With an entering into force of OPRC-HNS started in June 14th 2007, establishment of response system in a nationwide scale to take care of accidents is required to respond rapidly and effectively. This necessities drove us to analyze national contingency plan for chemicals including national response system against accidents, which is in operation in the US. Main characteristics of the system are well described as an integrated incident command system with a cooperation of responsibilities facilities, manpower, and technical support. In addition, state anψor local authorities tend to have responsibilities on management of disaster with its response activities. Polluters are also charged to pay expenses 3 times expensive provided state or local authorities are conducted. In general, response activities are conducted by private sectors. However, the government will take action with Superfund if the response capacity is over than the polluters can. However, safety are regarded as a primary factor to be considered in the response activities, and try not to recover any pollutants. Personals belonging to USCG and EPA are required to complete specialized courses to promαe professional skills, and are also welcomed to participate in "certification program"
Background: Measurement of body temperature is an important parameter in patient management in many clinical conditions. Failure to reach minimal acceptable body temperature standards has been associated with physiological derangements and has necessitated the application of additional therapy. The authors developed a new, simple, accurate thermometry system, which could be used to undertake precise temperature measurement for various clinical conditions. Materials and Methods: A new thermometry system using a specially designed temperature detecting and display system was developed. This system contains a temperature detecting sensor(LM 35CZ), which enables multiple serial checking of heat, data collection and processing computer, and 3-dimensional display system. It provides real time volumetric visualization of temperature distribution of a defined volume and stores and prints the data. Results: With this system, temperature can be measured at multiple interesting sites simultaneously, demonstrated as a 3-dimensional temperature distribution and stored. In well-controlled, systematic experiments a significant correlation has been observed between standard temperature and temperature using this system at various measuring points. Conclusion: This thermometry system is a real-time measurement system, which can demonstrate 3-dimensional heat distribution in experimental phantom and human body and can be used for diagnosing abnormal clinical conditions. In addition, this system reduces the nursing staff work load, providing them more time for long term care to patients.
Objective: The aim of this study was to evaluate predictive role of risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Methods: This retrospective study was conducted with a total of 569 patients with adnexal masses/ovarian cysts managed surgically at our clinic between January 2006 and January 2012. Obtained data from patient files were age, gravidity, parity, menopause status, ultrasound findings and CA125 levels. For all patients ultrasound scans were performed. For the assessment of risk of malignancy index (RMI) Jacobs' model was used. Histopathologic results of all patients were recorded postoperatively. Malignancy status of the surgically removed adnexal mass was the gold standard. Results: Of the total masses, 245 (43.1%) were malignant, 316 (55.5%) were benign and 8 (1.4%) were borderline. The mean age of benign cases was lower than malign cases ($35.2{\pm}10.9$ versus $50.8{\pm}13.4$, p<0.001). Four hundred and five of them (71.2%) were in premenopausal period. Malignant tumors were more frequent in postmenopausal women (81% versus 29%, p<0.001). All ultrasound parameters of RMI were statistically significantly favorable for malignant masses. In our study ROC curve analysis for RMI provided maximum Youden index at level of 163.85. When we based on cutoff level for RMI as 163.85 sensitivity, specificity, PPV, NPV was calculated 74.7%, 96.2%, 94% and 82.6%, respectively. Conclusions: RMI was found to be a significant marker in preoperative evaluation and management of patients with an adnexal mass, and was useful for referring patients to tertiary care centers. Although utilization of RMI provides increased diagnostic accuracy in preoperative evaluation of patient with an adnexal mass, new diagnostic tools with higher sensitivity and specificity are needed to discriminate ovarian cancer from benign masses.
Background: Platinum based concurrent chemo-radiation is the de-facto standard of care in the non-surgical management of locally-advanced head and neck cancer of squamous origin. Three-weekly single agent cisplatin at 100 $mg/m^2$ concurrent with radical radiotherapy has demonstrated consistent improvement in loco-regional control and survival. This improvement is however at the cost of considerable hematologic toxicity and poor overall compliance. The routine use of this regime is improbable in developing countries with limited resources. We therefore aimed to determine the safety and efficacy of an alternative regime of weekly cisplatin and concurrent radiotherapy in such patients. Materials and Methods: January-05 and April-12, 188 patients of locally-advanced head and neck cancer of squamous origin were treated with concurrent weekly-cisplatin at $35mg/m^2$ and conventional radiotherapy 60-66Gy/30-33 fractions/5days per week. Results: Overall, 95% patients received planned doses of RT while 74% completed within the stipulated overall treatment time of <50 days. Eighty-two percent received at-least 5 weekly cycles. Grade-III/IV mucositis was seen in 58%/9% respectively, which resulted in mean weight loss of 9.2% from a pre-treatment mean of 54.5 kg. Grade-III hematologic toxicity-0.5%; grade II nephrotoxicity-2.5% and grade III emesis-3% were also seen. Grade-III/IV subcutaneous toxicity-10%/1% and grade-III/IV xerostomia-10%/0% were observed. Complete responses at the primary site, regional nodes and overall disease were seen in 86%, 89% and 83% patients respectively. The median and 5-years disease-free survival were 26 months and 39.4% respectively, while the median and overall survival were 27 months and 41.8% respectively. Conclusions: Weekly-cisplatin at 35 $mg/m^2$ when delivered concurrently with conventional radical RT (at-least 66y/33 fractions) in locally-advanced head and neck cancer is well tolerated with minimal hematologic and neprologic toxicity and can be routinely delivered on an out-patient basis. It is an effective alternative to the standard 3-weekly cisplatin especially in the context of developing countries.
The purpose of this descriptive and comparative study was to examine gender differences relevant to pain intensity, opioid prescription patterns and opioid consumption in Taiwanese oncology outpatients. The 92 participants had been prescribed opioid analgesics for cancer-related pain at least once in the past week and were asked to complete the Brief Pain Inventory - Chinese questionnaire and to recall the dosage of each opioid analgesic that they had ingested within the previous 24 hours. For opioid prescriptions and consumption, all analgesics were converted to morphine equivalents. The results revealed a significant difference between males and female minimum pain thresholds (t = 2.38, p = 0.02) and current pain thresholds (t = 2.12, p = 0.04), with males reporting a higher intensity of pain than females. In addition, this study found that males tended to use prescribed opioid analgesics more frequently than females on the bases of both around the clock (ATC) (t = 1.90, p = 0.06) and ATC plus as needed (ATC + PRN) (t = 2.33, p = 0.02). However, there was no difference between males and females in opioid prescriptions on an ATC basis (t = 0.52, p = 0.60) or at an ATC + PRN basis (t = 0.40, p = 0.69). The results suggest that there may be a gender bias in the treatment of cancer pain, supporting the proposal of routine examination of the effect of gender on cancer pain management. These findings suggest that clinicians should be particularly aware of potential gender differences during pain monitoring and the consumption of prescribed opioid analgesics.
Purpose: To study the prevalence of CIN2+ diagnosis in women with atypical Papaniculoau (Pap) smears to suggest appropriate management option for Thai health care. Materials and Methods: Data from all patients with liquid based cytology with human papillomavirus (HPV) testing between May 2013 - May 2016 were collected from medical records. Women with atypical cervical Pap smears were recruited. Results for age, HPV testing, HPV 16, 18, 45 and other genotypes tested, colposcopic examination and histopathological assessment were all collected. Atypical smears were defined as atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells cannot be exclude high grade squamous intraepithelial lesion (ASC-H). Results: A total of 2,144 cases were recruited. Twenty six women with ASC-US on cytology had high risk (HR) HPV detection while eight cases with ASC-H had HR-HPV (40.0% VS 72.7%, p=0.005). Among the 26 women with ASC-US cytology and positive HR-HPV, HPV type 16 (n=8, 30.8%), type 18 (n=1, 3.8%), type 45 (n=1, 3.8%) and other HPV types (n=17, 65.4%) were found. Eight women with ASC-H and positive HR-HPV demonstrated type 16 (n=6, 75%) and other HPV types (n=2, 25%). Fifty seven women with ASC-US had normal colposcopy, CIN1 and CIN2+ at percentages of 80.7 (46/57), 14.0 (8/57) and 5.3 (3/57), respectively. In the ASC-H group, 7 out of 10 women had normal colposcopy and three (30%) had CIN2+ results. Conclusions: In women with ASC-US cytology, immediate colposcopy is highly recommended. HPV testing can be performed if colposcopy is not an available option because there was high prevalence (5.3%) of CIN2+ in our findings. ASCCP recommendations for ASC-H that colposcopy should be performed on all ASC-H cases regardless of HPV result are thereby supported by the findings of this investigation.
The Journal of the Convergence on Culture Technology
/
v.6
no.3
/
pp.125-133
/
2020
The purpose of this study is to analysis of the difference between dementia policy perception, dementia knowledge, dementia attitude and dementia prevention behavior of middle-aged. The subjects were 217 middle-aged in their 40 to 64 years old who lived in D and G cities. The mean sore of were dementia policy perception 75.42±8.52, dementia knowledge 8.71±1.90, dementia attitude 28.55±5.10, dementia prevention behavior 27.04±3.35. Dementia knowledge were significant differences in gender, number of diseases, source of dementia information. Dementia attitudes were significant differences in gender, age, education, dementia in family, dementia living together, job status, early examination, source of dementia information. Dementia prevention behavior were significant difference in dementia living together and early examination. The most category of dementia prevention behavior was 'cigarette smoking(Inverse question)', and blood pressure and diabetes management' were the lowest. Therefore, development of a professional and systematic dementia education program to raise the awareness of dementia policy among middle-aged adults and form the right dementia knowledge and positive dementia attitude. Development of customized dementia prevention behavior programs to maintain cognitive activities, social activities, proper eating habits, and health care is needed.
Journal of agricultural medicine and community health
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v.27
no.1
/
pp.125-142
/
2002
This study was carried out to purpose drawing up the efficient method of rural residents' health management, analyzing factors having influences on the behavioral intention and the behavior of hepatitis B vaccination of rural residents, using the theory of planned behavior(TPB). Surveying the first questionnaire about TPB to 439 people of rural adults over 40-year old who participated to hepatitis B examination program was made from March 14 to April 23 in 2001 at two primary health care posts in a city in Gyeongsangbuk-do and the second survey for hepatitis B vaccination was made to the last subjects of 332 people(75.6%) that had been proved as subjects of inoculation against the hepatitis B as the result of examination after two months of notification. In the behavioral intention rate of hepatitis B vaccination of the subjects within a month, 100%(the top) was 45.2%, 80-90%(the middle) was 21.1% and under 70%(the low) was 33.7%. In simple analysis, vaccination intention was related with significantly health security type and economic status(p<0.05). And vaccination intention was related with significantly all variables of attitude toward behavior and subjective norm, and economic power of utilizing medical facilities and perceived power variable of perceived behavioral control(p<0.01). The vaccination rate of the subjects within a month was 31.3%. In simple analysis, the vaccination rate was higher significantly in the lower the age was, the higher the educational level was(p<0.01), the larger the family was, and subjects having transport(p<0.05). And the vaccination rate was higher in the higher the economic power was and the higher the perceived ability was. As the results of making generalized logit analysis for behavioral intention, the more positive the subjective norm was, the higher was the score of the perceived behavioral control, the intention was higher significantly in the top class on a basis of the low class of behavioral intention. In multiple logistic regression analysis for vaccination(behavior) using intention and perceived behavioral control as dependent variables, it showed that perceived behavioral control variable only influenced significantly. The higher was the score of perceived behavioral control, it showed that they got the more vaccination(p<0.01). And even in the result having analyzed, adding the significant general characteristics variables in the simple analysis to the independent variable, the higher was the score of perceived behavioral control, it showed that they got vaccination more.
As the number of elderly grows in today's modern socity, dental hygienist's role is more emphasized than ever before for hygiene management of the aged. It is also find out college students knowledge, attitude and behavior towards the elderly Form March and May 2007 three monthly during collected. This is study conducted through interview with college students who are majoring in dental hygiene of health care in Gyeong-Ju and will be in charge of oral hygiene According to the interview, this study obtains the following results: 1. The level of undergraduate students knowledge of elderly shows a total score of $8.39{\pm}2.80$. 2. The average score of undergraduate students attitude toward elderly is in a neutral range(50~70), recording $55.1{\pm}8.66$ on a scale of 100. 3. The average score of undergraduate students behavior toward elderly is in a neutral range(43~60), recording $28.7{\pm}6.17$on a scale of 85 and showing negative behavior. 4. Participating in volunteer job lead the significant differences in undergraduate students attitude toward elderly. 5. Participating in volunteer job lead the significant differences in undergraduate students behavior toward elderly, That is undergraduate students volunteer job with the show a positive behavior towards elderly.
This study was done to identify the relationships between nursing practice stress and stress coping for the nursing students in Korea. Data were collected at 2 universities located in C city in Korea. Participants were 160 nursing students. Data were analyzed by SPSS 18.0 using descriptive statistics and Pearson's correlation coefficient. Nursing practice stress was $2.72{\pm}6.2$. Stress coping was $2.60{\pm}0.37$. Stress was correlated with wishful thinking coping strategy when doing orientation (r=0.32, p<0.01), conference(r=0.52, p<0.01), homework(r=0.29, p<0.01). Stress for practice exam was correlated with problem focused coping strategy(r=0.31, p<0.05). Stress was correlated with positive view coping strategy when face nurse(r=0.31, p<0.01) or interpersonal relations(r=0.35, p<0.01). Stress related to practice environment and class was correlated with indifference (r=0.26, p<0.01) and tension relieve strategy (r=0.28, p<0.01). There's no stress when they meet or serve direct care to patients. Students managed the stress by showing active coping pattern. It is considered that the experience gave students an excellent capacity to cope with stress. Since the degree of stress and coping pattern can differ from adaptability of situation, a research of change in clinical training stress by seasonal clinical training and coping patter is proposed.
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