• Title/Summary/Keyword: Medical safety

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Relationship between Spatial Inclusivity and Social Participation According to Degree of Disability (장애 정도에 따른 공간적 포용성과 사회참여의 관계)

  • Kim, Si Hwa;Park, In Kwon
    • Journal of the Korean Regional Science Association
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    • v.39 no.3
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    • pp.65-83
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    • 2023
  • The purpose of this study is to conceptually define "spatial inclusivity" and empirically examine the impact of disability severity and spatial inclusivity on social participation among individuals experiencing physical discomfort. The social and spatial environment of the residential area is crucial for individuals with disabilities who face limited activity range and complex barriers due to physical constraints. In this study, spatial inclusivity from the perspective of people with disabilities is defined as establishment of equal relationships with non-disabled individuals within the local community, as well as the availability of basic facilities and services in a safe urban space that allows for access and utilization. This concept consists of three dimensions: individual networks, social environment, and physical environment. The physical environment encompasses safety levels, natural environment, living environment, public transportation conditions, medical services in residential areas. We used the 2019 Community Health Survey to examine the relationship between disability severity, spatial inclusivity, and social participation using a two level regression model. The findings are as follows: Firstly, personal relationships at the individual level and the physical environment at the local level have a positive impact on social participation. Secondly, when identifying dividing the physical environment into five sub-factors, no significant influence of individual factors is found. Thirdly, trustworthy and friendly social environment at the local level has a negative impact on social participation. These results provide empirical evidence that spatial inclusivity has an effect on the social participation of individuals with disabilities and suggest implications for urban planning to create and enhance conditions for the social participation of individuals with disabilities.

Infection Control in Pulmonary Function Laboratories in Domestic Hospitals (국내 의료기관의 폐기능검사실에서 감염관리 실태조사)

  • Nan-Hee LEE;Suhng Wook KIM
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.3
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    • pp.143-150
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    • 2023
  • The global outbreak of COVID-19 has underscored the pressing need for robust infection control practices in pulmonary function laboratories (PFL). However, the existing guidelines and regulatory frameworks provided by relevant authorities in the country have revealed certain deficiencies in effectively addressing this significant public health crisis. This study surveyed the infection control regulations, disposable item usage, ventilation facilities, spatial separation, and the configuration of entrance doors in 51 domestic hospital facilities from Oct 1, 2021, to Nov 2, 2021. The survey findings revealed that while there was a relatively satisfactory adherence to airborne, droplet, and contact precautions with adequate awareness and utilization of personal protective equipment, the environmental disinfection practices exhibited a suboptimal performance rate of 39.22% per patient. Depending on the specific survey domains, substantial variations were observed in the utilization of disposable items (81.05%), ventilation systems (45.75%), dedicated testing spaces (80.39%), separation of administrative areas (15.69%), and the installation of automated doors (19.61%). This study not only highlights the paramount importance of infection control in PFLs within domestic medical institutions but also provides foundational data for developing and enhancing standardized guidelines that align with international benchmarks for infection control in these settings.

Cleft lip and palate surgery during COVID-19 pandemic in Indonesia: a 36-month experience at the Bandung Cleft Lip and Palate Center

  • Ali Sundoro;Dany Hilmanto;Hardisiswo Soedjana;Ronny Lesmana;Kevin Leonard Suryadinata
    • Archives of Craniofacial Surgery
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    • v.24 no.3
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    • pp.111-116
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    • 2023
  • Background: In Indonesia, the prevalence of cleft lip and palate increased from 0.08% to 0.12% between 2013 and 2018. Children with cleft deformities typically undergo staged surgery. However, the coronavirus disease 2019 (COVID-19) pandemic has had negative impacts on the healthcare sector, including the suspension of elective procedures; this has raised concerns about the safety of performing surgery and the functional consequences of delaying treatment, the latter of which is associated with poor prognosis. The purpose of this study was to report the characteristics of clefts treated by the Bandung Cleft Lip and Palate Center team during the pandemic period. Methods: This brief comparative study based on a chart review was conducted at the Bandung Cleft Lip and Palate Center. We statistically evaluated data from all patients treated between September 2018 and August 2021. Frequency analysis was performed to analyze the average number of each procedure by age before and during the COVID-19 pandemic. Results: Data from 18-month periods before (n= 460) and during (n= 423) the pandemic were compared. Cheiloplasty procedures were examined (pre-pandemic, n= 230; pandemic, n= 248); before the pandemic, 86.1% were performed according to the treatment protocol (patient < 1 year old), and this proportion non-significantly dropped to 80.6% during the pandemic (p= 0.904). Palatoplasty procedures were also compared (pre-pandemic, n= 160; pandemic, n= 139); the treatment protocol (patient 0.5-2 years old) was followed for 65.5% of procedures before the pandemic and 75.5% during the pandemic (p= 0.509). Additionally, 70 (mean age, 7.94 years) revision and other procedures were performed before the pandemic and 36 (mean age, 8.52 years) during the pandemic. Conclusion: The cleft procedures performed at the Bandung Cleft Lip and Palate Center did not significantly change during the COVID-19 pandemic.

The Characteristics of Firefighter Burn Injuries in a Burn Center: A Retrospective Epidemiological Study (소방관 화상 환자의 화상수상특징에 대한 1개 화상전문병원에서의 예비조사)

  • Kim, Hyeongtae;Kang, Gu Hyun;Jang, Yong Soo;Kim, Wonhee;Choi, Hyun Young;Kim, Jae Guk;Kim, Minji;You, Ki Cheol;Kim, Dohern;Yim, Haejun;Bang, Sung Hwan;Lee, Chang Sub
    • Journal of the Korean Burn Society
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    • v.19 no.1
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    • pp.12-15
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    • 2016
  • Purpose: Firefighters are vulnerable to burn injury during firefighting. In extensive fires, conducted heat and radiant heat can cause burn injury even though firefighters are not directly exposed to fire. There has been increasing interest in the health problems of firefighters considerably since Hongje-dong fire of 2001, which claimed the lives of six fireman. However, there have been no studies done on the characteristics of firefighter burn injuries in South Korea. Therefore, we investigated the characteristics of firefighter burn injuries in a burn center. Methods: A retrospective, single-center research was performed between Jan 2006 to Dec 2015. 24 firefighters came to the burn center. The electronic medical records of patients were reviewed. Results: Flame burns (87.5%) were the major cause of burn in firefighter. All the patients suffered second-degree or third-degree burns. Mean burn size was 6.1±6.7%. 22 of 24 patients were hospitalized and 2 of 22 hospitalized patients admitted to intensive care unit. Mean length of hospitalization was 29.1±23.7 days and mean length of intensive care unit hospitalization was 6.0±1.4 days. The face was the site most commonly burned, representing 25.8% of injuries. The hand/wrist, upper extremity, and neck were the next largest groups, with 19.4, 12.9, 11.3% of the injuries, respectively. Conclusion: Firefighter burn injuries occur to predictable anatomic sites with common injury patterns. The burn size was small but, admitted patients need about 30 days of hospitalization.

Tissue Adequacy and Safety of Percutaneous Transthoracic Needle Biopsy for Molecular Analysis in Non-Small Cell Lung Cancer: A Systematic Review and Meta-analysis

  • Bo Da Nam;Soon Ho Yoon;Hyunsook Hong;Jung Hwa Hwang;Jin Mo Goo;Suyeon Park
    • Korean Journal of Radiology
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    • v.22 no.12
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    • pp.2082-2093
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    • 2021
  • Objective: We conducted a systematic review and meta-analysis of the tissue adequacy and complication rates of percutaneous transthoracic needle biopsy (PTNB) for molecular analysis in patients with non-small cell lung cancer (NSCLC). Materials and Methods: We performed a literature search of the OVID-MEDLINE and Embase databases to identify original studies on the tissue adequacy and complication rates of PTNB for molecular analysis in patients with NSCLC published between January 2005 and January 2020. Inverse variance and random-effects models were used to evaluate and acquire meta-analytic estimates of the outcomes. To explore heterogeneity across the studies, univariable and multivariable metaregression analyses were performed. Results: A total of 21 studies with 2232 biopsies (initial biopsy, 8 studies; rebiopsy after therapy, 13 studies) were included. The pooled rates of tissue adequacy and complications were 89.3% (95% confidence interval [CI]: 85.6%-92.6%; I2 = 0.81) and 17.3% (95% CI: 12.1%-23.1%; I2 = 0.89), respectively. These rates were 93.5% and 22.2% for the initial biopsies and 86.2% and 16.8% for the rebiopsies, respectively. Severe complications, including pneumothorax requiring chest tube placement and massive hemoptysis, occurred in 0.7% of the cases (95% CI: 0%-2.2%; I2 = 0.67). Multivariable meta-regression analysis showed that the tissue adequacy rate was not significantly lower in studies on rebiopsies (p = 0.058). The complication rate was significantly higher in studies that preferentially included older adults (p = 0.001). Conclusion: PTNB demonstrated an average tissue adequacy rate of 89.3% for molecular analysis in patients with NSCLC, with a complication rate of 17.3%. PTNB is a generally safe and effective diagnostic procedure for obtaining tissue samples for molecular analysis in NSCLC. Rebiopsy may be performed actively with an acceptable risk of complications if clinically required.

Deriving Criteria Weights for Acute Care Hospital Accreditation in South Korea: Using Analytic Hierarchy Process (급성기병원 인증기준의 가중치 도출: 계층적 분석법을 활용하여)

  • Hwa Yeong Oh;Hyeon-Jeong Lee;Minsu Ock;In Ho Kim;Ho Yeol Jang;Ji-Eun Choi
    • Quality Improvement in Health Care
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    • v.30 no.1
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    • pp.33-43
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    • 2024
  • Purpose:The acute hospital accreditation program launched in South Korea has shown positive effects on safety culture and quality of care. However, relative weights have not yet been investigated for accreditation criteria with a hierarchical structure. This study aimed to derive the relative weights of acute-care hospital accreditation criteria. Methods: We conducted an online survey using the analytic hierarchy process (AHP) technique to assess the validity, importance, and urgency of acute hospital accreditation criteria. The AHP online survey link was distributed in November 2022 after obtaining informed consent from 10 experts in hospital accreditation. Results: 'Basic value system' ranked highest, while 'patient care system' ranked second in terms of validity, importance, and urgency. 'Performance management system' had the lowest validity and urgency, while 'organizational management system' carried the lowest importance. Within the 'patient care system' domain, 'surgery and anesthesia sedation management' scored highest in validity and importance, and 'patient care' scored highest in urgency. 'Care delivery system and evaluation' received the lowest scores for all three aspects. In the 'organizational management system' domain, infection control ranked highest in terms of validity, importance, and urgency. The lowest validity was observed for 'management and organizational operation' and the lowest importance and urgency were noted for 'human resource management'. Conclusion: The weights for validity, importance, and urgency, as shown in each domain and chapter, and the number of measurable elements included, are largely inconsistent. This study will contribute to the development of the structure and scientific improvement of accreditation standards.

Radiofrequency Ablation of Papillary Thyroid Microcarcinoma: A 10-Year Follow-Up Study (갑상선 미세유두암의 고주파 절제술 후 10년 경과 관찰)

  • Yoo Kyeong Seo;Seong Whi Cho;Jung Suk Sim;Go Eun Yang;Woojin Cho
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.914-922
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    • 2021
  • Purpose To investigate the efficacy and safety of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) after > 10 years of follow-up. Materials and Methods This study included five patients who underwent RFA to treat PTMCs (five lesions, mean diameter 0.5 cm, range 0.4-0.7 cm) between November 2006 and December 2009. The inclusion criteria were histopathologically confirmed PTMCs, a single PTMC lesion without extrathyroidal extension, no metastasis, and ineligibility or refusal to undergo surgery. RFA was performed by a single radiologist using a radiofrequency generator and an internally cooled electrode. We retrospectively analyzed the procedure-induced complications, serial changes in ablated tumors, recurrence, and local as well as lymph node metastasis based on data obtained from medical records and radiological images. Results The mean follow-up period was 130.6 months (range 121-159 months). Three patients underwent a single RFA session, and two patients underwent two RFA sessions. We observed no procedure-induced complications. Three tumors completely disappeared after ablation, and ablation of the other two tumors resulted in the formation of a small scar that showed long-term stability (mean duration 16.8 months, range 12-27 months). At the last follow-up, no patient showed recurrence or lymph node metastasis, and serum thyroglobulin levels were within normal limits in all patients. Conclusion RFA may be effective and safe to treat low-risk PTMC in patients who refuse or are ineligible for surgery.

Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea

  • Jongmin Oh;Youn-Hee Lim;Changwoo Han;Dong-Wook Lee;Jisun Myung;Yun-Chul Hong;Soontae Kim;Hyun-Joo Bae
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.2
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    • pp.185-196
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    • 2024
  • Objectives: Excess mortality associated with long-term exposure to fine particulate matter (PM2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM2.5 by considering the potential non-linear concentration-response relationship in Korea. Methods: Daily cause-specific mortality rates and PM2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM2.5 concentrations below 15 ㎍/m3. Overall deaths attributable to short-term PM2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM2.5 exposure. Results: Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM2.5. The estimated number of all-cause excess deaths due to short-term PM2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472). Conclusions: Our findings indicate an association between short-term PM2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM2.5.

A Study on the Dose Constraints for Occupational Exposure: Focusing on Expert Opinions by Field of Ridiation Industry (직무피폭의 선량제약치에 관한 연구: 분야별 전문가 의견 중심으로)

  • Il Park;Chan Hee Park;Kyu Hwan Jung;Chan Ho Park;Yong Geon Kim;Tae Jin Park
    • Journal of Radiation Industry
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    • v.17 no.1
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    • pp.61-67
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    • 2023
  • A Study on the Introduction of Dose Constraints for Occupational Exposures: Focusing on Experts' Opinions by Field of Radiation Industry. The International Commission on Radiological Protection suggests Justification, Optimization, and Dose Limits as the three principles of radiological protection, among which, as a means of protection optimization, ICRP 103 recommends to set dose constraints. In this study, opinions are collected from experts in each category of radiation industries for stakeholder participation to qualify dose constraints. A guidance and questionnaire for analyzing the dose constraints have been developed for their collection, and opinions were collected from radiation protection experts in selected categories. 20 out of 22 experts, consisted with 91%, have assessed the dose constraints setting is necessary, and 2 experts, consisted with 9%, assessed it is unnecessary. The average of dose constraint presented by experts for RI production institutions is to be the highest level of 15.3 mSv, and light-water reactors (14.6 mSv), non-destructive inspection (14.4 mSv), heavy-water reactor and medical institutes (13.9mSv) is to be above the overall average dose constraint. In case of public institutions, the average dose constraint is to be 8.6mSv, and research institutions (8.8mSv), educational institutions (9.6 mSv), waste disposal sites (9.7 mSv), and general industries (10.6 mSv) are resulted to below the overall average dose constraint. As for the means of setting dose constraints, 8 experts out of 22 suggested setting dose constraints for each specific industry or task. And, 5 experts especially suggest setting dose constraints for the specific groups with relatively high exposure, such as workers with above the record levels. As a countermeasure for workers who exceed the dose constraints, 15 experts out of 22 expressed that the cause analyses for them and preparation for a plan of reducing them are necessary.

Analysis of research trends on infants and school-age-child: Focusing on Journal of The Korean Society for School & Community Health Education from 2000 to 2023 (영·유아기 및 학령기 아동에 관한 연구동향 분석: 2000~2023년 한국학교·지역보건교육학회지 게재논문을 중심으로)

  • Hee-Jung Park;Minsung Sohn;Seok Hwan Kim
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.3
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    • pp.39-49
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    • 2024
  • Purpose: This study aims to analyze the current status of research related to infants and school-age-child published in the journal of Korean society for school & community health education from 2000 to 2023, with the goal of contributing to the future development and enhancement of the journal. Method: From 2000 to 2023, 52 papers were analyzed, comparing and classifying their journal topic, research types, data collection methods, and data analysis methods. Results: The results shows that the highest publication trend occurred between 2008 and 2012, with most studies focusing on school-age children. In terms of research topic, 'health behavior and health education' was the most frequent with 14 papers (26.9%), followed by oral health with 9 papers (17.3%), safety management with 7 papers (13.5%), and sexual awareness with 6 papers (11.5%). Quantitative research was the most common research type, with surveys being the primary data collection method. Descriptive statistics and t-test were the most frequently used data analysis methods. Conclusion: To enhance the quality of the journal of Korean society for school & community health education, there should be an expansion of evidence-based research focusing on infants and school-age children. Additionally, there is a need for greater diversity in research design, data collection, and analysis methods.