• Journal of the Korean Geographical Society
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• v.49 no.2
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• pp.245-263
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• 2014

This study tries to investigate the changes of mortality regarding heat waves which are usually considered as one of the most direct impacts of climate change. Based on 17 years data period (1994-2010), each city's threshold temperature and minimum mortality temperature are recognized. According to the results, minimum mortality temperature varies from 23 to $25^{\circ}C$, showing minimum temperature corresponding to $23^{\circ}C$ in Gangwondo and maximum temperature corresponding to $25.4^{\circ}C$ in Jeollabukdo and Major 7 city group. In case of threshold temperature, it ranges from 27 to $30^{\circ}C$. The cities having higher threshold temperatures tend to have large populations and vice versa. In addition, the cities having negative demographic vulnerability relatively have lower temperatures, representing correlation -0.44(p=0.06). The socio-economic-environmental vulnerability shows negative correlation with minimum mortality temperature(r=-0.36, p=0.032) and threshold temperature(r=-0.29, p=0.081). This paper represents that the number of mortality could increase rapidly and show large spatial differences in the number of mortality depending on various factors including natural, social, and economic factors of each region.

• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.93-111
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• 1975

As the hospitalized patients will be facing new stress situation due to change of his environment from home to hospital it will be very important to understand the psychological stress experienced by hospital patients not only for helping patients in the process of recovery from illness but also fulfil1ing the objective of comprehensive nursing care by understanding the needs of the patients. There is no doubt that it would be very helpful for treatment of patients as well as for improvement of nursing care if we know more about psychological needs of patients and give them adequate support to meet these needs. The study to find out the causes and degree of stress events experienced by hospitalized patients, with the objective of instituting improvement of nursing care program based on the needs of patients, was conducted during the month of September 1974 with 60 patients randomly selected from those admitted to medical and surgical wards at Yonsei Medical Center in that period The questionnaire form included 36 questions which are considered to be stress events for hospital patients, and was devide into five areas namely, such events related to 1) disease itself, 2) hospital environment, 3) nursing care and treatment, 4) communication and human relations, and 5) family and economic problems. The results of the study were as follows: 1. It was confirmed that hospitalization considered to be a stress producing factor and most patients perceived the admission to hospital as a stress factor. 2. According to the rating scale, it was found that degree of perceived stress shows a variation according to the source of stress producing event. 3. No significant differences in the mean values were observed statistically with the perceived stress levels according to demographic and other variables of patients related to hospitalization. 4. Among the questions related to disease itself, "Admission for surgery" was perceived most frequently as a stress event (97.14%) by patients. 5. With regard to the questions related to hospital environment, "death of the patient room-mate" was the most serious stress event perceived by patients (90%) and "living with hospital regulations"was considered to be less serious stress event (23.33%). 6. As for the questions related to nursing care and treatment, "limitation of freedom" was perceived as a stress factor most frequently (70.91%) by the patients and "worry for wrong treatment" turned out to be less frequent stress event (50.0%). 7. As for the questions related to communication and human relations, "difficulty to meet doctors when wanted"appeared to be the most frequent stress event by the respondents (75.86%) , followed by "no explanation about treatment or examination"(75.0%) and "no explanation about nursing care procedures"(71.66%). 8. With regard 111 tile questions related to family and economic problems, "inadequate finances for family living due to hospitalization"and "high cost of hospitalization" were the most frequent cause of stress mentioned by the patients. (80.0%). 9. As a result of application of the stepwise regression analysis, it was found that about 89% was explained by those events associated with disease itself, hospital environment and family and economic problems. By adding those events related to "nursing care and treatment" and "communication and human relation", 100% of stress associated with hospitalization was explained.

• Strategy21
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• s.41
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• pp.174-207
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• 2017

Human history shows diverse strategies for survival and prosperity. This study introduces the concept of the expansion of wealth as a key to explain choice and behavior of political entities. American scholar, -Bruce Bueno de Mesquita-, offers theoretical grounds for this concept in that the cores of selectorate theory is settled. The political entity consists of two groups, -the winning coalition that has power to replace leader and non-winning coalition that has not. Leaders implement policies serving for the welfare of winning coalition in return for their loyalty. Both internal problems caused by demographic changes and external ones of climate changes, epidemic disease, or invasion compel leader and winning coalition to adopt policies of expansion that they believe may lead to the acquisition of wealth needed to counter those problems. The process starts by occupying one spot where other entities reside and then connecting it to its own. The line between spots functions as a foothold to form a new line to other spots. By repeating this process, a space is created in which new laws and orders are instated. In the early stage of expansion, war is hardly avoidable. Once finished successfully, the political circumstance tilts to encourage economic activities in order to generate national revenues to strengthen political power of winning coalition. However, as scale of economic activities grows, so does political power of civic classes in production and trade. To gain financial support required to run the political entity, delegation of power or bestowing autonomy to non-winning coalition is inevitable. Thus, expansion is not the ultimate solution, only to prolong the political survival if succeed. Maritime power came to attractive option when overland expansion had become obstructed. It offered much greater advantages in terms of political risks and financial burdens in exploring new regions of precious commodities than overland expansion. Each political entity around world have been, for the first time in human history, connected by maritime means since 15th century. It is worthy of noting that land conditions propelled people out to sea. Political and economic situations created opportunities to exploit geographical position in pursuit of wealth. In the 21st century, we witness the operation of international winning coalition that presides over the rules of expansion. Competing for market is synonymous to the expansion in this era, the cause and aim of it has not been changed though. Energy and dollars are key factors of expansion since the end of the 2nd world war. No matter what the forms and conditions change, naval power is still the most relevant means for expansion as it retains unique characters of maneuver, flexibility, continuity, display and projection of power. The strategy for using naval power should be in line with two different approaches for expansion: Approaches to the international winning coalition by making contribution to world order, and approaches to the non-international winning coalition by enhancing military diplomatic activities. The former will serve our share of winning coalition while the latter will open chances to acquire further prosperity.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7897-7907
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• 2014

Background: There is paucity of studies defining the prevalence of non-communicable disease (NCD) risk factors in Saudi Arabia despite the surging epidemic of obesity, change in dietary habits and sedentary lifestyle. Objectives: This cross-sectional study aimed to assess the prevalence of NCDs risk factors among employees at King Faisal University in Al Hassa, Saudi Arabia and to determine the possible correlates for clustering of NCDs risk factors among them. Materials and Methods: All employees were invited to participate; the World Health Organization STEPwise approach was used for data collection which consisted of a personal interview to collect socio-demographic characteristics, NCD history, tobacco use, vegetables and fruit consumption, and physical activity (PA), followed by anthropometric measurements namely weight, height and waist circumference and blood pressure measurements, subjects were finally subjected to biochemical tests with determination of fasting plasma glucose, serum triglycerides, cholesterol and high density lipoproteins. Results: Of the surveyed employees (n=691), daily current smokers accounted for 22.7%. 94.9%, 95.1% and 86% consumed < 5 servings per day of vegetables, fruits and both fruits and vegetables respectively, 73% were physically inactive, 64% were overweight or obese, 22.1% had hypertension, and 21.5% were diabetics. Elevated cholesterol levels were found in 36.6%, low high density lipoproteins in 36.8%, and elevated triglycerides in 36.1%. Only 3% had no NCD risk factors, and 57.6% had ${\geq}3$ factors. Multivariate logistic regression showed that gender (being male, adjusted odds ratio 'aOR'=1.51), aged ${\geq}50$ years (aOR=3.06), < college education (aOR=1.75), current smokers (aOR=2.37), being obese (aOR=6.96) and having a low PA level (aOR=4.59) were the significant positive predictors for clustering of NCD risk factors. Conclusions: Over fifty percent of the studied university's employees had multiple (${\geq}3$) NCD risk factors. Screening and health promotion initiatives should be launched at least targeting the modifiable factors to avert the excessive risk for cardiovascular disease, diabetes mellitus and several types of cancers.

• Journal of Korean society of Dental Hygiene
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• v.7 no.1
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• pp.15-30
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• 2007

The main objective of this study is to investigate the improvement of the quality of dental health based on the dental service satisfaction factors of the old dental prosthesis patients of more than 60 years of age who use the dental institutes including dental hospital, clinic, and public health center and to identify the interest in the dental prosthesis as changing paint. Across the country through a questionnaire survey of a question and answer type conducted by the trained dental hygienists or dentist's. Major results of the empirical analysis are as follows. 1. looking at variation of the variables of socio-demographic features of the respondents, the group of female, age distribution of 60-65, average monthly income of 0.5-1 million Won, and schooling background of college showed significant difference. And the prosthesis treatment in terms of the purpose of isiting a dental institute, and the dental clinic in terms of the type of visiting dental institute showed a remarkably significant difference. 2. looking at variation of variables of the general features of the respondents, a prosthesis satisfaction service in terms of age showed significant difference: a prosthesis satisfaction service, dental staffs' service and dental facilities' service in terms of average monthly income showed significant difference: the entire conditions except for the dental facilities' service in terms of schooling and general features showed significant difference: and in terms of the purpose of visiting dental institute, it showed no significant difference. In terms of a visiting dental institute, the prosthesis satisfaction service, dental facilities, overall level of satisfaction, result of treatment, word of mouth and revisit showed significant difference. 3. looking at variation of the variables of post-installation prosthesis satisfaction of the respondents, the prosthesis satisfaction service, dentist's dental service, staffs' service, dental facilities' service and revisit in terms of the prosthesis type: and the prosthesis satisfaction service, word of mouth, revisit and overall level of satisfaction from the perspective of serious concern showed significant difference. The prosthesis satisfaction service and dentist's service in terms of the solving the economic burden: and the entire variables in terms of dissatisfaction elements showed a similar level of significant difference 4. in regard to the satisfaction of dental service and the change of the recognition of prosthesis patients, it was revealed that the level of dental prosthesis satisfaction of the respondents was closely related to the dentist's service, staffs' service, and dental facilities' service. Finally, looking at the influence of the dental service on the treatment result, satisfaction, word of mouth, revisit and the overall satisfaction level, it was revealed that they had a great impact on the prosthesis satisfaction service.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.493-506
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• 1999

The purpose of the study is to evaluate the effectiveness and competence level of trainees of Cardiopulmonary resuscitation training targeted for nursing students. 70 nursing students of Y nursing college are recruited as subjects from Dec. 1st, 1998 through Dec. 8th. 1998. For the pre-test. demographic data related to CPR and knowledge of CPR were evaluated. For the post-test, the next week of pre-test, three difference groups of subjects were tested their knowledge of CPR. CPR training was designed by two components which were 90 mins lecture and demonstration by one professor and individual practice using two educational models with two professors. As the tool of measurement estimating pre or post knowledge of CPR. questionnaires were developed based on self-diagnosis questionnaires of American Heart Association(AHA). The questionnaires were multiple choices (50 questions) and open end questions regarding CPR process. Each multiple choices questions valued 2 points (Score varied min. 0 point to max 100 points.). Collected data were computerized and analyzed by SPSS-WIN. Frequency and percentage of each questions analyzed. The differences of the knowledge and competency level of subjects between pre and post test was analyses by paired t-test. The followings are research outcome. 1. In the pre-test, 95% of subjects answered that they already knew what CPR was. but only 82% described correctly what CPR was. 49% learned CPR before, and 80s5 of them learned at high school. 2. 37 questions scores increases, and 10 questions scores decreased. 3 questions didnt change their score. After getting training, ratio of 80% correct score significantly increased 4 times. 3. In post-test. knowledge level of trainees increased compared to that of pre-test. (t=-15.075, p=.000) 4. Competence level also increased (t=-14.86, p=.00). In result, after getting CPR training, most CPR knowledge increased except open the air tract, toddler CPR, and alternative behavior when the air tract is blocked. CPR training needs to extend the educational scope not only CPR lecture but also psychomotor skill practice. CPR trainees are in need of appropriate feedback as well as enough opportunities of skill practice.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5923-5931
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• 2015

Background: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46% respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8969-8974
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• 2014

Background: The aim of this study was to determine the predictors of health promoting lifestyle behaviour among medical students attending seven of the medical schools in Turkey. Materials and Methods: This crosssectional descriptive study was performed during the second semester of the first and last (sixth) years of study from March to May 2011. A questionnaire with two sections was specifically designed. The first section contained questions on demographic characteristics; the second consisted of the Health Promoting Lifestyle Profile II (HPLP) Scale. From a total of 2,309 medical students, 2,118 (response rate 91.7%) completed the questionnaire. Data were analyzed using descriptive statistics, t, Anova, Tukey test and binary logistic regression analysis. The research was approved by the Ethics Committee of Erciyes University. Results: The mean age was $20.7{\pm}2.9$ years and it was found that 55.1% were men, 62.3% were in the first year. The overall prevalence of smoking was 19.1%, and for drinking alcohol was 19.4%. HPLP point averages of the first year students were $129.2{\pm}17.7$, and for last year $125.5{\pm}19.0$. The overall mean score for the HPLP II was $2.5{\pm}0.4$. They scored highest on the spiritual growth subscale ($2.9{\pm}0.5$), interpersonal relations ($2.8{\pm}0.5$), health responsibility subscale ($2.3{\pm}0.5$), nutrition subscale ($2.3{\pm}0.5$), stress management subscale ($2.3{\pm}0.4$), and the lowest subscale physical activity ($2.0{\pm}0.5$). It is established that student's grade, educational level of parents, economic status of family, marital status, smoking and general health perception of the students resulted in a significant difference in HPLP Scale total score average and the mean score of majority of subscales. There was no statistically significant difference between the total HPLP when evaluated for gender, chronic disease, alcohol drinking status and BMI. Conclusions: Based on these results, particularly in the curriculum of medical students in order to increase positive health behaviours including physical activity, health promotion issues, and giving more space to aim at behaviour change in these matters is recommended.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.514-526
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• 2000

The active treatment phase in preparation for bone marrow transplantation(BMT) of che- motherapy regimen and total body irradiation (TBI) containing regimen requires considerable teaching. There have been researches that are related to treatment onto BMT patients and to psychological change during BMT process. However, it was hard to find researches focused on learning needs of patients undergoing BMT. The purpose of this study was to provide the basic data for effective educational program about BMT by investigating the learning needs in patients undergoing BMT. The subjects consisted of 90 BMT patients have been admitted to the department of BMT at three university hospitals. Data were obtained from October 1998 to March 1999 and analyzed by SAS program for unpaired t-test, ANOVA, Duncan test. The results were as follows : 1. Learning needs related to demographic characteristics was identified as below. That of male was higher than that of female. That of under age 29, unmarried, religious and university graduated group was higher than that of opposite group but it didn't show significant difference. Learning needs of group of patients who were employed was significantly higher then that of unemployed patients. 2. According to types of diagnosis, learning needs of myelodysplastic syndrome(MDS) patients was the higher than that of others, but admission frequency was the least. Learning needs of unrelated matched BMT(UBMT) patients was higher than that of autologous BMT patients. However, it didn't show significant difference. With regard to learning needs according to process of BMT, learning needs of Pre- BMT period or Post-BMT period was significantly higher than that of BMT day. 3. Learning needs related to BMT was relatively high (total mean: 3.11 of 4.0). The order of the mean score of leaning needs was shown as follows : Restricted activities after discharge, Relapse symptom, Complications of BMT, Kinds of available drugs at home. Therefore the learning needs that is related to life after discharge and to relapse and complications after BMT was high. 4. Learning needs related to radiation therapy was high (total mean: 3.35 of 4.0). The learning needs in radiation therapy items was the Skin care of radiation therapy and Purpose of radiation therapy. 5. Learning needs related to graft versus host disease(GVHD) therapy was high (total mean: 3.55 of 4.0). The highest learning needs in GVHD therapy items was the Preventive method GVHD. less admission frequency and UBMT patients. It is necessary that education for BMT patients should be focused on life after discharge and on relapse and complications after BMT. Especially education for allogeneic BMT patients should be emphasized on GVHD. For all of these, it is necessary to develop systematic and concrete educational program.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.385-391
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• 2016

Objective : The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods : Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2-7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results : The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion : Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating.