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The Severity and Variables Influencing Depression in Cancer Patients with Pain (통증이 있는 암환자의 우울 정도 및 우울에 영향을 미치는 요인)

  • Kim, Hyun-Sook;Yun, Young-Ho;Lee, So-Woo;Heo, Dae-Seog;Son, Haeng-Mi;Huh, Bong-Yul
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.125-137
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    • 1999
  • Purpose : Surveying the rates, severity, and variables influencing depression and their correlation between pain and depression in Korean cancer patients, we attempted to provide a basic database for the effective depression management program. Methods : The results of survey were colleted from 10 patients who were hospitalized at Seoul National University Hospital for cancer treatment from February to June of 1999. Factors of depression and the level of pain were examined by self-reported survey employing Korean version of Beck Depression Inventory(BDI) and an abridged version of Brief pain Inventory respectively. The purpose of this study and guidelines for the questionnaires were clearly explained to participating patients by Resgitered Nurses before answering the survey. Demographic and clinical characteristics of patients were compiled by reviewing their medical records in corporation with a family physician. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with Pearson correlation coefficient. Results : 1) 142 subjects comprised 79 male and 63 female, and their mean age was 51.86. 2) The mean scores of the worst pain for last 24-hours was 6.08(SD 2.23), the average pain for last 24-hours 4.44(SD 1.85), and the mean scores of pain at the time of survey 3.48(SD 2.25), while the mean scores of the least pain for last 24-hours 2.25(SD 1.83). 3) The mean BDI scores were 23.73(SD 0.99), and 55.6% of patients were evaluated to be in depression(cutting point 21). Scores of depression for cancer patients were higher than normal population. 4) The correlation between worst pain for last 24-hours and depression(r=0.252, P=0.002), average pain for last 24-hours and depression(r=0.225, P=0.007), present pain and depression(r=0.291, P=0.000) were significant. 5) Significant differences were found among groups of cancer patients with pain with respect to gender(t=3.59, p=0.000), level of education(F=4.063, P=0.009), ECOG(F=3.352, P=0.021). There was significant positive correlation between depression and pain(r=0.171, P=0.042). Conclusions : More than 50% of cancer patients with pain are suffering from depression. We have shown that the variables like the degree of pain, gender, level of education, ECOG, and age are significantly related to the depression in cancer patients. The findings of this study may be used for assessing high-risk patients in need of intervention and for planning effective therapeutic strategies for them after the routine assessment. Further study is necessary to investigate the cultural differences and the variables influencing on depression in Korean cancer patients.

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Hazard Analysis for the Application of Good Agricultural Practices(GAP) on Paprika During Cultivation (파프리카의 농산물우수관리제도(GAP)적용을 위한 재배단계의 위해요소 분석)

  • Nam, Min-Ji;Chung, Do-Yeong;Shim, Won-Bo;Chung, Duck-Hwa
    • Journal of Food Hygiene and Safety
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    • v.26 no.3
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    • pp.273-282
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    • 2011
  • This study established hazards which may cause risk to human at farm during cultivation stage of paprika. Samples of plants (paprika, leaf, stem), cultivation environments (water, soil), personal hygiene (hand, glove, clothes), work utensils (carpet, basket, box) and airborne bacteria were collected from three paprika farms (A, B, C) located in Western Gyeongnam, Korea. The collected samples were assessed for biological (sanitary indications and major foodborne pathogens), chemical (heavy metals, pesticide residues) and physical hazards. In biological hazards, total bacteria and coliform were detected at the levels of 1.9~6.6 and 0.0~4.610g CFU/g, leaf, mL, hand or 100 $cm^2$, while Escherichia coli was not detected in all samples. In major pathogens, only Bacillus cereus were detected at levels of ${\leq}$ 1.5 log CFU/g, mL, hand or 100 $cm^2$, while Staphylococuus aureus, Listeria monocytogenes, E. coli O157 and Salmonella spp. were not detected in all samples. Heavy metal and pesticide residue as chemical hazards were detected at levels below the regulation limit, physical hazard factors, such as insects, pieces of metal and glasses, were also found in paprika farms. Proper management is needed to prevent biological hazards due to cross-contamination while physical and chemical hazards were appropriate GAP criteria.

Predictors of Participation Restriction in Community-dwelling Persons With Spinal Cord Injury (지역사회 거주 척수장애인의 참여 제약에 영향을 미치는 예측요인)

  • Kim, Yeon-Ju;Park, Ji-Hyuk;Kim, Jung-Ran;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.7 no.4
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    • pp.19-30
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    • 2018
  • Objective: The purpose of this study was to suggest predictors of participation restriction in community-dwelling Spinal Cord Injury (SCI) based on environmental, functional, injury-related, psychosocial, and sociodemographic factors. Methods: The participants were 82 community-dwelling SCI adults over the age of 18. They were all included in the American Spinal Injury Association's (ASIA) Levels A, B, and C. This study surveyed participants' participation using the CHART-K-SF, environmental factors using the CHIEF-25 Korean version, and functional factors using the SCIM III. Further, pain and distress were surveyed using Zung's Self-rating Pain and the PAD, self-esteem was assessed using the RSES, and self-efficacy using the GSS. Finally, information concerning injury levels, post-injury period, causes of injury-related factors, and sociodemographic factors such as gender, age, marriage, education level, and residence information were collected. The collected data were analyzed using SPSS Version 21.0 Results: Participants' risk factors were environmental and functional. The Nagelkerke's $R^2$ was.737. The OddsRatio(OR) of environmental factors(referent,0-1) was 40.346. Moreover, the OR of the $1^{st}$ quartile functional factor(referent,4thquartile) was 236. 621, and that of the$2^{nd}$ quartile was 21.174. In addition, the occupational predictors included the "policies" subscales in the CHART-K-SF, "physical/structural" in the CHIEF-25, and "mobility" in the SCIM III. Further, the predictors of "physical independence" were "services/assistance" in CHIEF-25, and "respiration and sphincter management' on the SCIM III. Additionally, "mobility" was predicted by "physical/structural" on the CHIEF-25 and "mobility" on the SCIM III. Conclusions: This study multidimensionally confirmed predictors of participation restriction. Through these facts, we investigated occupational therapists' roles in community setting. Therefore, this study's results will provide useful information for occupational therapy services, for which the goal is SCI participation improvement within the community.

Concerning the Constitution Court's constitutional decision and the direction of supplemental legislation concerning Article 33 paragraph 8 of the Medical Service Act - With a focus on legitimacy of a system that prohibits multiple opening of medical instituion, in the content of 2014Hun-Ba212, August 29, 2019, 2014Hun-Ga15, 2015Hun-Ma561, 2016Hun-Ba21(amalgamation), Constitutional Court of Korea - ('의료법 제33조 제8항 관련 헌법재판소의 합헌결정'에 대한 평가 및 보완 입법 방향에 대하여 -헌법재판소 2019. 8. 29. 2014헌바212, 2014헌가15, 2015헌마561, 2016헌바21(병합) 결정의 내용 중 의료기관 복수 개설금지 제도의 당위성 및 필요성을 중심으로-)

  • KIM, JOON RAE
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.143-174
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    • 2019
  • Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.

Role of Police for Enhancement of Elderly Safety (노인안전 강화를 위한 경찰의 역할)

  • Cha, Min-Kyu;Kwack, Dae-Gyung
    • Korean Security Journal
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    • no.41
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    • pp.387-408
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    • 2014
  • South Korea already became an aging society, and is now in the process of becoming an aged society. With increasing elderly population, elderly safety issues such as traffic accidents and elderly suicides are becoming important problems. Elderly victimization are increasing, and elderly safety accident is also becoming an imporotant social problem. The police is doing various activities for elderly safety. The police is conducting programs for the elderly, such as a prevention program for fraud against elderly, and safety checks and traffic safety education for preventing elderly traffic accidents. Also, there's a program of providing regular visits for a lone elderly, expansion of CCTV network and fingerprint registration to prevent elderlies with Alzheimer's disease going missing. However, these programs are not done on a national scale, but rather limited to local police stations. The purpose of this study is to seek police roles for enhancing elderly safety, due to lack of police activity in this area. Recommendation for police roles in enhancing elderly safety is to first conduct routine crackdowns on fraud against elderly and also conduct education programs for preventing fraud. Also, crimes such as elderly abuse is lead by elderly protection agencies, but considering elderly abuse is a crime, the police should take a leading role. Also, to prevent elderly suicide, meticulous management of elderlies with high suicide risk is necessary, and elderly protection areas should be designated to prevent traffic accidents. Also, elderlies should be induced to turn in their driver's license. To conduct these matters of elderly safety, an organization exclusively charged with elderly safety is necessary. Elderly safety is a broad concept, and since police alone cannot handle the task of ensuring elderly safety, the police should take on a leading role in cooperative efforts with various institutions of the government, non-profit organizations and the community to establish a social saftey net for elderly safety.

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A Study on Piracy Matters and Introduction of the Privately Contracted Armed Security Personnel on Board Ships (해적사건 대응을 위한 무장경비원제도 도입방안에 관한 연구)

  • Roh, Ho-Rae
    • Korean Security Journal
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    • no.41
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    • pp.293-326
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    • 2014
  • Piracy is a worldwide issue, but the deteriorating security situation in the seas off Somalia, the Gulf of Aden and the wider Western Indian Ocean between 2005 and 2012 and in the increasing number of attacks in the Gulf of Guinea are a major problem. The depth of concern for the problem internationally is amply demonstrated by the levels of co-operation and coordination among naval and other forces from several countries that have assembled in the west Indian Ocean region and the Gulf of Aden to escort ships carrying humanitarian aid to Somalia and to protect vulnerable shipping. Notwithstanding this unprecedented effort, the vast sea area in which the pirates now operate makes it difficult to patrol and monitor effectively, particularly with the limited resources available. More resources, in the form of naval vessels and aircraft, are needed and at every opportunity the IMO encourages Member Governments to make greater efforts to provide the additional naval, aerial surveillance and other resources needed through every means possible. IMO provide interim guidance and recommendations to be taken into account when considering the use of PCASP(privately contracted armed security personnel) if and when a flag State determines that such a measure would be lawful and, following a full risk assessment, appropriate. The interim guidance and recommendations of IMO are not intended to endorse or institutionalize the use of armed guards. Therefore, they do not represent any fundamental change of policy by the Organization in this regard. It is for each flag State, individually, to decide whether or not PCASP should be authorized for use on board ships flying their flag. If a flag State decides to permit this practice, it is up to that State to determine the conditions under which authorization will be granted. Therefore, Korea should be introduced rationally PCASP for safe shipping. PCASP on board ships is much the same to special guard personnel of security services industry act. Act plan of Oceans and fisheries ministry on PCASP collides with special guard personnel system of National Police Agency. Rather than new law making, PCASP regukations have to be included in security services industry act. Management Agency of PCASP is to not Oceans and fisheries ministry, but Central Headquarters Korea Coast Guard of Public Safety and Security Ministry because of specialty and closely connection.

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Middle and Long Term Results of 34 Cases of Emergency Coronary Artery Bypass Graft Surgery (응급 관상동맥 우회술 34예의 중장기 성적)

  • 손정환;김응중;지현근;신윤철;김건일;최광민;이원진;이원용
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.741-747
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    • 2003
  • Background: Coronary artery bypass graf t (CABG) has been settled as most safe surgery among the open heart surgeries. However, in patients with cardiogenic shock, the emergency CABG has higher mortality than elective CABG. We analyzed thirty four patients who underwent emergency CABG and report the middle and long-term results. Material and Method: From June 1994 to December 2001, 34 patients who underwent emergency CABG at Kang-dong Sacred Heart Hospital were include in this study. On the basis of hospital databases and Out Patient Department (OPD) follow up data, preoperative diagnosis, risk factor, coronary artery anatomy, operation technique, postoperative mortality, complication, recurrence of symptom, and mid and long term mortality were analyzed retrospectively. Result: Indications for emergency CABG were 29 cardiogenic shocks (85.3%), 4 intractable chest pains (11.8%), and 1 polymorphic ventricular tachycardia (2.9%). Preoperative angiographic diagnoses were triple vessel disease in 16 (47.1%) and left main disease in 8 (23.5%) patients. We used saphenous vein grafts in 81 and left internal thoracic artery grafts in 14 anastomosis. The mean number of grafts per patients was 2.8$\pm$0.8. The mean aortic cross clamp time was 91.9$\pm$34.6 minutes and the mean cardiopulmonary bypass time was 262.7$\pm$198.3 minutes. Early mortality was 50% and the most common cause of early mortality was low cardiac output in 7 (20.6%) patients. The mean follow-up period was 30.9$\pm$35.7 months. There were no recurrences of symptom and late mortality. Conclusion: In the case of emergency operation, aggressive and proper management with drugs and IABP should be done for preoperative hemodynamic stability and early surgical intervention is the most important factor for patient salvage.

Osteoporosis in Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서의 골다공증에 관한 연구)

  • Kim, Seong-Ja;Lee, Young-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.90-96
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    • 1999
  • Background : Osteoporosis has been reported in patients with chronic obstructive pulmonary disease, but this association is not well established. This study was undertaken to determine whether the prevalence of osteoporosis was increased in patients with chronic obstructive pulmonary disease and we examined the relationship of corticosteroid administration with osteoporosis. Method: Subjects were 23 patients with chronic obstructive pulmonary disease and 20 control patients. We reviewed hospital records and measured bone mineral density using dual-energy x-ray absorptiometry(Lunar. USA). Results: Mean bone mineral density(BMD) of spine in COPD group was $0.683{\pm}0.154 g/cm^2$ and $0.971{\pm}0.212g/cm^2$ in controls(p<0.01). But there was no significant difference in femoral neck BMD. There were seventeen cases of osteoporosis and six cases of osteopenia in COPD group and three patients of osteoporosis and one case of osteopenia in controls. But, there was no significant correlation between disease duration of COPD and spinal T score(r=-0.395, p>0.05). Ten patients were received corticosteroid in COPD group. Spinal T score in steroid receiving patients were $-3.82{\pm}0.94(SD)$ and $-2.82{\pm}0.97(SD)$ in not having steroid patients(p<0.01). Cumulative dose of corticosteroid was associated with spinal T score(r=-0.424, p<0.05) and duration of corticosteroid administration also associated with spinal T score(r=-0.457. p<0.05). Spinal BMD of patients not having corticosteroid in COPD group(n=13) were significantly lower than that of controls($0.71{\pm}0.13 g/cm^2$ and $0.97{\pm}0.21 g/cm^2$, p<0.01). Conclusion : Prevalence of osteoporosis is increased in patients with chronic obstructive pulmonary disease. Especially patients who are receiving corticosteroid have high risk of osteoporosis or osteopenia and need for preventive management.

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Serum 25-hydroxyvitamin D levels are associated with dental caries experience in Korean adolescents: the 2010~ 2014 Korean National Health and Nutrition Examination Surveys (청소년에서 혈중 비타민 D 농도와 치아우식 경험 간의 연관성 : 2010~ 2014 국민 건강영양조사)

  • Choi, Soyeon;Seo, Deog-Gyu;Hwang, Ji-Yun
    • Journal of Nutrition and Health
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    • v.51 no.4
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    • pp.287-294
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    • 2018
  • Purpose: This study was conducted to evaluate the association between serum 25-hydroxyvitamin D (25(OH)D) levels and dental caries experience in Korean adolescents based on the 2010 ~ 2014 Korean National Health and Nutrition Examination Surveys. Methods: The study subjects were 2,655 Korean adolescents aged 10 to 18 years. Subjects were classified into four groups according to their serum 25(OH)D levels. We used logistic regression to evaluate the relationship between vitamin D and for dental caries experience after adjusting for age, household income level, recipient of basic livelihood, tooth brushing and visiting dental clinics. Result: Multiple logistic regression analysis showed that serum 25(OH)D insufficiency (20 ng/mL ${\leq}25(OH)D$ < 30 ng/mL) was associated with increased odd ratios (ORs) for dental caries experience in boys (OR = 2.577, 95% CI = 1.013-6.557), compared with serum 25(OH)D sufficiency (25(OH)D ${\geq}30ng/mL$). Conclusion: The serum 25(OH)D levels were found to be related to risk of dental caries experience in Korean adolescent boys.

The Effect of Information Protection Control Activities on Organizational Effectiveness : Mediating Effects of Information Application (정보보호 통제활동이 조직유효성에 미치는 영향 : 정보활용의 조절효과를 중심으로)

  • Jeong, Gu-Heon;Jeong, Seung-Ryul
    • Journal of Intelligence and Information Systems
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    • v.17 no.1
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    • pp.71-90
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    • 2011
  • This study was designed to empirically analyze the effect of control activities(physical, managerial and technical securities) of information protection on organizational effectiveness and the mediating effects of information application. The result was summarized as follows. First, the effect of control activities(physical, technical and managerial securities) of information protection on organizational effectiveness showed that the physical, technical and managerial security factors have a significant positive effect on the organizational effectiveness(p < .01). Second, the effect of control activities(physical, technical and managerial securities) of information protection on information application showed that the technical and managerial security factors have a significant positive effect on the information application(p < .01). Third, the explanatory power of models, which additionally put the information protection control activities(physical, technical and managerial securities) and the interaction variables of information application to verify how the information protection control activities( physical, technical and managerial security controls) affecting the organizational effectiveness are mediated by the information application, was 50.6%~4.1% additional increase. And the interaction factor(${\beta}$ = .148, p < .01) of physical security and information application, and interaction factor(${\beta}$ = .196, p < .01) of physical security and information application among additionally-put interaction variables, were statistically significant(p < .01), indicating the information application has mediated the relationship between physical security and managerial security factors of control activities, and organizational effectiveness. As for results stated above, it was proven that physical, technical and managerial factors as internal control activities for information protection are main mechanisms affecting the organizational effectiveness very significantly by information application. In information protection control activities, the more all physical, technical and managerial security factors were efficiently well performed, the higher information application, and the more information application was efficiently controlled and mediated, which it was proven that all these three factors are variables for useful information application. It suggested that they have acted as promotion mechanisms showing a very significant result on the internal customer satisfaction of employees, the efficiency of information management and the reduction of risk in the organizational effectiveness for information protection by the mediating or difficulty of proved information application.