The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.63330.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.
Park, In-Hyae;Kang, Hae-Young;Lee, Jeong-Hee;Ryu, Hyun-Sook
Research in Community and Public Health Nursing
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v.11
no.1
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pp.21-36
/
2000
The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.
The AIDS is a serious health problem worldwide today and also in Korea. Increasing knowledge and modification of behavior by health education is an important goal of human immunodeficiency virus(HIV) prevention strategies. And school health education is an important part of health education. This study was conducted to evaluate the knowledge and attitude about AIDS in teachers and professors in Taegu City and to provide the basic data for school health education. A self-administered questionnaire was given to 1,124 teachers and professors from April to June 1992. Indeed, the majority of the teachers and professors have a lot of knowledges about AIDS, but many of them also have misconceptions. The level of knowledge about AIDS was positively associated with attitude toward infected students. The sources of knowledge about AIDS were mainly TV, newspapers and magazines, but a few of the subjects obtained their knowledge from health education programs. This study suggests that the reinforcement of health education for the teachers, professors and students he needed to provide the accurate knowledge on AIDS and adequate knowledge sources and materials for school health education on AIDS should be developed.
Bae, Jae Ho;Kang, Won Sub;Paik, Jong Woo;Kim, Jong Woo
Korean Journal of Psychosomatic Medicine
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v.20
no.2
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pp.112-119
/
2012
Objectives : Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. Methods : We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. Results : During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). Conclusions : In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.
Travel by airplane using airport in globalized modern society is familiar to our life but such airport can be a target of terrorists who would threaten our safety. However, aviation terrorism which is represented by 9.11 terror gives horror beyond our imagination to modern people. Since the first airplane hijacking in Peru in 1931 happened, security organization in each nation has taken various prevention measures to block aviation terrorism. The most realistic measures to prevent aviation terrorism would be security check activity to control approach of terrorist that passengers on airplane and cargos are checked to find out dangerous article like explosive etc. But security check activity in Korea shifted to security check activity focused on private security for efficiency of airport operation differently from security check activity in advanced countries where public interests is strengthened according to risk of terror after 9.11 system. That is, since Incheon airport opened in March 2001, security check system focused on the police was changed. Now Incheon international airport Corporation instructs and supervises security check job and private security personnel are in charge of actual security check activity. But this check system has limitation in blocking terror activity by terrorists which is systematized and intelligent as time passes due to deteriorated job satisfaction of private security personnel and confusing supervising system. Accordingly, it is suggested to introduce risk management skill which is one of management strategy of private corporation for security check activity to prevent terror activity. With this skill, risk factors of aviation terror are identified and analyzed regularly, and each process such as setting of priority, activity to reduce risk, and assessment of security is carried out. And it would be necessary to do efforts, for example, to properly change level of security check according to threat of terror such as to place policeman at airport security in case threat of terror is severe. On the other hand, it is necessary to establish national police organization for good communication of security check activity in field and supervising function, which can encourage systematization and specialization of aviation security job.
The idea of this study was derived from awareness of local governments and police's limitation on attempts to 'creating safe park'. The purpose of this study is to examine current political measures of preventing various types of possible crimes in the park and the limitation of those policies. Furthermore, this study aims to suggest possible explanations to utilize Private Security Sector for the effective and continuous way of managing park safety by considering legal and practical solutions and its expectations. The methods of analysis used in this study are, first, literature review of current park safety management policies. Second, this article examined implications of strategies of those policies throughout the case study of the USA's park safety policy. Third, this study suggested plans of action and role of Private Security Sector to improve park safety. The results present several arguments for the park safety. First, legislation of mandatory crime preventing programme in the early stages of designing park is required. Introducing the 'park special judicial police system' to the major parks for a immediate response to the crime can be one of suggestions. Moreover, proactive police response systems, such as one of the Seoul Metropolitan Police's policies- 'returning safe parks to a citizen' are required. Second, the case study of the USA regarding park safety confirmed that major parks in the USA have rigorous and detailed park regulations. It also showed that those parks take not only preventing measures, but also follow-up measures against crimes. Third, the results suggest creating human resources by contracting out Park Managers and Private Security Sector that have specialized experiences and techniques to prevent crimes and public disorders. Overall in this study, increased citizen's satisfaction level, control of continuous and systematic crimes, the spread of joint-production of public safety, and increased fields of the Private Security Sector are expected from the findings.
The vision disturbances of school- age children has been recognized as and important school health problem. As the visual disturbances of the school-age children is recognized as the nation's health problem. the importance of the development of educational program for visual health should be emphasized. Recently, eyeball movement and other visual health management method has been introduced for prevention or recovery of decrease in visual acuity. But, the effect of eyeball movement was not confirmed yet. And, the controversy around the treatment effect is continued. The decrease of visual acuity is one of the important school health problem as well as it causes discomfort in daily life of the students. So, it should be considered as an important subject for school health and there is a need to develop an effective intervention program for visual health. The purpose of this study is to develop and evaluate the program with the recognition of the need of the intervention for visual health. The visual health promotion program was developed by the researcher and the program was initiated by the school. Nonequivalent control group pretest-posttest design was applied for study which examined the effect of the visual health promotion program. The subjects were 742 children (experimental group: 398; control group: 344). The experiment was composed of health education and eyeball movement. Health education was provided 5 times to the children in the class room. Children of experimental group exercised eyeball movement in the class, watching video for 10 minutes two times a day. The exercise was continued for 10 weeks. The result of the study were as follows. 1) change of visual acuity Before the intervention, mean of the visual acuity was .86 for the experimental group and .91 for control group. After the intervention, mean of visual acuity was .95 for the experimental group and. 90 for the control group. There was no significant difference in the change of visual acuity between experimental and control group. 2) change of refraction. In the experimental group, 327 eyes (41.08%) were normal vision and 469 eyes (58.98%) were eyes of refraction errors, 38.82 % of the total eyes were myopia. There was no significant change in the refraction in the children with myopia after the intervention. 3) Awareness of visual acuity, change of knowledge, behavior. and attitude (1) After the intervention, there was a significant difference in the awareness of visual acuity (experimental group: 70.10%. control group: 50.97%, p<.01). (2) After the intervention, there was a significant knowledge increase in the experimental group (pp<.01). (3) There was no significant difference in the visual health behavior after the intervention. (4) There was a significant positive change in the attitude related to visual health in the experimental group ( pp<.05). 4) There was a significant positive change in the subjective discomfort of the students. But, there was no significant change in the objective eye symptom after the intervention. Even though there was no effect in the visual acuity and the change of the refraction. subjective visual health as well as the attitude and knowledge' of the children and parents toward visual health was improved significantly. Also, there was an increase in the intention of change and the awareness for the visual health management. It is suggested that various educational strategies for visual health promotion should be developed and examined for the visual health promotion of the students.
Lee, Eun Hee;Yim, Hyung Eun;Jang, Gi Young;Yoo, Kee Hwan;Son, Chang Sung;Hong, Young Sook;Lee, Joo Won
Clinical and Experimental Pediatrics
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v.51
no.9
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pp.992-997
/
2008
Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.
Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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1997.11a
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pp.3-31
/
1997
Water has always played a significant role in the lives of people. In urbanised Rome, with its million people. sophisticated supply systems developed and then fled with the empire. only to be rediscovered later But it was the industrial Revolution commencing in the eighteenth century that ushered in major paradigm shifts In use and altitudes towards water. Rapid and concentrated urbanisation brought problems of expanded demands for drinking supplies, waste management and disease. The strategy of using water from local streams, springs and village wells collapsed under the onslaughts of rising urban demands and pollution due to poor waste disposal practices. Expanding travel (railways. and steamships) aided the spread of disease. In England. public health crises peaks, related to water-borne typhoid and the three major cholera outbreaks occurred in the late eighteenth and early nineteenth century respectively. Technological, engineering and institutional responses were successful in solving the public health problem. it is generally accepted that the putting of water into pipe networks both for a clean drinking supply, as well as using it as a transport medium for removal of human and other wastes, played a significant role in towering death rates due to waterborne diseases such as cholera and typhoid towards the end of the nineteenth century. Today, similar principles apply. A recent World Bank report Indicates that there can be upto 76% reduction in illness when major water and sanitation improvements occur in developing countries. Water management, technology and thinking in Australia were relatively stable in the twentieth century up to the mid to late 1970s. Groundwater sources were investigated and developed for towns and agriculture. Dams were built, and pipe networks extended both for supply and waste water management. The management paradigms in Australia were essentially extensions of European strategies with the minor adaptions due to climate and hydrogeology. During the 1970s and 1980s in Australia, it was realised increasingly that a knowledge of groundwater and hydrogeological processes were critical to pollution prevention, the development of sound waste management and the problems of salinity. Many millions of dollars have been both saved and generated as a consequence. This is especially in relation to domestic waste management and the disposal of aluminium refinery waste in New South Wales. Major institutional changes in public sector water management are occurring in Australia. Upheveals and change have now reached ail states in Australia with various approaches being followed. Market thinking, corporatisation, privatisation, internationalisation, downsizing and environmental pressures are all playing their role in this paradigm shift. One casualty of this turmoil is the progressive erosion of the public sector skillbase and this may become a serious issue should a public health crisis occur such as a water borne disease. Such crises have arisen over recent times. A complete rethink of the urban water cycle is going on right now in Australia both at the State and Federal level. We are on the threshold of significant change in how we use and manage water, both as a supply and a waste transporter in Urban environments especially. Substantial replacement of the pipe system will be needed in 25 to 30 years time and this will cost billions of dollars. The competition for water between imgation needs and environmental requirements in Australia and overseas will continue to be an issue in rural areas. This will be especially heightened by the rising demand for irrigation produced food as the world's population grows. Rapid urbanisation and industrialisation in the emerging S.E Asian countries are currently producing considerable demands for water management skills and Infrastructure development. This trend e expected to grow. There are also severe water shortages in the Middle East to such an extent that wars may be fought over water issues. Environmental public health crises and shortages will help drive the trends.
It is quite difficult to actually prove the effectiveness of so-called target-hardening, one of the various strategies used to reduce crime, one of the serious problems in society recently. In particular, three to five minutes is often used as golden time for intruders to give up or stop, which is based on foreign and some indirect research cases in Korea, but there were no studies that more directly identified the average break-in operation time or the abandonment time based on the elapsed time when the shield hardware resists intruders. This study was the first of its kind in Korea to investigate and verify samples of 90 inmates of break-in burglars who were imprisoned in August 2018 by profiling the average criminal experience, education level, age, height and weight of typical Korean professional break-in thieves, and specific criminal methods, average break-in operation time, and the criteria for giving up if not breached. According to the analysis results, in the survey on the number of pre-invasion theft crimes by intruders, many of the respondents who participated in the survey were criminals of professional invasions, and by their physical characteristics, there was not much difference from ordinary adult men. Residential facilities were the highest in the world, followed by commercial and educational facilities. According to the survey on the types of facilities that committed intrusion into residential facilities, it was not safe to say that single-family housing accounted for the largest portion of single-family housing, multi-family housing, apartment high-rise (more than three stories), and apartment low-rise (more than one to three stories) among residential facilities, and that the ratio of apartment high-rise was higher than expected. Based on the average time required to break into a place for an intrusion crime, it is assumed that the psychological time worked in a place where the break-in was difficult, since the break-in was not performed while measuring the time of the break-in operation. In the case of time to give up a crime, more than half of the respondents said they would give up the crime even in less than four minutes, suggesting that a significant number of intrusive crimes can be prevented even if the facility has four minutes of intrusion resistance. This proves that most intruders will give up the break-in if the break-in resistance performance of the security facility is exercised for more than five minutes.
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