• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.126-136
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• 2018

The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.12
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• pp.938-943
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• 2018

Thin nano-sized fibres were prepared by an electrospinning method. The spinning appratus consisted of pump for polymer injection, nozzle and nozzle rotus, and an aluminum plate collected the polymer fibers. Its surface was chemically modified for selective improved adsorption of carbon monoxide at indoor level. The chemical activation enabled to form the fibres 250-350 nm in thickness with pore sizes distributed between 0.6 and 0.7 nm and an average specific surface area of $569m^2/g$. The adsorption capacities of pure (100%) and indoor (0.3%) $CO_2$, of which level frequently appears, at the ambient condition were improved from 1.08 and 0.013 to 2.2 and 0.144 mmol/g, respectively. It was found that the adsorption amount of $CO_2$ adsorbed by the chemically activated carbon nanofiber prepared through chemical activation would vary depending on the ratio of specific surface area and micropores. In particular, chemical interaction between adsorbent surface and gas molecules could enhance the selective capture of weak acidic $CO_2$.

• Korean Journal of Construction Engineering and Management
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• v.20 no.3
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• pp.46-53
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• 2019

Recently, the need for emergency medical facilities is increasing due to a large-scale disaster. The Ministry of the Interior and Safety has completed the development of Disaster Resource Sharing System (DRSS). In this system, only air tent and negative pressure tent, which are classified and managed as equipment are resources related to emergency medical facility at disaster site. However, the characteristics of resources for the facility such as the time of input, a period of stay, transportation, and installation methods were not reflected. So, The purpose of this study is to propose improvements of management of resources for emergency medical facility at disaster site, that classified to materials and equipment in DRSS. This study analyzed the state of resources for facilities and the attributes of resources based on literature and disaster medical consultation of mobile hospitals. The resources for emergency medical facility are required to be linked to medical support resources and reflected in the DRSS, since emergency medical facility resources at the disaster site should be managed through a combination of medical resources classified as equipment. And future research on installation of emergency medical facilities plan considering the cost of the disaster management resources should be carried out.

• Journal of Digital Convergence
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• v.18 no.12
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• pp.425-434
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• 2020

Background: Viral infection outbreaks are emerging public health concerns. They often exhibit seasonal patterns that could be predicted by the application of big data and bioinformatic analyses. Purpose: The purpose of this study was to identify trends in diarrhea-causing viruses such as rotavirus (Gr.A), norovirus G-I, and norovirus G-II in Cheonan, Korea. The identified related factors of diarrhea-causing viruses may be used to predict their trend and prevent their infections. Method: A retrospective analysis of 4,009 fecal samples from June 2010 to December 2019 was carried out at Dankook University Hospital in Cheonan. Reverse transcription-PCR (RT-PCR) was employed to identify virus strains. Information about seasonal patterns of infection was extracted and compared with local weather data. Results: Out of the 4,009 fecal samples tested using multiplex RT-PCR (mRT-PCR), 985 were positive for infection with Gr.A, G-I, and G-II. Out of these 985 cases, 95.3% (n = 939) were under 10 years of age. Gr.A, G-I, and G-II showed high infection rates in patients under 10 years of age. Student's t-test showed a significant correlation between the detection rate of Gr.A and the relative humidity. The detection rate of G-II significantly correlated with wind-chill temperature. Conclusion: Climate factors differentially modulate rotavirus and norovirus infection patterns. These observations provide novel insights into the seasonal impact on the pathogenesis of Gr.A, G-I, and G-II.

• Journal of Digital Convergence
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• v.19 no.1
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• pp.285-293
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• 2021

Politics and conflicts within organizations are natural phenomena found in any type of organization, affecting organizational outcomes and output variables. Nevertheless, there are not many previous studies on politics and conflict within nursing organizations. Therefore, in this study, we would like to analyze how the internal politics and conflicts, which have been excluded from the previous studies related to nursing organizations, affect the quality of communication between nurses. Data were collected from 310 nurses in an university hospital. Using SPSS21, the data were analyzed by descriptive statistics, Pearson's correlation analysis, and multiple regression analyses. As results of the analyses, the organizational politics and relationship conflict have negative effect on the quality of vertical and horizontal communication, and task conflict has a positive effect on them. Organizational politics and relationship conflict have negative effects on quality of formal communication. Organizational politics and conflicts did not significantly affect the quality of informal communication. These results suggest that active, managerial efforts should be executed to overcome the negative effects of organizational politics and emotional conflicts among nurses. Furthermore, empirical research on organizational politics and conflicts within nurses organizations should be expanded.

• 한국노년학
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• v.30 no.4
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• pp.1197-1211
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• 2010

This research was concucted to present a model of advance directives(AD) when a patient, who is in consciousness, shows a preference for an end of life care as an act of preparing for an uncertain situation that may arise in the forseeable future. The subjects of the research are 383 doctors/nurese and adults, who live in six cities and provinces, to investigate the status of AD, attitude regarding a meaningless life-prolonging treatment, and moreover, an understanding of and a preference for AD. The research was done by the well-structured questionnaire. Also, SPSS 14.0 is used to analyse the collected data, focused on frequency analysis, avearage and standard deviation, X2 test. As the results of the study, the most of the surveyed doctors/nurese knew DNR orders and AD and a few of them used DNR orders and AD practically. Also, the result shows that there is a negative conception of meaningless life-prolonging treatment among the responents, in addition, most of them agreed upon the idea of introducing AD to Korea, filling it out and making it legally effective. As a method of making AD out, the respondents wanted to use a form that mixed living will with an Power of Attorney in a document. Also, considering the appropriate time, respondents prefered when they are diagnosed with terminal illness. At the moment, the introductory model for AD, which is suitable for the Korean culture and current situation is presented based on the result of this research. In the future, other researches should deal with specific measures that can lead to a social consensus to adopt AD in Korea.

• Journal of the Health Care and Life Science
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• v.10 no.2
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• pp.295-303
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• 2022

The purpose of this study is to investigate the changes in smoking rates and smoking cessation plans before and after the cigarette price increases in 2015. Therefore, based on the National Health and Nutrition Survey, this study analyzes the correlation of the change in smoking rate and cessation plans with sociological variables (gender, age, income quintile, occupation, education level, hypertension, diabetes) and health behaviors (drinking, stress perception, obesity) in 2013 before the cigarette price increases and in 2015 and then in 2017. Results indicated that the smoking rate in 2013 was 23.3%, the smoking rate in 2015 was 20.5%, and the smoking rate in 2017 was 21.0%, indicating that the smoking rate decreased compared to before the cigarette price was raised. Among the sociological variables, the cigarette price increases showed a difference in the smoking rate of income, occupation, and education level, and health behavior was found to have no significant effect on smoking rate. In addition, the cigarette price increases showed a temporary effect on the increase in the smoking cessation plan, but the increase in the smoking cessation plan did not necessarily lead to decrease the smoking rate. Therefore, in the future, efforts will be needed at the national level to provide customized smoking cessation programs by gender, age, and social factors so that the smoking cessation plan can lead to decrease the smoking rate. In addition, Research on health behaviors that were not identifited in this study should also be conducted. We hope that this study will help the prediction of the impact of smoking rate in case the price increases policies are considered or implemented.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2293-2303
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• 2013

Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.297-341
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• 2017

We searched out court rulings on medical affairs through court library search sites and specialized articles on medically relevant judgments sentenced in 2016. And we selected and analyzed the judgements of the court we considered important as follows. In relation to the medical civil judgements, (1) In the case of applying surgery for female infertility during cesarean section operation but it has not been done, we expressed the regret for the lack of judgment in the process of entering the medical contract, introducing the rights infringed and the scope of compensation, (2) We pointed out that the ruling on the medical malpractice estimation goes out of limit of negligence estimation doctrine, and that the court asked very high degree duty of the traditional Korean medicine doctors to cooperate with Western medicine doctors. (3) In the case of admitting hospital's 100% responsibility, we pointed out the court overlooked the uncertainty and good intention of the medical practice. (4) Additionally, We introduced the cases admitted the hospital's responsibility in the accident related to the psychiatric patients in closed ward. Relating to a medical criminal ruling, we analyzed the supreme court decision about whether the dentist's Botox injection on the patient's face is a medical practice within the scope of the license from the viewpoint whether it is within the possible range of the word. And, concerning decisions on healthcare administration, (1) we analyzed the case about when medical personnel operate multiple medical institutions, whether it is possible to get back medical care costs under the National Health Insurance Law, (2) We commented on the ruling regarding explanation obligation in terms of object, degree, subject of explanation as a prerequisite for permissible arbitrary uninsured benefits. Finally, we reviewed the decision of the Constitutional Court about the Article 24 of the Mental Health Law, which it had allowed for a mental patient to be hospitalized forcibly by the consent of two guardians and a diagnosis of a psychiatrist. Also we indicated the problems of the revised Mental Health Law.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.474-480
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• 1995

Background: In spite of initial intensive and long-term chemotherapy for pulmonary tuberculosis, many problems remain in the treatment of the residual lesion. The role of surgical intervention for pulmonary tuberculosis is getting rid of such residual lesion of pulmonary tuberculosis to support the healing process and to induce bacteriologically negative conversion in the end. Method: We experienced 30 cases of pulmonary resection for pulmonary tuberculosis from Aug. 1994 through Apr. 1995 in National Masan Tuberculosis Hospital. We conducted retrospective study to analyze several variables for the cases. Results: 1) The ratio between male and female was 4:1(male 24, female 6) and the age of peak incidence was in 3rd and 4th decades. 2) Indications for pulmonary resection in the radiographic findings were cavitary lesions of 19 cases(63.3%), destroyed one side of 8 cases(26.7%) and destroyed one lobe of 3 cases(10%). 3) 16 of 20 cases with unilateral lesions and all of 10 cases with bilateral lesions on chest X-ray films showed AFB positive on preoperative sputum smears. 14 cases(87.5%) of unilateral lesions and 9 cases(90%) of bilateral ones were converted into AFB negative postoperatively. Negative conversion rates of pneumonectomy and lobectomy cases were 100% and 85.7%, respectively. 4) Preoperative combined disease was 3 cases(10%) of DM and postoperative complications were 2 cases(6.7%) of dead space and no death. Conclusion: Chemotherapy only has some limitation in treatment of all tuberculosis. So, surgical intervention for pulmonary tuberculosis is an effective method as partner of chemotherapy.