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Levels of Barriers to Pain Management of Cancer Patients and their Nurses (암 환자와 간호사의 통증관리 장애정도)

  • Yoo, Yang-Sook;Lee, Won-Hee;Cho, Ok-Hee;Lee, So-Woo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.224-233
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    • 2005
  • Purpose: This study was conducted to provide basic data for developing an effective strategy for cancer pain management by comparing the levels of barriers to pain management of metastatic or advanced cancer patient and their nurses. Methods: The subject of this study were 155 patients who were treated for metastatic or advanced cancer at one of three hospitals in Seoul from January 2004 to January 2005, and 153 nurses who take care of those patients. The levels of barriers to pain management were measured using a tool developed by Gunnarsdottir et al. (2002), 27 questions on a six point scale. The levels of stresses were measured using a tool modified from a stress response measurement reported by Goh Gyung-bong et al. (2000), 27 questions on a five point scale. The levels of barriers in cancer patients were analyzed using t-test and ANOVA, while the data obtained from patients and nurses were compared by t-test. Results: Higher levels of barriers to pain management were found in three groups: 'less than middle school,' 'not treated with anti-cancer chemotherapy,' and 'ECOG of 2.' The level (2.55) of barriers to pain management in the patient group was higher than that (1.76) of the nurse group. Both of the two groups had high levels of barriers in two variables: 'There is a danger of becoming addicted to pain medicine.' and 'Using pain medicine blocks your ability to know if you have any new pain.' There was not a significant difference in the levels of stresses between the two groups. Conclusion: It was found that, for effective cancer pain management practices, it would be necessary to provide cancer patients and their nurses with education and training about pain management and related barriers.

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A Study on Nutrition Status by Diet of Female College Students of Masan City - 1. Focus on Diet Survey - (여대생의 체중감량이 영양상태에 미치는 영향 - 제1보. 다이어트 실태조사를 중심으로 -)

  • 김종현
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.185-191
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    • 1998
  • This study was performed to investigate the nutrition status by weight loss(diet) of 287 female college students, focus on questionnaire about diet survey. The subjects mainly had irregularly one or two meal per a day so food behavior was not good. Over half of subjects had a tendency to overestimate body shape of self. The desired weight(46.95$\pm$0.39kg) was significant lower than real weight(50.32$\pm$0.9)(p=0.0114). The time when diet is first tried was mainly after high school(94.51%). Mean weight loss was 1~4kg but most of subjects didn't maintain the lost weight. The diet approach method tried was sequently the fasting 1 meal or the more in a day(23.61%), exercise(21.92%), restricting calories(15.85%) etc. The source of diet was orderly newspaper or magazine(30.86%), friends or relatives or family(28.86%) etc. The group who recognized the self body shape was normal or a little fat had higher self notion of health than other groups.

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Bone mineral density and nutritional state according to milk consumption in Korean postmenopausal women who drink coffee: Using the 2008~2009 Korea National Health and Nutrition Examination Survey (한국 폐경 후 여성 커피소비자에서 우유섭취여부에 따른 골밀도와 영양상태 비교 : 2008~2009년 국민건강영양조사 자료 이용)

  • Ryu, Sun-Hyoung;Suh, Yoon Suk
    • Journal of Nutrition and Health
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    • v.49 no.5
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    • pp.347-357
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    • 2016
  • Purpose: This study investigated bone mineral density and nutritional state according to consumption of milk in Korean postmenopausal women who drink coffee. Methods: Using the 2008~2009 Korean National Health & Nutrition Examination Survey data, a total of 1,373 postmenopausal females aged 50 yrs and over were analyzed after excluding those with diseases related to bone health. According to coffee and/or milk consumption, subjects were divided into four groups: coffee only, both coffee & milk, milk only, and none of the above. All data were processed after application of weighted values and adjustment of age, body mass index, physical activity, drinking, and smoking using a general linear model. For analysis of nutrient intake and bone density, data were additionally adjusted by total energy and calcium intake. Results: The coffee & milk group had more subjects younger than 65 yrs and higher education, urban residents, and higher income than any other group. The coffee only group showed somewhat similar characteristics as the none of the above group, which showed the highest percentage of subjects older than 65 and in a lower education and socio-economic state. Body weight, height, body mass index, and lean mass were the highest in coffee & milk group and lowest in the none of the above group. On the other hand, the milk only group showed the lowest values for body mass index and waist circumference, whereas percent body fat did not show any difference among the groups. The coffee and milk group showed the highest bone mineral density in the total femur and lumbar spine as well as the highest nutritional state and most food group intakes, followed by the milk only group, coffee only group, and none of the above group. In the assessment of osteoporosis based on T-score of bone mineral density, although not significant, the coffee and milk group and milk only group, which showed a better nutritional state, included more subjects with a normal bone density, whereas the none of the above group included more subjects with osteoporosis than any other group. Conclusion: Bone mineral density in postmenopausal women might not be affected by coffee drinking if their diets are accompanied by balanced food and nutrient intake including milk.

Clinical Applications and Efficacy of Korean Ginseng (고려인삼의 주요 효능과 그 임상적 응용)

  • Nam, Ki-Yeul
    • Journal of Ginseng Research
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    • v.26 no.3
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    • pp.111-131
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    • 2002
  • Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.

Burden, Job Satisfaction and Quality of Life of Nurses Caring for Cancer Patients (암 환자를 돌보는 간호사의 부담감, 직무 만족도 및 삶의 질)

  • Park, Mi-Sun;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.8-17
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    • 2005
  • Purpose: This study was performed to investigate burden, job satisfaction and quality of life of nurses who take care of cancer patients. Methods: The subjects were 237 nurses working at the oncology unit of hospitals with over 500 beds in Seoul and Gyeonggi-do. Data were collected using questionnaire from the February to March, 2005. Data were analyzed through t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression using SAS. Results: 1. The item that showed the highest level of burden was 'I feel limited even if I make efforts to reduce patients' pain. 'Burden was high in those group both who were younger than 35 years old and who had clinical experiences caring cancer patients for $3{\sim}4$ years. 2. The item that showed the lowest level of job satisfaction was 'the possibility of promotion'. Job satisfaction was high in those group both who had a spouse and were head nurses or incharge nurses. 3. The item that showed the lowest level of quality of life was 'I am physically exhausted'. Over 35 years old who had a spouse, and over 2,000,000 won monthly income made a high score in the quality of life. 4. There were negative correlations among burden, iob satisfaction and the quality of life. 5. The major factor affecting the quality of life was burden. Conclusion: The results of this study are expected to be utilized as basic data for developing support system to improve nurses' work conditions and quality of life.

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Potential Contamination Sources on Fresh Produce Associated with Food Safety

  • Choi, Jungmin;Lee, Sang In;Rackerby, Bryna;Moppert, Ian;McGorrin, Robert;Ha, Sang-Do;Park, Si Hong
    • Journal of Food Hygiene and Safety
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    • v.34 no.1
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    • pp.1-12
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    • 2019
  • The health benefits associated with consumption of fresh produce have been clearly demonstrated and encouraged by international nutrition and health authorities. However, since fresh produce is usually minimally processed, increased consumption of fresh fruits and vegetables has also led to a simultaneous escalation of foodborne illness cases. According to the report by the World Health Organization (WHO), 1 in 10 people suffer from foodborne diseases and 420,000 die every year globally. In comparison to other processed foods, fresh produce can be easily contaminated by various routes at different points in the supply chain from farm to fork. This review is focused on the identification and characterization of possible sources of foodborne illnesses from chemical, biological, and physical hazards and the applicable methodologies to detect potential contaminants. Agro-chemicals (pesticides, fungicides and herbicides), natural toxins (mycotoxins and plant toxins), and heavy metals (mercury and cadmium) are the main sources of chemical hazards, which can be detected by several methods including chromatography and nano-techniques based on nanostructured materials such as noble metal nanoparticles (NMPs), quantum dots (QDs) and magnetic nanoparticles or nanotube. However, the diversity of chemical structures complicates the establishment of one standard method to differentiate the variety of chemical compounds. In addition, fresh fruits and vegetables contain high nutrient contents and moisture, which promote the growth of unwanted microorganisms including bacterial pathogens (Salmonella, E. coli O157: H7, Shigella, Listeria monocytogenes, and Bacillus cereus) and non-bacterial pathogens (norovirus and parasites). In order to detect specific pathogens in fresh produce, methods based on molecular biology such as PCR and immunology are commonly used. Finally, physical hazards including contamination by glass, metal, and gravel in food can cause serious injuries to customers. In order to decrease physical hazards, vision systems such as X-ray inspection have been adopted to detect physical contaminants in food, while exceptional handling skills by food production employees are required to prevent additional contamination.

Outcomes after Radiotherapy in Inoperable Patients with Squamous Cell Lung Cancer (수술이 불가능한 편평상피성 폐암의 방사선치료 성적)

  • Ahn Sung-Ja;Chung Woong-Ki;Nah Byung-Sik;Nam Tack-Keun;Kim Young-Chul;Park Kyung-Ok
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.216-223
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    • 2001
  • Purpose : We evaluated retrospectively the outcomes of inoperable squamous cell lung cancer patients treated with radiotherapy to find out prognostic factors affecting survival. Materials and methods : Four hundred and eleven patients diagnosed as squamous cell lung cancer between November 1988 and December 1997 were the basis of this analyses. The planned dose to the gross tumor volume was ranged from 30 to 70.2 Gy. Chemotherapy was combined in 72 patients $(17.5\%)$ with the variable schedule and drug combination regimens. Follow-up period ranged from 1 to 113 months with the median of 8 months and survival status was identified in 381 patients $(92.7\%)$. Overall survival rate was calculated using the Kaplan-Meier method. Results : Age ranged from 23 years to 83 years with the median 63 years. The male to female ratio was about 16:1. For all 411 patients, the median overall survival was 8 months and the 1-year survival rate (YSR), 2-YSR, and 5-YSR were $35.6\%,\;12.6\%,\;and\;3.7\%$, respectively. The median and 5-YSR were 29 months and $33.3\%$ for Stage IA, 13 months and $6.3\%$ for Stage IIIA, and 9 months and $3.4\%$ for Stage IIIB, respectively(p=0.00). The median survival by treatment aim was 11 months in radical intent group and 5 months in palliative, respectively (p=0.00). Of 344 patients treated with radical intent, median survival of patients (N=247) who received planned radiotherapy completely was 12 months while that of patients (N=97) who did not was 5 months (p=0.0006). In the analyses of the various prognostic factors affecting to the survival outcomes in 247 patients who completed the planned radiotherapy, tumor location, supraclavicular LAP, SVC syndrome, pleural effusion, total lung atelectasis and hoarseness were statistically significant prognostic factors both in the univariate and multivariate analyses while the addition of chemotherapy was statistically significant only in multivariate analyses. The acute radiation esophagitis requiring analgesics was appeared in 49 patients $(11.9\%)$ and severe radiation esophagitis requiring hospitalization was shown in 2 patients $(0.5\%)$. The radiation pneumonitis requiring steroid medication was shown in 62 patients $(15.1\%)$ and severe pneumonitis requiring hospitalization was occurred in 2 patients $(0.5\%)$. During follow-up, 114 patients $(27.7\%)$ had progression of local disease with 10 months of median time to recur (range : $1\~87\;months$) and 49 patients $(11.9\%)$ had distant failure with 7 months of median value (range : $1\~52\;months$). Second malignancy before or after the diagnosis of lung cancer was appeared in 11 patients Conclusion : The conventional radiotherapy in the patients with locally advanced squamous cell lung cancer has given small survival advantage over supportive care and it is very important to select the patient group who can obtain the maximal benefit and to select the radiotherapy technique that would not compromise the life quality in these patients.

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Indonesia, Malaysia Airline's aircraft accidents and the Indonesian, Korean, Chinese Aviation Law and the 1999 Montreal Convention

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.37-81
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    • 2015
  • AirAsia QZ8501 Jet departed from Juanda International Airport in, Surabaya, Indonesia at 05:35 on Dec. 28, 2014 and was scheduled to arrive at Changi International Airport in Singapore at 08:30 the same day. The aircraft, an Airbus A320-200 crashed into the Java Sea on Dec. 28, 2014 carrying 162 passengers and crew off the coast of Indonesia's second largest city Surabaya on its way to Singapore. Indonesia's AirAsia jet carrying 162 people lost contact with ground control on Dec. 28, 2014. The aircraft's debris was found about 66 miles from the plane's last detected position. The 155 passengers and seven crew members aboard Flight QZ 8501, which vanished from radar 42 minutes after having departed Indonesia's second largest city of Surabaya bound for Singapore early Dec. 28, 2014. AirAsia QZ8501 had on board 137 adult passengers, 17 children and one infant, along with two pilots and five crew members in the aircraft, a majority of them Indonesian nationals. On board Flight QZ8501 were 155 Indonesian, three South Koreans, and one person each from Singapore, Malaysia and the UK. The Malaysia Airlines Flight 370 departed from Kuala Lumpur International Airport on March 8, 2014 at 00:41 local time and was scheduled to land at Beijing's Capital International Airport at 06:30 local time. Malaysia Airlines also marketed as China Southern Airlines Flight 748 (CZ748) through a code-share agreement, was a scheduled international passenger flight that disappeared on 8 March 2014 en route from Kuala Lumpur International Airport to Beijing's Capital International Airport (a distance of 2,743 miles: 4,414 km). The aircraft, a Boeing 777-200ER, last made contact with air traffic control less than an hour after takeoff. Operated by Malaysia Airlines (MAS), the aircraft carried 12 crew members and 227 passengers from 15 nations. There were 227 passengers, including 153 Chinese and 38 Malaysians, according to records. Nearly two-thirds of the passengers on Flight 370 were from China. On April 5, 2014 what could be the wreckage of the ill-fated Malaysia Airlines was found. What appeared to be the remnants of flight MH370 have been spotted drifting in a remote section of the Indian Ocean. Compensation for loss of life is vastly different between US. passengers and non-U.S. passengers. "If the claim is brought in the US. court, it's of significantly more value than if it's brought into any other court." Some victims and survivors of the Indonesian and Malaysia airline's air crash case would like to sue the lawsuit to the United States court in order to receive a larger compensation package for damage caused by an accident that occurred in the sea of Java sea and the Indian ocean and rather than taking it to the Indonesian or Malaysian court. Though each victim and survivor of the Indonesian and Malaysia airline's air crash case will receive an unconditional 113,100 Unit of Account (SDR) as an amount of compensation for damage from Indonesia's AirAsia and Malaysia Airlines in accordance with Article 21, 1 (absolute, strict, no-fault liability system) of the 1999 Montreal Convention. But if Indonesia AirAsia airlines and Malaysia Airlines cannot prove as to the following two points without fault based on Article 21, 2 (presumed faulty system) of the 1999 Montreal Convention, AirAsia of Indonesiaand Malaysia Airlines will be burdened the unlimited liability to the each victim and survivor of the Indonesian and Malaysia airline's air crash case such as (1) such damage was not due to the negligence or other wrongful act or omission of the air carrier or its servants or agents, or (2) such damage was solely due to the negligence or other wrongful act or omission of a third party. In this researcher's view for the aforementioned reasons, and under the laws of China, Indonesia, Malaysia and Korea the Chinese, Indonesian, Malaysia and Korean, some victims and survivors of the crash of the two flights are entitled to receive possibly from more than 113,100 SDR to 5 million US$ from the two airlines or from the Aviation Insurance Company based on decision of the American court. It could also be argued that it is reasonable and necessary to revise the clause referring to bodily injury to a clause mentioning personal injury based on Article 17 of the 1999 Montreal Convention so as to be included the mental injury and condolence in the near future.

Phase II Study of Gemcitabine and Vinorelbine as a Combination Chemotherapy for the Second-Line Treatment of Nonsmall Cell Lung Carcinoma (비소세포 폐암 환자의 2차 치료로서 Gemcitabine과 Vinorelbine의 병합 요법의 효과)

  • Lee, EunJoo;Ha, EunSil;Park, SangHoon;Hur, GyuYoung;Jung, KiHwan;Jeong, HyeCheol;Lee, SungYong;Kim, JeHyeong;Lee, SangYeub;Sin, Chol;Shim, JaeJeong;In, KwangHo;Kang, KyungHo;Yoo, SeHwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.510-516
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    • 2005
  • Backgroud : Lung cancer is the leading cause of cancer deaths in Korea and the number of lung cancer deaths is increasing. The higher response rates, decreased toxicity and improved performance status of the first-line treatments have resulted in an increased number of patients becoming candidates for second-line therapy. Several new antineoplastic agents, including gemcitabine, docetaxel and paclitaxel, have recently demonstrated second-line activity. This phase II study evaluated the efficacy and toxicity of gemcitabine and vinorelbine as combination chemotherapy for Korean patients with NSCLC as a second-line treatment. Methods : Sixty response-evaluable patients were enrolled from December 2000 to July 2003. We conducted a phase II study of a combination gemcitabine and vinorelbine chemotherapy for patients with histologically confirmed NSCLC that was stage IIIB and IV disease at the time of diagnosis, and the disease had progressed onward or the patients had relapsed after first-line platinum-based chemotherapy. They were treated with intravenous gemcitabine $1000mg/m^2$ and intravenous vinorelbine $25mg/m^2$ on days 1 and 8. This chemotherapy regimen was repeated every 3 weeks. Results : A total of 215 cycles of treatment were given and the mean number of cycles was 3.6 cycles. All the patients were evaluable for the toxicity profile. The response rate was 10% according to the WHO criteria. The median progression free survival was 3.8 months and the median survival time was 10.1 months. The 1-year survival rate was 32.9%. Grade III and IV neutropenia were seen in 20 (33.3%) and 7 (11.7%) patients, respectively. Conclusion : The combination of gemcitabine and vinorelbine is active and well tolerated as a second-line therapy for patients with advanced nonsmall cell lung carcinoma.

THE COMORBIDITY AND EMOTIONAL STATE OF THE ENURETIC CHILDREN (유뇨증 소아의 공존질병 및 정서상태)

  • Lee, Kyu-Kwang;Shin, Yun-O;Lee, Tae-Yong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.34-42
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    • 1997
  • Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N=14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.

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