• Title/Summary/Keyword: Control measures

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Review of 2017 Major Medical Decisions (2017년 주요 의료판결 분석)

  • Lee, Jung Sun;Lee, Dong Pil;Yoo, Hyun Jung;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.207-254
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    • 2018
  • The major court rulings delivered in 2017 include the ruling that separated the legal character of denture production agreement signed together with medical care agreement and found a subcontracting dimension in the former, and the ruling that overcame the limitations of the theory of entire appearance of a fetus as discussed in civil law by using the legal principle of insurance which suggests that unborn child insurance takes effect after the contract is signed and the first installment of the premium is paid in. As more court rulings find the medical specialists responsible for accidents and injuries from drugs, some argue that medication counseling by the druggist who makes and dispenses drugs should be upgraded. And with respect to a court ruling that denied the hospital's responsibility for an infection-involving accident even if there were no records on specific measures taken in infection management, some criticized the court for being too conservative in recognizing responsibilities. And with respect to infectious disease management, some criticized the court for its interpretation and application of the facts in the direction of denying the negligence. In addition, some claimed that it is necessary to establish institutional system for hospital infection control and its aid for victims, and to improve the system including the reversal of the burden of proof given the special nature of hospital infections. A number of rulings on the duty to disclose included the one which stated that the specific matter did not require a doctor's explanation as it was explained or the specific medical service would have been performed even if no explanation had been given. There was a greatly controversial ruling over the scope of indemnification, which accepted the occurrence of multiple scars and deformation as disorders while regarding breast as a thoracic organ. And a Supreme Court ruling over interpreting Medical Service Act was criticized as overstepping the boundary allowed in the law.

Confidence Bounds following Adaptive Group Sequential Tests with Repeated Measures in Clinical Trials (반복측정자료를 가지는 적응적 집단축차검정에서의 신뢰구간 추정)

  • Joa, Sook Jung;Lee, Jae Won
    • The Korean Journal of Applied Statistics
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    • v.26 no.4
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    • pp.581-594
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    • 2013
  • A group sequential design can end a clinical trial early if a confirmed efficacy or a futility of study medication is found during clinical trials. Adaptation can adjust the design of clinical trials based on accumulated data. The key to this methodology is considered to control the overall type 1 error rate while maintaining the integrity of clinical trials. The estimation would be more complex and the sample size calculation will be more difficult if the clinical trials have repeated measurement data. Lee et al. (2002) suggested a repeated observation case by using the independent increments properties of the interim test statistics and investigated the properties of the proposed confidence interval based on the stage-wise ordering. This study extend Lee et al. (2002) to adaptive group sequential design. We suggest test statistics for the adaptation as redesigning the second stage of clinical trials and induce the stage-wise confidence interval of parameter of interests. The simulation will help to confirm the suggested method.

Observational Motor Skill Learning in Individuals with Intellectual Disabilities (지적장애인의 관찰적 운동기술 학습)

  • Kim, Sung-Woon;Kim, Yu-Jin;Kim, Jin-Gu
    • Journal of the Korea Convergence Society
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    • v.9 no.9
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    • pp.293-297
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    • 2018
  • The purpose of this study was to determine the influence of video modeling observational learning intervention on the learning and performance of a bowling skill in adolescents with intellectual disabilities. Thirty special middle school students whose ages ranged from 14 to 16 years were recruited from Daegu, Korea. Intellectual disabilities of the participants were assessed by Korean version of the Wechsler intelligence scale for adolescent and a social maturity scale. During the experiment, participants repeatedly watched the one-minute action observation film for three minutes before beginning each frame and played 60 frames. Statistical comparisons were performed using a 2 (groups) ${\times}$ 6 (trials) ANOVA, with repeated measures on the last factor of the acquisition stage (p<0.05). Factors of the retention stage scores were analyzed by one-way ANOVA. The sources of any significant main effects were tested using a Tukey's HSD (honest significant difference) approach. SPSS 21.0 was used for statistical analyses. The performance scores of the action observation group were significantly higher than those of the control group. The findings showed that observational learning in the form video modeling has the potential to enhance acquisition and learning of a bowling sport skill in intellectual disability individuals; however, these findings are limited to adolescents with moderate intellectual disabilities.

Association between Scrub Typhus Outbreaks and Meteorological Factors in Jeollabuk-do Province (전북지역 쯔쯔가무시증 발생과 기후요소의 상호 관련성)

  • Kang, Gong-Unn;Ma, Chang-Jin;Oh, Gyung-Jae
    • Journal of Environmental Health Sciences
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    • v.42 no.1
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    • pp.41-52
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    • 2016
  • Objectives: Scrub typhus is one of the most prevalent vector-borne diseases. It is caused by Orientia tsutsugamushi, which is transmitted when people are bitten by infected chigger mites. This study aims at quantifying the association between the incidence of scrub typhus and meteorological factors in Jeollabuk-do Province over the period 2001-2015. Methods: Reported cases of scrub typhus were collected from the website of the Disease Web Statistical System supported by the Korea Centers for Disease Control and Prevention (KCDC). Simultaneous meteorological data, including temperature, rainfall, relative humidity, and sunshine duration were collected from the website of the National Climate Data Service System by the Korea Meteorological Administration. Correlation and regression analyses were applied to identify the association between the incidence of scrub typhus and meteorological factors. Results: The general epidemiological characteristics of scrub typhus in Jeollabuk-do Province were similar to those nationwide for sex, age, and geographical distribution. However, the annual incidence rate (i.e., cases per 100,000) of scrub typhus in Jeollabuk-do Province was approximately four times higher than all Korea's 0.9. The number of total cases was the highest proportion at 13.3% in Jeonbuk compared to other regions in Korea. The results of correlation analysis showed that there were significant correlations between annual cases of scrub typhus and monthly data for meteorological factors such as temperature and relative humidity in late spring and summer, especially in the case of temperature in May and June. The results of regression analysis showed that determining factors in the regression equation explaining the incidence of scrub typhus reached 46.2% and 43.5% in May and June. Using the regression equation, each 1oC rise in the monthly mean temperature in May or June may lead to an increase of 38 patients with scrub typhus compared to the annual mean of incidence cases in Jeollabuk-do Province. Conclusion: The result of our novel attempts provided rational evidence that meteorological factors are associated with the occurrence of scrub typhus in Jeollabuk-do. It should therefore be necessary to observe the trends and predict patterns of scrub typhus transmission in relation to global-scale climate change. Also, action is urgently needed in all areas, especially critical regions, toward taking steps to come up with preventive measures against scrub typhus transmission.

A Change of Turbidity on Forest Stands by Rainfall Characteristics in Small Watershed (산지소유역에 있어서 강우특성에 따른 임분별 탁도 변화)

  • Ma, Ho-Seop;Kang, Won-Seok;Kang, Eun-Min
    • Journal of Korean Society of Forest Science
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    • v.101 no.3
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    • pp.381-386
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    • 2012
  • This study was carried out to clarify the turbidity change on three stands (Castanea crenata, Pinus densiflora and Plantation Land) by rainfall characteristics in small watershed. The change of turbidity showed in order of plantation land, Castanea stand and Pinus stand. The linear equations models between turbidity and rainfall intensity were able to account for 91% in Castanea stand, 80% in Pinus stand and 71% in plantation land. The linear equations models between turbidity and duration of rainfall were able to account for about 0-1% in three stands. The linear equations models between turbidity and preceding dry days were able to account for about 30% in three stands. The linear equations models between turbidity and accumulative rainfall were able to account for about 6-22% in three stands. The results indicates that soil runoff by land use and development of forest area could be applied to the mitigation measures such as afforestation and erosion check dam for erosion control and water quality management in small watershed.

Influences of Forest Environmental Factors on Turbidity of Stream Water (산림환경인자가 계류수의 탁수화에 미치는 영향)

  • Ma, Ho-Seop;Kang, Won-Seok;Kang, Eun-Min
    • Journal of Korean Society of Forest Science
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    • v.101 no.4
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    • pp.574-578
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    • 2012
  • This study was carried out to clarify the influences of forest environmental factors on turbidity of Stream water on three stands (Castanea crenata, Pinus densiflora and Plantation Land) of small watershed in Samgyeri Naedong-myeon Jinju-si Gyeongsangnam-do. The relationship between turbidity and forest environmental factors was a positive correlation at 1% level with chromaticity, suspended solid, sediment runoff erosion, slope, rainfall intensity, preceding dry days, watershed area and stream length and at 5% level with accumulative rainfall. The important factors that affected turbidity in small watershed showed in order of preceding dry days, rainfall intensity, stream length, chromaticity and suspended solid. In the stepwise regression between turbidity and forest environmental factors, the estimation equation is as follow; Y=-28.125+0.047x (suspended solid)+0.058x (chromaticity)+1.518x (rainfall intensity)+0.264x (stream length)+1.837x (preceding dry days). The results indicates that dangerous areas of landslide and soil runoff by land use could be applied to the mitigation measures such as afforestation, erosion check dam and revetment for erosion control and water quality management in small watershed.

An improvement of real-time polymerase chain reaction system based on probe modification is required for accurate detection of African swine fever virus in clinical samples in Vietnam

  • Tran, Ha Thi Thanh;Dang, Anh Kieu;Ly, Duc Viet;Vu, Hao Thi;Hoang, Tuan Van;Nguyen, Chinh Thi;Chu, Nhu Thi;Nguyen, Vinh The;Nguyen, Huyen Thi;Truong, Anh Duc;Pham, Ngoc Thi;Dang, Hoang Vu
    • Asian-Australasian Journal of Animal Sciences
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    • v.33 no.10
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    • pp.1683-1690
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    • 2020
  • Objective: The rapid and reliable detection of the African swine fever virus (ASFV) plays an important role in emergency control and preventive measures of ASF. Some methods have been recommended by FAO/OIE to detect ASFV in clinical samples, including realtime polymerase chain reaction (PCR). However, mismatches in primer and probe binding regions may cause a false-negative result. Here, a slight modification in probe sequence has been conducted to improve the qualification of real-time PCR based on World Organization for Animal Health (OIE) protocol for accurate detection of ASFV in field samples in Vietnam. Methods: Seven positive confirmed samples (four samples have no mismatch, and three samples contained one mutation in probe binding sites) were used to establish novel real-time PCR with slightly modified probe (Y = C or T) in comparison with original probe recommended by OIE. Results: Both real-time PCRs using the OIE-recommended probe and novel modified probe can detect ASFV in clinical samples without mismatch in probe binding site. A high correlation of cycle quantification (Cq) values was observed in which Cq values obtained from both probes arranged from 22 to 25, suggesting that modified probe sequence does not impede the qualification of real-time PCR to detect ASFV in clinical samples. However, the samples with one mutation in probe binding sites were ASFV negative with OIE recommended probe but positive with our modified probe (Cq value ranked between 33.12-35.78). Conclusion: We demonstrated for the first time that a mismatch in probe binding regions caused a false negative result by OIE recommended real-time PCR, and a slightly modified probe is required to enhance the sensitivity and obtain an ASF accurate diagnosis in field samples in Vietnam.

Effectiveness of Cognitive Behavioral Therapy Techniques for Control of Pain in Lung Cancer Patients: An Integrated Review

  • Phianmongkhol, Yupin;Thongubon, Kannika;Woottiluk, Pakapan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6033-6038
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    • 2015
  • Background: Experience of lung cancer includes negative impacts on both physical and psychological health. Pain is one of the negative experiences of lung cancer. Cognitive behavioral therapy techniques are often recommended as treatments for lung cancer pain. The objective of this review was to synthesize the evidence on the effectiveness of cognitive behavioral therapy techniques in treating lung cancer pain. This review considered studies that included lung cancer patients who were required to 1) be at least 18 years old; 2) speak and read English or Thai; 3) have a life expectancy of at least two months; 4) experience daily cancer pain requiring an opioid medication; 5) have a positive response to opioid medication; 6) have "average or usual" pain between 4 and 7 on a scale of 0-10 for the day before the clinic visit or for a typical day; and 7) able to participate in a pain evaluation and treatment program. This review considered studies to examine interventions for use in treatment of pain in lung cancer patients, including: biofeedback, cognitive/attentional distraction, imagery, hypnosis, and meditation. Any randomized controlled trials (RCTs) that examined cognitive behavioral therapy techniques for pain specifically in lung cancer patients were included. In the absence of RCTs, quasi-experimental designs were reviewed for possible conclusion in a narrative summary. Outcome measures were pain intensity before and after cognitive behavioural therapy techniques. The search strategy aimed to find both published and unpublished literature. A three-step search was utilised by using identified keywords and text term. An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all the identified keywords and index terms was then undertaken across all included databases. Thirdly, the reference list of all identified reports and articles were searched for additional studies. Searches were conducted during January 1991- March 2014 limited to English and Thai languages with no date restriction. Materials and Methods: All studies that met the inclusion criteria were assessed for methodological quality by three reviewers using a standardized critical appraisal tool from the Joanna Briggs Institute (JBI). Three reviewers extracted data independently, using a standardized data extraction tool from the Joanna Briggs Institute (JBI). Ideally for quantitative data meta-analysis was to be conducted where all results were subject to double data entry. Odds ratios (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals were to be calculated for analysis and heterogeneity was to be assessed using the standard Chi-square. Where statistical pooling was not possible the finding were be presented in narrative form. Results: There were no studies located that met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to cognitive behavioral therapy techniques pain and lung cancer patients.Conclusions: There is currently no evidence available to determine the effectiveness of cognitive behavioural therapy techniques for pain in lung cancer patients.

The Effects of Regular Taekwondo Exercise on Brain wave activation and Neurotrophic Factors in Undergraduate male students (규칙적인 태권도 운동이 남자 대학생의 뇌파 활성화 및 뇌신경성장인자에 미치는 영향)

  • Kim, Young-Il;Ok, Duck-Pil;Cho, Su-Youn
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.2
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    • pp.412-422
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    • 2018
  • The purpose of this study was to investigate effects of 12-weeks aerobic exercise and taekwondo exercise on brain wave activation and brain-derived neurotrophic factors in undergraduate male students. Twenty four male subjects participated in this study. They were separated into a Control group(CG; n=8), Aerobic training group (ATG; n=8) and Taekwondo training group(TTG; n=8). ATG and TTG participated in Aerobic exercise training and Taekwondo exercise training for 12 weeks, 50~80 minutes per day, 3 times a week at 60~80% HRR respectively. All data were analyzed by repeated measures two-way ANOVA. As a result, there were no significant differences in the body composition and brain activation in all groups. However BDNF increased significantly after 12 weeks in the aerobic training groups(ATG). It is suggest that 12 weeks of regular Taekwondo exercise training did not statistically affect brain activation and neurotrophic factors in undergraduate students.

Integrating market chain assessments with zoonoses risk analysis in two cross-border pig value chains in Lao PDR

  • Okello, Anna L;Tiemann, Tassilo T;Inthavong, Phouth;Khamlome, Boualam;Phengvilaysouk, Ammaly;Keonouchanh, Soukanh;Keokhamphet, Chattouphone;Somoulay, Virasack;Blaszak, Kate;Blacksell, Stuart D;Okello, Walter O;Allen, John
    • Asian-Australasian Journal of Animal Sciences
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    • v.30 no.11
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    • pp.1651-1659
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    • 2017
  • Objective: Lao PDR's recent accession to the World Trade Organization necessitates a greater understanding of the patterns and risk of livestock production in order to better align national policy with the Agreement on the Application of Sanitary and Phytosanitary Measures. This eco-health study was conducted to improve understanding of the interrelations between market chains and zoonotic infection risks at two strategic cross border points between Lao PDR, Thailand and Viet Nam. Methods: Information gained from smallholder farmer/trader interviews was integrated with serological surveys for pig-associated zoonoses-including hepatitis E virus (HEV), Taenia solium (T. solium) and trichinella-to identify potential linkages between disease risk and pig production and slaughter in low input systems common across the country. Results: Trichinella and HEV exposure was high in both humans and pigs in both study areas, significantly associated with pig slaughter and the subsequent consumption and handling of raw pork products. T. solium demonstrated a strong geographical and ethnic association with the northern study area bordering Vietnam. With the right knowledge and accessible, affordable inputs, the majority of smallholder farmers indicated a willingness to invest more in pig production, which could simultaneously improve livelihoods and decrease exposure to HEV, Trichinella, and T. solium through increased access to formal markets and an improved slaughter processes. Conclusion: The linkages identified when assessing disease risk in the context of potential economic and cultural drivers of transmission highlight the importance of a systems-based approach for the detection and control of zoonotic disease, and contributes to an improved understanding of the Lao PDR livestock sector.