• Tuberculosis and Respiratory Diseases
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• v.64 no.2
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• pp.109-124
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• 2008

Background: The incidence of chronic obstructive pulmonary disease (COPD) is increasing and the disease is becoming an important cause of morbidity and mortality worldwide. It is important to implement evidence-based guidelines by primary care physicians (PCPs) to establish qualified management of COPD patients. The aim of this survey is to investigate the pattern of COPD management among PCPs and to apply it to the development of Korean COPD guidelines. Methods: A web-based questionnaire was prepared that consisted of 25 questions on the pattern of COPD management. A total of 217 PCPs participated in the survey from June 2006 to May 2007. Results: Many PCPs (61.8%) possessed a spirometer, but the application rate was relatively low (35.8%) and more than half of the COPD patients (57%) did not receive a diagnosis based on spirometry. Administration of oral medication was preferred than the administration of inhaled medication for both stable COPD and acutely exacerbated COPD. More than 90% of the PCPs endorsed educational measures to quit smoking and vaccinate against influenza. It was noted that 56.7% of the PCPs were aware of the GOLD guidelines, but only 7.3% tended to fully implement the recommendations of the guidelines in daily practice. Conclusion: The results of the survey indicate that despite the high awareness rate of the current COPD guidelines, deficits exist among the PCPs with respect to the diagnosis and treatment of COPD. The results of this survey should be applied for the development of new COPD guidelines in order to decrease the discrepancy between the guidelines and the daily practice of the PCPs.

• Journal of East-West Nursing Research
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• v.5 no.1
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• pp.90-101
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• 2000

The study attempts to examine the degree of cognition and demand on health promotion center of oriental nursing. It puts unique nursing intervention using traditional health promotion connected with oriental medicine to practical use for residents' health promotion and prevention of disease. With the study design of cross-sectional descriptive study, 516 residents who live in 26 Dongs, Dongdaemoon-gu were selected. The tool of study consists of 30 questions which the study team made for the degree of cognition and demand on health promotion center of oriental nursing. Cronbach's $\alpha$ in the degree of cognition was .8028. Collection of research data had been done from October 1 to October 30, 1999 with help of Dongdaemoon-gu office after pretest from 20 residents. Collected data were analyzed into the number and percentage in the characteristic of a subject and connected with demand on the establishment of center, the mean and the standard deviation in the degree of cognition and F-tests in the difference of the degree of cognition by characteristics. The results were as follow; 1) The characteristic of subject of this study was male 50.6%, and average age was 38.5 years old and 30-39 years old occupied the highest percentage with 31.6%. The married were 71.8%, over high school graduates was 85.6%, monthly income from 500 thousand won to 2 million won was 86.1%. 50.8% was the type living with parents, children and sibling. 2) When they were sick, the institution which residents used at first was a pharmacy(69.2%) and hospital(27.5%), but oriental medicine hospital was just 1.4%. As for subjective health condition, 82.5% answered over average, and 28.7% answered that they had chronic illness such as arthritis, chronic digestion problem, hypertension and so on. As for information collection on health, mass communication(34.9%) and medically concerned people(28.1%) occupied relatively high rate. Free health diagnosis system(36.8%) and establishment of health promotion center(31.5%) among welfare programs that residents want to enjoy were high ranked. The rate using a special institution for health was 17.8%, and among these institutions, the rate using aerobic exercises, health center(7.0%) and steamed room(5.4%) was high. Besides, other institutions such as breathing at the abdomen, finger-pressure therapy, meridian massage, foot massage, and so on were being used. 3) As the average of the degree of cognition on health promotion center of oriental medicine was 2.92, the degree of cognition was medium. The description, "health promotion center of oriental medicine is necessary for health keeping of healthy people, including people who have a problem in health" showed the highest degree of cognition(3.04, ${\pm}0.64$). 4) As for the intention on using health promotion center of oriental nursing, 61.4% said "yes", "no" was just 1.4%. The services that people relatively high wanted to be served from the center were measures reducing stress(68.0%) (relaxation therapy, meditation, breathing at the abdomen and so on), acupuncture(66.5%), finger-pressure(61.6%), moxibustion(57.6%), meridian massage(44.2%), postpartum care(40.3%) and so on. 5) As for the degree of cognition on the establishment of health promotion center of oriental nursing by characteristics of subject, there was significant difference(F=4.03, p=.046) between male(3.01) and female(2.91). But there was no significant difference by age, marital status, level of educational achievement and monthly income. As the above result, cognition on the establishment of health promotion center of oriental nursing was relatively low because people were not familiar with about the health promotion center of oriental nursing yet. However once the center will be established, the degree of demand on the center will be relatively high. So positive advertisement will be necessary, and the management of useful programs will be also required in order to make people recognize the advantage when they actually will use the center. On the other hand, as the subject of the study consists of many young people of below 30, the health problem came to be low. And in the case of sampling, the study using random sampling that can represent population will be required.

• Journal of Gifted/Talented Education
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• v.11 no.3
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• pp.131-153
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• 2001

The importance of identifying gifted children during early childhood is becoming recognized. Nonetheless, most researchers preferred to study the primary and secondary levels where children are already and more clearly demonstrating what talents they have, and where more reliable predictions of gifted may be made. Comparatively lisle work has been done in this area. When we identify giftedness during early childhood, we have to consider the potential of the young children rather than on actual achievement. Giftedness during early childhood is still developing and less stable than that of older children and this prevents us from making firm and accurate predictions based on children's actual achievement. Dynamic assessment, based on Vygotsky's concept of the zone of proximal development(ZPD), suggests a new idea in the way the gifted young children are identified. In light of dynamic assessment, for identifying the potential giftedness of young children. we need to involve measuring both unassisted and assisted performance. Dynamic assessment usually consists of a test-intervene-retest format that focuses attention on the improvement in child performance when an adult provides mediated assistance on how to master the testing task. The advantages of the dynamic assessment are as follows: First, the dynamic assessment approach can provide a useful means for assessing young gifted child who have not demonstrated high ability on traditional identification method. Second, the dynamic assessment approach can assess the learning process of young children. Third, the dynamic assessment can lead an individualized education by the early identification of young gifted children. Fourth, the dynamic assessment can be a more accurate predictor of potential by linking diagnosis and instruction. Thus, it can make us provide an educational treatment effectively for young gifted children.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.2
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• pp.170-181
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• 1996

Objective : This study was tried to investigate the specific relationships among cognitve function, neurbehavioral symptoms, and daily living functions, as well as provide the guidline of more proper clinical approches for patients with subcortical cerebrovascular disease. Objects and Methods Subjects were 85 patients whose diagnosis was confirmed by brain CT or MRI and controls were 195 normal persons matched by educational level with the subjects. The cognitive functions were evaluated by BNA(Benton neuropsychiatric assessment), subjective neurobehavioral symptoms by SCL-90-R(Sympton Check List-90-Revised), objective neurobehavioral symptoms by NRS(Neurobehavioral Rating Scale), and daily living function symptoms by NRS(Neurobehavioral Rating Scale), and daily living function by GERRI(Geriatric Evaluation by Relative's Rating Instrument) and IADL(Instrumental Activities of Daily Living Scale). Results: 1) Subjects showed significantly lower cognitive functions than controls in all tests of BNA except Lt-Rt Orientation Test(p=0.09) and facial Recognition Test(p=0.186). 2) In subjective neurobehavioral symptoms, subjects showed significantly lower scores in all symptoms except anxiety(p=0.059), hostility(p=0.159), and phobic anxiety(p=0.849). But in objects neurobehavioral symptoms, subjects showed significantly higher in scores in psychoticism (p=0.000) and neuroticism(p=0.025) of NRS. 3) The score of social functioning of GERRI(p=0.000) and that of IADL(p=0.000) were significantly higher in subjects than in controls. 4) for correlation between cognitive and daily living functions, there were significant correlations between the scores of all items on BNA and the score of cognitive or social function of GERRI and the socre of MDL in corntrols, whereas in subjects, there were significant correlations only between the scores of BNA and the score of IADL. 5) for correlation between neuroehavioral symptoms and daily living functions, there were significant correlatons between the socre of subjective neurobehavioral symptoms and the scores of all subscales of GERRI and the score of MDL in controls. On the contrary, in subjects, there were significant correlations between the score of social function of GERRI and the score of objective neurobehavioral symptoms such as psychoticism, agitiation-hostility, and decrease d motivation-emotional withdrawl. Conclusion : Above results suggest that disturbances in specific function of brain may play a role as a predictor of impairments with specific daily living functions and also suggest that specific correlations among various functions may be useful as clinical parameters for setting of the treatment goal and for assessing the ongoing process in the treatment and rehavilitation of the patients with subcortical cerebrovascular disease.

• The Journal of Korean Society for School & Community Health Education
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• v.13 no.3
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• pp.57-71
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• 2012

Objectives: This study examines the situation regarding smoking among high school students in Seoul Province and identifies smoking-related factors. Methods: The study sample consisted of 1,000 high school second-grade students from 6 high schools in Seoul. The PRECEDE model was used to assess the students' needs. We carried out an educational diagnosis on attitudes, outcome expectations and social norms. Date were collected from June. 7 to 21, 2011, and were analyzed using SPSS-15.0 according to the study objectives. Results: Of 906 respondents, 9.4% had experiences to smoking: 12.7% were male and 5.7% were female. Smoking-related factors from among general characteristics were statistically significant depending on the degree of gender($x^2$=14.515, p=.001), school performance($x^2$=40.289, p=.001) and friends 'smoking status($x^2$=88.615, p=.001). Factors concerning attitudes toward smoking were statistically significant depending on the students' perceptions as follows: 'Smoking is fun(t=-14.801, p=.000)', 'Smoking looks cool(t=-10.349, p=.000)', 'People who smoke have more friends(t=-11.295, p=.000)', 'Smoking helps me manage stress(t=-15.059, p=.000)' and 'Smoking is not harmful to the body if you exercise(t=-6.388, p=.000)'. Factors concerning outcome expectations were statistically significant depending on their perceptions as follows: 'Tobacco smells good(t=-8.939, p=.000)' and 'Smoking helps in weight management (t=-7.304, p=.000)'. Factors concerning social norms were statistically significant depending on the following perception: 'My friends will not like it if I smoke(t=4.605, p=.000)'. The following influence high school students attitudes toward smoking: School performance (OR=11.66, 95%CI=1.67~81.37; OR=18.27, 95%CI=2.58~129.24; OR=26.74, 95%CI=3.06~233.79), Friends smoking status(OR=80.05, 95%CI=6.94~922.77), 'Smoking is fun(OR=12.90, 95%CI=3.87~43.04; OR=63.41, 95%CI=10.66~377.09)', 'Smoking looks cool(OR=0.15, 95%CI=0.03~0.64)', 'Smoking is not harmful to the body if you exercise(OR=1.44, 95%CI=0.03~0.62)', 'When there is no work to do, smoking is a good way to pass the time(OR=21.68, 95%CI=4.27~109.90)', 'When you are angry, smoking calms you down.(OR=13.39, 95%CI=3.92~45.65; OR=8.69, 95%CI=1.67~45.13)' and 'My parents consider it important that I do not smoke(OR=10.05, 95%CI=1.00~100.43)'. Conclusions: The study suggests that effective ways to discourage of high school students from smoking are changing their attitudes toward smoking, reducing the motivation to smoke, and controlling the number of cigarettes. Therefore, aiming at preventive education. Schools must provide accurate information about the effects of smoking. Thus, health education should actively involve preventive education not only in schools but also at home, the societal and national levels. Cooperation between various sectors of society is required for this.

• Journal of Navigation and Port Research
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• v.46 no.1
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• pp.1-10
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• 2022

This study aims to investigate changes in the demand for ship officers in response to changes in the shipping industry environment in which Maritime Autonomous Surface Ships (MASS) emerge according to the application of the fourth industrial revolution technology to ships, and it looks into changes in the skill of ship officer. It also analyzes and proposes a plan for nurturing ship officers accordingly. As a result of the degree of recognition and AHP analysis, this study suggests that a new training system is required because the current training and education system may cover the job competencies of emergency response, caution and danger navigation, general sailing, cargo handling, seaworthiness maintenance, emergency response, and ship maintenance and management, but tasks such as remote control, monitoring diagnosis, device management capability, and big data analysis require competency for unmanned and shore-based control. By evaluating the importance of change factors in the duties of ship officers in Maritime Autonomous Surface Ships, this study provides information on ship officer educational institutions' response strategies for nurturing ship officers and prioritization of resource allocation, etc. The importance of these factors was compared and evaluated to suggest changes in the duties of ship officers and methods of nurturing ship officers according to the introduction of Maritime Autonomous Surface Ships. It is expected that the findings of this study will be meaningful as it systematically derives the duties and competency factors of ship officers of Maritime Autonomous Surface Ships from a practical point of view and analyzed the perception level of each relevant expert to diagnose expert-level responses to the introduction of Maritime Autonomous Surface Ships.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.1
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• pp.64-75
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• 1999

Objective：The purpose of this study was to investigate the prevalence and characteristics of comorbid disorders and associated symptoms in pervasive developmental disorder(PDD) and to examine the correlation between associated symptoms and developmental characteristics in PDD children. Method：The sample consisted of 209 cases of PDD and 143 cases of developmental language disorder(DLD)(control group) who were treated at the Seoul National Mental Hospital from Jan. 1996 to Mar. 1999. The diagnostic work based on DSM-IV criteria was performed by one or two child psychiatrists, while the clinical feature was evaluated by doctors’s notes, occupational/speech therapy reports, and results of social maturity scale(SMS), childhood autism rating scale(CARS), and psycho-educational profile(PEP). Two groups were compared on a wide range of measures including comorbid disorders, associated symptoms, treatment drugs, and PEP. The relation between associated symptom & PEP was investigated in total(106 cases) and in each dignostic group. Sixty-four cases of PDD were divided into three groups by CARS and then compared on associated symptoms. Result：The prevalence of comorbid disorder was 19.6% in PDD, 41.2% in DLD. The rate of manifestation of 13 associated symptoms was 31.47% in PDD, 22.13% in DLD on the average. Associated symptoms significantly high in PDD were preoccupation, obsession, self-mutilation, stereotypy, sleep problems, and odd response. In total patient group, associated symptoms that significantly influenced PEP were preoccupation, self-stimulation, stereotypy, inappropriate affect, sleep problems, and odd response. But, in each diagnostic group, no associated symptom influenced PEP. Associated symptoms significantly different between the 3 groups of CARS were stereotypy, anxiety, and sleep problems. Conclusion：These preliminary results suggest that developmental characteristics may influence associated symptoms in PDD children and a realistic approach considering minute diagnosis by associated symptoms and comorbid disorders is required.

• Journal of Genetic Medicine
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• v.8 no.2
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• pp.89-99
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• 2011

Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.