[ $\underline{Purpose}$ ]: To evaluate the incidences and potential predictive factors for symptomatic radiation pneumonitis (SRP) and radiographic pulmonary toxicity (RPT) following adjuvant radiotherapy (RT) for patients with breast cancer. A particular focus was made to correlate RPT with the dose volume histogram (DVH) parameters based on three-dimensional RT planning (3D-RTP) data. $\underline{Materials\;and\;Methods}$: From September 2003 through February 2006, 171 patients with breast cancer were treated with adjuvant RT following breast surgery. A radiation dose of 50.4 Gy was delivered with tangential photon fields on the whole breast or chest wall. A single anterior oblique photon field for supraclavicular (SCL) nodes was added if indicated. Serial follow-up chest radiographs were reviewed by a chest radiologist. Radiation Therapy Oncology Group (RTOG) toxicity criteria were used for grading SRP and a modified World Health Organization (WHO) grading system was used to evaluate RPT. The overall percentage of the ipsilateral lung volume that received ${\geq}15\;Gy\;(V_{15}),\;20\;Gy\;(V_{20})$, and $30\;Gy\;(V_{30})$ and the mean lung dose (MLD) were calculated. We divided the ipsilateral lung into two territories, and defined separate DVH parameters, i.e., $V_{15\;TNGT},\;V_{20\;TNGT},\;V_{30\;TNGT},\;MLD_{TNGT}$, and $V_{15\;SCL},\;V_{20\;SCL},\;V_{30SCL},\;MLD_{SCL}$ to assess the relationship between these parameters and RPT. $\underline{Results}$: Four patients (2.1%) developed SRP (three with grade 3 and one with grade 2, respectively). There was no significant association of SRP with clinical parameters such as, age, pre-existing lung disease, smoking, chemotherapy, hormonal therapy and regional RT. When 137 patients treated with 3D-RTP were evaluated, 13.9% developed RPT in the tangent (TNGT) territory and 49.2% of 59 patients with regional RT developed RPT in the SCL territory. Regional RT (p<0.001) and age (p=0.039) was significantly correlated with RPT. All DVH parameters except for $V_{15\;TNGT}$ showed a significant correlation with RPT (p<0.05). $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory than $V_{15\;SCL}$ for the SCL territory. $\underline{Conclusion}$: The incidence of SRP was acceptable with the RT technique that was used. Age and regional RT were significant factors to predict RPT. The DVH parameter was good predictor for RPT for the SCL territory while $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory.
Journal of the Korean Association of Geographic Information Studies
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v.26
no.1
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pp.89-113
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2023
This study aimed to identify heat wave vulnerable areas and discuss spatial typology and policy directions through spatial coincidence analysis of heat wave damage. By utilizing the climate change vulnerability assessment of the Intergovernmental Panel on Climate Change (IPCC) and Spatial Statistics Comparison Analysis, this study examined cities, counties, and districts in South Korea for five years (2015-2019), including 2018, when the heat wave was most extreme. It was determined that the number of heat wave days (exposure) was the most impactful among various factors for heat wave vulnerability. Sensitivity and adaptive capacity to heat waves were found to vary according to regional characteristics. The relationship between heat wave vulnerability and damage was categorized into four types through spatial coherence. Hot to Hot and Cold to Cold types have a positive relationship between vulnerability and damage, while Hot to Cold and Cold to Hot types have a negative relationship. The findings suggest that since different types of regions have distinct characteristics and conditions, policies and research for improvement should be directed to address each region separately. This study may be used as basic data for establishing heat-related policies in the future, as it categorizes regions by considering both heat vulnerability and damage and examines the direction of response by type.
The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.
This study applied an exploratory analysis based on Self Organizing Map and GIS to cause specific age-standardized regional death rates data related to ten types of male cancers to find meaning patterns in the data. Then the patterns revealed from the exploratory analysis was evaluated to investigate possible relationship between these patterns and regional socio-economic status represented by regional educational attainment levels of head of household. The results from this analysis show that SI-GUN-GUs in Korea can be clustered to eighteen unique clusters in the stand point of male cancer death rates and these clusters are also spatially clustered. Also, the results reveal that regions with higher socio-economic status show lower level of the death rates compared with the regions with lower socio-economic status. However, for some cancer types, the regions with higher socio-economic status show relatively higher death rates. These patterns imply that the prevention, detection, and treatment of male cancers might be strongly affected by regional factors such as socio-economic status, environmental factors, and cultures and norms in Korea. Especially, one of the eighteen clusters, which includes Gangnam-Gu and Seocho-Gu, shows lower death rates in many of male cancer types. This implies that socio-economic status may be one of the most influential factors for regional cancer control.
Objectives: To outline overall duties of quality improvement (QI) performers within a health care organization, thus describing their key tasks, including task element-related frequency, importance and difficulty in enough detail. Methods: A DACUM (Developing A CurriculUM) workshop took place to outline overall job activities of QI performers. To examine the scope of their duty and task, we performed a questionnaire survey of 338 QI performers from 111 hospitals. Results: The results of our survey showed that for the task assigned to each QI performer, there were 10 duties, 31 tasks and 119 task elements. Respondents cited a project planning as the most frequent/important duty, and a research was the highest level of difficulty in their duty. They also said that the most frequent task was index management, the most important task was a business plan, and the highest level of difficulty was a practical application of QI research. QI performers added that the most frequent task element was receipt of patient safety reporting in patient safety system, the most important task element was an analysis for patient safety and its improvement, and the highest level of difficulty was a regional influence analysis related to the patient safety and its improvement. Conclusion: To ensure that QI performers play a pivotal role as a manager to better improve patient safety and the quality of health care services, proper training program for them should be developed by reflecting the results of our study.
No, Dae-Myung;Choi, Byung-Doo;Cho, Myung-Rae;Ryu, Jeong-Soon
Journal of the Korean association of regional geographers
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v.12
no.6
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pp.671-692
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2006
In recent years, it seems that a considerable stratum of working poor as a new urban poverty among labor population within large cities has been generated, deepening socio-spatial conflicts. This paper is to bring focus on the working poor which can be seen as a newly emerged special problem intermingling labor and poverty. It first begins with a consideration of definitions on the working poor, then discusses on the internal relationship between labor and poverty problems by analyzing causes of the generation of the working poor and looking into actual conditions of working poor from both static and dynamic perspectives, and finally considers existing policies for supporting the working poor, suggesting some alternative policy tasks for resolving the problem of the working poor.
Park, Eun-Ok;Hyun, Mi-Yeol;Lee, Chang-In;Lee, Eun-Joo;Hong, Seong-Chul
Journal of Korean Academy of Nursing
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v.37
no.1
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pp.44-51
/
2007
Purpose: The purpose of this study was to compare suicide mortality by region in South Korea. Method: Suicide mortality differentials were calculated for several mortality indicators by geographical regions from raw data of the cause of death from KNSO. Results: The results are as follows; the Crude suicide death rate was 22.63 per 100,000. The highest was in Kangwon showing 37.84% whereas, Chungnam, and Jeonbuk followed after. Suicide was 4.4% of all causes of death, but Inchon and Ulsan showed a higher proportion. The male suicide death rate was 31.12 per 100,000 and females 14.09. The ratio of gender suicide mortality was 2.21, per 100,000 and was the highest in Jeju. For age-specific suicide death rates, the rate increased as age advanced, showing 2.33 per 100,000 in 0-19years, 18.68 in 20-39, 30.48 in 40-59, 63.33 in 60 years and over. In Ulsan, Kangwon, and Inchon, age-specific suicide death rates of the 60 and over age group were higher than other regions, Daegu, Busan, and Kangwon showed a higher age-specific suicide mortality of the 40-59 age group, and Kangwon, Jeonnam, and Chungnam had a higher age-specific suicide mortality of the 20-39 age group. Conclusions: Suicide mortality differed by region. These results can be used for a regional health care plan and planning for suicide prevention by regions.
Objectives : This study aimed to calculate the survival rates of cancer patients in Jeju Island residents from 2000 to 2001, based on their major primary sites of occurrence. Methods : Data were extracted from the database of the Jejudo Cancer Registry (JCR). The eligible population comprised 2,382 cancer cases, whose cancers were diagnosed from 1 January 2000 through 31 December 2001. Of the eligible population, 1,438 patients with 5 major cancers defined by the level of incidence rates were selected as the study participants. The period of survival for each case was calculated from the date of first diagnosis to the date of death, or the end of follow-up, i.e., 31 December 2003. The observed survival rates (OSR) and relative survival rates (RSR) were calculated according to sex, age-group, and primary sites of occurrence. Results : The 3-year OSR and RSR in 5 major cancers were higher in women than in men except 75 year-old over group. The 3-year RSR of stomach, colorectum, liver, and lung in both sexes were 61.0%, 62.6%, 24.7%, and 22.8%, respectively. The respective rates in JCR showed some statistically significant differences from those in the Korea Central Cancer Registry (KCCR). Conclusions : These results would suggest some clues about prognostic factors of major cancers in Korean, and could apply to planning and evaluating of cancer control strategies in Jeju Island.
Journal of the Korean Regional Science Association
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v.36
no.4
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pp.43-56
/
2020
This study aims to explore the possibilities of social integration focused on the inclusionary housing scheme developed in the United States. Inclusionary housing is produced by inclusionary zoning with planning power. One of the main goals of developing inclusionary housing is to achieve social integration in neighborhoods. The author investigates the origin, evolution, characteristics, and mechanism of the inclusionary housing scheme in the United States. Results show that the inclusionary housing scheme utilizes market mechanism such as the incentives of floor ratio bonus, fast tract permit approach as well as the affordability obligation for the low-income households. Considering the policy orientation in the United States toward market mechanism, the inclusionary housing program has played a significant role in producing and preserving affordable housing for the underprivileged in affluent neighborhoods and has produced meaningful results in academic achievements, better job outcomes, health results, and social interaction even though it has been also criticized with by its superficiality. Finally, the author draws policy implications for housing policy in Korea from the lessons and limitations of the inclusionary housing mechanism.
Journal of the Economic Geographical Society of Korea
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v.26
no.3
/
pp.190-201
/
2023
This study conducted an in-depth case study of bio-health companies in the Chungcheong region to examine the factors influencing the relocation of new industry cluster firms in non-metropolitan areas. Focusing on the experiences and perceptions of key stakeholders within the cluster, which have been relatively overlooked in previous research, this narrative research explored the factors that lead entrepreneurs who initially founded their businesses in non-metropolitan areas to relocate to metropolitan areas as well as the decision-making process involved. Through interviews with 61 key stakeholders within the Chungcheong cluster, it was observed that entrepreneurs receive various benefits from local stakeholders during the initial stages of entrepreneurship. However, as the company enters a phase of significant growth, matters such as securing specialized talent and market accessibility lead them to contemplate relocating to metropolitan areas. Based on case studies of companies that both remained and relocated in the Chungcheong region, this study examines structural drawbacks within non-metropolitan clusters and provides policy implications.
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