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Reliability and Validity of the Behavioral Observation Method for Assessing Low Back Pain in Patients with Spinal Diseases (척추질환자의 요통사정을 위한 통증행위 관찰법의 신뢰도 및 타당도 검정)

  • Yoon, Ho-Soon;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.97-115
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    • 1994
  • The purpose of this study was to examine the reliability and validity of the observed behaviors of subjects who suffered from low back pain with spinal diseases, Thirty two low back pain patients admitted on the neurosurgical unit in an army hospital were compared with 30 normal controls belonged to an army unit, by means of matching the age, hight and weight. Observed pain behaviors were developed by the researcher on the bases of literature and patient observation. This tool consists of 18 behaviors seperated into two major groups : mutually exclusive and concomittent behaviors. The mutually exclusive behaviors included coding cathegories for 6. body motions assumed by the subjects during the observation session. These 6 standardized motions consisted of sitting from standing first, and serially tying down, reclining, sitting again, and then standing, 6 steps walking. Concomittent behaviors consisted of 12 observable patterns that can be observed systematically from the face, grimacing, bracing, rubbing, walking with arms fixed, support with hands on sitting or standing, guarded movement, limping, unbalaced weightbearing, stopped movement from tying position to sitting, sighing and graoning. Subjects were videotrecorded as they performed a 6-standardized sequence of motions, simultanously researcher measured the time spent performing each motion and step length. Patients were asked torate their subjective pain score on the 10 mm graphic rating scale ranging from 'no pain' to 'sever pain'. For scoring of the pain behaviors, two trained nursing officiers independently and simutanously viewwd each videorecording and checked subject 'pain behaviors at the observational item checklist. The result of the study are summarized as follows : 1. Reability of the observational tool was a=.845. 2. Spearman's rho and percentage agreement were p=.97 and 81.7 persent respectively, that indicate adequate interrater reability of this tool. 3. The sensitivity rate of the tool was .875 while specificity rate .866 for differentiating patient from the normal. 4. When difference in the objective pain indices between patient group and control were compared, there was significant difference of all indices, such as pain behavior(t=7.71, p=.0001). spent time performing motion(t=14.2, p=.0001), step length (t=-10.72, p=.0001). 5. There were differences in the objective indices the subjective pain subgroups (low, medium, high). Differences in the mean score of objective pain behavior (F=6.376. p=.005) and spent time for moyion(F=4.631, p=.018). But there were no significant differences in the step length among the subgroups(F=.667, p=.521). 6. Highly correlated pain behavior items wiyh subjective pain score were 'stopped movement from lying position to sitting', 'limping', 'support with hands on sitting or standing', 'bracing', 'guarding' and 'walking with arms fixed'. In summary, although some of rho behavior items such as sighing and groaning in this study could not be observed because of videotaped datd, the reliability and validity of the over all observation method were satifactory. Thus, the results of the present study demonstrate rye potetional utility of the tool in assessing objective pain complementing self-reported pain in low back pain patients.

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A Qualitative Case Study Research of Application of Saam Five Element Acupuncture in Psychiatry -the Field Study of a Clinic- (사암침법의 정신과적 활용에 대한 질적 사례연구 -한 의료기관에 대한 현장연구-)

  • Suh, Hyo-Weon;Lee, Jung Hwan;Kwak, Hui-Yong;Chung, Sun-Yong;Kim, Jong Woo
    • Journal of Oriental Neuropsychiatry
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    • v.29 no.3
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    • pp.183-195
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    • 2018
  • Objectives: To investigate validity and effectiveness of Saam five element acupuncture treatment in psychological problems. Methods: We selected a Korean medicine doctor known to apply Saam five element acupuncture treatment to the psychiatry field. An investigator visited the doctor's clinic to observe the cases and interview patients. Duration of each interview was 30 minutes to one hour. A semi-structured questionnaire was used for in-depth interviews. All interviews were recorded and converted into texts. Converted texts were then summarized and analyzed qualitatively. Results and Discussion: Treatment process of Saam five element acupuncture designed for psychiatric use is divided into four stages: qi transformation (氣化), acupuncture treatment, deep breathing, and acupressure. In the first stage, patients are asked to express their feelings and emotions in a physical sense; to imagine their feelings have colors, weight, and physical form, and to describe those characteristics. Next, the doctor evaluates each patient's qi according to the six qi (六氣), and then determines protocol of Saam five element acupuncture treatment. This treatment is focused on suffering of the patient and specific symptoms or emotions. The treatment duration is brief and changes in symptoms are frequently checked during treatment sessions. Without discussing details of stressful events, the doctor enables patients to express physical aspects of their feelings. He also provides them with psychoeducational resources. As a result, patients experienced immediate changes in body sensation, emotions and thinking, decreased response to triggers, and increased self-control after treatment. Conclusions: The Saam five element acupuncture treatment has the potential to be used as a treatment for psychiatric disorders. Treatment can be effective in managing psychiatric disorders when applied by primary Korean medicine clinics.

Analysis of Risk Factors Affecting Breast Cancer Incidence : Breast Ultrasonography (유방암 발생에 영향을 미치는 위험인자 분석: 유방초음파 검진자 대상으로)

  • An, Hyun;Yang, Sung-Hee;Im, In-Chul;Lee, Jin-soo
    • Journal of the Korean Society of Radiology
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    • v.11 no.4
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    • pp.289-295
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    • 2017
  • In general, a number of studies have been conducted on factors affecting breast cancer development, but systematic investigations of risk factors are rare. The purpose of this study was to investigate the factors involved in breast cancer screening before breast ultrasound diagnosis and the risk factors associated with breast cancer screening by ultrasound. Self-administered questionnaire was performed on 417 patients who underwent breast ultrasonography and classified as benign and malignant. Breast cancer was associated with age, BMI, and type of medication(p<0.05). Multivariate analysis showed that the odds ratio was 4.93 times higher in the 50s compared to the less than 50s, 2.43 times higher in the obese group than in the normal group, 0.14 times and 0.16 times lower in hormonal replacement therapy(p<0.05). Therefore, as age increases, periodical examination of health and appropriate weight management are needed. So this study is expected to provide basic data for identification of risk factors affecting breast cancer development.

Prevalence of Hyperhomocysteinemia and Related Factors in a Community-based Health Examination Survey: A Cross-sectional Study (경기도 일개 지역사회 대표집단에서 고호모시스테인혈증의 유병률 및 관련요인에 대한 단면조사연구)

  • Kim, Soo-Jeong;Lim, Kyung-Sook;Song, Mi-Sook;Kang, Yeon-Ji;Lee, Soon-Young
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.5
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    • pp.337-342
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    • 2009
  • Background : Many previous studies have shown that elevated homocysteine in the serum is a well known risk factor for cardiovascular disease and this is associated with other risk factors for cardiovascular disease, but any Korean data on this is limited. Objectives : This study aimed to calculate the prevalence of hyperhomocysteinemia and to analyze the relation between elevated homocysteine and the lifestyle factors of Korean adults. Methods : We conducted a cross-sectional survey that included 650 men and 743 women (age range, 20 to 79 years) who were residents of Gwangju City in Gyeonggi-do. These subjects participated in the health interview and examination survey from November to December 2005. The total homocysteine, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride in the serum were measured. All the participants had their body composition measured such as height and weight, and we obtained health-related behavioral information through the self-entry questionnaire. Results : Very right-handed skewed distributions of homocysteine were shown in men and women. The prevalence of hyperhomocysteinemia was 22.6% in men and 13.7% in women in Gwangju city. On the multiple logistic regression analysis, hyperhomocysteinemia was associated with age (OR=1.02, 95% CI=1.01-1.04), male gender (OR=1.60, 95% CI=1.02-2.52), severe general physical activity (OR=0.32, 95% CI=0.15-0.69) and nutrient consumption (OR=0.49, 95% CI=0.31-0.76). Conclusions : There is a great prevalence of hyperhomocysteinemia in adults of Gwangju City, Korea and it was associated with both genetic factors and lifestyle risk factors. This study can suggest that comprehensive lifestyle modification is needed in order to diminish the prevalence of hyperhomocysteinemia and to prevent CVD.

Hazardous Health Behaviour among Medical Students: a Study from Turkey

  • Nacar, Melis;Cetinkaya, Fevziye;Baykan, Zeynep;Yilmazel, Gulay;Elmali, Ferhan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7675-7681
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    • 2015
  • Background: Hazardous health behaviour in young people is an important factor that affects the individual risk for non-communicable diseases and other disorders later in life. This study aimed to determine the hazardous health behaviour of first and last class medical students of Erciyes University. Materials and Methods: This descriptive study was carried out with 240 medical students from the first and 130 students from the last (sixth) class. Data were obtained by questionnaire between March-April 2012. In total, 339 students were included with a response rate of 91.6%. Socio-demographic characteristics, school success, self-reported economic difficulties, health perceptions, hazardous health behaviour related to chronic disease, tobacco, alcohol, substance use, body weight, height, traffic, violence and nutrition were assessed in line with the literature. Results: Of the participants; 64.0% were from first and 36.0% were from the last class. Mean ages for the first and last classes were $19.4{\pm}1.5$ and $24.0{\pm}1.5years$, respectively. In the current study, males exhibited more hazardous behaviour than females. Sime 19.8% of the students in the study group used alcohol, 35.4% used a waterpipe, and 24.8% used tobacco at least once. These rates increased in both genders in the last class and the increase in males was significant. Some 3.8% of the students in the current study used pleasure-inducing illegal substances at least once. All the students participating in the current study were single, the number of males reported not using condoms (8.6%) was 4.56 times higher compared to females. Some 64.0% of the students did not perform physical activity lasting at least 30 minutes for five times a week, 13.0% did not sleep for mean 7-8 hours daily, males having a 2.9 times higher risk. More than 1/3 of the students did not consume cooked vegetable dishes and 1/4 did not consume fresh fruits and salads, the rates were higher among males. Conclusions: In the current study, hazardous health behaviour was prevalent among medical students, with higher risks among males and last class students. According to these results, medical curriculum may be focused on decreasing hazardous health behaviour. In addition, in order to prevent unhealthy behaviour, the number of youth-friendly health facilities should be increased.

Factors related to the Health Behavior of Rural Adolescents (일부 농촌지역 청소년들의 건강행태 관련요인 분석)

  • Jo, Heui-Sug;Lee, Sun-Hee
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.315-326
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    • 2000
  • Objectives : Health behaviors that contribute to the leading cause of mortality, morbidity, and social problems among youth and adults are mostly established during youth, extend into adulthood, and are interrelated. The purpose of this study is to investigate health behavior, juvenile delinquent behavior, mental status and to understand related factor to health behavior. Methods : The study items of life style were health related habit including smoking, drinking, breakfast, regular diet, regular exercise, sleeping time and weight status. Also, sexual evidence, violence, suicidal perceptions were surveyed. Questionnaire survey was conducted from January to February, 2000 by adolescence living in Kyunggi-Do. Data were collected by self-administered questionares. The collected data were analyzed using PC-SPSS 9.0 version. Results : Most students perceived to be healthy themselves but just two thirds students had concern for health. 64.9% ever drank alcohol, 26.4% ever smoked, and also and 2.9% had attempted suicide during preceding the survey. The rate of sleeping over 8 hours is 31.8%, 65.6% had breakfast. Multiple regression analysis to find related factor with adolescents health behavior were conducted. As a results, concern for health, sex, grade, spending money and attempt to suicide were related to health behavior. Conclusion : These results showed that many efforts to improve the health-concern are necessary and suggest the need for further studies including follow-up study, intervention study on the relationship of life style.

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The Stress-Strain Properties of No-Fines Lightweight Concrete Using Synthetic Lightweight Coarse Aggregate (인공경량조골재(人工輕量粗骨材)를 사용(使用)한 무세골재(無細骨材) 경량(輕量)콘크리트의 응력(應力)-변형특성(變形特性))

  • Min, Jeong Ki;Kim, Seong Wan;Sung, Chan Yong;Kim, Kyung Tae
    • Korean Journal of Agricultural Science
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    • v.23 no.1
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    • pp.120-130
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    • 1996
  • Concrete is the most commonly used structural materials, but in concrete construction, its self-weight represents a very large proportion of the total load on the structure, and there are clearly considerable advantages in reducing the density of concrete. This study was carried out to investigate the stress-strain properties of no-fines synthetic lightweight concrete with synthetic lightweight coarse aggregates. The used synthetic lightweight coarse aggregate were two types, one was expanded clay with grading 3~8mm, the other is pumice stone with grading 4.75~10mm. The results of this study were summarized as follows ; The static modulus of elasticity of the synthetic lightweight concrete was $1.8{\times}10^5kg/cm^2$ at type CE using the expanded clay and $1.6{\times}10^5kg/cm^2$ at type CL using the pumice stone. The dynamic modulus of elasticity was $1.9{\times}10^5kg/cm^2$(CE) and $2.0{\times}10^5kg/cm^2$(CL). The dynamic modulus of elasticity was 10~30% larger than that of the static modulus of elasticity. The load-time curves of synthetic lightweight concrete were shown approximately similar to each other type except for added foaming agent. The stress-strain curves in uniaxial compressive of synthetic lightweight concrete were similar to each other.

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Survey on the Farms in Main Producing Area of Job's Tears (율무 주산 지역 농가의 실태조사)

  • 강치훈;박기준;유창재;김두환
    • Korean Journal of Plant Resources
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    • v.14 no.1
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    • pp.77-83
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    • 2001
  • This survey was carried out to collect the basic informations for the improvement of cultivation in job's tears (Coix lachryma-jobi L.) by investigating the general facts, farming practices, growth characteristics, grain yield, and chemical properties of soil in Yonchon-gun farms. The age of farmers were over 51 and the cultivated area was small. Most farmers were self-laboring and produced seeds on their land. Sowing method was usually drilling by hand, 64% of farms had the density of 2000-3500 plant per 10 a, amount of fertilizer application was diverse and the number of pest control was a few. The averages of plant height, number of main culm node, culm diameter, tiller number of plant, thousand grain weight, and grain yield were 184 cm, 10, 10 mm, 14, 108 g, and 341 kg/10a, respectively. The averages of pH, organic matter, $P_2O_5$, K, and EC of soil after harvest were 5.8, 1.1 g/kg, 385 mg/kg, 0.48 cmol+/kg, and 0.21 dS/m, respectively. Grain yield and hardness were negatively correlated -0.7442 at the level of P=0.01.

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Organo-Compatible Gate Dielectrics for High-performance Organic Field-effect Transistors (고성능 유기 전계효과 트랜지스터를 위한 유기친화 게이트 절연층)

  • Lee, Minjung;Lee, Seulyi;Yoo, Jaeseok;Jang, Mi;Yang, Hoichang
    • Applied Chemistry for Engineering
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    • v.24 no.3
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    • pp.219-226
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    • 2013
  • Organic semiconductor-based soft electronics has potential advantages for next-generation electronics and displays, which request mobile convenience, flexibility, light-weight, large area, etc. Organic field-effect transistors (OFET) are core elements for soft electronic applications, such as e-paper, e-book, smart card, RFID tag, photovoltaics, portable computer, sensor, memory, etc. An optimal multi-layered structure of organic semiconductor, insulator, and electrodes is required to achieve high-performance OFET. Since most organic semiconductors are self-assembled structures with weak van der Waals forces during film formation, their crystalline structures and orientation are significantly affected by environmental conditions, specifically, substrate properties of surface energy and roughness, changing the corresponding OFET. Organo-compatible insulators and surface treatments can induce the crystal structure and orientation of solution- or vacuum-processable organic semiconductors preferential to the charge-carrier transport in OFET.

Complement-dependent Cytotoxic Crossmatch for Prevention of Hyperacute Rejection in Canine Renal Allografts (개의 신장 동종 이식에서 초급성 거부반응의 예방을 위한 보체의존성 세포독성 DLA 플래스 I 교차 반응)

  • Ghil Heh Myung;Woo Heung-Myung
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.322-327
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    • 2005
  • DLA class I complement-dependent cytotoxicity (CDC) cross-match method was established to control hyperacute rejections in organ transplantation. The aim of the present study is to investigate if DLA class 1 CDC corssmatch method is effective to prevent hyperacute rejections in canine renal allografts. Seven mongrel dogs of similar age and weight were used. Erythrocyte crossmatch was first performed and only the negatives were used. Among the same blood types, CDC cross-match was performed. Anti-dog serum, Hank's balanced salt solution(HBSS), and tile self-serum was used as a positive-, a negative-, and all auto-control respectively. After the reaction with class I complement, it was stained with eosin and scored by international cytotoxicity scoring system under inverted phase microscope. According to these results, kidneys oi CDC negatives among same blood types were cross-transplanted to observe the incidence of hyperacute rejections. One of four 1.2 B blood type dogs had autoantibodies. here were negative CDC results among each blood type, and also there were negative results between different blood types. Two pairs with the same blood types and negative CDC results underwent allo-transplantation each other. There were no hyperacute rejections. DLA cross-match method studied in this experiment for canine renal allograft can be effective to prevent hyperacute rejections. it may be applicable for the future studies of histocompatibility testing in canine renal allografts.