• The Journal of Korean Physical Therapy
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• 제25권3호
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• pp.160-166
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• 2013

Purpose: The aim of the study was to survey satisfaction with physical therapy. Methods: After the physical therapy consultation, patients filled in a Korean-language version of the 20-tiem version of the MedRisk Instrument developed for measuring Patient Satisfaction with physical therapy. Items are scored on a five-point Likert scale ranging from strongly disagree to strongly agree. The last two items are general satisfaction and future return to the clinic. Age and gender information was also collected anonymously. Exploratory factor analysis based on principal components analysis with varimax rotation was performed on the first 18 items of the MedRisk Instrument using SPSS v.20. Results: Four factors emerged with eigenvalues greater than 1, and these cumulatively explained 55% of the total variance in item scores. The factors were labelled: Internal, External Positives, External Negatives, and Clinic Presentation. Correlations of the factor scores with the two global items ranged from 0.29 to 0.70 (both p<0.001). Gender differences were only found on the last factor, with male Korean patients rating Clinic Presentation significantly higher than females (p=0.001). Conclusion: Using factor analysis, the proposed factor structure was revealed using the positive and negative components of the external aspects of the physical therapy and by identifying a clinic presentation which contributes to patients' satisfaction. The largest proportion of the variance in Patient Satisfaction was related to clinicians' attention and behaviour. The results of the analysis provide guidelines as to the dimensions of professional physical therapy care and the implications for service delivery and patient experience.

• Safety and Health at Work
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• 제11권1호
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• pp.10-18
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• 2020

Background: The elevated risk of occupational infection such as tuberculosis among health workers in many countries raises the question of whether the quality of occupational health and safety (OHS) and infection prevention and control (IPC) can be improved by auditing. The objectives of this study were to measure (1) audited compliance of primary health-care facilities in South Africa with national standards for OHS and IPC, (2) change in compliance at reaudit three years after baseline, and (3) the inter-rater reliability of the audit. Methods: The study analyzed audits of 60 primary health-care facilities in the Western Cape Province of South Africa. Baseline external audits in the time period 2011-2012 were compared with follow-up internal audits in 2014-2015. Audits at 25 facilities that had both internal and external audits conducted in 2014/2015 were used to measure reliability. Results: At baseline, 25% of 60 facilities were "noncompliant" (audit score<50%), 48% "conditionally compliant" (score >50 < 80%), and only 27% "compliant" (score >80%). Overall, there was no significant improvement in compliance three years after baseline. Percentage agreement on specific items between internal and external audits ranged from 28% to 92% and kappa from -0.8 to 0.41 (poor to moderate). Conclusion: Low baseline compliance with OHS-IPC measures and lack of improvement over three years reflect the difficulties of quality improvement in these domains. Low inter-rater reliability of the audit instrument undermines the audit process. Evidence-based investment of effort is required if repeat auditing is to contribute to occupational risk reduction for health workers.

• 한국가스학회지
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• 제5권4호
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• pp.40-48
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• 2001

본 연구에서는 LPG 충전소에 대하여 Fussel-Vesely 중요도와 RDF 및 RIF 중요도를 수행하여 위험성 등급(Risk Rank)을 설정하였다 설정된 위험성 등급에서 위험성이 가장 큰 장치 및 설비에 대하여 정량적 위험성 분석을 수행하였다. LPG 충전소에 대한 중요도 분석결과 외부사고가 가장 위험하다고 확인되었으며, ekda 으로 구조물 결함과 파이프 배관의 부식의 위험등급이 높았다. 정량적 위험성 분석 결과로는 LPG 충전소 저장탱크의 완전히 파열하였을 경우에 대한 BLEVE의 경가 발생하였을 경우에 복사열에 의해 공정 설비에 손해를 입히기에 충분한 거리는 46.3m로 분석되었다.

• 한국가스학회지
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• 제18권5호
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• pp.12-19
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• 2014

매설배관의 부식위험성을 최소화하고 음극방식의 효율극대화를 위해 다양한 비굴착 간접검사기법들이 수십년 전부터 이용되고 있으며, 미국에서는 굴착을 통한 매설배관 외면부식 직접평가법을 CFR 코드에서 규정하고 있다. 국내의 경우에는 도시가스사업법 관련 4개의 기준(KGS Code)에서 배관의 손상여부를 측정할 수 있는 장비를 이용하여 배관의 상태를 점검, 측정하고 이상부위에 대하여 누출검사를 한 경우 매설배관의 기밀시험을 한 것으로 보고 있을 뿐 배관외면부식 직접평가에 대한 규정은 없다. 본 논문에서는 미국, 영국 등 국외의 매설배관 건전성 관리 기준 및 방법을 조사하고, 국내의 매설배관 방식관리 실태 및 피복손상탐지 장치 이용실태 등을 조사한 후 국내 실정에 맞는 매설배관 외면부식 직접평가법을 제시하였다. 본 논문에서 제시한 매설배관 외면부식 직접 평가법은 국내에서 중압배관의 정밀안전진단 제도를 도입하는데 기초 자료로 활용되었다.

• Archives of Plastic Surgery
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• 제47권1호
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• pp.54-61
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• 2020

Background Conventional methods of external bleeding for congested fingertip replants exhibit notable problems, including uncontrollable bleeding and unpredictable survival of the replant. We have added a local injection of heparin calcium to the routine use of systemic heparinization for inducing external bleeding. We retrospectively examined patients who underwent external bleeding using our method. Methods Local subcutaneous injections of heparin calcium were made in 15 congested replants in addition to systemic heparinization. Each injection ranged from 500 to 5,000 U. The average duration of the injections was 4.1 days. Surgical outcomes were analyzed and compared with a control group of patients who underwent external bleeding without heparin calcium. Results The overall survival rate was 93.3%, which was higher than that of the control group (83.3%), but the difference was not statistically significant (P=0.569). The survival rate for subzones I and II by the Ishikawa subzone classification was 100%, whereas it was 87.5% in subzones III and IV. No statistically significant difference was observed. The rate of partial necrosis was 0% in subzones I and II, whereas it was significantly higher (66.7%) in subzones III and IV (P=0.015). The mean total blood loss via external bleeding was 588 g in 10 fingers. No patients required blood transfusion. Conclusions Congestion of a replanted fingertip can be successfully managed without blood transfusion by our method. Although complete relief from congestion in replants in subzones I and II is achievable, there is a higher risk of partial necrosis in subzones III and IV.

• 한국운동역학회지
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• 제33권2호
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• pp.62-72
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• 2023

Objective: Although balance training has been used as an effective ankle injury rehabilitation program to restore neuromuscular deficits in patients with chronic ankle instability, it is not effectively used in terms of motor learning. Attentional focusing can be an effective method for improving ankle kinematics to prevent recurrent ankle injuries. This study aimed to 1) evaluate the effects of attentional focus, including internal and external focus, and 2) determine a more effective focusing method for patients with chronic ankle instability to learn balance tasks. Method: Twenty-four patients with chronic ankle instability were randomly assigned to three groups (external focus, internal focus, and no feedback) and underwent four weeks of progressive balance training. The three-dimensional ankle kinematics of each patient were measured before and after training as the main outcomes. Ensemble curve analysis, discrete point analysis, and post hoc pairwise comparisons were performed to identify interactions between groups and time. Results: The results showed that (1) the external focus group was more dorsiflexed and everted than the internal focus group; (2) the external focus group was more dorsiflexed than the no feedback group; and (3) the no feedback group was more dorsiflexed than the internal focus group. Conclusion: Because dorsiflexion and eversion are ankle motions that oppose the mechanism of lateral ankle sprain, using the external focus method during balance training may be more effective in modifying these motions, thereby reducing the risk of ankle sprain.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2777-2782
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• 2013

The aim of the present study was to assess criterion validity and external reliability of a questionnaire on risk factors for breast cancer. Materials and Methods. Women with breast cancer diagnosis (the cases) (N=40) and matched individuals without cancer (the controls) (N=40) were asked to fill in a questionnaire twice: on a day of admission to hospital (Q1) and on a day before discharge (Q2), with a time interval of 4-6 days. The questionnaire included questions (N=150) on demographic and socioeconomic factors, diseases in the past, family history of cancer, woman's health, smoking, alcohol use, diet, physical activity, and work environment. Criterion validity of the questionnaire Q2 relative to reference questionnaire Q1 was assessed with the Spearman correlation coefficient (SCC); external reliability of the questionnaire was measured in terms of the intraclass correlation coefficient (ICC). Statistical analysis was performed with SPSS 16. Results. The responses to most of the questions on socioeconomic factors, family history on cancer, female health, lifestyle risk factors (smoking, alcohol use, physical activity) correlated substantially in both the cases and the controls with SCC and ICC>0.7 (p<0.01). Statistically non significant relationships defined only between the responses on amount of beer the cases drank at the ages up to 25 years and 26-35 years as well as time of use of estrogen and estrogens-progestin during menopause by the cases. Moderate and substantial SCC and ICC were determined for different food items. Only the response of the cases on veal consumption did not correlate significantly. Conclusions. The questionnaire on breast cancer risk factors is valid and reliable for most of the questions included.

• 대한간호학회지
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• 제50권4호
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• pp.621-630
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• 2020

Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness. Results: The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors' cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively. Conclusion: The CREP-model's discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.

• 한국전산구조공학회논문집
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• 제34권5호
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• pp.319-325
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• 2021

후쿠시마 원전사고 발생으로 다수기의 지진안전성에 관한 연구의 필요성이 부각되었다. 한 부지에 건설된 원자력발전소의 경우 유사한 지진응답을 보이기 때문에 적게나마 원자력발전소 SSCs간의 지진손상에 대하여 상관성이 존재하므로 합리적 지진안전성 평가를 위하여 지진손상 상관성을 고려하여야 한다. 본 연구에서는 쌍둥이 호기의 필수전원상실사건에 대하여 확률론적 지진안전성 평가를 수행하였다. 적절한 지진손상 상관계수를 도출하기 위하여 확률론적 지진응답해석을 수행하여 적용하였다. External Event Mensuration System 프로그램을 활용하여 다수기의 필수전원상실사건의 고장수목을 구성하여 지진취약도 및 지진리스크를 분석하였다. 또한 SSCs간의 지진손상 상관성을 완전독립 및 완전종속으로 고려하여 비교 분석을 수행하였다.

• 한국의학물리학회지:의학물리
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• 제29권4호
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• pp.123-136
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• 2018

The complex dose distribution and dose transfer characteristics of intensity-modulated radiotherapy increase the importance of precise beam data measurement and review in the acceptance inspection and preparation stages. In this study, we propose a process map for the introduction and installation of high-precision radiotherapy devices and present items and guidelines for risk management at the acceptance test procedure (ATP) and commissioning stages. Based on the ATP of the Varian and Elekta linear accelerators, the ATP items were checked step by step and compared with the quality assurance (QA) test items of the AAPM TG-142 described for the medical accelerator QA. Based on the commissioning procedure, dose quality control protocol, and mechanical quality control protocol presented at international conferences, step-by-step check items and commissioning guidelines were derived. The risk management items at each stage were (1) 21 ionization chamber performance test items and 9 electrometer, cable, and connector inspection items related to the dosimetry system; (2) 34 mechanical and dose-checking items during ATP, 22 multileaf collimator (MLC) items, and 36 imaging system items; and (3) 28 items in the measurement preparation stage and 32 items in the measurement stage after commissioning. Because the items presented in these guidelines are limited in terms of special treatment, items and practitioners can be modified to reflect the clinical needs of the institution. During the system installation, it is recommended that at least two clinically qualified medical physicists (CQMP) perform a double check in compliance with the two-person rule. We expect that this result will be useful as a radiation safety management tool that can prevent radiation accidents at each stage during the introduction of radiotherapy and the system installation process.