• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.336-342
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• 2014

Objectives: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Methods: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. Results: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). Conclusions: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제20권2호
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• pp.76-81
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• 2009

Ovjectives: As the attention devoted to children's mental health increases, medical costs and burdens mount as well. In the present study, we evaluated the association between socioeconomic status(SES) and major child psychiatric symptoms. Methods: The subjects of this study were children of recruited from a mental health screening program in the Seoul Sungbuk mental health center over the course of 3 months. To establish the SES of each child, we collected data about each child's medical insurance, years of parental education, household income, family structure and housing. 149 children & parents completed questionnaires including the Childhood Depression Inventory(CDI) and the Korean Attention Deficit Hyperactivity Disorder Rating Scale(K-ARS). Results: The mean K-ARS-P score was $12.1{\pm}11.1$ and the suspected prevalence of ADHD was 20.8%(n=31). The mean cm score was $12.9{\pm}7.9$, and the prevalence of suspected depression was 16.8%(25). Depressive symptoms and ADHD symptoms were both more severe than those observed in a previous epidemiologic study in Korea. Depressive symptoms were more closely associated with family SES status. Conclusion: SES status is one of the most important risk factors in the development of major child psychiatric symptoms. In our study we found that depressive symptoms in particular were most tightly associated with psychosocial factors. Evaluation of the risk factors, early screening and intervention for low SES children would be valuable mental health management tactics to implement in a community mental health system.

• The Journal of Korea Assosiation for Disability and Oral Health
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• 제14권1호
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• pp.31-35
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• 2018

Dentinogenesis imperfecta is a hereditary disorder that causes abnormal dentin formation and tooth morphology. Affected teeth show very thin dentin and large pulp chamber. Immediately after their eruption, the teeth tend to be destroyed rapidly. Early dental intervention is recommended to improve the feeding capacity and quality of life for the child, to maintain vertical dimension, and to promote healthy and functional dentition. This case report describes a treatment for a 4-year-2-month-old girl whose primary and permanent dentition were affected by Dentinogenesis Imperfecta. Shell teeth were observed in the entire primary dentition. The pulp of most teeth was exposed and the patient complained of pain. Most paternal family members were transferred to the Dentinogenesis Imperfecta. She needed an extensive dental treatment, but her compliance could not be expected because she was very young and anxious. So we decided to treat her under general anesthesia. All molar teeth are restored with Stainless Steel crown. Maxillary anterior teeth were extracted and mandibular anterior teeth are restored with composite resin. The patient's pain disappeared and masticatory function was restored.

• Advances in pediatric surgery
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• 제20권1호
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• pp.17-22
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• 2014

The aim of this study was to identify the risk factor related to the need for operative treatment and avoid unnecessary non-operative management for intussusception in children. We retrospectively reviewed medical records of patient treated for intussusception at our institution between January 2006 and January 2013. Clinical features such as gender, age, seasonal variation, symptoms and signs, treatment results were analyzed. Univariate and multivariate analyses including a chi-square test for categorical variables and logistic regression analysis were performed. During the study period, 356 patients were treated for intussusception. 328 (92.1%) was treated successfully by the non-operative pneumoreduction, and 28 (7.9%) required operative management. On univariate analysis, risk factors which were related to the need for operative treatment were age, vomiting, bloody stool, lethargy, and symptoms duration. A logistic regression analysis in order to assess for independent predictors of operative treatment was performed. Age (<6 vs ${\geq}12$ months) (OR 4.713, 95% CI 1.198~18.539, p=0.027) and symptoms duration longer than 48 hours (OR 4.534, 95% CI 1.846~11.137, p=0.001) were significantly associated with a requirement for operative treatment. We conclude that younger age and a longer duration of symptoms (${\geq}48$ hours) are the independent risk factor related to the need for operative treatment for intussusception. Early surgical intervention or transfer to a hospital with pediatric surgical capabilities should be considered for patients with these findings.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5817-5823
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• 2013

Background: It is important to understand the perceptions of oncologists to understand the comprehensive picture of clinical presentation of breast cancer. In the absence of clear evidence, clinical practice involving patients of breast cancer in India should provide insights into stages of breast cancer with which women present to their clinics and mode of screening of breast cancer prevalent in Andhra Pradesh. Materials and Methods: A qualitative study was conducted to understand the perceptions of oncologists regarding clinical presentation of breast cancer, stages at which women present to clinics, and mode of screening of breast cancer prevalent in Andhra Pradesh. In-depth interviews (IDI) were conducted with ten practising oncologists from various public and private cancer hospitals in Hyderabad city to understand their perspectives on breast cancer and screening. The data were triangulated to draw inferences suitable for the current public Health scenario. Results: Late presentation was indicated as the most important cause of decreased survival among women. Most women present at Stage 3 and 4 when there is no opportunity for surgical intervention. The results indicate that there is a huge gap in awareness about breast cancer, especially in rural areas and among poor socioeconomic groups. Even despite knowledge, most women delay in reporting due to reasons like fear, embarrassment, cost, ignorance, negligence, and easy going attitude. Conclusions: It is important to improve awareness about breast cancer and screening methods for promoting early screening. The study inferred that it would be beneficial to establish cancer registries in rural areas. Also, the policymakers need to make key decisions which among three methods (breast self examination (BSE), clinical breast examination and mammography) can best be used as a screening tool and how to successfully implement population wide screening program to prevent mortality and morbidity from breast cancer in India.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4591-4594
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• 2013

Breast cancer is the most common cancer among Malaysian women. Other than hospital-based results, there are no documented population-based survival rates of Malaysian women for breast cancers. This populationbased retrospective cohort study was therefore conducted. Data were obtained from Health Informatics Centre, Ministry of Health Malaysia, National Cancer Registry and National Registration Department for the period from $1^{st}$ January 2000 to $31^{st}$ December 2005. Cases were captured by ICD-10 and linked to death certificates to identify the status. Only complete data were analysed. Survival time was calculated from the estimated date of diagnosis to the date of death or date of loss to follow-up. Observed survival rates were estimated by Kaplan-Meier method using SPSS Statistical Software version 17. A total of 10,230 complete data sets were analysed. The mean age at diagnosis was 50.6 years old. The overall 5-year survival rate was 49% with median survival time of 68.1 months. Indian women had a higher survival rate of 54% compared to Chinese women (49%) and Malays (45%). The overall 5-year survival rate of breast cancer patient among Malaysian women was still low for the cohort of 2000 to 2005 as compared to survival rates in developed nations. Therefore, it is necessary to enhance the strategies for early detection and intervention.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1225-1233
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• 2015

This study aims to clarify the psychosocial reactions of female patients with gynecological cancer undergoing chemotherapy and in the process of suffering from alopecia and to examine their nursing support. The target group comprised female patients who had received two or more cycles of chemotherapy, were suffering from alopecia, and were aged 30-65. Data were collected from semi-structured interviews, conducted from the time the patients were informed by their doctors that they might experience alopecia due to chemotherapy to the time they actually experienced alopecia and until they were able to accept the change. Inductive qualitative analysis was employed to close in on the subjective experiences of the cancer patients. The results showed the existence of six phases in the psychosocial reactions in the process of alopecia: phase one was the reaction after the doctor's explanation; phase two was the reaction when the hair starts to fall out; phase three was the reaction when the hair starts to intensely fall out; phase four was the reaction when the hair has completely fallen out; phase five was the reaction to behavior for coping with alopecia; and phase six was the reaction to change in interpersonal human relationships. The results also made it clear that there are five types of reaction patterns as follows: 1) treatment priority interpersonal relationship maintenance type; 2) alopecia agitated interpersonal relationship maintenance type; 3) alopecia agitated interpersonal relationship reduction type; 4) alopecia denial interpersonal relationship reduction type; and 5) alopecia denial treatment interruption type. It is important to find out which of the five types the patients belong to early during treatment and provide support so that nursing intervention that suits each individual can be practiced. The purpose of this study is to make clear the process in which patients receiving chemotherapy come to accept alopecia and to examine evidence-based nursing care on patients with strong mental distress from alopecia.

• The Journal of the Korea Contents Association
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• 제13권1호
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• pp.234-246
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• 2013

Microcredit was first introduced by non-profit organization in early 2000s and the Ministry of Health and Welfare promoted the support policy of self-support community and the hope-developing bank. And then, microcredit policy was suddenly changed while the microfinance policy was promoted in 2009. For example, there were changes of the control tower of the policy, the emphasis on financial approach from welfare approach, the establishment of the operation agency. This study analyzed the policy changes on microcredit policy using the framework of Hood(1994) and Joo(1999) in order to analyze causes of sudden changes. As results, the reason affecting microcredit policy change was changes of an unemployment rate and the financial environment, the change of outside situation, the policy idea of the middle practicalism of government and the success of the experiment in microcredit, the passive intervention of stakeholders, the internal factors on the policy custom. So the results suggests that the policy is produced illogically because of the absence of stakeholders' participation.

• Journal of Korean Medical classics
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• 제26권1호
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• pp.27-38
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• 2013

Objective : This article shows that while Seishu Hanaoka(華岡靑洲) is known to have developed an effective anesthetic formula composed of traditional herbs and performed the world first partial mastectomy under a general anesthesia in 1804, anesthetic formulas very similar to those developed by him were widely recorded and deemed used in Japan and Northeast Asia before his invention. The origin of the formulas will be tracked down to compare with the several formulas broadly administered in the region. Methods : Historical literature analysis was adopted to achieve the objective. 1. Mayaku-ku (麻藥考): this book is the main medical classic by Nakagawa Syutei(中川修亭) that introduces Seishu Hanaoka, his anesthetic formulas and mastectomy. 2. Northeast medical classics: Seuideukhyobang (世醫得效方) in 1337, Uibangryuchui (醫方類聚), Uihui(宜彙) and so on. Result : Herbs such as aconitum and datura were applied as a anesthetic agent early on before the Chinese Yuan dynasty. In Korea as well, some old medical books documented such use of those herbs and relevant formulas. Conclusion : Formulas that counted as invented and employed by Seishu Hanaoka as anesthetics, in fact, had been widely known and used in the region before his era. We should pay due attention to his creativity that combined a western surgical intervention and traditional anesthetic agents and successfully performed a newly introduced surgical practice in Japan. The point is that Hanaoka took note of anesthetic herbs or formulas traditionally inherited in North-east Asian medicine and successfully applied them to the surgical procedures for breast cancer, or mastectomy and mammotomy. This history alerts us to neglected or forgotten potentials of traditional medicine in anesthetic treatment and more.

• Journal of Korean Academy of Nursing
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• 제22권3호
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• pp.271-296
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• 1992

The purposes of this study were 1) to identify patterns and trends of studies of anxiety and stress and 2) to provide direction on which to base further research. Research studies of anxiety and stress were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, Monthly Nurse, and from theses and dissertations, which had been conducted for the 20 years from 1970 to 1990. The total population of the studies numbered 463. Seven studies were excluded from the analysis because of duplication, so that 252 studies of anxiety and 204 of stress were analyzed. These studies were analyzed for 1) time of publication or presentation, 2) research design, 3) characteristics of subjects used in each study, 4) types of correlated variables, and 5) types of nursing interventions. Findings obtained in the study were as follows : 1. The number of studies related to anxiety and stress has increased rapidly since the early 1980's. 2. The studies were primarily descriptive throughout the 20 years. However, correlational studies, comparative studies and experimental studies slowly increased. 3. Anxiety studies tend to be conducted more on patients and stress studies with normal subjects in non - experimental research. However, experimental studies were conducted more with patients than with normal subjects. 4. In correlational studies, the trend was to study physical conditions in relation to anxiety, and coping and adaptation in relation to stress. 5. In experimental studies, teaching and information therapy and relaxation were the most popular interventions for anxiety, and supportive care for stress. On the bases of these findings, the following recommendations were made : 1. These patterns of studies related to anxiety and stress in Korea need to be compared with studies conducted in other countries. 2. More attention is needed in terms of research design, reliability and validity of tools, and results of statistical analysis. 3. Meta -analysis should be done to analyze and integrate the results of various studies. 4. For theory testing and identification of useful intervention methods, experimintal studies with the same protocols must be conducted rather than more descriptive studies.