• Korean Journal of Radiology
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• v.24 no.6
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• pp.541-552
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• 2023

Objective: Detection of pneumoperitoneum using abdominal radiography, particularly in the supine position, is often challenging. This study aimed to develop and externally validate a deep learning model for the detection of pneumoperitoneum using supine and erect abdominal radiography. Materials and Methods: A model that can utilize "pneumoperitoneum" and "non-pneumoperitoneum" classes was developed through knowledge distillation. To train the proposed model with limited training data and weak labels, it was trained using a recently proposed semi-supervised learning method called distillation for self-supervised and self-train learning (DISTL), which leverages the Vision Transformer. The proposed model was first pre-trained with chest radiographs to utilize common knowledge between modalities, fine-tuned, and self-trained on labeled and unlabeled abdominal radiographs. The proposed model was trained using data from supine and erect abdominal radiographs. In total, 191212 chest radiographs (CheXpert data) were used for pre-training, and 5518 labeled and 16671 unlabeled abdominal radiographs were used for fine-tuning and self-supervised learning, respectively. The proposed model was internally validated on 389 abdominal radiographs and externally validated on 475 and 798 abdominal radiographs from the two institutions. We evaluated the performance in diagnosing pneumoperitoneum using the area under the receiver operating characteristic curve (AUC) and compared it with that of radiologists. Results: In the internal validation, the proposed model had an AUC, sensitivity, and specificity of 0.881, 85.4%, and 73.3% and 0.968, 91.1, and 95.0 for supine and erect positions, respectively. In the external validation at the two institutions, the AUCs were 0.835 and 0.852 for the supine position and 0.909 and 0.944 for the erect position. In the reader study, the readers' performances improved with the assistance of the proposed model. Conclusion: The proposed model trained with the DISTL method can accurately detect pneumoperitoneum on abdominal radiography in both the supine and erect positions.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5011-5017
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• 2012

Background: Overexposure to sunlight in childhood and the adolescent period and associsated sunburns significantly increase the risk of skin cancer in adulthood. In Turkey, the incidence of skin cancer in the general population is 0.8%. The incidence is 0.6% and the mortality rate is 0.4% for men, while these rates are 1.0% and 0.7%, respectively, for women. If skin cancer is found early, its treatment is facilitated. Therefore, personal skin examination is important for early diagnosis. Objectives: Our aim was to determine the effects of training for raising consciousness among adolescents to protect against skin cancer by influencing skin self examination behavior. Method: This quasi experimental intervention study was conducted between February and April 2012 in Izmir. The study population consisted of students attending $6^{th}$, $7^{th}$ and $8^{th}$ classes of a primary school (n:302). No sampling was performed. Data were collected with a form developed by the researchers based on the literature. The first part of form is aimed to determine demographic characteristics of adolescents (3 questions) and their risk status of skin cancer (6 questions). The second part was prepared for skin cancer risks of adolescents (8 questions) and indications of skin cancer (12 questions). The last part was intended to determine their knowledge about skin self examination (4 questions) and behavioral stages of skin self examination (1 question). Data collection was achieved with a questionnaire form in three phases. In the 1st phase, data about demographic characteristics of students, risk status of skin cancer, knowledge level of skin cancer and behavior stages were collected. In the $2^{nd}$ phase, skin self examination training based on the transtheoretical model was performed within the same day just after obtaining preliminary data. In the $3^{rd}$ phase, adolescents were followed up three times to establish the efficacy of the training (on the $15^{th}$ day after training program and at end of the $1^{st}$ and $2^{nd}$ months). Follow-up data were evaluated by questioning skin self examination performing behavior stages through electronic mail. Results: Half of the adolescents (50.5%) are male, and 58.4% of them are 13 years old with a mean age of $12{\pm}1.15$ years. About 29.4% of adolescents had brown hair color, 37.9% had brown/hazel eye color, 29.4% had white skin, and 47.2% had fewer than 10 moles in their body. The pretest mean score on knowledge level about risks of skin cancer was found to be $4.19{\pm}1.96$, while the post-test mean score was $6.79{\pm}1.67$ (min:0, max:8).The pretest mean score about indications of skin cancer was $7.45{\pm}3.76$, while the post-test mean score was $10.7{\pm}2.60$ (min:0, max:12). The increases were statistically significant (p<0.05). The behavior "I do not perform skin self examination regularly in every month and I do not think to perform it in the next 6 months" was reduced from 52.8 to 35.5% after training. Conclusion: The training program organized to raise consciousness among adolescents for protection against skin cancer increased the knowledge level about risks and indications of skin cancer and it also improved the behavior of performing skin self examination.

• Korean Journal of Community Nutrition
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• v.11 no.3
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• pp.327-337
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• 2006

The major purpose of this study was to develop the nutrition education contents and material through the basic data from the service provider and the consumer. And also, to find out the differences of attitude and needs between the service provider (SP breastfeeding specialist), present consumer (PC, pregnant or lactating women) and future consumer (FC, college women). There were types of questionnaires, which consisted of needs and attitudes toward child and maternal nutrition, as well as the personal characteristics of the study subjects. The subjects consisted of 113 breastfeeding specialists who served at medical related institutions, 197 pregnant or lactating women and 309 college women. The self-administered questionnaires from subjects were collected from October to November 2005 in Seoul and Kyunggi Province. The data was analysed by SPSS Win 12.0, ANOVA and Kruskal-Wallis test. The results of this study were as following: 1) The most Important determining factors on breastfeeding was 'medical specialist's support' (3.51) and the next one was 'knowledge of maternity care practice' (3.39). And the importance score of determinating factors on breastfeeding was significantly different between each group (p < 0.001). The groups of consumer (3.50 at PC and 3.59 at FC) considered the service provider (3.32) more important. The service providers considered a more effective determining factor to be 'husband and family support' and 'peer support' than the others (p <0.001). 2) To compare the effective factors of breastfeeding practices between the three groups, the service providers were more significantly considered than the otters such as 'attendance of intervention program' (p < 0.001). But the PC group considered the most effective factors wis 'mother's job after delivery'. 3) The self-evaluated score of the breastfeeding knowledge was the most high in SP; the score was significantly different between groups. The knowledge score of nutritional aspects in human milk was most highly evaluated. But maternity care practice and public acceptance marked the lower evaluation score than other issues. 4) The desirable types of educational material was mass media, and the next was printed matter such as booklets. Two kinds if consumers preferred DVD or VCR tapes than and the service provider group (p < 0.001). 5) The priority contents of nutrition service PC group wanted the information about infant care more than maternal care (p < 0.05), but FC group's priority was significantly different compared with PC group (p < 0.001). The priority of SP group pointed out the information of practical child care methods. The results showed the needs of nutrition service, education channels, and perception toward effective factors on consumer behavior changes were significantly different between each group. Thus the result of this study may suggest that consumer oriented nutrition service programs must be developed.

• Research in Community and Public Health Nursing
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• v.32 no.4
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• pp.415-429
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• 2021

Purpose: The purpose of this study was to develop the Self-Care Non-adherence Risk Assessment Scale (SCNRAS) for patients with chronic illness in South Korea. Methods: This study was conducted from April to July, 2020 and utilized a convenience sampling method to recruit 336 patients with chronic illness from three hospitals located in South Korea. The content, factorial structure, item-convergent/discriminant validity, convergent validity, internal consistency reliability, and test-retest reliability of the scale were evaluated. The data were analyzed using exploratory and confirmatory factor analyses, Pearson's correlation coefficient, Cronbach's α, and intra-class correlation coefficient. Results: The exploratory and confirmatory factor analyses yielded six-factors. Convergent validity was demonstrated using measures of defining issues. Internal consistency reliability and test-retest reliability were found to be acceptable, as indicated by a Cronbach's α of .65~.81 and an intra-class correlation coefficient of .93~.98. The Self-Care Non-adherence Risk Assessment Scale for patients with chronic illness is a new instrument that comprehensively measures the knowledge, skill, physical function status, access to health care, social support, motivation, and confidence. It comprises 18 items scored on a 5-point Likert scale. The validity and reliability of the scale were verified. Conclusion: The scale developed through this study is expected to screen those who need nursing intervention early by predicting the self-care non-adherence risk group.

• Journal of the Korean Society of School Health
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• v.8 no.1
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• pp.143-154
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• 1995

Korea has been recently reducing the quality of life as well as rising medical cost because of the increase of chronic diseases. But we can prevent those chronic diseases through the improvement of environment or life style. We evaluated the educational effectiveness of chronic diseases(hypertention, diabetes, cancer, stroke and other chronic diseases) designed to increase the knowledge, attitude and practice of chronic diseases among university students. Between August 1994 and November 1994, we implemented chronic diseases prevention instruction in intervention students; unmatched control students were selected in same university. We conducted pre- and post-intervention surveys both intervention and control students with self-reported questionnaires(50 items). We assigned score(0-4 points) to items and conducted a analysis of covariance(ANCOVA) with sex, grade and economic status as the covariate, using the SAS PC computer statistical package. And we culculated odds ratio with safety scores between intervention and control students. The results of this study were followed. 1. In demographic characteristics of subjects both pre- and post intervention, we found no significant differences in intervention and control students at religion, father's education, mother's education, mother's occupation and type of residence(p>0.05), but we found significant differences at sex(p<0.001), grade(p<0.001) and economic status(p<0.05). 2. The sex, grade and economic status-adjusted mean prevention knowledge scores for diabetes and stroke increased from the pre- to post-survey in the intervention students(p<0.001), but control students did not increased(p>0.05). As odds ratios in knowledge were below 1, the knowledge of intervention students were higher than control students. 3. The attitudes for general adult health increased from the pre- to post-survey in the intervention students(p<0.05), but control students did not increased(p>0.05). As odds ratios in attitudes were approximately 1, we can not say effectiveness in intervention students 4. The pratices for cancer and stroke increased from the pre- to post-survey in both the intervention and control students(p<0.001). Also odds ratio of hypertention was 0.91, and that of stroke was 1.14. 5. Health related behaviors did not increased from the pre- to post- survey in both the intervention and control students(p>0.05). But odds ratio of drinking was 0.76 and that of body weight was 1.21. 6. Health status did not increased from the pre- to post- survey in both the intervention and control students(p>0.05). As odds ratio of health status was 1.09, prevention education was not effect in intervention students We would like to recommend as follows; 1. University students must learn about prevention of chronic diseases. Because the knowledge of invetervention students was higher than that of control students. 2. The prevention education of chronic diseases should be taught from primary school. 3. Adult health education for university students must be practiced continuously. Education period(l5 weeks) in this study was not complete. 4. The evaluation of chronic diseases was conducted real measurement(such as BP check) as well as self reported-survey. 5. Educational materials(video tape, pamphlet) related the prevention of chronic diseases should be developed at national level. And we must easely use those materials. 6. The prevention education of chronic diseases should be made through mass media as well as school education.

• The Research Journal of the Costume Culture
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• v.24 no.6
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• pp.743-755
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• 2016

This study aimed to reveal the designer's creative process in the development of clothing designs. The researcher has taken roles both as a design practitioner and an observer. The full process of design development was concurrently documented while working to solve a specific problem. This included noting down the concept, keywords, and detailed scratch ideas, as well as refining the design by collecting sketches and taking photos. Integrated data from the captured design process were analyzed based on Lamb and Kallal's apparel design framework, which included problem identification, construction of preliminary ideas, design refinement, prototype development, and evaluation. The functional, expressive, and aesthetic (FEA) criteria of the entire process were thus assessed. Additionally, five professional apparel reviewers evaluated the design project based on FEA criteria. The results showed the processes for identifying targets and intentions, extracting the main elements from sources, developing the major visual concepts, and making final adjustments. Ultimately, this study revealed how a designer manages each stage of the creative design process. Sharing such detailed observations of the design process can help refine the knowledge involved in each stage of the creative process, and provide guidance for instructors in design education.

• Journal of the Korean Dietetic Association
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• v.17 no.2
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• pp.130-141
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• 2011

This study was conducted to develop a nutrition education workbook to improve picky eating in children and to evaluate the effect of nutrition education using this developed workbook. The developed workbook focused on 2nd and 3rd grade students and consisted of five units. The contents included: multi-grain, vegetables (2 units), fish, and milk. The activities, including observation, and learning the roles and names of the foods, were developed mainly to increase motivation for eating a balanced diet. This workbook was developed from April to December 2008, and was applied at 15 elementary schools containing 1,674 students from April to September 2009 in Changwon City, Korea. We evaluated changes in knowledge before and after education on nutrition, eating behavior, dietary habits, and educational activities using self-administered questionnaires. The children demonstrated significant improvements in nutritional knowledge (P<0.001), eating behavior (P<0.001), and dietary habits (P<0.001). Most of the children answered that the education program was helpful and exciting. Based on these results, we believe that the developed workbook is suitable for children picky eaters, and hope it will be used in the field of child nutrition education.

• Journal of muscle and joint health
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• v.28 no.3
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• pp.223-233
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• 2021

Purpose: This study aimed to systematically review the contents and effectiveness of education programs for preventing diabetic foot ulcer among patients with type 2 diabetes mellitus in Korea. Methods: Six electronic databases were searched using search terms, and 748 articles were identified. Ten articles were eligible based on inclusion and exclusion criteria. Article quality was evaluated using a critical evaluation checklist for manuscripts before performing the systematic review. Results: Although education programs for preventing diabetic foot ulcers have been continuously studied for 20 years, the number of studies is small, and to our knowledge, there have been no studies reporting on the subsequent prevalence of foot ulcers or amputations. While the effect of these education programs on knowledge (ES=1.23) and self-management behavior (ES=.96) was shown to be statistically significant, it was not shown to be significant in preventing diabetic foot ulcers (ES=.03). Conclusion: The actual preventive effect on the prevalence of foot ulcers, through education programs for preventing diabetic foot ulcer could not be determined. Our findings highlight a potential need for studies aimed at developing effective programs to improve education on preventing diabetic foot ulcers.

• Journal of Korean Biological Nursing Science
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• v.24 no.2
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• pp.95-103
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• 2022

Purpose: The purpose of this study was to provide multifaceted interventions for nurses and to confirm changes in their knowledge, perception, and actual practice on the adequate storage, conditions, and transportation of culture specimens. Methods: A one-group pretest-posttest experimental design was conducted with 41 nurses in two general wards of a tertiary acute care hospital in Seoul. Multifaceted interventions including education, feedback, posting guidelines and reminders, and improvement in specimen management accessibility were provided from May 2019 to January 2020. Outcomes were measured before and after the interventions. Knowledge and perception of the nurses were evaluated using self-reported questionnaires and actual practice by observation. Results: After the interventions, the average knowledge score on transportation time was significantly increased (Z= -4.89, p< .001). However, the knowledge score on storage methods was not significantly increased. The perception score was significantly increased (t= -3.19, p= .003). The proportion of specimen storage times, places, and conditions managed properly was significantly increased from 43.0% (46/107) to 77.1% (84/109) (p< .001). The average transportation time of blood samples to the laboratory significantly decreased from 3 hours 36 minutes (± 1 hour 52 minutes) to 3 hours 1 minute (± 1 hour 41 minutes) (t= 2.51, p= .013). The percentage of blood culture specimens arriving within 2 hours was increased significantly from 22.9% to 39.2% (χ²= 6.90, p= .009). Conclusion: The interventions were effective. However, some specimens remained in the ward longer than expected after the interventions. This requires further interventions.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.154-163
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• 2023

Objectives: Systemic lupus erythematosus (SLE) or lupus patients usually experience various physical and psychological challenges. Since the coronavirus disease 2019 pandemic, these challenges have become even harsher. Using the participatory action research approach, this study evaluated how an e-wellness program (eWP) impacted SLE-related knowledge and health behaviors, mental health, and quality of life among lupus patients in Thailand. Methods: A 1-group, pretest-posttest design study was conducted among a purposive sample of lupus patients who were members of Thai SLE Foundation. The 2 main intervention components were: (1) online social support, and (2) lifestyle and stress management workshops. Sixty-eight participants completed all the study requirements, including the Physical and Psychosocial Health Assessment questionnaire. Results: After being in the eWP for 3 months, participants' mean score for SLE-related knowledge increased significantly (t=5.3, p<0.001). The increase in sleep hours was statistically significant (Z=-3.1, p<0.01), with the percentage of participants who slept less than 7 hours decreasing from 52.9% to 29.0%. The percentage of participants reporting sun exposure decreased from 17.7% to 8.8%. The participants also reported significantly lower stress (t(66)=-4.4, p<0.001) and anxiety (t(67)=-2.9, p=0.005). The post-eWP quality of life scores for the pain, planning, intimate relationship, burden to others, emotional health, and fatigue domains also improved significantly (p<0.05). Conclusions: The overall outcomes showed promising results of improved self-care knowledge, health behaviors, mental health status, and quality of life. It is recommended that the SLE Foundation continues to use the eWP model to help the lupus patient community.