• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4427-4430
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• 2012

Breast cancer is the most common cancer and the leading cause of cancer death among women in Malaysia. Despite the campaigns undertaken to raise the awareness of the public regarding breast cancer, breast cancer screening rates are still low in the country. The community pharmacist, as one of the most accessible healthcare practitioners, could play a role in the provision of breast cancer health promotion services to the community. However, there are no documented data regarding the community pharmacists' involvement in breast cancer related health promotion activities. Hence, this study was conducted to examine self-reported knowledge, practice and perception of community pharmacists on provision of breast cancer health promotion services and to investigate the barriers that limit their involvement. This cross-sectional survey conducted between May to September 2010, included a sample of 35 community pharmacists working in the districts of Hulu Langat and Sepang in state of Selangor. A 22-item validated questionnaire that included both closed and Lickert scale questions was used to interview those pharmacists who gave their informed consent to participate in the study. The data was analysed using SPSS. Only 11.3% of the community pharmacists answered all the questions on the knowledge section correctly. The mean overall knowledge of the community pharmacists on risk factors of breast cancer and screening recommendations is 56%. None of the respondents was currently involved in breast cancer health promotion activities. Lack of time (80%), lack of breast cancer educational materials (77.1%) and lack of training (62.9%) were the top three mentioned barriers. Despite these barriers, 94.3% (33) of the community pharmacists agreed that they should be involved in breast cancer health promotion activities. Hence, there is need to equip community pharmacists with necessary training and knowledge to enable them to contribute their share towards prevention and screening of breast cancer.

• 비파괴검사학회지
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• 제24권2호
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• pp.186-196
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• 2004

각 국의 법령에서는 원자력발전소에서 발생할 수 있는 사고로부터 국민의 건강과 재산을 보호하기 위해 원자력발전소의 압력경계 주요 용접부 등에 대해서는 주기적으로 열화의 정도를 파악하기 위한 가동중 비파괴검사를 수행하도록 규정하고 있으며, 이를 뒷받침하기 위한 가동중검사 기술기준을 제정하여 이행하고 있다. 최근 리스크를 반영한 가동중검사 프로그램을 개발하여 적용을 시도하고 여지만, 기존의 결정론적 검사대상 선정 프로그램은 아직도 상당한 의미가 있다고 할 수 있다. 본 논문에서는 가동중검사에 관한 선진국 즉 미국, 프랑스, 캐나다, 일본 등의 기술기준과 IAEA에서 제시하는 안전지침의 비교검토를 통하여 현재 국내 가동중검사 기술기준의 개선방안을 모색하고자 하였다.

• 대한한의학회지
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• 제30권3호
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• pp.98-105
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• 2009

Objective: Increased aortic and carotid arterial augmentation index (AI) is associated with the risk of cardiovascular disease. The most widely used approach for determining central arterial AI is by calculating the aortic pressure waveform from radial arterial waveforms using a transfer function. But how the change of waveform by applied pressure and the pattern of the change rely on subject's characteristics has not been recognized. In this study, we use a new method for measuring radial waveform and observe the change of waveform and the deviation of radial AI in the same position by applied pressure. Method: Forty-six non-patient volunteers (31 men and 15 women, age range 21-58 years) were enrolled for this study. Informed consent in a form approved by the institutional review board was obtained in all subjects. Blood pressure was measured on the left upper arm using an oscillometric method, radial pressure waves were recorded with the use of an improved automated tonometry device. DMP-3000(DAEYOMEDI Co., Ltd. Ansan, Korea) has robotics mechanism to scan and trace automatically. For each subject, we performed the procedure 5 times for each applied pressure level. We could thus obtain 5 different radial pulse waveforms for the same person's same position at different applied pressures. All these processes were repeated twice for test reproducibility. Result: Aortic AI, peripheral AI and radial AI were higher in women than in men (P<0.01), radial AI strongly correlated with aortic AI, and radial AI was consistently approximately 39% higher than aortic AI. Relationship between representative radial AI of DMP-3000 and peripheral AI of SphygmoCor had strongly correlation. And there were three patterns in change of pulse waveform. Conclusion: In this study, it is revealed the new device was sufficient to measure how radial AI and radial waveform from the same person at the same time change under applied pressure and it had inverse-proportion to applied pressure.

• 간호행정학회지
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• 제21권3호
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• pp.327-339
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• 2015

Purpose: This study was done to identify the experiences of ethical issues and needs for ethics education in clinical nurses. Methods: A cross-sectional survey was used and data were collected in 2013. Participants were 428 clinical nurses working in the general units of seven medical hospitals. The Ethical Issues in Clinical Practice Tool was used. Data analysis was performed using SPSS/WIN 19.0. Results: 'Providing care with a possible risk to your health' was the most frequent and disturbing ethical problems for nurses. The highest helpful ethical topic was 'the patients' right, autonomy and informed consent'. The ethical issue experience was significantly different according to education level, work units, and type of employment. The necessity of ethics education was statistically different according to age, religion, level of education, duration of working as RN, position, shift type, and continuing education about nursing ethics. Conclusion: The results of this study show that nursing educators need to provide practical ethics education based on frequent ethical issues and helpful education topics. These findings can be used in developing effective education strategies for clinical nurses and nursing organizations to improve nurses' ethical decision-making abilities.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8473-8477
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• 2016

Background: High risk human papilloma virus (HPV) types 16 and 18 have been proven as central causes of cervical cancer and safety and immunogenicity of HPV vaccines are sufficiently established. Knowledge and practices of HPV vaccination among medical and paramedical students is vital as these may strongly determine intention to recommend vaccination to others in the future. The present study was therefore undertaken to assess the knowledge, attitude and practices regarding cervical cancer screening and HPV vaccination among medical and paramedical students and to analyze factors influencing them. Materials and Methods: The present cross sectional study, conducted in a tertiary care teaching hospital in south India, included undergraduate students aged 18 years and above, belonging to medical, dental and nursing streams, after informed written consent. Results: Out of 957 participants, only 430 (44.9%) displayed good knowledge and only 65 (6.8%) had received HPV vaccination. Among the unvaccinated, 433 (48.54%), were not willing to take the vaccine. Concerns regarding the efficacy (30.5%), safety (26.1%) and cost of the vaccine (21.7%) were responsible for this. Age, gender, family history of malignancy and mother's education had no influence on knowledge. Compared to medical students, nursing students had better knowledge (OR-1.49, 95% CI 0.96 to 2.3, p = 0.072) and students of dentistry had poor knowledge (OR-0.50 95% CI 0.36 to 0.70, p<0.001). Conclusions: The knowledge and uptake of HPV vaccination among medical and paramedical students in India is poor. Targeted health education interventions may have huge positive impact not only on the acceptance of vaccination among them, but also on their intention to recommend the vaccine in future.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1675-1682
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• 2012

Aim: The study aim was to determine the frequency with which women decline clinicians' treatment recommendations and variations in this frequency by age, cancer and service descriptors. Design: The study included 36,775 women diagnosed with early invasive breast cancer in 1998-2005 and attending Australian and New Zealand breast surgeons. Rate ratios for declining treatment were examined by descriptor, using bilateral and multiple logistic regression analyses. Proportional hazards regression was used in exploratory analyses of associations with breast cancer death. Results: 3.4% of women declined a recommended treatment of some type, ranging from 2.6% for women under 40 years to 5.8% for those aged 80 years or more, and with parallel increases by age presenting for declining radiotherapy (p<0.001) and axillary surgery (p=0.006). Multiple regression confirmed that common predictors of declining various treatments included low surgeon case load, treatment outside major city centres, and older age. Histological features suggesting a favourable prognosis were often predictive of declining various treatments, although reverse findings also applied with women with positive nodal status being more likely to decline a mastectomy and those with larger tumours more likely to decline chemotherapy. While survival analyses lacked statistical power due to small numbers, higher risks of breast cancer death were suggested, after adjusting for age and conventional clinical risk factors, (1) for women not receiving breast surgery for unstated reasons (RR=2.29; p<0.001); and (2) although not approaching statistical significance $p{\geq}0.200$), for women declining radiotherapy (RR=1.22), a systemic therapy (RR1.11), and more specifically, chemotherapy (RR=1.41). Conclusions: Women have the right to choose their treatments but reasons for declining recommendations require further study to ensure that choices are well informed and clinical outcomes are optimized.

• Nuclear Engineering and Technology
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• 제47권2호
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• pp.204-211
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• 2015

Probabilistic safety assessment (PSA) has had a significant role in quantitative decision-making by finding design and operational vulnerabilities and evaluating cost-benefit in improving such weak points. In particular, it has been widely used as the core methodology for risk-informed applications (RIAs). Even though the nature of PSA seeks realistic results, there are still "conservative" aspects. One of the sources for the conservatism is the assumptions of safety analysis and the estimation of failure frequency. Surveillance, diagnosis, and prognosis (SDP), utilizing massive databases and information technology, is worth highlighting in terms of its capability for alleviating the conservatism in conventional PSA. This article provides enabling techniques to solidify a method to provide time- and condition-dependent risks by integrating a conventional PSA model with condition monitoring and prognostics techniques. We will discuss how to integrate the results with frequency of initiating events (IEs) and probability of basic events (BEs). Two illustrative examples will be introduced: (1) how the failure probability of a passive system can be evaluated under different plant conditions and (2) how the IE frequency for a steam generator tube rupture (SGTR) can be updated in terms of operating time. We expect that the proposed model can take a role of annunciator to show the variation of core damage frequency (CDF) depending on operational conditions.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3805-3809
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• 2014

Background: In Mexico, breast cancer (BCa) is the leading type of cancer in women. Cytochrome P450 (CYP450) is a superfamily of major oxidative enzymes that metabolize carcinogens and many antineoplastic drugs. In addition, these enzymes have influence on tumor development and tumor response to therapy. In this report, we analyzed the protein expression in patients with BCa and in healthy women. Links with some clinic-pathological characteristic were also assessed. Materials and Methods: Immunohistochemical analyses were conducted on 48 sets of human breast tumors and normal breast tissues enrolled in Hospital Militar de Especialidades de la Mujer y Neonatologia and Hospital Central Militar, respectively, during the time period from 2010 to 2011. Informed consent was obtained from all participants. Statistical analysis was performed using ${\chi}^2$ or Fisher exact tests to estimate associations and the Mann Whitney U test for comparison of group means. Results: We found a significant CYP3A4 overexpression in BCa stroma and gland regions in comparison with healthy tissue. A significant association between protein expression with smoking, alcoholism and hormonal contraceptives use was also observed. Additionally, we observed estrogen receptor (ER) and progesterone receptor (PR) positive association in BCa. Conclusions: We suggest that CYP3A4 expression promotes BCa development and can be used in the prediction of tumor response to different treatments. One therapeutic approach may thus be to block CYP3A4 function.

• 토지주택연구
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• 제7권4호
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• pp.315-322
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• 2016

최근 국토교통부는 실시설계 단계에서 설계의 안전성 검토를 실시할 수 있도록 건설기술진흥법을 일부 개정하였다. 설계의 안전성 검토에서 위험성을 판단하기 위해서는 단위작업별 재해의 발생빈도수와 심각성을 파악해야 한다. 따라서 본 연구에서는 ${\bigcirc}{\bigcirc}$ 공사의 건설재해자료(471건)를 24개 단위작업으로 분류하고, 각 단위작업별 재해발생 빈도수 및 심각성을 분석하였다. 그 결과를 토대로 단위작업별 안전관리 수준을 3개 그룹(특별관리, 중점관리, 상시 관리)으로 제안하였다. 본 연구결과는 건설공사에서 설계의 안전성 검토를 하는데 있어 기초정보로 활용될 수 있을 것이다. 또한 이 정보를 활용하여 재해발생률을 저감시킬 수 있을 것으로 판단된다.

• 한국화재소방학회논문지
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• 제30권4호
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• pp.20-26
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• 2016

원자력발전소의 화재방호 목적은 예방, 화재의 진압 및 영향을 완화하는 데 있으며, 화재가 발생하면 원자로를 안전하게 정지하여 유지하고 환경으로 방사성물질의 유출을 최소화하는 것이다. 미국의 원자력규제위원회는 10CFR50.48과 10CFR50 APP.R을 발행한 이래 지난 20여년간 화재방호와 관련하여 많은 일반 통신문(Generic Communications)을 발행하였으며, 미국원전 발전사업자(Nuclear Energy Institute)에서는 회로고장 해결을 위한 다중오동작과 관련된 결정론적 방법 등을 사용과 연계하여 위험도정보를 활용한 화재 안전정지분석 방법론을 개발하였다. 본 논문에서는 중수로원전의 주제어실 화재시 화재안전정지분석 방법론을 적용하여 안전정지용 한 계열의 안전관련 계통 및 기기가 손상되어도 원자로의 사고 후 안전정지를 달성하고 유지함을 확인하였다.