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Experiences of Unmet Healthcare Service Utilization in Rural Populations Using Primary Health Care Posts during the COVID-19: A Mixed Method Study Based on Andersen's Behavior Model (COVID-19 기간 동안 보건진료소를 이용하는 마을 주민의 미충족 보건의료서비스 이용 경험: 앤더슨 행동모델을 기반으로 한 혼합연구)

  • Ha, Yeongmi;Kim, Youngnam;Choi, Hyunkyoung;Yang, Seung-Kyoung;Ko, Young-Suk;Jung, Mira;Yi, Jee-Seon;Choi, Youngmi;Shin, Eun Ji;Kim, Younkyoung;Lee, Kowoon;Jung, Aeri;Jang, Ji Hui;Kim, Da Eun;Kim, Kyunghee;Shin, So Young;Park, Song Ran;Yim, Eun Shil
    • Journal of Korean Academy of Rural Health Nursing
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    • v.18 no.2
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    • pp.80-91
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    • 2023
  • Purpose: The purpose of the study quantitatively investigates the experience of unmet healthcare service utilization by rural populations in vulnerable areas during the COVID-19 pandemic based on Andersen's behavior model. At the same time, this study attempts to describe the experiences of unmet healthcare service utilization among participants in vulnerable rural areas by analyzing qualitative contents through open-ended question. Methods: Data were collected from October to November 2022 using Qualtrix, a web-based survey platform. A total of 863 participants completed an online survey. Quantitative data were analyzed using 𝑥2 test and logistic regression analysis. Qualitative data were analyzed using content analysis. Results: The factors affecting participants' unmet healthcare service utilization were type of residential area and underlying disease. The qualitative analysis identified; four categories and nine sub-categories. Conclusion: Based on these findings, it is necessary to develop a disaster nursing response model according to the type of residential areas and the number of people.

Analysis and suggestion of research trends related to NLL -Focused on academic papers from 1998 to 2023- (북방한계선(Northern Limit Line : NLL)관련 연구 경향 분석 및 제언 -1998년~2023년 학술논문을 중심으로-)

  • Hyeon-Sik Kim;Jeong-Hoon Lee
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.6
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    • pp.25-31
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    • 2023
  • The dispute over the Northern Limit Line in the West Sea has been sharply opposed since the U.N. commander set it in August 1953 with the aim of preventing accidental armed conflict between the two Koreas in the waters of the Korean Peninsula. In 2022, for the first time since the division, North Korea made a missile provocation beyond the NLL. The purpose of this study is to identify how the research on the NLL, which is under way by North Korea's actual provocation, has been conducted and to suggest a direction to proceed. This study examined the trend of research using a total of five academic information DBs, including RISS and Scholar, focusing on academic papers studied on NLL from 1998 to 2023. As a result of examining the current status of each year, field, and research method, significant differences in research volume were identified according to the government's relationship with North Korea, and the research field had the most introduction of the concept of NLL and historical background, confirming the need to expand to more diverse fields to have international legal justification and justification for the NLL, considering the changing international environment according to the logic of power. In terms of final research methods, most of them were literature studies, so the need for quantitative research using interviews, surveys, and big data was also found. It is hoped that the analysis results of this paper will play a positive role in setting the research direction for the international response of the NLL in the future amid the interests of the international political environment that is still ongoing.

Evaluating the Usability of Medical Body Wrap in Whole Body Bone Scan (전신 뼈 검사에서 의료용 신체 고정구의 유용성 평가)

  • Dong-Oh Shim;Woo-Young Jung;Jae-Kwang Ryu;Cheol-Hong Park;Yoon-Jae Kim
    • The Korean Journal of Nuclear Medicine Technology
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    • v.28 no.1
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    • pp.49-56
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    • 2024
  • Purpose: When performing nuclear medicine examinations, body wraps or plastic supports are used to support and immobilize the patient's upper extremities to prevent patient safety accidents. However, the existing plastic supports compromised patient and staff safety, including finger entrapment and falls. Moreover, the body wrap provided by manufacturers compromised image quality such as upper extremities cutoff during whole body bone scan. Therefore, a new design of body wrap was developed to improve the issue, and this study aims to evaluate the usability of this medical body wrap. Materials and Methods: To evaluate the usability of the newly designed medical body wrap, a quality assessment of whole body bone scan images and a user satisfaction survey were conducted. Adult patients (male:female=129:152, age: 60.3±12.4 years, BMI: 24.0±4.2) aged 16 years or older who underwent a whole body bone scan during two periods: June to July 2022 (before improvement, n=139) and June to July 2023 (after improvement, n=142) were randomly selected for image quality evaluation. Five radiotechnologists visually evaluated the posterior view of the whole body bone image, including the left and right elbow (2 points), arm (2 points), whether the hand is extended (2 points), whether the hand is included (2 points), and the number of visible fingers (10 points), with a total of 18 points, which were converted to 100 points and analyzed for difference before and after improvement using an independent sample t-test. The user satisfaction questionnaire was evaluated using a 5-point Likert scale among 16 radiotechnologists from three general hospitals who experienced the new body wrap. Results: The image quality assessment was 82.0±13.8 before the improvement and 89.3±10.1 after the improvement, an average of 7.3 points higher, with a statistically significant difference (t=5.02, p<0.01). The user satisfaction survey showed an overall satisfaction rating of 4.1±0.8 for ease of use, 3.8±0.7 for scan preparation time, 3.9±0.7 for patient safety, 3.8±1.2 for scan accuracy, and 4.2±0.7 for recommendation (87.5% questionnaire response rate). Conclusion: The developed body wrap showed higher image quality and user satisfaction compared to the old method. Considering these results, it is deemed that the new body wrap may be more useful than existing methods.

Analysis of characteristics of out-of-hospital cardiac arrest patients by region in Chungcheong buk-do (충청북도 내 지역별 병원 전 심장정지 환자의 특성에 대한 분석)

  • Seong Bin Im;Hyeon Mo Yang;Young Jae Kim
    • Smart Media Journal
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    • v.13 no.5
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    • pp.33-44
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    • 2024
  • Chungbuk has various regional characteristics in terms of population composition by region, industrial facilities, and distribution of emergency medical institutions. However, there are no studies yet that have analyzed regional characteristic factors related to the occurrence characteristics of cardiac arrest patients. Therefore, this study provided basic data to establish a response system for OHCA patients suitable for the characteristics of the Chungcheongbuk-do region by analyzing the characteristics of OHCA patients and the transfer status of 119 paramedics in Chungcheongbuk-do. This study is a retrospective study that analyzed 1,188 cardiac arrest patients transferred by ambulance based on raw data from the survey on acute cardiac arrest in Chungbuk (2020). There are a total of 11 emergency medical institutions in Chungbuk-do, which are concentrated in city-level areas, so the transfer time of patients to hospitals in county-level areas was delayed. In the county-level area, the frequency of dispatch of special paramedics was relatively small, and the frequency of administration of cardiac arrest drugs to help resuscitate cardiac arrest patients was also low. In conclusion, efforts should be made to improve accessibility of emergency medical services (deployment of emergency vehicles in marginal areas, proper placement of emergency medical institutions, etc.), to promote prevention of traumatic cardiac arrest patients, and to expand the scope of work to strengthen the first aid expertise of paramedics.

Physicochemical characteristics of carotenoid-enriched extract prepared from persimmon peels by ultrasound-assisted extraction with soybean oil solvent (초음파와 대두유 용매를 이용한 감 껍질 추출물의 이화학적 특성 )

  • Hun Sik Chung;Kwang Sup Youn;Soo Won Lee;Hey Kyung Moon;Jong Kuk Kim
    • Food Science and Preservation
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    • v.30 no.1
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    • pp.122-131
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    • 2023
  • Persimmon peels are mostly discared as a by-product of dried persimmon manufacturing, but effective use is required as it contains various functional constituents. This study covers the preparation of carotenoid-enriched oil by ultrasound treatment of persimmon peel in soybean oil solvent, and the investigation of its physicochemical characteristics. Using the Box-Behnken design and response surface methodology, the optimal extraction conditions (temperature, 62℃; time, 32 min; and persimmon peel to oil ratio, 1:3.1) were determined based on the carotenoid concentration of the extract. The physicochemical characteristics of the extract obtained under optimal conditions and the untreated soybean oil (control) were compared. The total carotenoid content of the extract increased. The carotenoid-enriched soybean oils had a lighter color than the controls, but with high redness and yellowness values. The effect of sonication and a component of the persimmon peel on the oxidation and heating stability of soybean oil was weak. The viscosity and activation energy of carotenoid-enriched soybean oil were slightly higher than those of the control. Thus, it was possible to prepare yellow-red carotenoid-enriched soybean oil by applying ultrasonic-soybean oil solvent extraction to persimmon peel. The oil is expected to be useful as an additive as well as a substitute for general edible oils.

Along and across-wind vibration control of shear wall-frame buildings with flexible base by using passive dynamic absorbers

  • Ivan F. Huergo;Hugo Hernandez-Barrios;Roberto Gomez-Martinez
    • Wind and Structures
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    • v.38 no.1
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    • pp.15-42
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    • 2024
  • A flexible-base coupled-two-beam (CTB) discrete model with equivalent tuned mass dampers is used to assess the effect of soil-structure interaction (SSI) and different types of lateral resisting systems on the design of passive dynamic absorbers (PDAs) under the action of along-wind and across-wind loads due to vortex shedding. A total of five different PDAs are considered in this study: (1) tuned mass damper (TMD), (2) circular tuned sloshing damper (C-TSD), (3) rectangular tuned sloshing damper (R-TSD), (4) two-way liquid damper (TWLD) and (5) pendulum tuned mass damper (PTMD). By modifying the non-dimensional lateral stiffness ratio, the CTB model can consider lateral deformations varying from those of a flexural cantilever beam to those of a shear cantilever beam. The Monte Carlo simulation method was used to generate along-wind and across-wind loads correlated along the height of a real shear wall-frame building, which has similar fundamental periods of vibration and different modes of lateral deformation in the xz and yz planes, respectively. Ambient vibration tests were conducted on the building to identify its real lateral behavior and thus choose the most suitable parameters for the CTB model. Both alongwind and across-wind responses of the 144-meter-tall building were computed considering four soil types (hard rock, dense soil, stiff soil and soft soil) and a single PDA on its top, that is, 96 time-history analyses were carried out to assess the effect of SSI and lateral resisting system on the PDAs design. Based on the parametric analyses, the response significantly increases as the soil flexibility increases for both type of lateral wind loads, particularly for flexural-type deformations. The results show a great effectiveness of PDAs in controlling across-wind peak displacements and both along-wind and across-wind RMS accelerations, on the contrary, PDAs were ineffective in controlling along-wind peak displacements on all soil types and different kind of lateral deformation. Generally speaking, the maximum possible value of the PDA mass efficiency index increases as the soil flexibility increases, on the contrary, it decreases as the non-dimensional lateral stiffness ratio of the building increases; therefore, there is a significant increase of the vibration control effectiveness of PDAs for lateral flexural-type deformations on soft soils.

Medical Students Understanding of The Scope of Plastic Surgery

  • Mohammad K.H.B. Abdulaziz;Mohammad Al-Jamali;Sundus Al-Mazidi;Sarah Albuloushi;Ahmad B. Al-Ali
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.251-257
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    • 2024
  • Background Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Medical students do not have a clear picture of plastic surgery as a career due to lacking scope, clinical practice, and understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public, and misconceptions about the extent of reconstructive and plastic surgery. Methods A cross-sectional observational study was conducted on Kuwait University Medical students (2nd-7th Years) over a period of 1 month. A questionnaire and a consent form were provided to eligible students. The inclusion criteria were Kuwait University Medical students from 2nd to 7th Years with signed consent form. The response was collected via email sent in coordination with the Vice Dean of Student Affairs in the Faculty of Medicine. Using statistical package for the social sciences, responses were statistically analyzed. Pearson's chi-square test was used to calculate p-values, where p < 0.05 was considered statistically significant. Results A total of 244 eligible medical students, 121 males and 123 females, were included in the study, with a mean age of 21 (±2) years. Similarly, 126 (51.6%) were preclinical students (2nd-4th-year students), while 118 (48.4%) were clinical students (5th-7th-year students). About 79.8% of medical students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. This study found that only 15.5% of medical students were interested in enrolling in plastic surgery residency after graduation, while 47.1% of students did not consider plastic surgery residency after graduation. However, 37.4% were uncertain. The two most driving factors in deciding on plastic surgery residency were expected income (61.8%) and lifestyle (14.3%). Conclusion Improving medical students' education quality can enhance their perception and awareness of plastic surgery. Students should be taught the broader scope of plastic surgery. The inclusion of formal training during undergraduation is the essence of time and should be added to or improved during plastic surgery rotations with more emphasis on reconstructive and hand/peripheral nerve surgery. Student-led interest groups can be a useful tool for educating students about their specialty.

Identification and functional prediction of long non-coding RNAs related to oxidative stress in the jejunum of piglets

  • Jinbao Li;Jianmin Zhang;Xinlin Jin;Shiyin Li;Yingbin Du;Yongqing Zeng;Jin Wang;Wei Chen
    • Animal Bioscience
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    • v.37 no.2
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    • pp.193-202
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    • 2024
  • Objective: Oxidative stress (OS) is a pathological process arising from the excessive production of free radicals in the body. It has the potential to alter animal gene expression and cause damage to the jejunum. However, there have been few reports of changes in the expression of long noncoding RNAs (lncRNAs) in the jejunum in piglets under OS. The purpose of this research was to examine how lncRNAs in piglet jejunum change under OS. Methods: The abdominal cavities of piglets were injected with diquat (DQ) to produce OS. Raw reads were downloaded from the SRA database. RNA-seq was utilized to study the expression of lncRNAs in piglets under OS. Additionally, six randomly selected lncRNAs were verified using quantitative real-time polymerase chain reaction (qRT-PCR) to examine the mechanism of oxidative damage. Results: A total of 79 lncRNAs were differentially expressed (DE) in the treatment group compared to the negative control group. The target genes of DE lncRNAs were enriched in gene ontology (GO) terms and Kyoto encyclopedia of genes and genomes (KEGG) signaling pathways. Chemical carcinogenesis-reactive oxygen species, the Foxo signaling pathway, colorectal cancer, and the AMPK signaling pathway were all linked to OS. Conclusion: Our results demonstrated that DQ-induced OS causes differential expression of lncRNAs, laying the groundwork for future research into the processes involved in the jejunum's response to OS.

Studying the Comparative Analysis of Highway Traffic Accident Severity Using the Random Forest Method. (Random Forest를 활용한 고속도로 교통사고 심각도 비교분석에 관한 연구)

  • Sun-min Lee;Byoung-Jo Yoon;WutYeeLwin
    • Journal of the Society of Disaster Information
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    • v.20 no.1
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    • pp.156-168
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    • 2024
  • Purpose: The trend of highway traffic accidents shows a repeating pattern of increase and decrease, with the fatality rate being highest on highways among all road types. Therefore, there is a need to establish improvement measures that reflect the situation within the country. Method: We conducted accident severity analysis using Random Forest on data from accidents occurring on 10 specific routes with high accident rates among national highways from 2019 to 2021. Factors influencing accident severity were identified. Result: The analysis, conducted using the SHAP package to determine the top 10 variable importance, revealed that among highway traffic accidents, the variables with a significant impact on accident severity are the age of the perpetrator being between 20 and less than 39 years, the time period being daytime (06:00-18:00), occurrence on weekends (Sat-Sun), seasons being summer and winter, violation of traffic regulations (failure to comply with safe driving), road type being a tunnel, geometric structure having a high number of lanes and a high speed limit. We identified a total of 10 independent variables that showed a positive correlation with highway traffic accident severity. Conclusion: As accidents on highways occur due to the complex interaction of various factors, predicting accidents poses significant challenges. However, utilizing the results obtained from this study, there is a need for in-depth analysis of the factors influencing the severity of highway traffic accidents. Efforts should be made to establish efficient and rational response measures based on the findings of this research.

Comparative analysis of RN-BSN Program in Korea and U. S. A. (간호학사 편입학제도의 교과과정 비교분석)

  • Lee Ok-Ja;Kim Hyun-Sil
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3
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    • pp.99-116
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    • 1997
  • In response of the increasing demand for professional degree in nursing, some university in Korea offers RN-BSN program for R. N. from diploma in nursing. However, RN-BSN program in Korea is in formative period. Therefore, the purpose of this survey study is for the comparative analysis of RN-BSN curriculum in Korea and U.S.A. In this study, subjects consisted of 18 department of nursing in university and 5 RN-BSN programs in Korea and 18 department of nursing in university and 12 RN-BSN programs in U.S.A. For earn the degree of Bachelor of Science in Nursing, the student earns 134 of mean credits in U.S.A., whereas 150.3 of mean credits in Korea. The mean credit for clinical pratice is 30.1 in U.S.A., whereas 23.9 in Korea. Students are assigned to individually planned clinical experiences under the direction of a preceptor in U.S.A. In RN-BSN program, total mean credits through lecture and clinical practice for earn the degree of BSN is 35.5(lecture : 27.7, practice ; 7.8)in U.S.A., whereas,48.1 (lecture;42.1, practice;6.0) in Korea. RN-BSN program can be taken on a full-or-part time basis in U.S.A., whereas didn't in Korea. Especially, emphasis is place on the advanced nursing practicum that focus on the role of the professional nurse in providing health care to individuals, families, and groups in community setting in U.S.A. 27.7 of mean credits was earned through lecture in U.S.A., whereas 42.1 of mean credits in Korea. It means that RN-BSN program in Korea is the lesser development in teaching method and appraisal method than in U.S.A. Students of RN-BSN program in U.S.A. can earns credit through CLEP, NLN achievement test, portfolio review session etc as well as lecture. Therefore, the authors suggests some recommendations for the development of curriculum of RN-BSN program in Korea based on comparative analysis of RN-BSN curricula in U.S.A. and Korea. 1. The curriculum of RN-BSN Program in nursing was required to do some alterations. Nursing care, today, is complex and ever changing. According to change of public need, RN-BSN curriculum intensified primary care program in community setting, geriatric nursing, marketing skill, computer language. 2. The various and new methods of earning credit should be developed. That is, the students will earn credits through the transfer of previous nursing college credits, accredited examination of university, advanced placement examination, portfolio review session, case study, report, self-directed learning and so on. Flexible teaching place should ile offered. 3. Flexible teaching place should be offered. The RN-BSN curriculum should accommodate each RN student's geographical needs and school/work schedule. Therefore, the university should search a variety of teaching places and the RN students can obtain their degrees comfortably throughout the teaching place such as lecture room inside the health care agency and establishment of the branch school in each student's residence area. 4. The RN-BSN program should offer a long distance education to place-bound RN student in many parts of Korea. That is, from the main office of university, the RN-BSN courses are delivered to many areas by Internet, EdNet (satellite telecommunication) and other non-traditional methods. 5. For allowing RN student to take nursing courses, program length should be various, depending upon the student's study/work schedule. That is, the various term systems such as semester, three terms, quarter systems and the student's status like full time or part time should be considered. Therefore, the student can take advantage of the many other educational and professional opportunities, making them available during the school year.

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