• Title/Summary/Keyword: prevention of recurrence

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Association between Socioeconomic Status and Altered Appearance Distress, Body Image, and Quality of Life Among Breast Cancer Patients

  • Chang, Oliver;Choi, Eun-Kyung;Kim, Im-Ryung;Nam, Seok-Jin;Lee, Jeong Eon;Lee, Se Kyung;Im, Young-Hyuck;Park, Yeon Hee;Cho, Juhee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8607-8612
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    • 2014
  • Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

Electronic Roll Book using Electronic Bracelet.Child Safe-Guarding Device System (전자 팔찌를 이용한 전자 출석부.어린이 보호 장치 시스템)

  • Moon, Seung-Jin;Kim, Tae-Nam;Kim, Pan-Su
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.143-155
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    • 2011
  • Lately electronic tagging policy for the sexual offenders was introduced in order to reduce and prevent sexual offences. However, most sexual offences against children happening these days are committed by the tagged offenders whose identities have been released. So, for the crime prevention, we need measures with which we could minimize the suffers more promptly and actively. This paper suggests a new system to relieve the sexual abuse related anxiety of the children and solve the problems that electronic bracelet has. Existing bracelets are only worn by serious criminals, and it's only for risk management and positioning, there is no way to protect the children who are the potential victims of sexual abuse and there actually happened some cases. So we suggest also letting the students(children) wear the LBS(Location Based Service) and USN(Ubiquitous Sensor Network) technology based electronic bracelets to monitor and figure out dangerous situations intelligently, so that we could prevent sexual offences against children beforehand, and while a crime is happening, we could judge the situation of the crime intelligently and take swift action to minimize the suffer. And by checking students' attendance and position, guardians could know where their children are in real time and could protect the children from not only sexual offences but also violent crimes against children like kidnapping. The overall system is like follows : RFID Tag for children monitors the approach of offenders. While an offender's RFID tag is approaching, it will transmit the situation and position as the first warning message to the control center and the guardians. When the offender is going far away, it turns to monitoring mode, and if the tag of the child or the offender is taken off or the child and offender stay at one position for 3~5 minutes or longer, then it will consider this as a dangerous situation, then transmit the emergency situations and position as the second warning message to the control center and the guardians, and ask for the dispatch of police to prevent the crime at the initial stage. The RFID module of criminals' electronic bracelets is RFID TAG, and the RFID module for the children is RFID receiver(reader), so wherever the offenders are, if an offender is at a place within 20m from a child, RFID module for children will transmit the situation every certain periods to the control center by the automatic response of the receiver. As for the positioning module, outdoors GPS or mobile communications module(CELL module)is used and UWB, WI-FI based module is used indoors. The sensor is set under the purpose of making it possible to measure the position coordinates even indoors, so that one could send his real time situation and position to the server of central control center. By using the RFID electronic roll book system of educational institutions and safety system installed at home, children's position and situation can be checked. When the child leaves for school, attendance can be checked through the electronic roll book, and when school is over the information is sent to the guardians. And using RFID access control turnstiles installed at the apartment or entrance of the house, the arrival of the children could be checked and the information is transmitted to the guardians. If the student is absent or didn't arrive at home, the information of the child is sent to the central control center from the electronic roll book or access control turnstiles, and look for the position of the child's electronic bracelet using GPS or mobile communications module, then send the information to the guardians and teacher so that they could report to the police immediately if necessary. Central management and control system is built under the purpose of monitoring dangerous situations and guardians' checking. It saves the warning and pattern data to figure out the areas with dangerous situation, and could help introduce crime prevention systems like CCTV with the highest priority. And by DB establishment personal data could be saved, the frequency of first and second warnings made, the terminal ID of the specific child and offender, warning made position, situation (like approaching, taken off of the electronic bracelet, same position for a certain time) and so on could be recorded, and the data is going to be used for preventing crimes. Even though we've already introduced electronic tagging to prevent recurrence of child sexual offences, but the crimes continuously occur. So I suggest this system to prevent crimes beforehand concerning the children's safety. If we make electronic bracelets easy to use and carry, and set the price reasonably so that many children can use, then lots of criminals could be prevented and we can protect the children easily. By preventing criminals before happening, it is going to be a helpful system for our safe life.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.248-329
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    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Comparative Study on Social Support and Perceived Health between Obese Women and Normal Weight Women (비만여성과 정상체중 여성의 사회적지지 및 건강지각의 비교)

  • Kim, Jeong-Ah;Wang, Myoung-Ja
    • Research in Community and Public Health Nursing
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    • v.15 no.4
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    • pp.587-599
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    • 2004
  • Purpose: The purpose of this study is to compare abdomen-fat rate, life style and social-support between normal weight women and obese women. Method: 304 women objectives from their 30 to 59 years of age were selected living in Je-chon city, Chung-Buck province and their height and weight were measured from April 1st to June 30th, 2003. Data were classified into low-weight group ($18.5kg/m^2$), normal-weight group ($18.5{\sim}22.9kg/m^2$), over weight group ($23{\sim}24.9kg/m^2$), and obese group ($25kg/m^2$) following the Korean Conference of Obesity, 2001. in which 119 people in the normal weight group and 91 people in the obese group, i.e. total 210 people were analyzed in sequence. Using SPSS Win 10.1 Program, frequency and percentile, and by ANOVA, $X^2-test$ and t-test were treated. Results: The average age of obese women was 46.68 distributing 40.7% of forties and 39.6% of fifties while normal-weight women were average 41.73-year old distributing 53.8% of forties and 34.5% of thirties, which revealed aged in obese women. The body fat rate of obese women averaged $37.52{\pm}4.17%$, in which 98.9% of obese women and 21.0% of normal weight women with a more than 30% of body-fat rate resulted in a higher body-fat rate in obese women. The waists of obese women averaged $88.37{\pm}8.22cm$, in which more than 85cm showed in obese women of 68.2% and normal weight women of 7.6% indicating a higher waist-fat rate in obese women. The abdomen-fat rate of more than 0.85 of waist vs hip-fat showed 74.7% in obese women and 58.4% in normal weight women, indicating a higher abdomen-fat rate in obese women. Obese women and normal weight women showed significant differences in education level, number of children, religion, menstrual status, and mother's weight. Especially, obese women ate hotter or saltier food than normal weight women preferring meat. However, no significant differences appeared in marital status, social economic status. occupation. eating habits. smoking. drinking and physical exercise. Social support levels showed a lower rate in obese women than in normal weight women, indicating a statistically significant difference (p<.05). Observing areas of social support, obese women showed lower rates in attachment/intimacy, social integrity, opportunity of foster and confidence in value except help and instruction, which indicated a statistically significant difference (p<.05). Social support for obese women showed significant differences in age, education level, social hierarchy, religion and menstrual status. Obese women were more negative than normal weight women in health recognition, indicating a statistically significant difference (p<.01). Normal weight women showed higher health recognition when provided high social support and significantly low (p<.01) health recognition when provided low social support. However, there was no significant difference in health recognition in obese women whether high or low social support was given. The health recognition of obese women showed significant differences in age, education level, social hierarchy, number of children, menstrual status, physical exercise, eating habits, eating taste and preference of food. Conclusion: Obese women showed elder than normal-weight women, higher body-fat rate and abdomen-fat rate, lower social support, and a tendency to more negative health recognition. Therefore, providing weight-control programs for the treatment of obesity and prevention of recurrence for obese women to prevent progressing to adult disease and promote a healthy life, we suggest that better eating habits and the encouragement of regular physical exercise should be included, as well as total approachment on change of health recognition and social support would be needed.

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Study of the Introduction on the Aviation Safety Data Protection System (항공안전데이터 보호제도 도입 방안 연구)

  • Kim, Eun-jung
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.1
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    • pp.81-120
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    • 2018
  • To promote the aviation safety reporting system that is operated to enhance aviation safety and to utilize related information, it should first be preceded by standards for non-punishment and data protection. It is because the purpose of collection and analysis of aviation safety related data through the aviation safety reporting system is to prevent recurrence of accidents by investigating their causes through collection and analysis of diverse types of information related to aviation safety. Both mandatory and voluntary reporting systems are in operation for aviation safety under the current Aviation Safety Act. It is said that they were introduced to survey causes for accidents and to prevent recurrences. In fact, however, it is hard to expect active implementation of the reporting system for aviation safety unless the reporters are firstly exempted from punishment. Therefore, the system should be improved so that it can satisfy its purpose and the purposes of data collection concerning aviation safety through examination of the purposes of the reporting system. One of the matters that needs to be considered to promote the reporting system should be the scope of aviation safety hindrances presupposed under the current institution. The voluntary aviation safety reporting system differs from the systems of ICAO or the key advanced countries, including the USA and the UK as it limits the target accidents subject to reporting to minor aviation safety hindrances only. That being said, improvements should be made by requiring mandatory reporting of aviation safety hindrances based on their severity while recognizing a greater variety of aviation safety concerns like international standards. Safety actions and sharing of information based on collection and analysis of diverse data related to aviation safety will greatly contribute to enhance aviation safety as the purposes of the reporting system are to explore causes for accidents and to prevent their recurrences. What is most important in this regard is strict data protection and non-punishment principles; compliance with them should be secured. We can hardly expect the successful operation of the system unless the reporter is exempted from punishment and the relevant data is protected as promotion of voluntary reporting is an essential factor for enhancing the safety culture. Otherwise, the current system may induce hiding of relevant facts or data to evade punishment. It is true that the regulation for enhancing safety tends to have limitations or blind spots; nevertheless, it should still be enforced strictly and completely. Technological progresses and mistakes of operators appear in different forms based on individual cases. The consequential damages may amount to a truly severe level. Therefore, we have studied and suggested to the methods of activiation and amendments on the aviation safety reporting system, which is referred for one of the proactive safety management systems. The proposed improvement of the reporting system and introduction of non-punishment for collection of aviation safety data for deploying a preemptive prevention system would serve as the backbone for enhancing aviation safety in Korea.

Limitations of National Responsibility and its Application on Marine Environmental Pollution beyond Borders -Focused on the Effects of China's Three Gorges Dam on the Marine Environment in the East China Sea- (국경을 넘는 해양환경오염에 대한 국가책임과 적용의 한계 -중국의 산샤댐 건설로 인한 동중국해 해양환경 영향을 중심으로-)

  • Yang, Hee Cheol
    • Ocean and Polar Research
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    • v.37 no.4
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    • pp.341-356
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    • 2015
  • A nation has a sovereign right to develop and use its natural resources according to its policies with regard to development and the relevant environment. A nation also has an obligation not to harm other countries or damage environments of neighboring countries as consequences of such actions of developments or use of natural resources. However, international precedents induce a nation to take additional actions not to cause more damages from the specific acts causing environmental damages beyond national borders, when such acts have economic and social importance. That is to say that there is a tendency to resolve such issues in a way to promote the balance between the mutual interests by allowing such actions to continue. A solution to China's Three Gorges Dam dilemma based on a soft law approach is more credible than relying on a good faith approach of national responsibilities and international legal proceedings since the construction and operation of the dam falls within the category of exercising national sovereign rights. If a large scale construction project such as the Three Gorges Dam or operation of a nuclear power plant causes or may cause environmental damage beyond the border of a nation engaged in such an undertaking, countries affected by this undertaking should jointly monitor the environmental effects in a spirit of cooperation rather than trying to stop the construction and should seek cooperative solutions of mutual understanding to establish measures to prevent further damages. If China's Three Gorges Dam construction and operation cause or contain the possibility of causing serious damages to marine environment, China cannot set aside its national responsibility to meet international obligations if China is aware of or knows about the damage that has occurred or may occur but fail to prevent, minimize, reverse or eliminate additional chances of such damages, or fails to put in place measures in order to prevent the recurrence of such damages. However, Korea must be able to prove a causal relationship between the relevant actions and resulting damages if it is to raise objections to the construction or request certain damage-prevention actions against crucial adverse effects on the marine environment out of respect for China's right to develop resources and acts of use thereof. Therefore, it is essential to cumulate continuous monitoring and evaluations information pertaining to marine environmental changes and impacts or responses of affected waters as well as acquisition of scientific baseline data with observed changes in such baseline. As China has adopted a somewhat nonchalant attitude toward taking adequate actions to protect against marine pollution risks or adverse effects caused by the construction and operation of China's Three Gorges Dam, there is a need to persuade China to adopt a more active stance and become involved in the monitoring and co-investigation of the Yellow Sea in order to protect the marine environment. Moreover, there is a need to build a regular environmental monitoring system that includes the evaluation of environmental effects beyond borders. The Espoo Convention can serve as a mechanism to ease potential conflicts of national interest in the Northeast Asian waters where political and historical sensitivities are acute. Especially, the recent diplomatic policy advanced by Korea and China can be implemented as an important example of gentle cooperation as the policy tool of choice is based on regional cooperation or cooperation between different regions.

The Effects of Diluted Fibrin Glue about Continuous Air Leakage after Lung Surgery (폐수술 후 지속적 공기누출에 희석한 Fibrin Glue의 효과)

  • Choi Chang-Woo;Lee Seong-Jin;Lee Chol-Sae;Lee Kihl-Rho;Lee Seock-Yeol
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.770-774
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    • 2006
  • Background: Continuous air leakage through chest tube after lung surgery may increase pt's hospital stay and lead to many complications including empyema etc. Chemical pleurodesis has frequently been used for prevention of air leakage. Therefore, we performed chemical pleurodesis using diluted fibrin glue in patients with continuous air leak-age and observed the effects and efficiency of treatment. Material and Method: From September, 2001 to August, 2005, 16 patients whose continuous air leakage lasted more than 7 days underwent chemical pleurodesis with diluted fibrin glue. The effects of treatment, complications and recurrences were reviewed. Dissolved fibrinogen 1.0 g and aprotinin 500,000 KIU were mixed in a 50 cc syringe (Mixed solution A). And dissolved thrombin 5,000 IU and Calcium chloride 600 mg were mixed in a 50 cc syringe (Mixed solution B). Cefazolin 1.0 g was mixed in a 50 cc syringe (Mixed solution C). Rubber tube was inserted between the chest tube and the collecting bottle. An inserted rubber tube was positioned 60cm above the patient and forming a loop appearance was done. Mixed solutions A, B and C were injected into the highest rubber tube. Results: Continuous air leakages disappeared in all f6 patients at next day. Chest tubes were removed after 3 days in all patients. Complications were chest pain in 12 patients (75%), leukocytosis in 14 patients (88%), fever and chill in 14 patients (88%). All complications were transient and disappeared without specific treatment. Conclusion: Our findings demonstrated that diluted fibrin glue chemical pleurodesis was effective in patients with continuous air leakage lasting more than 7 days. Diluted fibrin glue chemical pleurodesis had good results with acceptable complications. long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence in a large number of patients.