Postsurgical patients usually have difficulty in answering the self-report pain scales due to the residual effects of anesthetic or sedative agents in the post-anesthesia care unit (PACU). A comparative analysis of pain assessment tools used in the PACU is lacking. In this prospective observational study, we compared the intensity of pain using the 11-point numeric rating scale (NRS) and the 4-category verbal rating scale (VRS) thrice, 5 minutes after PACU admission, 20 minutes after the first assessment, and just before discharge from the PACU in 200 patients undergone surgery. Spearman rank correlation analysis was used to investigate the correlation between 2 scales, and the weighted kappa (κ) coefficient was performed to evaluate inter-scale reliability. Response rates of the 2 scales were also compared. VRS and NRS were highly correlated during all 3 comparisons (r = 0.767, 0.714, and 0.653, respectively; P < .0001). Each category of VRS showed a statistically significant difference in pain intensity measured by NRS during all 3 assessments. Inter-scale reliability had a fair strength of agreement for all 3 measurements (weighted κ = 0.519, 95% CI: 0.421–0.618; weighted κ = 0.511, 95% C.I: 0.409–0.613; weighted κ = 0.452, 95% C.I: 0.352–0.551, respectively). VRS showed a higher response rate for PACU patients compared to NRS in all 3 measurements (96% vs 77.5%, 99% vs 81.5%, and 96.5% vs 86.5%, respectively; P < .0001). In the PACU, VRS is a reasonable and practical pain intensity measurement tool for postsurgical patients, considering the high correlation between VRS and NRS, and a higher response rate.
Primary care is not well established in Korea despite its importance in population health. To reinforce the primary care system, understanding the public view of primary care will be essential. We aimed to compare the public perception of primary care qualities across types of healthcare facilities. We conducted a cross-sectional, web-based survey at a university in Seoul, South Korea, from October 2018 to February 2019. Using the Korean Primary Care Assessment Tool (K-PCAT), participants assessed the qualities of primary care services provided by the university health service (a university-based, patient-centered primary care model), community clinics, and hospitals. We compared K-PCAT scores across facilities and evaluated the factors associated with the differences using general linear models. A total of 5,748 responses were analyzed. K-PCAT total scores were highest for the university health service (61.0 ± 15.9) and lowest for hospitals (48.1 ± 14.5), with significant differences between facilities (P < .001). The university health service received the highest scores for first contact, comprehensiveness, personalized care, and family/community orientation; community clinics for continuity of care; and hospitals for care coordination and trust/satisfaction. Primary care facilities were rated higher than hospitals by individuals in good health, with low income levels, using ambulatory care more frequently, and spending less on medical expenses. In conclusion, the user-perceived primary care quality was higher for community-based primary care facilities than hospitals. The highest score was for the university health service, suggesting that setting-based, patient-centered primary care would be an effective model for restructuring the primary care system in Korea.
We investigated degradation mechanism of a-IGZO TFTs under NBIS with different wavelengths λ and intensities I L of light. Negative gate bias was applied for 4000 s while drain and source were grounded, and illuminations with λ = 450, 530, or 700 nm were applied. Illumination with photon energy exceeding ∼2.3 eV (530 nm) induced noticeable change in threshold voltage shift V th , which can be interpreted in terms of ionization of oxygen vacancies V O . In addition, I L of blue illumination (450 nm) was varied from 6 to 200 lux and saturation in V th was observed after exceeding a certain I L . We suggest that the saturation occurs because V O -ionization rate is saturated by outward relaxation of metal atoms in the a-IGZO film. Metal oxide-based materials have high carrier mobility, low offcurrent, and good transparency, so they are promising candidates for the channel material of thin film transistors (TFTs).1 In particular, amorphous-InGaZnO (a-IGZO) TFTs have excellent properties such as high on/off ratio, good uniformity, and low processing temperature. However, a-IGZO TFTs exhibit some instability problems.Stability of a-IGZO TFTs is affected by several factors including bias/current stress, temperature, light illumination and passivation conditions.2-5 Among several factors, bias stress is most widely studied because bias is always applied to TFTs in practical display applications. In darkness, the transfer curves of TFTs shift positively when positive bias stress (PBS) is applied to the gate, but shift relatively little when negative bias stress (NBS) is applied.6,7 Although a-IGZO TFTs remain stable under NBS, their electrical characteristics degrade when it is combined with illumination, 7,8 i.e., negative bias illumination stress (NBIS).Instability of a-IGZO TFTs under NBIS has been widely investigated and reported.7-11 Though some papers dealt with the effect of light intensity on reliability of the TFT, 12,13 the effects of wavelength λ and intensity I L of light during NBIS have not been fully explained yet, especially in terms of oxygen vacancy which is crucial factor affecting reliability of a-IGZO TFTs. In this paper, we investigated degradation mechanism of a-IGZO TFTs under NBIS with light of various λ and I L . Degradation of a-IGZO TFT under NBIS with different λ, and the saturation of threshold voltage shift V th independent of I L were identified. We propose that the saturation phenomenon can be explained by restriction in the ionization rate of oxygen vacancy V O due to their effect on the structure of a-IGZO. Method and MeasurementsWe fabricated a-IGZO TFTs with bottom gate, back channel etch structure (Fig. 1). A 500 nm-thick and 200 nm-thick SiO 2 were used as gate insulator and passivation layer, respectively. The a-IGZO active layer was formed with the channel width/length of 110 μm/6 μm. Transfer characteristics of the TFTs were measured after NBIS was applied. For bias stress, negative gate voltage was applied for 4000 s while drain and source were grounded. Illumination from white ...
Many lifelong smokers establish smoking habits during young adulthood. A university can be an effective setting for early smoking cessation. We evaluated long-term predictors of smoking cessation among smokers in a university setting. We longitudinally followed a cohort of smokers enrolled in a university smoking cessation program in Seoul, South Korea. Sociodemographic factors, smoking-related variables, and changes in smoking habits were assessed during 6-week visit sessions and follow-up telephone interviews conducted 1 year or more later. A total of 205 participants were followed up (mean follow-up duration: 27.1 months). Cessation rates were 47.3% at the end of the visit sessions and 28.8% at follow-up. The long-term persistent smoking rate was significantly higher among individuals with peers who smoked (odds ratio [OR] = 8.64; 95% confidence interval [CI] = 1.75, 42.80), with family members who smoked (OR = 3.28; 95% CI = 1.20, 9.00), and who smoked 10 to 19 cigarettes/day (OR = 4.83; 95% CI = 1.49, 15.69). Conversely, persistent smoking was less likely among those who attended the program regularly (OR = 0.84 per visit; 95% CI = 0.72, 0.99) and attempted quitting more frequently (OR = 0.93 per attempt; 95% CI = 0.87, 0.99). Use of smoking cessation medications (varenicline or bupropion) was not significantly associated with long-term quitting (OR = 0.71; 95% CI = 0.26, 1.93). Peer influences were the strongest predictors of failure in long-term cessation among smokers who attempted to quit. Similarly, the existence of smokers in the family was negatively associated with successful quitting. Regular attendance at a smoking cessation program and a high number of attempts to quit were positively associated with successful quitting. Targeting peer and family smoking groups together rather than targeting individual smokers alone, implementing active cessation programs encouraging regular attendance, and providing comprehensive antismoking environments might be effective strategies in a university setting.
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