three constructs explained 29.7% of cancer screening intention in multiple linear regression analysis. External factors such as socio-demographic status, health and health behavior variables explained 8.9% of screening intention. Among them, household monthly income, past cancer screening experience, exercise and daily eating habit were significantly associated with screening intention. Conclusions: Cancer screening intention may be influenced by focusing attitude, subjective norm in TPB model and other external factors. However, further studies are warranted to identify factors influencing cancer screening intention and behavior.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.609-614
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• 2016

Background: Although breast cancer is the most common cancer in women, economic evaluation of breast cancer screening is not fully addressed in developing countries. The main objective of the present study was to analyze the cost-effectiveness of breast cancer screening using mammography in 35-69 year old women in an Iranian setting. Materials and Methods: This was an economic evaluation study assessing the cost-effectiveness of a population-based screening program in 35-69 year old women residing in rural areas of South east Iran. The study was conducted from the perspective of policy-makers of insurance. The study population consisted of 35- to 69-year old women in rural areas of Kerman with a population of about 19,651 in 2013. The decision tree modeling and economic evaluation software were used for cost-effectiveness and sensitivity analyses of the interventions. Results: The total cost of the screening program was 7,067.69 US$ and the total effectiveness for screening and no-screening interventions was 0.06171 and 0.00864 disability adjusted life years averted, respectively. The average cost-effectiveness ratio DALY averted US$ for screening intervention was 7,7082.5 US$ per DALY averted and 589,027 US $ for no-screening intervention. The incremental cost-effectiveness ratio DALY averted was 6,264 US$ per DALY averted for screening intervention compared with no-screening intervention. Conclusions: Although the screening intervention is more cost-effective than the alternative (noscreening) strategy, it seems that including breast cancer screening program in health insurance package may not be recommended as long as the target group has a low participation rate.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1761-1766
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• 2012

Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.

• 실천공학교육논문지
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• 제15권2호
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• pp.495-502
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• 2023

우리나라는 세계적으로 국가 암검진 지원을 오랜 시간 지원하고 있음에도 불구하고 암검진 수검률은 다른 건강검진과 영유아 검진에 비교해 저조한 수검률을 보인다. 특히, 여성 장애인은 여성 비장애인과 비교해 자궁경부암 검진에서 더 낮은 수검률을 보인다. 따라서 이 연구는 2011~2019년 동안 30세 이상 여성 장애인과 비장애인의 자궁경부암 검진 수검률의 추이를 알아보고, 지역 간의 자궁경부암 수검률을 통해 여성 장애인의 자궁경부암 수검에 영향을 미치는 요인을 개인 수준과 지역 수준으로 지역 간 변이에 어느 정도 영향을 미치는지 알아보고자 한다. 2011~2019년도까지 장애인의 자궁경부암 수검률은 대전이 가장 높았고 세종과 제주지역이 가장 낮게 나타났으며, 지역별 장애인의 자궁경부암 수검률 격차는 최대 13.1%로 분석되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3773-3779
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• 2012

Objective: Despite government efforts to increase participation in gastric cancer screening, the rate is still suboptimal in Korea. Therefore, we explored barriers to and predictors of gastric cancer screening participation among a nationally representative sample. Methods: We used the Health Interview Survey sub-dataset derived from the Fourth Korean National Health and Nutrition Examination Survey 2008 (KNHANES IV) to evaluate participation in gastric cancer screening and factors associated with attendance in individuals age ${\geq}40$ years. We enrolled 4,464 subjects who completed the questionnaire and were not previously diagnosed with gastric cancer. Four groups of factors were considered potential predictors of gastric cancer screening in a multivariate analysis: sociodemographic, health behavior, psychological and cognitive, and dietary factors. Results: Overall, 41.3% complied with the gastric cancer screening recommendations. Younger age, lower education level, living without a spouse, frequent binge drinker, and current smoker were significantly associated with less participation in gastric cancer screening. Conclusions: To improve participation in gastric cancer screening, more focused interventions should be directed to vulnerable populations, such as groups with low socioeconomic status or unhealthy behavior. In addition, there should be new promotional campaigns and health education to provide information targeting these vulnerable populations.

• 대한기계학회논문집A
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• 제27권6호
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• pp.987-996
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• 2003

The structural integrity of the reactor vessel with the approaching end of life must be assured for pressurized thermal shock. The regulation specifies the screening criteria for this and requires that specific analysis be performed for the reactor vessel which is anticipated to exceed the screening criteria at the end of plant life. In case the screening criteria is exceeded by the deterministic analysis, probabilistic analysis must be performed to show that failure probability Is within the limit. In this study, probabilistic fracture mechanics analysis of the reactor vessel for pressurized thermal shock is performed and the effects of residual stress and master curve on the failure probability are investigated.

• 대한조선학회논문집
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• 제54권6호
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• pp.476-484
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• 2017

The purpose of this paper is to verify the structural integrity of a region with numerous penetration-holes in offshore structures such as semi-submersible rig and FPSO. In order to effectively check the yielding and buckling strength of plate members with penetration-holes, a screening analysis program was developed with the FE analysis tool to generate fine meshed model using the theoretical and analysis methods. When a hole is appeared in the plate structure members, the flow of stress is altered such that concentrations of stress form near the hole. Stress concentrations are of concern during both preliminary and detail design and need to be addressed from the perspectives of strength. To configure the geometrical shape, very fine meshed FE analysis is needed as the most accurate method. However, this method is practically impossible to apply for the strength verifications for all perforated plates. In this paper, screening analysis method was introduced to reduce analysis tasks prior to detailed FE analysis. This method is applied to not only the peak stress calculation combined stress concentration factor with nominal stress but also nominal equivalent stress calculation considering cutout effects. The areas investigated by very fine meshed analysis were to be chosen through screening analysis without any reinforcements for penetration-holes. If screening analysis results did not satisfy the acceptance criteria, direct FE analysis method as the 2nd step approach were applied with one of the coarse meshed model considering hole or with the very fine meshed model considering the hole shape and size. In order to effectively perform the local fine meshed analysis, automatic model generating program was developed based on the MSC/PATRAN which is pre-post FE analysis program. Buckling strength was also evaluated by Common Structure Rule (CSR) adopted by IACS as the stress obtained from very fine meshed FE analysis. Due to development of the screening analysis program and automatic FE modeling program, it was able to reduce the design periods and structural analysis costs.

• KSBB Journal
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• 제29권2호
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• pp.124-130
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• 2014

Acer tegmentosum was a traditional Korean herbal medicine showing various pharmacological activities. In this work, A. tegmentosum were extracted with boiling water and then successively partitioned with dichloromethane, ethyl acetate, n-butyl alcohol (n-BuOH), and water. Salidoside, the target compound, was purified in n-BuOH phase using a chromatography method. For the analysis of salidoside, TLC and LC-MS were used as well as on-line screening $HPLC-ABTS^+$ assay with three different wavelength of 254, 280, and 320 nm. An amount of 1.34 g of salidoside were obtained in n-BuOH phase fromAcer tegmentosum was a traditional Korean herbal medicine showing various pharmacological activities. In this work, A. tegmentosum were extracted with boiling water and then successively partitioned with dichloromethane, ethyl acetate, n-butyl alcohol (n-BuOH), and water. Salidoside, the target compound, was purified in n-BuOH phase using a chromatography method. For the analysis of salidoside, TLC and LC-MS were used as well as online screening $HPLC-ABTS^+$ assay with three different wavelength of 254, 280, and 320 nm. An amount of 1.34 g of salidoside were obtained in n-BuOH phase from 3 kg of dry biomass. The on-line screening $HPLC-ABTS^+$ assay is rapid and efficient tool to search bioactivity from A. tegmentosum. 3 kg of dry biomass. The on-line screening $HPLC-ABTS^+$ assay is rapid and efficient tool to search bioactivity from A. tegmentosum.