• 대한간호학회지
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• 제13권1호
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• pp.7-21
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• 1983

For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5％ 10％ 20％ 30％ 40％ 50％ 60％ Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

• 대한후두음성언어의학회지
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• 제29권1호
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• pp.37-40
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• 2018

Background and Objectives : This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. Materials and Methods : The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. Results : Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p<0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p<0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). Conclusion : Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.

• 대한간호
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• 제31권2호
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• pp.51-69
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• 1992

Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

• 의학교육논단
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• 제17권3호
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• pp.110-121
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• 2015

Competency-based medical education (CBME) is an outcome-oriented curriculum model for medical education that organizes learning activities and assessment methods according to defined competencies as the learning outcomes of a given curriculum. CBME emerged to address the accountability of medical education in response to growing concerns about the patient safety in North America in the 1970s, and the number of medical schools adopting CBME has dramatically increased since 1990. In Korea, CBME has been under consideration as an alternative curriculum model to reform medical education since 2006. The purpose of this paper is three-fold: (1) to review the literature on CBME to identify the challenges and benefits reported in North America, (2) to summarize the process and experiences of planning and implementing CBME at Inje University College of Medicine, and finally (3) to provide recommendations for Korean medical schools to be better prepared for the successful adoption of CBME. In conclusion, one of the key factors for successful CBME implementation in Korea is how well an individual school can modify the current curriculum and rearrange the existing resources in a way that will enhance students' competencies while maximizing the strengths of the school's existing curriculum.

• 한국환경복원기술학회지
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• 제27권3호
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• pp.45-56
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• 2024

Heavy metals emitted from urban development do not decompose in the soil and remain for long periods, continually impacting the environment. Since the mid-1990s, there has been increasing societal concern in South Korea regarding soil contamination, prompting various legislative revisions to reduce pollution. This study utilizes the Environmental Impact Assessment Support System (EIASS) to investigate projects in the metropolitan area that have exceeded the Ministry of Environment's soil contamination concern levels from 1989 to 2022 and to examine improvements in the environmental impact assessment (EIA) process. The results reveal that the average concentrations of nine contaminants-cadmium (Cd), copper (Cu), arsenic (As), mercury (Hg), lead (Pb), hexavalent chromium (Cr6+), zinc (Zn), nickel (Ni), and fluoride (F)-have all increased over the years. Among these, Zn had the highest relative proportion, with 37.5% of the 40 sites exceeding environmental concern levels. Investigation of 19 specific projects at these exceedance sites showed that only 7 had documented analyses of contamination causes and remediation plans, and just one had contracted additional remediation services, though results from these efforts were found to be lacking. Furthermore, since 2019, a significant proportion of these sites were involved in residential developments, likely due to government initiatives in new city development and extensive housing supply plans. This research emphasizes the importance of public disclosure of the processes and outcomes of remediation efforts on historically contaminated soils prior to project development. It discusses improvements to the EIA by reviewing current legislation and international examples. The findings of this study are expected to heighten public awareness about heavy metal contamination and enhance transparency in soil remediation efforts, contributing to sustainable environmental management and development.

• 환경영향평가
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• 제33권2호
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• pp.53-63
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• 2024

생물다양성은 환경영향평가 제도의 목표에 중요한 부문으로, 개발대상지 입지 선정, 주변 환경 파악 및 교란으로 인한 생물종 영향 등에서 활용되고 있다. 환경영향평가 분야에서 새로운 기술과 모델을 활용하여 생물다양성을 보다 정확하게 평가하고 예측하는 방안에 대한 연구가 많이 진행되고 있다. 비록 현장, 문헌조사를 통한 데이터를 바탕으로 종 풍부도 지수를 평가하고 있으나, 현장 데이터는 시·공간적으로 미흡하므로 고해상도의 종 풍부도 매핑을 통한 기초자료를 활용함으로서, 모니터링 실효성 문제 해결이 필요하다. 따라서 본 연구에서는 제4차 전국자연환경조사 데이터와 환경변수를 바탕으로 Random forest 모델을 활용하여 종 분포모형을 개발하였다. 해당 모델은 24종의 포유류 종 분포 매핑 결과를 species richness index를 활용하여 100m 해상도의 종 풍부도 매핑 결과를 도출하였다. 연구 결과, 종 분포모형은 평균 0.82의 AUC값으로 우수한 예측 정확도를 보였다. 또한, 전국자연환경조사 데이터와 비교결과, 고 해상도의 종 풍부도 매핑 결과의 종 풍부도 분포는 정규분포의 형태를 가지고 있어 환경영향평가에서의 기초자료로 사용함에 있어 신뢰성이 높다. 본 연구의 분석결과는 추후 도시개발과 사업을 함에 있어 생물다양성 평가, 서식지 보전 등에 새로운 참고자료로 활용될 수 있을 것으로 사료된다.

• 대한통합의학회지
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• 제11권2호
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• pp.49-60
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• 2023

Purpose : We aimed to evaluate the impact of a exercise with kinect-based mixed reality device (KMR) on physical function, upper extremity disability, fatigue, and quality of life in breast cancer survivors. We hypothesized that this exercise program would improve physical function, physical activity, fatigue, and quality of life. Methods : Thirty-nine breast cancer survivors were randomized to either the KMR exercise group (KE) or the home stretch group (HS). The KE participated in 8 weeks of exercise, exercising 3 times per week, while the HS performed 8 weeks of stretching exercises, also 3 times per week. Before and after the intervention period, participants underwent assessments of physical function, including body composition, chester step test (CST), and hand grip strength (HGS). Additionally, participants completed questionnaires including the international physical activity questionnaire (IPAQ), disabilities of the arm, shoulder and hand (DASH) questionnaire, and functional assessment of cancer therapy-breast (FACT-B) questionnaire to measure their physical activity levels, upper extremity disability, and quality of life, respectively. Results : Overall, significant improvements were observed in several shoulder movements, body weight, and physical activity, with no significant interaction effects between groups and time. Furthermore, there was a significant group by time interaction for body weight, left flexion, right flexion, right abduction, and left adduction, as well as for upper extremity disability (K-DASH) and quality of life (FACT-B). Conclusion : In conclusion, the KMR exercise program was found to be effective at improving physical function, upper extremity disability, quality of life, and overall well-being in breast cancer survivors. The significant improvements observed in multiple measures and the significant group by time interactions for various outcomes highlight the potential benefits of this KMR exercise program in promoting a better quality of life for breast cancer survivors.

• 한국보건간호학회지
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• 제35권3호
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• pp.430-447
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• 2021

Purpose: The purpose of this study was to analyze the role and tasks of nurses who were working for the elderly in the visiting health services at the public health centers. Methods: Literature reviews, two rounds of meetings with 5 experts and a two-round Delphi technique with 15 experts were performed in this study. Results: The nurses' role and job analysis revealed 5 roles, 16 duties and, 71 tasks. The nurses' roles, including discovery and registration of households/groups in visiting health service in the community, case manager, administrative management, program planning, operation and evaluation, and development of job competency. Sixteen duties included client registration and management, need assessment and plan establishment, education, consultation and support, seasonal health care, prevention and monitoring of infectious diseases, basic nursing care, chronic disease management, linkage and utilization of resources, team cooperation and coordination, home environment management, monitoring and support for intervention outcomes, evaluation, administrative management, program planning, operation and evaluation, development of professional competency and, adoption of fourth industrial revolution technology. Conclusions: Based on the results, the government should provide sufficient nursing personnel to provide universal preventive health services for the elderly and a job training program to perform these roles well.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.1-10
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• 2016

Background: Many studies regarding task-oriented training have recently demonstrated functional improvement in patients with post-stroke hemiparesis. The task-oriented approach is very diverse, and chronic stroke patients must have access to a sustained systematic treatment program to enhance their walking ability. Objectives: This study aimed to compare the effects of the task-oriented circuit training and treadmill training on walking function and quality of life in patients with chronic stroke. Methods: Fourteen patients with chronic stroke volunteered for this study. The subjects were randomly divided into a task-oriented circuit training group and a treadmill training group with 7 patients in each. Each training regimen was performed for 30 min a day and 3 days a week for 4 weeks. Assessment tools included the Timed Up-and-Go Test (TUGT), 10-m Walk Test, 6-min Walk Test (6MWT), and the Stroke Impact Scale (SIS). Results: The change in results of the TUGT, 6MWT, and SIS measured prior to and following the training regimens appeared to be significantly different between the two groups (p<.05). In addition, after the intervention, significant differences were found for all parameters in the task-oriented circuit training group and for the TUGT, 6MWT, and SIS in the treadmill training group (p<.05). Conclusion: The findings suggest that task-related circuit training and treadmill training may be helpful to improve walking function and quality of life of patients with post-stroke hemiparesis. Additionally, a task-related circuit training program may achieve more favorable outcomes than a treadmill program.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5171-5176
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• 2012

We here performed a systematic review of PBIC literature using terms analysis in a hope of both identifying potential trends and patterns and exploring methods leveraging traditional literature reviews in this specific area. Articles meeting inclusion criteria were retrieved from PUBMED and translated into dichotomized article records representing presence or non-presence of MeSH terms and a metric consisting of numbers of times of co-occurrence between all pairs of terms identified using a self-designed program. The occurrence of and relations among the terms were calculated and visualized using Excel2007 and UCINET respectively. A total of 1,742 terms were identified from 997 articles retrieved. Put in a descending order, the lines representing the times of term occurrence formed a typical hyperbolic curve; when plotted along the x-axis of whole MESH terms, the lines clustered within four specific regions. Comparison of term occurrence between 2002 and 2011 revealed priority changes in population and subjects (from general groups to priority groups), intervention approaches (from medicine to exercise and psychotherapy), methodology and techniques (from cohort studies to randomized controlled trials) and outcomes (from health and mental health to quality of life, depression etc.). Networks of the terms featured a number of closely linked groups of topics including method and questionnaires, therapy and outcomes, survival management, psychological assessment and intervention, behavioral intervention (individual and community oriented). Terms analysis revealed interesting trends and patterns about PBIC publications and both the analysis methods and findings have implications for future research and literature reviews.