• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7309-7314
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• 2013

Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and Methods: We recruited 702 consecutive patients (${\geq}18$ years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2895-2898
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• 2015

Background: In the years 2014, coverage rates of cervical cancer screening in Nakornnayok province accounted to 76.5%. This was lower than the government's specified goal of 80%. Community health volunteers are members of a Thai healthcare alliance established to help promoting healthcare service communication and collaboration at the primary level. Such village health volunteers (VHVs) are established in most villages. Objective: To assess the knowledge and attitudes of cervical cancer screening among VHVs. Materials and Methods: The subjects were 128 VHVs from four Nakornnayok sub-districts; namely KlongYai, Chomphol, Buangsan and Suksara, Thailand. The study was conducted from December 2014 to January 2015. The questionnaire was designed to assess the knowledge and attitude of cervical cancer screening provided by the VHVs. In addition, cervical cancer screening coverage rates of each area were collected. The demographic data, scores of knowledge, attitudes, practices and the cervical cancer screening coverage rates were analyzed by one-way ANOVA. Results: The questionnaire reliability was assessed as 0.81. The total knowledge and attitude scores were 10 and 15 points. The mean knowledge scores of KlongYai, Chomphol, Buangsan and Suksara were 6.8, 7.0, 6.5 and 9.0 points, respectively. The VHVs had a high level of overall knowledge about cervical cancer screening. The mean attitude scores were 12.4, 13.2, 13.4 and 13.1 points. VHVs had a positive attitude to the promotion of cervical cancer screening at the overall level. The percentages of VHVs promoting cervical cancer information in respective districts were 72.2, 94.3, 94.9 and 50.0. However, the cervical cancer screening coverage rates were 62.4%, 34.7%, 80.3% and 47.3% respectively. Conclusions: The knowledge, attitudes and percentages of promoting information of cervical cancer screening among VHVs in the four sub-districts were high but did not correlate with the cervical screening coverage rates for each area. VHVs needed to understand socio-cultural beliefs of the women in the target population and design suitable strategies to encourage higher cervical screening coverage.

• 농촌의학ㆍ지역보건
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• 제43권2호
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• pp.114-124
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• 2018

본 연구는 지역사회보건사업의 한 영역인 보건간호의 근대 역사를 6개 시기로 구분하여 고찰하고 보건간호가 나아갈 방향에 대해 제안하였다. 태동기는 1908년부터 시작되었으며 선교사에 의해 보건간호가 시작되었으나 귀국 조치되면서 위축되었다. 기반형성기는 대한민국정부 수립 후 중앙정부조직과 보건관련 법령을 체계화한 시기로 1956년 보건소법 제정으로 보건소의 법적 근거를 확보하였다. 기반조성기에 정부는 가족계획사업을 정책사업으로 수행하였고 기생충질환예방법, 결핵예방법, 모자보건법 등이 제정되면서 보건소 사업이 증가하였다. 의료법 개정으로 업무분야별 간호사 자격이 인정되어 보건간호분야 간호사가 인정되었으며 조산원이 읍면동에 배치되어 임부의 분만 출산을 돕는 등 보건간호가 활성화되었다. 분야별 정비기에는 보건소 건강증진사업이 새롭게 영입되고 정신보건센터가 전국적으로 설치되면서 국민건강의 분야별 사업이 정비되었다. 또한 지역보건의료계획을 작성하게 되어 지역주민들의 요구를 반영한 사업을 할 수 있게 되었으며 정부는 국민건강증진종합계획을 설정하여 이를 보건의료 사업의 목적으로 삼았다. 보건소 기능확대기에는 건강형평성 확보를 위해 전국 차원의 맞춤형 방문건강관리사업을 실시하였고 도시보건지소와 건강생활지원센터를 설립하여 주민들에게 접근성을 높인 일차보건의료서비스를 제공하였다. 앞으로 보건간호는 우리나라 보건의료전달체계의 특성에 알맞은 보건간호체계의 구상과 설계, 간호 인력에 대한 동기부여, 역할개발과 훈련, 새로운 보건체계와 보건간호서비스에 대한 종합적 평가 등을 통해 발전해 나가야 할 것이다.

• 대한지리학회지
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• 제49권6호
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• pp.935-948
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• 2014

고혈압과 같은 만성 질환의 관리는 국가보건정책에서 중요한 사업이다. 본 연구는 지역사회 특성이 고혈압의 유병률에 어떻게 영향을 주는지를 분석하였다. 분석을 위해 237개 시군구 소지역의 건강상태 및 건강 행태를 포함한 다년간의 자료를 수집하였다. 지표는 2009~2011년 질병관리본부의 지역사회건강조사와 국민건강보험공단 등의 자료를 사용하였다. 지역간 변이 분석을 위해 지리적 가중회귀분석과 의사결정나무 모형을 이용하였다. 연구결과 다년간 자료를 이용하는 것이 단년간 자료를 이용하는 것보다 더 적합도가 높았는데 이것은 대부분의 변수에서 연도별 유의한 차이가 있었기 때문이다. 또 고혈압 유병률은 당뇨병 및 비만 유병률과 양의 관련성이 있었으며 인구밀도와는 음의 상관관계를 보였다. 특히 이러한 요인들의 지역적 변이는 지리적 가중회귀분석 결과에서 더욱 뚜렷하였다. 이상의 결과를 바탕으로 분석한 의사결정나무 모형에서는 고혈압 유병률에 영향을 미치는 중요한 변수가 지역별로 매우 상이하다는 것을 확인할 수 있었다. 지역주민의 건강상태, 건강행태, 사회경제적 요인의 지역간 차이를 규명하는 것은 고혈압 유병률을 감소시키기 위한 지역별 맞춤형 보건정책을 수립하는데 매우 중요하다. 본 연구의 결과는 만성질환 관리를 위한 맞춤형 지역보건정책을 수립하는데 기초자료를 제공할 수 있다는 데 의의가 있다.

• 디지털융복합연구
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• 제14권6호
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• pp.325-333
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• 2016

본 연구는 일개 대학병원의 수술 예방항생제 사용의 실태 및 적정성 평가 주기별 변화를 분석, 향후 수술 예방항생제 사용 및 평가 지침에 대한 기초자료를 마련하는 것을 목적으로 시행되었다. 요양급여 적정성 평가가 시행된 첫해인 2007년 1차 평가부터 2008년, 2009년, 2010년, 2012년, 2014년을 조사기간으로 선정하였다. 본 연구를 위해 건강보험심사평가원의 요양급여 적정성 평가 자료를 이용하였으며, 위수술, 대장수술, 담낭절제술의 평가지표 중 최초 투여시기 1항목, 항생제 선택 3항목, 투여 기간 2항목의 연도별 변화 추이를 분석하였다. 분석결과, 항생제 투여일수는 위수술의 경우, 2007년 13.5일에서 2014년 1.5일로 감소하였고, 대장수술은 2007년 12.8일에서 2014년 1.5일로 감소하였다. 담낭절제술 또한 2007년 6.9일에서 2014년 0.6일로 감소한 것으로 나타났다. 위와 같은 결과를 토대로, 수술 예방항생제 사용의 질적 향상을 위하여 의료진들이 충분히 받아들일 수 있을 만한 권고사항(또는 지표) 의 마련 및 그러한 권고사항의 효율적인 배포와 전달을 위한 노력이 필요할 것으로 생각된다. 더불어 병원이 스스로 장애 요인을 파악하여 개선할 수 있도록 모니터링 제도 실시를 고려해 볼 수 있을 것이다.

• 한국정보전자통신기술학회논문지
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• 제8권6호
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• pp.460-469
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• 2015

본 연구는 IoT 기술을 이용한 의료기기에서 송수신되는 대량의 이진데이터의 디지털 변조 과정시 독특한 압축 알고리즘을 적용하여 보다 빠른 시간내에 데이터를 송수신하기 위한 연구이다. 이를 위해 이진데이터 스트리밍을 간단한 규칙에 따라 바이너리 클러스터라는 단위로 구분한 뒤, 각 바이너리 클러스터에 대해 1차 압축바이너리 클러스터를 생성하고 유형별로 추가적인 압축 연산을 통해 1 내지 2비트를 압축한 2차 압축 바이너리 클러스터를 생성한 뒤, 각각의 2차 압축 바이너리 클러스터를 맨체스터 라인코딩 방식으로 전송하였다. 특히 본 연구에서는 각각의 2차 압축바이너리 클러스터들의 구분을 위한 정보로서 휴지 전위를 2차 압축 바이너리 클러스터를 코딩한 맨체스터 코드 사이에 삽입 전송하는 방법을 제안하였다. 이를 통해, 2비트 압축된 바이너리 클러스터의 경우 휴지 전위를 위한 1 전송 단위 시간의 소요를 고려하더라도 추가적으로 1 전송 단위 시간의 시간적 이득을 얻게 됨으로써 전송 속도를 향상시킬 수 있을 것으로 기대되었다. 휴지 전위는 1개 전송 단위로서만 독립적으로 각각 분리된 압축바이너리 클러스터들의 연결에 사용하므로, 2개 전송단위 시간 이상의 연속된 휴지 전위는 존재하지 않게 되고, 맨체스터 코딩의 기본 규칙을 준수하므로 직류 성분도 존재하지 않게 된다. 특히 이미 정보이론 알고리즘을 이용한 압축된 이진 데이터에 대해서도 본 연구에서 제안한 압축전송 과정을 이용할 경우 전송 속도를 추가적으로 약 12.6% 향상 시킬 수 있음이 예측되었다.

• Journal of Genetic Medicine
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• 제15권2호
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• pp.72-78
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• 2018

Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권4호
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• pp.41-50
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• 2022

Purpose: This study aims to suggest an analysis model finding the relationship between building scale characteristics of Public-use facilities and infectious disease outbreaks around senior leisure welfare facilities and the features and their scopes where quarantine resources are to be concentrated. Methods: Reviewing previous studies found the user characteristics of senior leisure welfare facilities and scale characteristics of urban architectures. The data preprocessing was performed after collecting building data and infectious disease outbreak data in the analysis area. This study derived data for attributes of building size and frequency of infectious disease outbreaks in Public-use facilities around senior leisure welfare facilities. A computing algorithm was implemented to analyze the correlation between the building size characteristics and the infectious disease outbreak frequency as per the change of the spatial scope. Results: The results of this study are as follows: First, the suggested model was to analyze the correlation between the infection frequency and the number of senior leisure welfare facilities, the number of Public-use facilities, building area, total floor area, site area, height, building-to-land ratio, and floor area ratio varied as per the change of spatial scope. Second, correlation results varied between the infection frequency and the number of senior leisure welfare facilities, the number of Public-use facilities, building area, total floor area, site area, height, building-to-land ratio, and floor area ratio. Third, a negative correlation appeared in the analysis between the number of senior leisure welfare facilities and infection frequency. And positive correlations appeared noticeably in the study between the number of Public-use facilities, building area, total floor area, height, building-to-land ratio, and floor area ratio. Implications: This study can be used as primary data on the utilization of limited quarantine resources by analyzing the relationship between the Public-use facilities around the senior leisure welfare facilities and the spread of infectious diseases. In addition, it suggests that infectious disease prevention measures are necessary considering the spatial scope of the analysis area and the size of buildings.

• 대한본초학회지
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• 제35권1호
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• pp.45-55
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• 2020

Objectives : The purpose of this study is to determine whether Rhus verniciflua Stokes with Latin name Lacca Sinica Exsiccata, and Eucommia ulmoides Oliver with Latin name Eucommiae Cortex Extract Combination (ILF-RE) improves laboratory test results in participants with liver function disorder. Methods : This study was conducted at Woosuk university Korean medicine hospital where participants with high serum alanine transaminase (ALT) levels from 45 to 135 U/L were enrolled. Subjects received ILF-RE 3.6 g (1.2 g/day as ILF-RE) or placebo 3.6 g for 12 weeks. It was confirmed that urushiol was not detected in ILF-RE. The primary outcomes were the decrement degree of serum ALT and gamma-glutamyl transferase (GGT) levels between two groups. The secondary outcomes were the decrement degree of serum aspartate transaminase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LD), total bilirubin, total cholesterol, triglyceride (TG) and fatty liver index (FLI) levels between two groups. Adverse events, skin prick tests, laboratory tests, and vital signs were observed and analyzed to confirm the safety of ILF-RE.1) Results : In the ILF-RE group, the liver function index ALT, GGT, lipid metabolism index TG, and fatty liver index FLI were significantly decreased compared to the placebo group. There was no significant difference in ILF-RE group in terms of adverse events, severe adverse events, skin prick test, laboratory test, and vital signs compared with placebo group. Conclusions : ILF-RE was found to be effective in improving liver function. In addition, no clinically significant adverse events or body changes were observed during this study.

• 대한통합의학회지
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• 제12권3호
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• pp.163-178
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• 2024

Purpose : This study aimed to evaluate the effectiveness of an integrative medical service model applied to breast cancer patients and their caregivers, exploring its feasibility and challenges within the context of South Korean healthcare system. Methods : A case study approach was chosen to assess the integrative medical service model's efficacy, involving one breast cancer patient and her primary caregiver from W University Hospital. The patient had completed reconstructive surgery and chemotherapy and was undergoing radiotherapy. The model included standard treatments alongside psychological counseling, aromatherapy, axillary rehabilitation exercise, make-up program, art therapy, laughter therapy, horticultural therapy, and yoga programs, and meditation programs delivered over eight weeks. Quantitative and qualitative data were collected through surveys, psychological tests, and feedback assessments. Results : The integrative medical service model demonstrated notable improvements in the quality of life for both breast cancer patients and their caregivers. Participants reported enhanced emotional well-being, reduced stress levels, and improved coping mechanisms throughout the treatment journey. Qualitative feedback highlighted the positive impact of holistic interventions in alleviating psychological distress and fostering resilience. Quantitative data corroborated these findings, showing statistically significant improvements in various psychosocial parameters assessed. Conclusions : Our findings underscore the benefits of integrative medical service model with standard medical treatments in the care of breast cancer patients and their caregivers. The holistic approach not only addresses physical symptoms but also enhances overall well-being and quality of life. However, the implementation of such models faces challenges within the South Korean healthcare system, including fragmented service networks and financial constraints. Addressing these structural barriers is crucial for the widespread adoption and sustainability of integrative care models in oncology practice. Future research should focus on larger-scale studies to further validate these findings and inform policy decisions aimed at optimizing cancer care delivery.