• Title/Summary/Keyword: Social burden

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Women's Knowledge, Attitudes, and Practices about Breast Cancer in a Rural District of Central India

  • Gangane, Nitin;Ng, Nawi;Sebastian, Miguel San
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6863-6870
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    • 2015
  • Background: Breast cancer accounted for almost 25% of all cancers in women globally in 2012. Although breast cancer is the most prevalent cancer in India, there is no organised national breast cancer screening programme. Local studies on the burden of breast cancer are essential to develop effective context-specific strategies for an early detection breast cancer programme, considering the cultural and ethnic heterogeneity in India. This study examined the knowledge, attitudes, and practices about breast cancer in rural women in Central India. Materials and Methods: This community-based cross sectional study was conducted in Wardha district, located in Maharashtra state in Central India in 2013. The sample included 1000 women (609 rural, 391 urban) aged 13-50 years, selected as representative from each of the eight development blocks in the district, using stratified cluster sampling. Trained social workers interviewed women and collected demographic and socio-economic data. The instrument also assessed respondents' knowledge about breast cancer and its symptoms, risks, methods of screening, diagnosis and treatment, as well as their attitudes towards breast cancer and selfreported practices of breast cancer screening. Chi-square and t-test were applied to assess differences in the levels of knowledge, attitude, and practice (the outcome variables) between urban and rural respondents. Multivariable linear regression was conducted to analyse the relationship between socio-demographic factors and the outcome variables. Results: While about two-thirds of rural and urban women were aware of breast cancer, less than 7% in rural and urban areas had heard about breast self-examination. Knowledge about breast cancer, its symptoms, risk factors, diagnostic modalities, and treatment was similarly poor in both rural and urban women. Urban women demonstrated more positive attitudes towards breast cancer screening practices than their rural counterparts. Better knowledge of breast cancer symptoms, risk factors, diagnosis, and treatment correlated significantly with older age, higher levels of education, and being office workers or in business. Conclusions: Women in rural Central India have poor knowledge about breast cancer, its symptoms and risk factors. Breast self-examination is hardly practiced, though the willingness to learn is high. Positive attitudes towards screening provide an opportunity to promote breast self-examination.

Breakthrough Cancer Pain (돌발성 암성 통증)

  • Seo, Min Seok;Shim, Jae Yong
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.1-8
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    • 2015
  • Breakthrough cancer pain is a transient exacerbation of pain that occurs despite relatively well controlled background pain with around-the-clock analgesia. It is highly prevalent in patients with cancer pain, with an overall prevalence of 70~90%. Breakthrough cancer pain has several negative effects on quality of life, including a decrease in functional status and social relationship, and higher incidence of anxiety/depression. It also places a detrimental burden on their families, society, and the healthcare system. According to the pathogenic mechanism, breakthrough cancer pain is classified into two categories: idiopathic (or spontaneous) pain and incident pain. Episodes of breakthrough cancer pain have typical characteristics, including rapid onset (5~10 min), severe intensity, and short duration (30~60 min). However, there are some variations in timing and severity of pain among patients and episodes. Therefore, a thorough assessment of pain episodes is needed and management plan must be individualized to provide optimal treatment. Several immediate-release formulations such as oxycodone, morphine, and hydromorphone are widely used despite relatively slow onset of action. Recent studies have shown that transmucosal fentanyl preparations were effective for faster control of breakthrough pain. We hope to improve management of breakthrough cancer pain with more efficient analgesics in line with currently available evidence.

How to Maintain the Financial Stability and Adequacy of Teachers Pension (사학연금의 재정안정화와 적정성 유지 방안)

  • Park, Yousung;Jeong, Min-Yeol;Jeon, Saebom
    • The Korean Journal of Applied Statistics
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    • v.28 no.4
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    • pp.643-661
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    • 2015
  • Korea Teachers Pension (private school pension) is a mandatory pension and a social security system for private school teachers to ensure the stability of subscribers by a supplying pension when they (and their dependents) face future economic risk due to retirement or death. Therefore, the Teachers Pension must provide stability and sustainability in regards to adequacy of income and to function as a pension. However, the Government Employees Pension System (GEPS) of Korea (the most representative special occupation pension) recorded a fiscal deficit in 2001 and with an accumulated deficit that is expected to grow; subsequently, various plans for the reform of GEPS have been actively discussed. The Korea Teachers Pension system is based on the GEPS scheme and is not free from the GEPS discussions on reforms of national pension. The current system for the Teachers Pension needs to be improved because it is expected to be depleted within the next 30 years due to low fertility and an aging population in Korea. This study discusses existing Teachers Pension schemes problems and suggests a projection method and revised plans to improve it. We use long-term financial projections of the Teachers Pension to estimate the fund exhaustion point and the minus balance of the financial scale as well as analyze the supply-demand burden structure that reflects the future population structure to propose Teachers Pension reforms that will improve stability and adequacy.

A Study on the Postpartum Depression Experience : Q-Methodological Approach (산후 우울 경험에 관한 연구 -Q 방법론적 접근-)

  • 장혜숙;김수진;김정선;김흥규;최의순
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.917-929
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    • 1996
  • The purpose of this study is to explore types of postpartum depression and to understand the nature and structure of the postpartum depression by using Q-methodological approach. As a way of research, 55 statements concerning postpartum depression were selected through individual interviews with postpartum mothers and literature review. 30 women were chosen as a subject group for the study, with opinions shown in 55 statements divided into 9 scales by forced distribution. PC QUANL Program was used for analysis and Q-factors were analyzed by using principal component analysis. As a result, postpartum depression experience was classified into 5 types. There are "Role-Strain Type", "Unattributional Depression Type", "Psychosomatic Symptoms Type", "Self-Compassion Type", and "Role-Crisis Type". Type I was named "Role-Strain Type", referring to the strain generally experienced by mothers with regard to the new role as a mother and as a social member. Type II was named "Unattributional Depression Type", referring to the symptom experienced by people who were in a state of vanity and a sense of loss. They often break into tears for no specific reasons. In case of Type III, people in a state of "Psychosomatic Symptoms Type" develop physical symptoms after suffering from inherent emotional conflict. Type IV was named "Self-Compassion Type" refers to the symptom shown by those who feel pity for their children and for themselves. And they show inability to cope with the reality properly. Type V was named "Role -Crisis Type", which is experienced by people who have a burden and a severe fear of their own job and their children in their mind, also showing serious conflict with maternal role. Futhermore, it was carried out to examine structure of postpartum depression in terms of degree of depression and adjustment ability. Type I showed mild degree of depression and relatively good adjustment ability. Type II showed broad range of degree in depression and moderate adjustment ability. Type III showed moderate depression and relatively low adjustment ability. Type IV revealed relatively serious degree of depression and the lowest adjustment ability. Type V revealed very serious degree of depression and the lowest adjustment ability. As a result, considering the structure of postpartum depression. Type I is considered to be a normal depression sympton which most mothers generally experience, followed by Type II, Type III, Type IV and Type V, each of which show increasingly worse degree of depression and lower adjustment ability. In conclusion, it seems to be it is necessary to understand distinct symptoms of postpartum depression and to examine the characteristics and structure of those types, so that it could lead to more individual nursing approach.cteristics and structure of those types, so that it could lead to more individual nursing approach.

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The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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Information Needs Expressed by Mothers of Young Children with Disabilities (장애아동 양육을 위한 어머니의 정보요구에 관한 연구)

  • Chung, Gui-Ok;Lee, Jong-Ryol;Park, Chun-Man
    • Korean Journal of Health Education and Promotion
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    • v.22 no.2
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    • pp.195-213
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    • 2005
  • Objectives: This study aims to determine fostering stress and mental health state that mothers of handicapped children perceive as primary care givers and to analyze their demand for information assistance in order to release their stress so that it can provide materials that contribute to establishment of assistance system for families with handicapped children. Methods: The research subjects were 340 mothers whose children went to a nursery for special children, 3 general nurseries and 6 special schools in Daegu, and the data were collected using structures questionnaires. The survey analyzed mothers' fostering stress, their demand for fostering information assistance, children's daily activity abilities. Component concepts of each scale was validated by adopting confirmatory factor analysis, and factors affecting demand for fostering information assistance were analyzed by adopting covariance structural analysis. Results: Younger mothers tend to have higher demand for information, and mothers with younger children or children with double handicaps also have higher demand. Mothers under 30 have the lowest demand for public health and medical care assistance and for home and community life assistance, while mothers with children with physical handicaps have the highest. The validity of component concepts was verified by categorizing as cognitive structure models fostering stress, information demand, children's daily activity abilities, and their appropriateness was evaluated through confirmatory factor analysis using structural equation modelling. And then, GFI (more than 0.9), CFI (more than 0.9), TLI (more than 0.9) and RMSAE (less than 0.08) were used to evaluate the appropriateness. It was found that all the component concepts are valid, as every item is within appropriate range. The result of analyzing information demand demonstrated that children's handicap levels significantly affect their mothers' mental health, while fostering stress significantly affect mothers' metal health, information demand. As well, it was confirmed that mothers' mental health has a significant effect on information demand. Conclusions: Therefore, to reduce special children's mothers' uncertainty, helplessness and fostering burden, it is necessary to provide them with information on children's challenges, development and fostering and to offer them quality public health, medical care and welfare assistance along with family and local community life assistance.

Deep Learning-based Abnormal Behavior Detection System for Dementia Patients (치매 환자를 위한 딥러닝 기반 이상 행동 탐지 시스템)

  • Kim, Kookjin;Lee, Seungjin;Kim, Sungjoong;Kim, Jaegeun;Shin, Dongil;shin, Dong-kyoo
    • Journal of Internet Computing and Services
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    • v.21 no.3
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    • pp.133-144
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    • 2020
  • The number of elderly people with dementia is increasing as fast as the proportion of older people due to aging, which creates a social and economic burden. In particular, dementia care costs, including indirect costs such as increased care costs due to lost caregiver hours and caregivers, have grown exponentially over the years. In order to reduce these costs, it is urgent to introduce a management system to care for dementia patients. Therefore, this study proposes a sensor-based abnormal behavior detection system to manage dementia patients who live alone or in an environment where they cannot always take care of dementia patients. Existing studies were merely evaluating behavior or evaluating normal behavior, and there were studies that perceived behavior by processing images, not data from sensors. In this study, we recognized the limitation of real data collection and used both the auto-encoder, the unsupervised learning model, and the LSTM, the supervised learning model. Autoencoder, an unsupervised learning model, trained normal behavioral data to learn patterns for normal behavior, and LSTM further refined classification by learning behaviors that could be perceived by sensors. The test results show that each model has about 96% and 98% accuracy and is designed to pass the LSTM model when the autoencoder outlier has more than 3%. The system is expected to effectively manage the elderly and dementia patients who live alone and reduce the cost of caring.

A Study on the Parking Supply and Management Strategics for Multi-Family Housing Sites (공동주택 주차공급 및 관리방안 연구)

  • 안정근
    • Journal of Korean Society of Transportation
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    • v.17 no.2
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    • pp.41-53
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    • 1999
  • The rate of automobile ownerships has been increased significantly in multi-family housing sites so that government has made new parking regulations increasing the rate of parking supply by the high demand of parking lots in multi-family housing sites. However, the new regulation of parking supply has several problems that it applies to only new multi-family housing sites and disregards to the locational distinctions around the sites. It also has reduced to the open spaces in the sites and increased the price of housing units especially to the small size units of multi-family housing sites by increasing the number of underground parking lots. Furthermore, the residents have not been equal opportunity to access their parking lots even though they have been charged to equal amount of financial burden for the construction of underground parking lots. This research aims to relieve above problems by analysing parking supply and demand management strategies both domestic and foreign countries, and suggest to new parking management system for multi-family housing sites in 21st Centuries. This research reveals that most of multi-family housing sites want to be applied 1) diverse parking supply regulations considering the locational distinctions of sites, 2) parking lot ownership programs, 3) charging parking fees to second vehicles, 4) increasing parking lots both in the sites and around the sites, 5) enforcing police power to the parking violation vehicles to their sites. Especially, the multi-family housing sites consisting of small & medium size of units and locating in small & medium size of cites strongly want to be accepted new Parking regulations considered their locational and social distinctions and applied police power to the parking violation vehicles in their sites compared to the other multi-family housing sites.

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Requirements for Cerebrovascular Surgery in Comprehensive Stroke Centers in South Korea

  • Kim, Tackeun;Oh, Chang Wan;Park, Hyeon Seon;Lee, Kunsei;Lee, Won Kyung;Lee, Heeyoung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.478-484
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    • 2018
  • Objective : Cerebrovascular disease (CVD) was the third most common cause of death in South Korea in 2014. Evidence from abroad suggests that comprehensive stroke centers play an important role in improving the mortality rate of stroke. However, surgical treatment for CVD is currently slightly neglected by national policy, and there is still regional imbalance in this regard. For this reason, we conducted a survey on the necessity of, and the requirements for, establishing regional comprehensive cerebrovascular surgery centers (CCVSCs). Methods : This investigation was performed using the questionnaire survey method. The questionnaire was consisted with two sections. The first concerned the respondent's opinion regarding the current status of demand and the regional imbalance of cerebrovascular surgery in South Korea. The second section asked about the requirements for establishing regional CCVSCs. We sent the questionnaire to 100 board members of the Korean Society of Cerebrovascular Surgeons. Results : Most experts agreed that cerebrovascular surgery patients were concentrated in large hospitals in the capital area, and 83.6% of respondents agreed that it was necessary to alleviate the regional imbalance of cerebrovascular surgery. With regards to personnel, over 90% of respondents answered that at least two neuro-vascular surgeons and two neuro-interventionists are necessary to establish a CCVSC. Regarding facilities, almost all respondents stated that each CCVSC would require a neuro-intensive care unit and hybrid operating room. The survey asked the respondents about 13 specific neurovascular surgical procedures and whether they were necessary for a regional CCVSC. In the questions about the necessity of cerebrovascular surgical equipment, all seven pieces of equipment were considered essential by all respondents. A further five pieces of equipment were considered necessary on site: computed tomographic angiography, magnetic resonance angiography, conventional angiography, surgical microscope, and surgical navigation. Our results may provide a basis for future policy regarding treatment of cerebrovascular disease, including surgery. Conclusion : Raising the comprehensiveness of treatment at a regional level would lower the national disease burden. Policies should be drafted regarding comprehensive treatment including surgery for cerebrovascular disease, and related support plans should be implemented.

Clinical Characteristics of Psychiatric Patients with Military Issues Using MMPI-2-RF (군복무 적합성 평가를 위해 정신건강의학과에 내원한 환자군의 MMPI-2-RF 프로파일)

  • Sung, Gyhye;Park, Ji-Hyun;Kim, Keun-Hyang;Lee, Sang-Hyuk;Park, Eun-Hee;Choi, Ji Young
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.33-45
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    • 2017
  • Objectives : The purpose of this study was to examine psychological characteristics of patients who visited psychiatric clinic for medical certificate for military service using MMPI-2-RF. We compared target group with general psychiatric patients with same age range. Methods : A total of 165 male patients for medical certificate and 154 general psychiatric patients were collected from the Department of Psychiatry of three university hospitals. There were significant differences of age and educational level between two groups. We used independent t-test, ANCOVA, ${\chi}^2$ test to examine differences between two groups. Results : Medical certificate group scored higher on the validity scales, the Higher-Order(H-O) scales, the Restructured Clinical(RC) Scales, the Specific Problems(SP) Scales, and the Personality Psychopathology Five (PSY-5) Scales. Especially, EID, RC7, HLP, SFD, SAV, SHY, DSF, and INTR-r showed significant differences between two groups on all three statistical tests. Conclusions : The present study showed that psychiatric patients who received psychological evaluation for military service have significantly higher emotional distress, helplessness, lower self-confidence, and lower quality of interpersonal relationships. And the difference of validity scales between two groups could be related with psychological burden of compulsory military service in the study sample which causes elevation on scales of infrequent responses. MMPI-2-RF would be helpful instrument to assess these emotional and psychological characteristics.