The study of MDCT of Radiation dose in the department of Radiology of general hospitals in the local area (일 지역 종합병원 영상의학과 MDCT선량에 대한 연구)
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- Journal of the Korean Society of Radiology
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- v.6 no.4
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- pp.281-290
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- 2012
The difference of radiation dose of MDCT due to different protocols between hospitals was analyzed by CTDI, DLP, the number of Slice and the number of DLP/Slice in 30 cases of the head, the abdomen and the chest that have 10 cases each from MDCT examination of the department of diagnostic imaging of three general hospitals in Gyeongsangbuk-do. The difference of image quality, CTDI, DLP, radiation dose in the eye and radiation dose in thyroid was analyzed after both helical scan and normal scan for head CT were performed because a protocol of head CT is relatively simple and head CT is the most frequent case. Head CT was significantly higher in two-thirds of hospitals compared to A hospital that does not exceed a CTDI diagnostic reference level (IAEA 50mGy, Korea 60mGy) (p<0.001). DLP was higher in one-third of hospitals than a diagnostic reference level of IAEA 1,050mGy.cm and Korea 1,000mGy.cm and two-thirds exceeded the recommendation of Korea and those were significantly higher than A hospital that does not exceed a diagnostic reference level (p<0.001). Abdomen CT showed 119mGy that was higher than a diagnostic reference level of IAEA 25mGy and Korea 20mGy in one-third. DLP in all hospitals was higher that Korea recommendation of 700mGy.cm. Among target hospitals, C hospital showed high radiation dose in all tests because MPR and 3D were of great importance due to low pitch and high Tube Curren. To analyze the difference of radiation dose by scan methods, normal scan and helical scan for head CT of the same patient were performed. In the result, CTDI and DLP of helical CT were higher 63.4% and 93.7% than normal scan (p<0.05, p<0.01). However, normal scan of radiation dose in thyroid was higher 87.26% (p<0.01). Beam of helical CT looked like a bell in the deep part and the marginal part so thyroid was exposed with low radiation dose deviated from central beam. In addition, helical scan used Gantry angle perpendicularly and normal scan used it parallel to the orbitomeatal line. Therefore, radiation dose in thyroid decreased in helical scan. However, a protocol in this study showed higher radiation dose than diagnostic reference level of KFDA. To obey the recommendation of KFDA, low Tube Curren and high pitch were demanded. In this study, the difference of image quality between normal scan and helical scan was not significant. Therefore, a standardized protocol of normal scan was generally used and protective gear for thyroid was needed except a special case. We studied a part of CT cases in the local area. Therefore, the result could not represent the entire cases. However, we confirmed that patient's radiation dose in some cases exceeded the recommendation and the deviation between hospitals was observed. To improve this issue, doctors of diagnostic imaging or technologists of radiology should perform CT by the optimized protocol to decrease a level of CT radiation and also reveal radiation dose for the right to know of patients. However, they had little understanding of the situation. Therefore, the effort of relevant agencies with education program for CT radiation dose, release of radiation dose from CT examination and addition of radiation dose control and open CT contents into evaluation for hospital services and certification, and also the effort of health professionals with the best protocol to realize optimized CT examination.
The levels of health knowledge, attitude and practice of housewives considerably effect to the health of households, communities and the nation. This study was designed to grasp the levels of health knowledge, attitude and practice of houswives and analyse the various factors effecting to health in order to provide health education services as well as materials for effective formulation and implementation of health policy to improve the health of the nation. This study has been conducted through interviews by trained surveyers for 4,281 housewives selected from 4,500 households throughout the country for 40 days during July 11-August 20, 1983. The results of survey were analysed by stepwise multiple regression and path analysis are summarized as follows; 1. Based on the measurement instrument applied to this study, the levels of health knowledge, attitude and practice of housewives were extremely low with 54.5 points out of 100 points in full. Higher level with 72 points and above was approximately 21 percent and lower level with 39 points and below was approx. 24 percent. The middle level was approx. 55 percent. In order to implement health programs successively, health education should be more strengthened and to improve the level of health knowledge, attitude and practice (KAP) of the nation, political consideration as a part of spiritual reformation must be concentrated on health. 2. The level of health knowledge indicated the highest points with 57.3 the level of attitude was the second with 55.0 points and the practice level was the lowest with 50.0 point. Therefore, planning and implementation of health education program must be based on the persuasion and motivation that health knowledge turn into practice. 3. Housewives who had higher level of health knowledge, showed their practice level was relatively lower and those who had middle or low level of it practice level was the reverse. 4. Correlations among health knowledge, attitude and practice (KAP) were generally higher and statistically significant at 0.1 percent level. Correlation between total health KAP level and health knowledge was the highest with r=.8092. 5. Health KAP levels showed significant differences according to the age, number of children, marital status, self-assessed health status and concern on health of the housewives interviewed (p<0.001) 6. Health KAP levels also showed significant differences according to the education level, economic status, employment before marriage and grown-up area of the housewives interviewed. (p<0.001) 7. Heath KAP levels showed significant differences according to health insurance benificiary and the existence of patients in the family. (p<0.001). 8. Health KAP levels showed significant differences according to distance to government organizations, schools, distance to health facilities, telephone possession rate, television possession rate, newspaper reading rate and activities of Ban meeting and Women's club. (p<0.001) 9. Health KAP levels showed significant differences according to electric mass communication media such as television, radio and village broadcasting etc. and printed media such as newspaper, magazine and booklets etc., IEC variables such as individual consultation and husband-wife communication, however, there was no significance with group training. 10. Health KAP of the housewives showed close correlation with personal characteristics variables, i.e., education level (r=.5302), age (r=-.3694) grown-up area (r=.3357) and employment before marriage. In general, correlation of health knowledge level was higher than the levels of attitude or practice. In case of health concern and health insurance, correlation of practice level was higher than health knowledge level. 11. Health KAP levels showed higher correlation with community environmental characteristics, Ban meeting and activity of Women's club, however, no correlation with New-village movement. 12. Among IEC variables, husband-wife communication showed the highest correlation with health KAP levels and printed media, electric mas communication media and health consultation in order. Therefore, encouragement of husband-wife communication and development of training program for men should be included in health education program. 13. Mass media such as electric mass com. and printed media were effective for knowledge transmission and husband-wife communication and individual consultation were effective for health practice. Group training was significant for knowledge transmission, however, but not significant for attitude formation or turning to health practice. To improve health KAP levels, health knowledge should be transmitted via mass media and health consultation with health professionals and field health workers should be strengthened. 14. Correlation of health KAP levels showed that knowledge level was generally higher than that of practice and recognized that knowledge was not linked with attitude or practice. 15. The twenty-five variables effecting health KAP levels of housewives had 41 per cent explanation variances among which education level had great contribution (β=.2309) and electric mass com. media (β=.1778), husband-wife communication (β=.1482), printed media, grown-up area, and distance to government organizations in order. Variances explained (R²) of health KAP were 31%, 15%, and 30% respectively. 16. Principal variables contributed to health KAP were education level (β=.12320, β=.1465), electric mass comm. media (β=.1762, β=.1839), printed media, (β=.1383, β=.1420) husband-wife communication (β=.1004, β=.1067), grown-up area and distance to government organizations, in order. Since education level contributes greatly to health KAP of the housewives, health education including curriculum development in primary, middle and high schools must be emphasized and health science must be selected as one of the basic liberal arts subject in universities. 17. Variences explained of IEC variables to health KAP were 19% in total, 14% in knowledge, 9% in attitude, and 10% in health practice. Contributions of IEC variables to health KAP levels were printed media (β=.3882), electric mass comm media (β=.3165), husb-band wife com. (β=.2095,) and consultation on health (β=.0841) in order, however, group training showed negative effect (β=-.0402). National fund must be invested for the development of Health Program through mass media such as TV and radio etc. and for printed materials such as newspaper, magazines, phamplet etc. needed for transmission of health knowledge. 18. Variables contributed to health KAP levels through IEC variables with indirect effects were education level (Ind E=0.0410), health concern (Ind E=.0161), newspaper reading rate (Ind E=.0137), TV possession rate and activity of Ban meeting in order, however, health facility showed negative effect (Ind E=-.0232) and other variables showed direct effect but not indirect effect. 19. Among the variables effecting health KAP level, education level showed the highest in total effect (TE=.2693) then IEC (TE=.1972), grown-up city (TE=.1237), newspaper reading rate (TE=.1020), distance to government organization (TE=.095) in order. 20. Variables indicating indirect effects to health KAP levels were; at knowledge level with R²=30%, education level (Ind E=.0344), newspaper reading rate (Ind E=.0112), TV possession rate (Ind E=.0689), activity of Ban meeting (Ind E=.0079) in order and at attitude level with R²=13%, education level (Ind E=. 0338), activity of Ban meeting (Ind E=.0079), and at practice level with R²=29%. education level (Ind E=.0268), health facility (Ind E=.0830) and concern on health (Ind E=.0105). 21. Total effect to health KAP levels and IEC by variable characteristics, personal characteristics variables indicated larger than community characteristics variables. 22. Multiple Correlation Coefficient (MCC) expressed by the Personal Characteristic Variable was .5049 and explained approximately 25% of variances. MCC expressed by total Community environment variable was .4283 and explained approx. 18% of variances. MCC expressed by IEC Variables was .4380 and explained approx. 19% of variances. The most important variable effected to health KAP levels was personal characteristic and then IEC variable, Community Environment variable in order. When the IEC effected with personal characteristic or community characteristic, the MCC or the variances were relatively higher than effecting alone. Therefore it was identified that the IEC was one of the important intermediate variable.
Korea-China FTA entered into force on the 20th of December 2015, and one year elapsed after its effectuation as the FTA with China, our country's largest trading partner. Therefore, this study looks at the trends of air transport trade between Korea and China, and examines the contents of concessions to the air transport services sector in Korea-China FTA, and analyzes the impact on the air transport sector by Korea-China FTA, and proposes our country's aviation policy direction in order to respond to such impact. In 2016 the trends of air transport trade between Korea and China are as follows : The export amount of air transport trade to China was 40.03 billion dollars, down by 9.3% from the last year, and occupied 32.2% of the total export amount to China. The import amount of air transport trade from China was 24.26 billion dollars, down by 9.1% from the last year, and occupied 27.7% of the total import amount from China. The contents of concessions to the air transport services sector in Korea-China FTA are as follows : China made concessions to the aircraft repair and maintenance services and the computer reservation system services with limitations on market access and national treatment in the air transport services sector of the China Schedule of Specific Commitments of Korea-China FTA Chapter 8 Annex. Korea made concessions to the computer reservation system services, selling and marketing of air transport services, and aircraft repair and maintenance without limitations on market access and national treatment in the air transport services sector of the Korea Schedule of Specific Commitments of Korea-China FTA Chapter 8 Annex. The impact on the air transport sector by Korea-China FTA are as follows : As for the impact on the air passenger market, in 2016 the arrival passengers of the international flight from China were 9.96 million, up by 20.6% from the last year, and the departure passengers to China were 9.90 million, up by 34.8% from the last year. As for the impact on the air cargo market, in 2016 the exported goods volumes of air cargo to China were 105,220.2 tons, up by 6.6% from the last year, and imported goods volumes from China were 133,750.9 tons, up by 12.3% from the last year. Among the major items of exported air cargo to China, the exported goods volumes of benefited items in the Tariff Schedule of China of Korea-China FTA were increased, and among the major items of imported air cargo from China, the imported goods volumes of benefited items in the Tariff Schedule of Korea of Korea-China FTA were increased. As for the impact on the logistics market, in 2016 the handling performance of exported air cargo to China by domestic forwarders were 119,618 tons, down by 2.1% from the last year, and the handling performance of imported air cargo from China were 79,430 tons, down by 4.4% from the last year. In 2016 the e-commerce export amount to China were 109.16 million dollars, up by 27.7% from the last year, and the e-commerce import amount from China were 89.43 million dollars, up by 72% from the last year. The author proposes the aviation policy direction of Korea according to Korea-China FTA as follows : First, the open skies between Korea and China shall be pushed ahead. In June 2006 Korea and China concluded the open skies agreement within the scope of the third freedom and fourth freedom of the air for passenger and cargo in Sandong Province and Hainan Province of China, and agreed the full open skies of flights between the two countries from the summer season in 2010. However, China protested against the interpretation of the draft of the memorandum of understanding to the air services agreement, therefore the further open skies did not take place. Through the separate aviation talks with China from Korea-China FTA, the gradual and selective open skies of air passenger market and air cargo market shall be pushed ahead. Second, the competitiveness of air transport industry and airport shall be secured. As for the strengthening methods of the competitiveness of Korea's air transport industry, the support system for the strengthening of national air carriers' competitiveness shall be prepared, and the new basis for competition of national air carriers shall be made, and the strategic network based on national interest shall be built. As for the strengthening methods of the competitiveness of Korea's airports, particularly Incheon Airport, the competitiveness of the network for aviation demand creation shall be strengthened, and the airport facilities and safety infrastructure shall be expanded, and the new added value through the airport shall be created, and the world's No.1 level of services shall be maintained. Third, the competitiveness of aviation logistics enterprises shall be strengthened. As for the strengthening methods of the competitiveness of Korea's aviation logistics enterprises, as the upbringing strategy of higher added value in response to the industry trends changes, the new logistics market shall be developed, and the logistics infrastructure shall be expanded, and the logistics professionals shall be trained. Additionally, as the expanding strategy of global logistics market, the support system for overseas investment of logistics enterprises shall be built, and according to expanding the global transport network, the international cooperation shall be strengthened, and the network infrastructure shall be secured. As for the strengthening methods of aviation logistics competitiveness of Incheon Airport, the enterprises' demand of moving in the logistics complex shall be responded, and the comparative advantage in the field of new growth cargo shall be preoccupied, and the logistics hub's capability shall be strengthened, and the competitiveness of cargo processing speed in the airport shall be advanced. Forth, in the subsequent negotiation of Korea-China FTA, the further opening of air transport services sector shall be secured. In the subsequent negotiation being initiated within two years after entry into force of Korea-China FTA, it is necessary to ask for the further opening of the concessions of computer reservation system services, and aircraft repair and maintenance services in which the concessions level of air transport services sector by China is insufficient compared to the concessions level in the existing FTA concluded by China. In conclusion, in order to respond to the impact on Korea's air passenger market, air cargo market and aviation logistics market by Korea-China FTA, the following policy tasks shall be pushed ahead : Taking into consideration of national air carriers' competitiveness and nation's benefits, the gradual and selective open skies shall be pushed ahead, and the support system to strengthen the competitiveness of air transport industry and airport shall be built, and entry into aviation logistics market by logistics enterprises shall be expanded, and the preparations to ask for the further opening of air transport services sector, low in the concessions level by China shall be made.