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The Nature of Patient's Disagreement with Doctors among Some Rural Residents (일부 농촌주민에서 의사에 대한 환자의 의견불일치)

  • Lee, Moo-Sik;Cho, Hyong-Won;Kim, Eun-Young;Chun, Byung-Chul;Shin, Dong-Hoon
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.315-329
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    • 1999
  • Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

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Standardization and Reliability and Validity of the Korean Edition of Profile of Mood States(K-POMS) (한국판 기분상태척도(K-POMS)의 표준화와 신뢰도와 타당도 평가)

  • Kim, Eui-Joong;Lee, Sang-Ick;Jeong, Do-Un;Shin, Min-Sup;Yoon, In-Young
    • Sleep Medicine and Psychophysiology
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    • v.10 no.1
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    • pp.39-51
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    • 2003
  • Objectives: The Profile of Mood States (POMS) has been used broadly and frequently in various medical studies with various subjects. For the development and application of the Korean edition of POMS, called K-POMS, we translated POMS into Korean and then evaluated the reliability and validity of K-POMS. Methods: The subjects were 161 male students with a mean age of 18.1 years (15-30) and 244 female students with a mean age of 16.6 years (14-23). They were requested to perform K-POMS and SCL-90-R (Korean version) at the same time. Means, reliability coefficients, and test-retest correlations of K-POMS were calculated. Content validities, correlations with SCL-90-R, and discrimination validities in comparison with 76 depressive patients were obtained, and factor analyses were carried out. Results: Mean scores of Total Mood Disturbance (TMD) and some subscales (T, F, C, V factor) showed a significant difference between male and female students. The internal consistency coefficient ($\alpha$) of the total 65 items was 0.93, and ranged from 0.67 to 0.90 for subscales. Test-retest correlations of 43 subjects ranged from 0.27 to 0.63. Seven psychiatrists rated the properness of the content of each item as more than moderate degree (mean scale points=2.66, in the range of 0 to 4). Every subscale of KPOMS exhibited significant correlation with the matching subscale of SCL-90-R. Mean scores of K-POMS of the total 405 subjects were significantly different from those of the 76 depressive subjects after age correction. Six factors were extracted, accounting for 51.2% of total variance. Factor 6 consisted of 6 items which came from various subscales of POMS and represented "uncertainty and helplessness," which may be somewhat different to depression or sadness proper. Conclusion: The validity and reliability of K-POMS could be confirmed. The significant difference in K-POMS scores between depressive subjects and normal subjects suggests that K-POMS can be used clinically for the evaluation and screening of depression. The main structure of K-POMS is very similar to that of POMS, except the Confusion-Bewilderment factor which shows weak factor consistency in K-POMS. This may reflect some emotional characteristic of Koreans such as an undifferentiated aspect of cognitive efficiency. The sixth factor newly extracted from K-POMS also may be indicative of an unique emotional aspect of young Koreans.

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Effects of Yucca Extracts and Protein Levels on Growth Performance, Nutrient Utilization and Carcass Characteristics in Finishing Pigs

  • Min, T.S.;Kim, J.D.;Lee, J.H.;Hyun, Y.;Sohn, K.S.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.14 no.4
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    • pp.525-534
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    • 2001
  • A total of 120 pigs were used to investigate the effects of yucca extracts on the growth performance, nutrient digestibility, nutrient excretion and carcass characteristics of finishing pigs fed different levels of dietary protein. Pigs were allotted into $2{\times}3$ factorial design by the supplementation of yucca extracts (YE, 0 and 120 mg/kg) and 3 levels of dietary protein (14, 16, 18% for early finisher and 12, 14, 16% for late finisher for low, medium and high protein diet, respectively). During the early finishing period (51~76 kg BW), no significant difference was found in growth performance regardless of the YE supplementation or dietary protein levels. Growth performance of late finishing pigs (76~101 kg BW) was also not significantly different among treatments. However, ADG of pigs fed YE diet was significantly improved (p<0.05) regardless of the dietary protein levels. For the overall period (51~101 kg BW), although adding YE to the diet and elevating the protein level showed better ADG, there were no significant differences on growth performance among treatments. Early finishers showed significantly higher crude protein, crude ash and crude fat digestibilities when they were fed diets supplemented with YE. Digestibilities of amino acids were not affected by YE. Late finishers did not show any significant differences in proximate nutrient digestibilities regardless of YE supplementation or dietary protein levels. YE tended to slightly improve the CP digestibility, however no significant difference was found with increased dietary protein levels. There was no significant difference in amino acid digestibilities with YE supplementation or dietary CP levels during the late finishing period. Dry matter (DM) and nitrogen (N) excretion in feces did not show any significant difference among treatments. Early finishing pigs also did not respond to the inclusion of YE or dietary protein levels (p<0.05). Fecal N excretion of early finishing pigs seemed to be lowered in pigs fed YE. Pigs fed medium dietary protein diet tended to excrete a higher amount of N during the early finishing period, but not statistically different. A slight increase in fecal N excretion was found with the increased level of dietary protein during the late finishing period. For ammonia nitrogen excretion, although there was no significance, the NH3-N content tended to be increased by the increased dietary protein levels and with YE supplementation. The NH3-N content in manure increased by 24.5% with YE supplementation. There were no significant differences in carcass weight, backfat thickness, carcass grade and loin eye area among treatments. However, pigs fed non-YE with low protein diet showed a significantly (p<0.05) low carcass ratio among treatments and there was significant (p<0.05) difference between the YE-added treatment and non YE treatment in carcass ratio. As for the feed cost, the cost of feeding high level protein was higher than that of medium level protein by 5% and low level protein by 9% (p<0.05). Therefore, based on this study, it could be concluded that environmentally friendly agents might play a role to some extent in finishing pigs from the aspect of pollution control, and that more than 14 and 12% of dietary protein for early finishing and late finishing pigs respectively do not necessarily guarantee high growth performance.

Effect of Water-Extracts from Sludge Compost on Seed Germination (퇴비의 부숙 과정 중 추출물이 종자 발아력에 미치는 영향)

  • Kang, Sang-Jae;Lee, Chang-Hee;Seo, Sang-Hyun
    • Journal of Bio-Environment Control
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    • v.16 no.4
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    • pp.407-414
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    • 2007
  • In order to evaluate the physicochemical properties of sludge compost and to identify the effects water-extracts from sludge compost in 2, 6, 8, 12 weeks of decomposing process on seed germination and root elongation in cabbage, lettuce, soybean and barley plants was investigated. The content of total nitrogen in sludge compost increased slightly in 6 weeks decomposing process, and then decreased gradually. Organic matter content decreased continuously overall decomposing process. As decomposition was processing, pH of sludge compost decreased slightly, and EC increase within 6 weeks decomposing process, and then decreased. The content of nitrogen in water-extracts from sludge compost increased within 8 weeks decomposing process and decreased in 12 weeks decomposing process. The content of ammonium nitrogen was similar with that of total nitrogen, and the ratio of ammonium and nitrate increased within 8 weeks, and then decreased. Cation content and EC decreased the late of decomposing process and pH didn't change. The water-extracts from sludge compost during decomposing process inhibited seed germination and root elongation in cabbage (Brassica campestris), lettuce (Lactuca sativa), barley (Hordeum vulgare) and soybean (Glycine max). The inhibition of root elongation in cabbage was greater than that of relative seed germination, whereas relative seed germination in lettuce was more inhibit than root elongation. Relative seed germination and root elongation in soybean were inhibited slightly, but those of in barley was inhibited strongly. In this study, we would identify the effects of water-extracts from sludge compost on seed germination and root elongation was different to the species of seed. The inhibition of seed germination and root elongation treated with the water-extracts which extracted from sludge compost in the early stage of decomposing process was greater than that of in the late stage of decomposing process.

Research on Changing of Renal Relative Uptake Depending on the Setting of Background ROI in Kidney MAG3 Study of Hydronephrosis Patients (Hydronephrosis 환자의 Kidney MAG3 검사 시 Background ROI 설정에 따른 신장 상대 섭취율 변화에 관한 연구)

  • Noh, Ik Sang;Ahn, Byung Ho;Kim, Soo Yung;Choi, Sung Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.25-30
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    • 2013
  • Purpose: To evaluate kidney function, renal relative uptake is very important and is affected by kidney and the setting of background region of interest (ROI). In particular, in the case of patients with hydronephrosis to the naked eyes, such as size, position and shape etc. can be difficult to identify. So according to ROI to be set by user, the results are many differences. This study assumes the ROI of a constant kidney. According to the change of background ROI by analyzing renal relative uptake affect how the results are intended to study. Materials and Methods: From January 2012 to February 2013, we analyzed 27 patients with hydronephrosis who were examined MAG3 test in nuclear medicine department of Samsung medical center. After patients were received intravenous injection of $^{99m}Tc-MAG3$ 185 MBq (5 mCi) data were obtained. While we reconstructed images of patients, we've changed background ROI in the process of setting up ROI. First, in the process of renal processing, automatic ROI which set automatically and background ROI which needed to set manually were compared. Second, we set the ROI position separated by above, lateral and bottom of kidney. Third, background setting time were compared with 1-2 min and 2-3 min. Results: The relative uptake occurred in 3.7%p of the errors on average in Automatic & Manual ROI study. And comparison of background ROI position study, located in the lower position was more accurate results. Above, lateral, bottom each of the values 74.6%, 67.6% and 62.0% showed respectively. The standard value was 59.9%. finally, split function range test doesn't show significant difference. Conclusion: The study shows that relative uptake of kidney is affected in the background ROI. Therefore, it should be set by considering various dependent factors.

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Effect of Onion Peel Extracts on Blood Lipid Profile and Blood Coagulation in High Fat Fed SD Rats (고지방 섭취 흰쥐에서 양파 껍질 추출물의 보충 섭취가 혈중 지질농도와 혈행 개선에 미치는 효과)

  • Chung, Hye-Kyung;Shin, Min-Jeong;Cha, Yong-Jun;Lee, Kyung-Hea
    • The Korean Journal of Food And Nutrition
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    • v.24 no.3
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    • pp.442-450
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    • 2011
  • Numerous studies have suggested that dietary flavonoids contribute to prevent cardiovascular disease. Onion contains many functional phytochemicals such as quercetin. The aim of this study was to examine whether onion peel extracts supplementation affect blood lipid profiles and blood coagulation in animal model. Total 48 Sprague-Dawley male rats at 5 weeks old were divided into 6 groups with different diets(C: control, HF: high fat diet, HFOE 0.01%: high fat+onion peel extract 0.01% diet, HFOE 0.02%, HFOE 0.05%, HFOE 0.1%) for 8 weeks. Onion peel extract supplementation significantly decreased serum levels of LDL-cholesterol and increased HDL-cholesterol, while total cholesterol and triglyceride levels were not affected. Hematological parameters(hematocrit, white blood cell, red blood cell, and platelet count) and blood coagulation parameters(prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen) were not significantly different among 6 groups. However, activated partial thromboplastin time of HFOE 0.05% group was significantly longer than that of HF group. These results indicate that onion peel extract supplementation displays hypocholestrolemic effects but does not seem to have anti-coagulation effects in high fat fed SD rats.

Phylogenetic Analysis based on Metallothionein Gene Sequence of an Indigenous Species Pisidium (Neopisidium) coreanum in Korea (한국 고유종 Pisidium (Neopisidium) coreanum (산골조개) 의 metallothionein 유전자를 기초로 한 분자계통 분류학적 연구)

  • Baek, Moon-Ki;Lee, Jun-Seo;Kang, Se-Won;Lee, Jae-Bong;Kang, Hyun-Jung;Jo, Yong-Hun;Noh, Mi-Young;Han, Yeon-Soo;Choi, Sang-Haeng;Chae, Sung-Hwa;Park, Hong-Seog;Lee, Jun-Sang;Lee, Yong-Seok
    • The Korean Journal of Malacology
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    • v.25 no.2
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    • pp.153-160
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    • 2009
  • Pisidium (Neopisidium) coreanum is a freshwater snail and lives in spring water near mountain areas. Interestingly, this snail has been traditionally regarded as medicinal food, and thus has been used as folk remedies for healing broken bones. Recently, alpha classification on Pisidium (Neopisidium) coreanum through redescription has been conducted. However, not much attention has been made in beta classification. In this study, we performed the beta classification based on metallothionein (MT) genes found from various organisms. To this end, the complete cDNA sequences were obtained from the Expressed Sequence Tag (EST) sequencing project of Pisidium (Neopisidium) coreanum. The coding region (315 bp) encoded an amino acid sequence of 105 residues. The combined results from BLAST analyses, multiple sequence alignment and molecular phylogenetic study of Pc-MT gene indicate that Pisidium (Neopisidium) coreanum has similarity to freshwater bivalve such as Dreissena polymorpha (zebra mussel), Unio tumidus (swollen river mussel) and Crassostrea ariakensis (suminoe oyster).

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A 0.31pJ/conv-step 13b 100MS/s 0.13um CMOS ADC for 3G Communication Systems (3G 통신 시스템 응용을 위한 0.31pJ/conv-step의 13비트 100MS/s 0.13um CMOS A/D 변환기)

  • Lee, Dong-Suk;Lee, Myung-Hwan;Kwon, Yi-Gi;Lee, Seung-Hoon
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.46 no.3
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    • pp.75-85
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    • 2009
  • This work proposes a 13b 100MS/s 0.13um CMOS ADC for 3G communication systems such as two-carrier W-CDMA applications simultaneously requiring high resolution, low power, and small size at high speed. The proposed ADC employs a four-step pipeline architecture to optimize power consumption and chip area at the target resolution and sampling rate. Area-efficient high-speed high-resolution gate-bootstrapping circuits are implemented at the sampling switches of the input SHA to maintain signal linearity over the Nyquist rate even at a 1.0V supply operation. The cascode compensation technique on a low-impedance path implemented in the two-stage amplifiers of the SHA and MDAC simultaneously achieves the required operation speed and phase margin with more reduced power consumption than the Miller compensation technique. Low-glitch dynamic latches in sub-ranging flash ADCs reduce kickback-noise referred to the differential input stage of the comparator by isolating the input stage from output nodes to improve system accuracy. The proposed low-noise current and voltage references based on triple negative T.C. circuits are employed on chip with optional off-chip reference voltages. The prototype ADC in a 0.13um 1P8M CMOS technology demonstrates the measured DNL and INL within 0.70LSB and 1.79LSB, respectively. The ADC shows a maximum SNDR of 64.5dB and a maximum SFDR of 78.0dB at 100MS/s, respectively. The ABC with an active die area of $1.22mm^2$ consumes 42.0mW at 100MS/s and a 1.2V supply, corresponding to a FOM of 0.31pJ/conv-step.

Kinetics and Mechanism of Alkalie Hydrolysis of Cinnamonitrile (II) (Cinnamonitrile의 알카리 가수분해(加水分解) 반응(反應)메카니즘 (II))

  • Sung, Nack Do;Chung, Woo Jin;Kwon, Ki Sung;Park, Byung Kwan
    • Korean Journal of Agricultural Science
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    • v.10 no.2
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    • pp.354-364
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    • 1983
  • Confonmation of (Z)-cinnamonitrile have been studied by molecular orbital theoretically using extended Huckel theory(EHT) and CNDO/2 molecular orbital calculation methods. The results indicate that the stability of conformation is(Z)-gauch>(Z)-planar. The rate constants for alkalie hydrolysis of cinnamonitrile at pH 7.0-14.0 range have been determined by ultra-violet spectrophotometry in 50% methanol at $25^{\circ}C$ and the following rate equation which can be applied over wide pH range was obtained; $${\therefore}k=({\frac{1.41{\times}10^{-14}+1.21{\times}10^7/[H_3O^+]}{2.65{\times}10^{-7}+1.64/[H_3O^+]})+9.14{\times}10^9/[H_3O^+]$$ The rate equation reveals that, at pH 7.0-10.0, the reaction is initiated by the addition of water molecule to unsaturated cabon-carhon double bond of cinnamonitrile and ${\alpha}C-{\beta}C$ bond scission follow subsequently in neutral and alkalie media. At pH 12.0-14.0, in strong alkalie solution, that so-called Michael type nucleophilic addition that the over-all rate constants is only dependent upon the concentration of hydroxide ion occurs competitively and are very complicated. Hence, the reaction mechanism of alkalie hydrolysis of cinnamonitrile which did not carefully before can be fully explained.

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An Analysis on Factors Related to the Job Satisfaction of Dental Hygienists at J Region (J지역 치과위생사의 직무스트레스 요인 분석)

  • Lee, Hyun-Ok;Ju, On-Ju;Kim, Young-Im
    • Journal of dental hygiene science
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    • v.7 no.2
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    • pp.65-72
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    • 2007
  • The purpose of this study was to examine the job stress and job stressors of dental hygienists. The subjects in the study were 220 dental hygienists who worked in north Jeolla province. After a mail survey was conducted from July 24 through September 24, 2006, the responses from 180 dental hygienists(response rate 81.8%) were gathered, and 156 answer sheets were analyzed except 24 incomplete ones that couldn't be analyzable. The findings of the study were as follows: 1. As for the correlation of overall job stress to turnover intention, their entire stress was under the influence of unreasonable treatment (r = 0.382), conflicts as a professional(r = 0.285), tough working environments(r = 0.303), conflicts with colleagues(r = 0.233), and heavy workload (r = 0.262). Those who were more stressed were more willing to change their occupation, and their stress level made a statistically significant difference to that(p < 0.01). 2. A multiple regression analysis was carried out by selecting the job stressors and turnover intention as independent and dependent variables respectively to see how each of the stressors affected job stress. And unreasonable treatment(p < 0.001) was identified as what had the biggest impact on that, followed by conflicts as a professional(p < 0.05), and tough working environments (p < 0.05). The stressors made a 22.2% prediction of turnover intention.

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