• Title/Summary/Keyword: Tertiary

Search Result 2,328, Processing Time 0.027 seconds

Antibiotics Susceptability of Streptococcus pneumoniae Isolated from Single Tertiary Childrens' Hospital Since 2014 and Choice of Appropriate Empirical Antibiotics (최근 4년간 국내 단일 의료기관을 내원한 소아청소년에서 분리된 폐구균의 항생제 감수성 양상 분석)

  • Jung, Jiwon;Yoo, Ree Nar;Sung, Hungseop;Kim, Mina;Lee, Jina
    • Pediatric Infection and Vaccine
    • /
    • v.26 no.1
    • /
    • pp.1-10
    • /
    • 2019
  • Purpose: We investigated the distribution and antimicrobial resistance of pneumococcal isolates from hospitalized children at Asan Medical Center for recent 4 years, and aimed to recommend proper choice of empirical antibiotics for pneumococcal infection. Methods: From March 2014 to May 2018, children admitted to Asan Medical Center Childrens' Hospital with pneumococcal infection were subjected for evaluation of minimal inhibitory concentration (MIC) for ${\beta}-lactams$ and macrolide antibiotics. Patient's age, underlying disease, gender were retrospectively collected. Using Monte Carlo simulation model and MIC from our study, we predicted the rate of treatment success with amoxicillin treatment. Results: Sixty-three isolates were analyzed including 20.6% (n=13) of invasive isolates, and 79.4% (n=50) of non-invasive isolates; median age were 3.3 years old, and 87.3% of the pneumococcal infections occurred to children with underlying disease. Overall susceptibility rate was 49.2%, 68.2%, and 74.6% for amoxicillin, parenteral penicillin, and cefotaxime respectively. 23.8% and 9.5% of the isolates showed high resistance for amoxicillin, and cefotaxime. Only 4.8% (n=3) were susceptible to erythromycin. Monte Carlo simulation model revealed the likelihood of treatment success was 46.0% at the dosage of 90 mg/kg/day of amoxicillin. Conclusions: Recent pneumococcal isolates from pediatric patients with underlying disease revealed high resistance for amoxicillin and cefotaxime, and high resistance for erythromycin. Prudent choice of antibiotics based on the local data of resistance cannot be emphasized enough, especially in high risk patients with underlying disease, and timely vaccination should be implemented for prevention of the spread of resistant strains.

A Study on the Development of Middle School History Curriculum Standards for Revitalization of Cultural Property Education (문화재 교육 활성화를 위한 중학교 역사교육과정기준 개발 방안 연구)

  • AHN, Daehyun;HONG, Hoojo
    • Korean Journal of Heritage: History & Science
    • /
    • v.54 no.3
    • /
    • pp.150-167
    • /
    • 2021
  • Since the advent of tertiary curriculum, middle school history education has been focused on political history, but many students perceive history as a simple memorization subject and complain about difficulties in abstract learning. The researcher saw this problem as caused by the history curriculum, and carried out this study for the purpose of proposing a revitalization of cultural property education in the middle school history curriculum. First, through the analysis of prior research, the usefulness of cultural property education, such as nurturing creative talent and realizing interactive history classes, was revealed, and the problems of the current political history-centered middle school history curriculum were pointed out. Afterwards, as a result of conducting an opinion survey on middle school 3rd grade students and social studies teachers, it was found that first, both middle school students and their teachers thought that the current political history-centered history had much room for improvement. Second, all groups agreed on the necessity of cultural property education in history education. However, in reality, it was found that it was not easy to sufficiently educate students about cultural property in a political history-centered curriculum. Third, teachers thought that it was necessary to improve the current history curriculum in order to enhance cultural property education. Based on these findings, the researcher suggested an improvement plan for the 2015 revised history curriculum. First, in the 'nature of the subject' section, cultural properties and historical materials should be included, and in the 'objective' section, politics, economy, society, and culture should be included. Contents related to cultural properties should be added to the sub-themes in the 'content system and achievement standards', and cultural properties-related contents should be further reinforced in the achievement standards, 'teaching, learning and evaluation'. It was suggested that this section should include cultural property learning and historical material learning, and guidance on teaching and learning methods of cultural property education should be added. If these aspects are reflected in the 2022 revised curriculum that is currently being developed, cultural property education will be improved, and more lively history education will be provided to students.

Incidence and Characteristics of Clostridioides difficile Infection in Children (소아 Clostridioides difficile 감염의 발생률 및 임상양상)

  • Jeong, Heera;Kang, Ji-Man;Ahn, Jong Gyun
    • Pediatric Infection and Vaccine
    • /
    • v.27 no.3
    • /
    • pp.158-170
    • /
    • 2020
  • Purpose: We evaluated the incidence and characteristics of Clostridioides difficile infection (CDI) in Korean children. Methods: Medical records of patients aged 2-18 years and diagnosed with CDI at a tertiary hospital between 2009 and 2018 were analyzed. The patients were classified into three CDI groups: community-acquired (CA), community onset-health care facility-associated (CO-HCFA), and healthcare facility onset (HO). Results: The incidence of CDI increased from 1.00 to 10.01 cases per 10,000 admissions from 2009 to 2018 (P<0.001). As compared to the CA group, the HO group had a higher frequency of operation and malignancy as predisposing factors (40.4% vs. 0.0%, P=0.001; and 27.7% vs. 0.0%, P=0.027, respectively), frequency and number of previous antibiotic use (97.9% vs. 31.3%, P<0.001; and 2 vs. 0, P<0.001, respectively), and median postdiagnosis hospital stay (13 vs. 5 days, P=0.008). The CO-HCFA group had a lower median age and higher frequency of malignancy than the CA group (5 vs. 13 years, P=0.012; and 30.8% vs. 0.0%, P=0.030, respectively). As compared to the HO group, the CA group had a higher frequency of abdominal pain and hematochezia (56.3% vs. 10.6%, P=0.001; and 50.0% vs. 10.6%, P=0.002, respectively), inflammatory bowel disease (68.8% vs. 2.1%, P=0.001), and intravenous metronidazole treatment (37.5% vs. 2.1%, P=0.001). Conclusions: With the increasing incidence of pediatric CDI, awareness regarding its epidemiology and clinical characteristics is important to manage nosocomial infections.

Development of A Material Flow Model for Predicting Nano-TiO2 Particles Removal Efficiency in a WWTP (하수처리장 내 나노 TiO2 입자 제거효율 예측을 위한 물질흐름모델 개발)

  • Ban, Min Jeong;Lee, Dong Hoon;Shin, Sangwook;Lee, Byung-Tae;Hwang, Yu Sik;Kim, Keugtae;Kang, Joo-Hyon
    • Journal of Wetlands Research
    • /
    • v.24 no.4
    • /
    • pp.345-353
    • /
    • 2022
  • A wastewater treatment plant (WWTP) is a major gateway for the engineered nano-particles (ENPs) entering the water bodies. However existing studies have reported that many WWTPs exceed the No Observed Effective Concentration (NOEC) for ENPs in the effluent and thus they need to be designed or operated to more effectively control ENPs. Understanding and predicting ENPs behaviors in the unit and \the whole process of a WWTP should be the key first step to develop strategies for controlling ENPs using a WWTP. This study aims to provide a modeling tool for predicting behaviors and removal efficiencies of ENPs in a WWTP associated with process characteristics and major operating conditions. In the developed model, four unit processes for water treatment (primary clarifier, bioreactor, secondary clarifier, and tertiary treatment unit) were considered. Additionally the model simulates the sludge treatment system as a single process that integrates multiple unit processes including thickeners, digesters, and dewatering units. The simulated ENP was nano-sized TiO2, (nano-TiO2) assuming that its behavior in a WWTP is dominated by the attachment with suspendid solids (SS), while dissolution and transformation are insignificant. The attachment mechanism of nano-TiO2 to SS was incorporated into the model equations using the apparent solid-liquid partition coefficient (Kd) under the equilibrium assumption between solid and liquid phase, and a steady state condition of nano-TiO2 was assumed. Furthermore, an MS Excel-based user interface was developed to provide user-friendly environment for the nano-TiO2 removal efficiency calculations. Using the developed model, a preliminary simulation was conducted to examine how the solid retention time (SRT), a major operating variable affects the removal efficiency of nano-TiO2 particles in a WWTP.

A Study on World University Evaluation Systems: Focusing on U-Multirank of the European Union (유럽연합의 세계 대학 평가시스템 '유-멀티랭크' 연구)

  • Lee, Tae-Young
    • Korean Journal of Comparative Education
    • /
    • v.27 no.4
    • /
    • pp.187-209
    • /
    • 2017
  • The purpose of this study was to highlight the necessity of a conceptual reestablishment of world university evaluations. The hitherto most well-known and validated world university evaluation systems such as Times Higher Education (THE), Quacquarelli Symonds (QS) or Academic Ranking of World Universities (ARWU) primarily assess big universities with quantitative evaluation indicators and performance results in the rankings. Those Systems have instigated a kind of elitism in higher education and neglect numerous small or local institutions of higher education, instead of providing stakeholders with comprehensive information about the real possibilities of tertiary education so that they can choose an institution that is individually tailored to their needs. Also, the management boards of universities and policymakers in higher education have partly been manipulated by and partly taken advantage of the elitist ranking systems with an economic emphasis, as indicated by research-centered evaluations and industry-university cooperation. To supplement such educational defects and to redress the lack of world university evaluation systems, a new system called 'U-Multirank' has been implemented with the financial support of the European Commission since 2012. U-Multirank was designed and is enforced by an international team of project experts led by CHE(Centre for Higher Education/Germany), CHEPS(Center for Higher Education Policy Studies/Netherlands) and CWTS(Centre for Science and Technology Studies at Leiden University/Netherlands). The significant features of U-Multirank, compared with e.g., THE and ARWU, are its qualitative, multidimensional, user-oriented and individualized assessment methods. Above all, its website and its assessment results, based on a mobile operating system and designed simply for international users, present a self-organized and evolutionary model of world university evaluation systems in the digital and global era. To estimate the universal validity of the redefinition of the world university evaluation system using U-Multirank, an epistemological approach will be used that relies on Edgar Morin's Complexity Theory and Karl Popper's Philosophy of Science.

Development History of Neotectonic Fault Zone in the Singye-ri Valley, Oedong-eup, Gyeongju, Korea (경주시 외동읍 신계리 계곡에 발달하는 신기 단층대 발달사)

  • Kang, Ji-Hoon;Son, Moon;Ryoo, Chung-Ryul
    • Korean Journal of Mineralogy and Petrology
    • /
    • v.33 no.4
    • /
    • pp.349-359
    • /
    • 2020
  • The Ulsan Fault Zone (UFZ) of NNW trend is developed in the Gyeongsang Basin, the southeastern part of the Korean Peninsula, and the Quaternary faults have been found around the UFZ. The faults generally thrust the Bulguksa igneous rocks of Late Cretaceous-Early Tertiary upon the Quaternary deposits or are developed within the Quaternary deposits. They mainly show the reverse-slip sense of top-to-the west movement. The lines connecting the their outcrop sites show a zigzag-form which is similar to the orientation of their fault surfaces which show the various trends, like (W)NW, N-S, (E)NE, ENE trends. The E-W trending dextral strike(-slip) fault is found in the Quaternary deposits of the Singye-ri valley. It cuts the N-S trending reverse fault and are cut by the N-S trending thrust fault again. Two types of at least two times of Quaternary tectonic movements related to the formation of neotectonic fault zone in the Singye-ri valley are considered from such the geometric and kinematic characteristics of Quaternary faults. One is the reverse faulting of N-S trend by the E-W directed 1st compression and associated the strike-slip tear faulting of E-W trend, and then the thrust faulting of N-S trend by the E-W directed 2nd compression. The other is the reverse faulting of N-S trend, and then the dextral strike-slip faulting of E-W trend by the NW-SE directed compression, and then the thrust faulting of N-S trend. In this paper is suggested the development history of Singye-ri neotectonic fault zone on the basis of the various orientations of Quaternary fault surfaces around the UFZ, and the zigzag-form connecting line of their outcrop sites, and the compressive arc-shaped lineaments which convex to the west reported recently in the Yangsan Fault Zone.

Frequency of Candida Strains Isolated from Candidiasis Patients at A Tertiary Hospital over the Last 10 Years (최근 10년 동안 일개 상급종합병원의 칸디다혈증 환자에서 분리된 칸디다 균종의 빈도)

  • Hwang, Yu-Yean;Kang, On-Kyun;Park, Chang-Eun;Hong, Sung-No;Kim, Young-Kwon;Huh, Hee-Jae;Lee, Nam-Yong
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.54 no.2
    • /
    • pp.110-118
    • /
    • 2022
  • Candidemia is a major cause of nosocomial infections resulting in increased morbidity and mortality. It remains a serious risk in inpatients and increases medical treatment costs. From 2009 to 2018, Candida strains (3,533) isolated from blood culture tests at the S Hospital were analyzed according to the period, year, sex, age, ward, etc. During the entire period, 54,739 of 717,996 blood culture tests showed a positive rate (7.6%) and the Candida isolation rate was 3,533 (6.4%) out of 1,036 patients. Among the Candida isolates, C. albicans was most common (33.8%), followed by C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), and C. krusei (4.0%). In early (2009~2013)/late (2014~2018) isolation, C. tropicalis decreased by 3.8% and C. glabrata increased by 3.4%. After 50 years of age, the higher the separation frequency. C. parapsilosis (31.3%) in 1~10s, C. tropicalis (30.3%) and C. glabrata (27.6%) in 41~50s, and C. tropicalis (28.6%) in 80s are relatively frequent. has been separated C. krusei was isolated in a relatively high proportion from females (60.9%). Therefore, a systematic and continuous nosocomial infection control system should be established for appropriate treatment as per antifungal treatment guidelines. The system should continuously monitor the distribution of Candida species and provide rapid identification results.

Development and Validation of the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC) (한국형 긍정적 행동지원 3차 실행충실도 척도(KT3-FC)의 개발과 타당화)

  • Won, Sung-Doo;Chang, Eun Jin;Cho Blair, Kwang-Sun;Song, Wonyoung;Nam, Dong Mi
    • Korean Journal of School Psychology
    • /
    • v.17 no.2
    • /
    • pp.165-180
    • /
    • 2020
  • As a tiered system of supports, School-Wide Positive Behavior Support (SWPBS) is an evidence-based practice in the educational system of Korea. An important aspect of SWPBS is the ongoing progress monitoring and evaluation of implementation fidelity. This study aimed to develop and validate the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC). The preliminary KT3-FC consisted of a 37-item, 6-factor checklist. In the first phase of the study, 10 experts reported that the range of content validity of the KT3-FC was adequate. In the second phase of the study, 185 teachers (52 men and 133 women) who implemented SWPBS completed the KT3-FC, Individualized Supports Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and PBS Effectiveness Scale. An exploratory factor analysis resulted in a 5-factor structure, with 20 items, instead of 37 items, consisting of: (a) progress monitoring and evaluation of the individualized supports, (b) provision of supports by aligning and integrating mental health and SWPBS, (c) crisis management planning, (d) problem behavior assessment, and (e) establishment of individualized support team. The internal consistency of the KT3-FC was good (full scale α = .950, sub-factor α = .888 ~ .954). In addition, the KT3-FC showed good convergent validity, having statistically significant correlations with the Individualized Support Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and the PBS Effectiveness Scale. Finally, the confirmatory factor analysis showed that the 5-factor model of the KT3-FC had some good model fits, indicating that the newly developed fidelity measure could be a reliable and valid tool to assess the implementation of Tier 3 supports in Korean schools. Accordingly, the KT3-FC could contribute to implement SWPBS as an evidence-based behavioral intervention for Korean students.

Rare Earth Elements (REE)-bearing Coal Deposits: Potential of Coal Beds as an Unconventional REE Source (함희토류 탄층: 비전통적 희토류 광체로서의 가능성에 대한 고찰)

  • Choi, Woohyun;Park, Changyun
    • Economic and Environmental Geology
    • /
    • v.55 no.3
    • /
    • pp.241-259
    • /
    • 2022
  • In general, the REE were produced by mining conventional deposits, such as the carbonatite or the clay-hosted REE deposits. However, because of the recent demand increase for REE in modern industries, unconventional REE deposits emerged as a necessary research topic. Among the unconventional REE recovery methods, the REE-bearing coal deposits are recently receiving attentions. R-types generally have detrital originations from the bauxite deposits, and show LREE enriched REE patterns. Tuffaceous-types are formed by syngenetic volcanic activities and following input of volcanic ash into the basin. This type shows specific occurrence of the detrital volcanic ash-driven minerals and the authigenic phosphorous minerals focused at narrow horizon between coal seams and tonstein layers. REE patterns of tuffaceous-types show flat shape in general. Hydrothermal-types can be formed by epigenetic inflow of REE originated from granitic intrusions. Occurrence of the authigenic halogen-bearing phosphorous minerals and the water-bearing minerals are the specific characteristics of this type. They generally show HREE enriched REE patterns. Each type of REE-bearing coal deposits may occur by independent genesis, but most of REE-bearing coal deposits with high REE concentrations have multiple genesis. For the case of the US, the rare earth oxides (REO) with high purity has been produced from REE-bearing coals and their byproducts in pilot plants from 2018. Their goal is to supply about 7% of national REE demand. For the coal deposits in Korea, lignite layers found in Gyungju-Yeongil coal fields shows coexistence of tuff layers and coal seams. They are also based in Tertiary basins, and low affection from compaction and coalification might resulted into high-REE tuffaceous-type coal deposits. Thus, detailed geologic researches and explorations for domestic coal deposits are required.

A Consideration of Perception on Enforcement of Serious Accident Punishment Act(SAPA) among the Workers in the Nuclear Medicine Department (중대재해처벌법 시행에 따른 핵의학 종사자의 인식 고찰)

  • Lee, Joo-Young
    • Journal of the Korean Society of Radiology
    • /
    • v.16 no.4
    • /
    • pp.477-490
    • /
    • 2022
  • Serious Accident Punishment Act(SAPA) went into effect as of Jan. 27, 2022. The subject of study was the worker of the nuclear medicine department and the investigation was aimed at identifying the present situation of their understanding on the issue in the here and now, which can be utilized as basic research for further study. The survey was conducted on 51 people of the worker in the nuclear medicine department. The general factors were classified by their gender, the scale of the hospitals, the period of career, and the detailed occupational categories. The conclusion was drawn, including 1 missing data in gender and 2 in the type of occupation. The targeted hospitals were tertiary hospital, university hospital, and general hospital which have nuclear medicine department in. The period of subjects' career was categorized by less than 3 years, 3 to 5 years, 5 to 10 years, and more than 10 years. The specific occupation was classified by in-vivo radiological technologist, radiation safety manager and others. The amount of pressure that the job entails was highest in the category of general hospital, the period of 3 to 5 years of job experience, and radiation safety manager each. The system of the code was well constructed in the category of general hospital, the period of less than 3-year career, and radiation safety manager, as they responded. The blood transmissible disease had the largest number of outbreak of accidents related to the serious industrial accident. In addition, the radiopharmaceutical dosing error had the highest number of outbreak of accidents related to the serious civil accident. Therefore, we need to improve SAPA, facility inspection, security of budget, security of professional manpower. It will help the stable use of radiation and ensure patient safety.