• Title/Summary/Keyword: Care time

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Up-to-date or Complete Immunization Coverage and Their Related Factors (영유아의 예방접종 및 그 관련요인)

  • Lee, Moo-Sik;Kim, Eun-Young;Kim, Keon-Yeop;Lee, Jin-Yong;Jang, Min-Young;Hong, Jee-Young
    • Journal of agricultural medicine and community health
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    • v.37 no.4
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    • pp.233-245
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    • 2012
  • Objectives: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. Methods: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. Results: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. Conclusions: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.

Comparison of Single vs Combined Modality Treatment in Locally Advanced Non-Small Cell Lung Cancer (국소 진행된 비소세포 폐암에서 복합요법과 단일요법의 비교)

  • Kim, Ae-Kyoung;Jeong, Seong-Su;Shin, Kyoung-Sang;Park, Sang-Gee;Jo, Hai-Jeong;Lee, Jong-Jin;Seo, Jee-Won;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.502-512
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    • 1995
  • Background: One quarter to one third of patients with NSCLC present with primary tumors that although confined to the thorax are too extensive for surgical resection. Until resently standard treatment for these patients had been thoracic radiation, which produces tumor regression in most patients but few cures and dismal 5-year survival rate. The fact that death for most patients with stage III tumors is caused by distant metastases has promped a reevaluation of combined modality treatment approaches that include systemic chemotherapy. Therefore, we report the results observed in a study to evaluate the effect of multimodality treatment in locally advanced non-small cell lung cancer from 1/91 to 8/93 in CNUH. Method: We grouped the patients according to the treatment modalities and evaluated response rate, median survival and the effect of prognostic variables. Among 67 patients evaluated, twenty seven patients classified with group A, received cisplatin and etoposide containing combination chemotherapy alone, eighteen patients, classified with group B, received chemotherapy and radiotherapy, fifteen patients, group C, received neoadjuvant or adjuvant chemotherapy and surgery with/without radiation therapy, seven patients, group D, received only supportive care. Result: The major response rate for group A and B was 37% and 61% respectively. There was no statistically significant difference in response rate between A and B groups(p=0.97). The analysis of prognostic factors showed that differences of age, sex, pathology, blood type, smoking year, stage and ECOG performance did not related to improvement in survival. Median survival time was 8.6 months for group A, 13.4 months for group B, 19.2 months for group C, and 5.4 months for group D, respectively and there was statistically significant difference(p=0.003), suggesting that multimodality therapy was associated with signigicant improvement in survival. Subset survival analysis showed a significant therapeutic effect for earlier stage and good performance state(p=0.007, 0.009, respectively). A possible survival advantages were observed for major response groups. Conclusion: It was suggested that multimodality therapy for the management of patients who had stage III disease, has yielded good median survival and long survival for seleted patients. But, it is necessory to validate above result with further investigation in large scale and in prospective randomized trials.

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Application of Noninvasive Positive Pressure Ventilation in Patients with Respiratory Failure (호흡부전 환자에서 비침습적 양압환기법의 적용)

  • Seol, Young Mi;Park, Young Eun;Kim, Seo Rin;Lee, Jae Hyung;Lee, Su Jin;Kim, Ki Uk;Cho, Jin Hoon;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew;Kim, Young Dae
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.26-33
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    • 2006
  • Background: Noninvasive positive pressure ventilation(NPPV) has been increasingly used over the past decade in the management of acute or chronic respiratory failure and weaning of mechanical ventilation. We performed this clinical study to evaluate the usefulness of NPPV in patients who developed acute respiratory failure or post-extubation respiratory failure. Methods: We analysed thirty four patients(sixteen males and eighteen females, mean ages 58 years) who applied NPPV(BIPAP S/T, Respironics co., USA) for respiratory failure or weaning difficulty at medical intensive care unit(MICU), emergency room and general ward of a tertiary hospital. We evaluated the underlying causes of respiratory failure, duration of treatment, the degree of adaptation, complication and predictive parameters of successful outcome. Results: The overall success rate of NPPV was seventy-one percent. The duration of NPPV applying time, baseline blood pressure, pulse rate, respiration rate, $PaO_2$, $PaCO_2$, $SaO_2$ were not different between success group and failure group. But, the baseline pH was higher in the success group. Predictors of success were higher baseline pH, patients with underlying disease of COPD, improvement of vital sign and arterial blood gas value after NPPV application. The success rate in patients with post-extubation respiratory failure was eighty percent. There were no serious complication on applying NPPV except minor complications such as facial skin erythema, abdominal distension & dry mouth. Conclusion: NPPV may be effective treatment in patients with acute respiratory failure or post-extubation respiratory failure in selected cases.

Pilot and Feasibility Study of a Management Program for Elementary School Students with Asthma (우리나라에서 학교 중심의 소아천식관리사업의 적용가능성과 발전 방향: 일부 학교의 시범사업 평가결과를 중심으로)

  • Seo, He-Jin;Lee, Weon-Yong
    • Journal of the Korean Society of School Health
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    • v.22 no.1
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    • pp.1-16
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    • 2009
  • Purposes: The objective of this study was to develop a management program for Korean elementary school students suffering from asthma, which would be based on the Australian Asthma-Friendly Schools (AFS) program. Methods: On the basis of the AFS program, we designed a 6-month pilot project for asthmatic students in two elementary schools in a rural area and one elementary school in an urban area of Korea. The pilot project consisted of the following processes: identifying students with asthma in a school, educating school staffs and the parents of an asthmatic child, registering those with asthma, and installing emergency kits for asthma attacks in school health rooms. In order to evaluate these processes, group discussions were held between project team members and school staffs in each area. In addition, we conducted a postal survey of 144 households having an asthmatic child. Results: The screening process adopted in this program resulted in the early diagnosis in asthma; however, it needs to be evaluated economically due to expensive diagnostic test for asthma. For the school nurses, asthma lessons were evaluated as being very helpful for their tasks, while teachers tended to take less interest in the program with only 45% of all teachers attending these lessons. Almost all participating parents reported that such lessons would be beneficial for the care of their child, even though only 24.2% of the survey respondents (122 households) attended the lessons. Installing emergency kits in school health rooms was regarded as a key feature of this project. The introduction of a register card containing more specific health records of asthmatic students was considered necessary to replace the existing list of students with asthma. Conclusion: This study has merit in that a Korean asthma-friendly schools program was developed for the first time, despite the many obstacles to such programs becoming more common.

A Stochastic Study for the Emergency Treatment of Carbon Monoxide Poisoning in Korea (일산화탄소중독(一酸化炭素中毒)의 진료대책(診療對策) 수립(樹立)을 위한 추계학적(推計學的) 연구(硏究))

  • Kim, Yong-Ik;Yun, Dork-Ro;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.135-152
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    • 1983
  • Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

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Epstein-Barr Virus in Nasal Angiocentric Lymphoma with Malignant Histiocytosis-like Hemophagocytic Syndrome (악성조직구증과 유사한 혈구탐식증후군을 동반한 코의 혈관중심위 림프종과 Epstein-Barr 바이러스의 관련성 연구)

  • Han Ji-Youn;Kim Hoon-Kyo;Moon Han-Lim;Seo Eun-Joo;Kwon Hi-Jeong;Park Yeon-Joon;Min Ki-Ouk;Yoon Sei-Cheol;Kim Min-Shik;Cho Seong-Ho;Kim Byung-Kee;Lee Kyung-Shik;Kim Dong-Jip
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.9-15
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    • 1997
  • Malignant histiocytosis(MH)-like hemophagocytic syndrome(HS) is a fatal complication of nasal angiocentric lymphoma(AL) and difficult to distinguish from MH. Ten of total 42 patients with nasal AL had HS and 9 of them were initially suspected to have MH. Five patients had HS as initial manifestation, 3 at the time of relapse, and 2 during the clinical remission of lymphoma. Four patients were treated by combination chemotherapy(CHOP) and others had only supportive care. Immunohistochemical study and in situ hybridization were performed on the specimen obtained from 10 patients. The median survival of all patients from HS was 18 days(range 2 - 44 days) and all had fatal outcome regardless of the treatment-modality. All cases were positive for UCHL1(CD45RO) and Epstein-Barr virus (EBV) by EBER in situ hybridization. MH-like HS is a fatal complication of nasal AL and has a high association with EBV. Reactivation of EBV may contribute to HS and further investigation of predictive factors and effective treatment of HS should be pursued in future.

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Development and relative validity of semi-quantitative food frequency questionnaire for Korean adults (한국인을 위한 반정량 식품섭취빈도 조사지의 개발 및 타당도 연구)

  • Kim, Sohye;Lee, Jung Sug;Hong, Kyung Hee;Yeom, Hye Sun;Nam, Yeon Seo;Kim, Ju Young;Park, Yoo Kyung
    • Journal of Nutrition and Health
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    • v.51 no.1
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    • pp.103-119
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    • 2018
  • Purpose: This study was implemented to develop and validate the semi-quantitative food frequency questionnaire (SQ-FFQ) to assess energy, carbohydrates, fat, protein, minerals, and vitamins as well as fatty acids and alcohol in Korean adults. Methods: The SQ-FFQ consisted of 88 food items, and 12 food groups were selected based on information of frequently consumed foods from the Korean Health and Nutrition Examination survey. Each portion size was categorized as one of three amounts: small (0.5 times), medium (1 time), and large (1.5 times). A total of 111 subjects finished 3-day diet records and the SQ-FFQ. The relative validity of SQ-FFQ was assessed by comparison with the 3-day diet records. Results: The mean nutrient intakes obtained from the SQ-FFQ were estimated to be greater than those of the two 3-day dietary records. Spearman's correlation coefficient between the two methods was the highest for energy (r = 0.583; p < 0.001) and lowest for saturated fatty acid (r = 0.121). Correlation coefficients were energy (r = 0.583; p < 0.001), carbohydrates (r = 0.500; p < 0.001), protein (r = 0.466; p < 0.001), fat (r = 0.411; p < 0.001), dietary fiber (r = 0.467; p < 0.001), alcohol (r = 0.527; p < 0.001), calcium (r = 0.409; p < 0.001), phosphorus (r = 0.499; p < 0.001), potassium (r = 0.418; p < 0.001), magnesium (r = 0.427; p < 0.001), and zinc (r = 0.464; p < 0.001), respectively, for all subjects. Conclusion: The developed SQ-FFQ in this study seems to be useful for estimating nutritional status, particularly energy, carbohydrates, protein, fat, dietary fiber, alcohol, calcium, phosphorus, potassium, magnesium, and zinc of Korean adults.

Growth, Quality and Irrigation Requirements of Melon Cultivars in Hydroponic Cultivation Using Coir Substrate (코이어 배지를 이용한 멜론 수경재배 시 품종별 생육, 품질 및 급액 요구량)

  • Lim, Mi Young;Roh, Mi Young;Jeong, Ho Jeong;Choi, Gyeong Lee;Kim, So Hui;Choi, Su Hyun;Lee, Choung Keun
    • Journal of Bio-Environment Control
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    • v.30 no.3
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    • pp.188-195
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    • 2021
  • This study was conducted to investigate the growth and quality characteristics of melon (Cucumis melo L.) cultivars and the irrigation requirements for cultivars. In our previous study in 2019, twelve melon cultivars including 'Dalgona' were examined for their cultivar characteristics under the same irrigation condition for all cultivars, and sorted into several groups based on different growth condition; for the internode length (from 0 to 20th node), leaf area, and fruit weight, 'Kingstar' belonged to the largest group, 'Worldstar' the middle group, and 'Dalgona' the smallest group. After analyzing the results of the previous experiment, 'Dalgona', 'Worldstar', 'Kingstar', and 'Rubyball' were selected as test cultivars for the growth group in 2020, and irrigated according to different irrigation levels for each cultivar. The control of the irrigation volume for each melon cultivar by monitoring the drainage rate during the cultivation periods showed that all four cultivars required a similar amount of irrigation in the 'early growth' stage where crops grew at about the same rate. From 'flowering time', however, the change in irrigation requirements showed a similar tendency for 'Worldstar' and 'Kingstar' and for 'Rubyball' and 'Dalgona' respectively. A sudden change in each irrigation volume was observed from the fruit set; 'Dalgona' began first to decline and 'Rubyball' was second, followed by 'Worldstar' and 'Kingstar'. In conclusion, the irrigation volume was the largest in 'Kingstar', followed by 'Worldstar', 'Rubyball', and 'Dalgona' in the same order as the growing amount of plant length, leaf area, and fruit weight. Therefore, it is necessary to control exactly the irrigation volume by reflecting the unique growth characteristics of each cultivar for the production of high-quality fruit in melon hydroponics, and especially to use great care when different cultivars are cultivated together.

Diagnosis and Improvements Plan Study of CIPP Model-based Vocational Competency Development Training Teacher Qualification Training (Training Course) (CIPP 모형 기반 직업능력개발훈련교사 자격연수(양성과정) 진단 및 개선 방안 연구)

  • Bae, Gwang-Min;Woo, Hye-Jung;Choi, Myung-Ran;Yoon, Gwan-Sik
    • Journal of vocational education research
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    • v.36 no.2
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    • pp.95-121
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    • 2017
  • The vocational competency development training teacher must complete the training course for the training of vocational competency development training instructor and get the qualification of the vocational competency development training teacher from the Ministry of Employment & Labor with the criteria set by the Presidential Decree. Therefore, it can be said that H_university 's educational performance, which is the only vocational competency development training teacher in Korea and that plays a role of mass production in the labor market, has a great influence on vocational competency development training. The purpose of this study is to identify the problems through the analysis of actual condition of vocational competency development training education based on CIPP model, Furthermore, it was aimed to suggest improvement plan of qualification training education. In order to accomplish the purpose of the research, the present situation of the training course for the vocational competency development training teacher training students was grasped. And We conducted a survey to draw out the improvement plan and utilized the results of 173 copies. We conducted interviews by selecting eight subjects for in-depth analysis and Understand the details of the results of the surveys conducted. As a result of the study, positive responses were obtained from the educational objectives and educational resources in the context factors. On the other hand, there were negative opinions about the curriculum reflecting the learner and social needs. In the input factors, positive opinions were derived from the educational objectives and training requirements. However, there were many negative opinions about the achievement of the learner's educational goals. In addition, there were many negative opinions of online contents education. In the process factors, positive evaluation was high in class related part, learner attendance management, and institutional support. However, negative opinions were drawn on the comprehensive evaluation of qualification training period, and the learner's burden due to lack of learning period appeared to be the main reason. In the factor of calculation, Positive opinions were derived from the applicability of the business curriculum for training courses for training teachers who are in charge of education and training in industry occupations. However, there were negative opinions such as learning time, concentration of learning, and communication of instructors. Based on the results of the study, suggestions for improving the operation of vocational competency training teacher qualification training are as follows. First, it is necessary to flexibly manage the training schedule for the weekly training course for vocational competency development training teachers. Second, it is necessary to seek to improve the online education curriculum centered on consumers. Third, it is necessary to seek access to qualification training for local residents. Fourth, pre - education support for qualified applicants is required. Finally, follow-up care of qualified trainees is necessary.

"Critical Application of Witness Commentaries: The Case of Guerrilla Warfare in the Korean War" ("증언자료의 비판적 활용 - 6.25전쟁 시기 유격대의 경우")

  • Cho, Sung Hun
    • The Korean Journal of Archival Studies
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    • no.12
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    • pp.137-178
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    • 2005
  • The anticommunist guerrillas' activities that aretheconcern of this article took place largely in North Korea or behind the enemy-held lines. Verifying their history is accordingly difficult and requires careful attention, but despite their active operations the military as well as the scholarly community have been lax in studying them. The Korean War came to be perceived as a traditional, limited war with regular battles, so that the studies addressed mostly the regular operations, and guerrilla warfare is remembered as an almost 'exclusive property' of the communist invaders; a small wonder that the anticommunist guerrillas have not been studied much and the collection of materials neglected. Therefore, in contrast with the witness accounts concerning regular battles, witness resources were of a small volume about these "patriots without the service numbers." For the above reasons the guerrilla participants and their later-organized fellowships took to the task of leaving records and compiling the histories of their units. They became active preservers of history in order to inform later generations of their works and also to secure deserved benefits from the government, in a world where none recognized their achievements. For instance, 4th Donkey Unit published witness accounts in addition to a unit history, and left video-recordings of guerrilla witnesses before any institute systematized the oral history of the guerrillas. In the case of Kyulsa ("Resolved to Die") Guerrilla Unit, the unit history was 10 times revised and expanded upon for publication, contributing substantially to the recovery of anticommunist guerrilla history which had almost totally lacked documented resources. Now because the guerrilla-related witness accounts were produced through fellowship societies and not individually, it often took the form of 'collective memory.' As a result, though thousands of former guerrillas remain surviving, the scarcity of numerous versions of, or perspectives upon, an event renders difficult an objective approach to the historical truth. Even requests to verify the service of a guerrilla member or to apply for decoration or government benefits for those killed in action, the process is taken care of not at the hands of the first party but the veteran society, so that a variety of opinions are not available for consideration. Moreover, some accounts were taken by American military personnel, and since some historians, unaware of official documents or evaluation of achievements, tended to center the records around their own units and especially to exaggerate the units' performances, they often featured factual errors. Thefollowing is the means to utilize positively the aforementioned type of witness accounts in military history research. It involves the active use of military historical detachments (MHD). As in the examples of those dispatched by the American forces during the Korean War, experts should be dispatched during, and not just after, wartimes. By considering and investigating the differences among various perspectives on the same historical event, even without extra documented resources it is possibleto arrive at theerrors or questionable points of the oral accounts, supplementing the additional accounts. Therefore any time lapses between witness accounts must be kept in consideration. Moreover when the oral accounts come from a group such as participants in the same guerrilla unit or operation, a standardized list of items ought to be put to use. Education in oral history is necessary not just for the training of experts. In America wherethefield sees much activity, it is used not only in college or graduate programs but also in elementary and lifetime educational processes. In comparison in our nation, and especially in historical disciplines, methodological insistence upon documented evidences prevails in the main, and in the fields of nationalist movement or modern history, oral accounts do not receive adequate attention. Like ancient documents and monuments, oral history also needs to be made a regular part of diverse resource materials at our academic institutes for history. Courses in memory and history, such as those in American colleges, are available possibilities.