• Proceedings of the Korean Society of Health Policy and Administration Conference
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• 2004.05a
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• pp.89-104
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• 2004

최근 들어 국가질병관리체계 현대화가 세계 각국 정부의 중요한 과제가 되고 있다. 캐나다 연방정부는 감염병과 만성질환을 관리하고 생물테러 등 응급상황에 효과적으로 대처하기 위하여 새로운 질병관리조직인 Public Health Agency를 창설하기로 결정하였다. 연방정부는 앞으로 2년간 1,412억원을 투입하여 Agency를 설립하고 사업기반을 확충해 나갈 예정이다(Health Canada, 2004). 또 EU 집행위원회도 지난 3월 European Center for Disease Prevention and Control 설립계획을 최종 승인하고 ECDC가 발족하는 내년 한 해에만 71억원을 투입할 예정이다(Bosch, 2004). 이렇듯 새로운 질병관리조직들이 만들어지고 있는 직접적인 계기는, 중증급성호흡기증후군(이하 SARS) 사태로 대변되는 신종 및 재출현 전염병의 폭발적 발생(outbreak)이다. 전염병의 만연 사태가 일어나면서 각국 정부는 국민건강 보호의 중요성을 재확인하는 한편, 질병으로 인한 경제적 손실을 현실적 문제로 인식하게 되었다. 비전염성질환과 손상으로 인한 질병부담도 세계 각국의 골칫거리다. 서구 여러 나라에서는 비전염성질환과 손상의 질병부담이 이미 매우 큰 상태이며, 저개발 국가들은 전염병과 비전염성질환으로 인한 "이중의 질병부담(double burden of disease)"을 안고 있다고 한다. (중략)고 한다. (중략)

• Korean Journal of Adult Nursing
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• v.21 no.5
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• pp.489-503
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• 2009

Purpose: This study was conducted to test criterion-related validity of the Critical Patients' Severity Classification System (CPSCS) developed by the Hospital Nurses' Association by examining relationships with brain injury severity measured by Glasgow Coma Scale (GCS), recovery state measured by Glasgow Outcome Scale (GOS), and days of stay in ICU of brain injury patients. Methods: Prospective correlational research design was adopted by including 194 brain injury patients admitted to ICU of one university hospital. Results: The score of CPSCS appeared to significantly discriminate the severity of brain injury. Among nursing activities in CPSCS, Respiratory therapy, IV Infusion and Medication, Monitoring, Activities of Daily Living (ADL), Treatment and Procedure were significant to discriminate the severity of brain injury. Respiratory therapy, Vital Signs, and Monitoring appeared to significantly discriminate the recovery states of 1- and 3-months. Nursing activities significantly contributed to predict the days of ICU stay were Respiratory therapy, ADL, and Teaching and Emotional Support. Conclusion: CPSCS developed by the Hospital Nurses Association appeared to be valid to discriminate or predict brain injury severity, recovery states, and days of stay in ICU for brain injury patients.

• Korean Journal of Biological Psychiatry
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• v.12 no.1
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• pp.20-31
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• 2005

Objectives:This study was designed to investigate the characteristics of personality changes and emotional distress using the Personality Assessment Inventory (PAI) in patients with traumatic brain injury(TBI), divided into mild (MTBI) and severe (STBI) groups according to the severity of injury. Methods:The subjects were consisted of 25 patients with MTBI, 25 patients with STBI, and 25 normal controls. They were interviewed with the PAI. The data were analyzed by ${\chi}^2$ test, analysis of variance and Tukey test. Results:The results were the followings. First, Negative Impression in validity scales was elevated above cutoff point(T score 70) in both MTBI and STBI groups. Second, the clinical scales of which scores elevated above the cutoff point were Somatic Complaints, Anxiety, Anxiety-Related Disorders, Depression, and Schizophrenia in the MTBI, and Somatic Complaints and Depression in the STBI. Third, the clinical subscales above the cutoff point were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Traumatic Stress, Cognitive Depression, Affective Depression, Physiological Depression, Thought Disorder, and Affective Instability in the MTBI, and Health Concerns, Cognitive Depression, Affective Depression, and Physiological Depression in the STBI. Fourth, Suicide Ideation in treatment scales was the only scale above the cutoff point in the MTBI and the others of the treatment and interpersonal scales in the MTBI and all of these scales of the STBI were not elevated above the cutoff point. Fifth, the scales of which scores showed significant difference between the MTBI and the STBI were Somatic Complaints, Anxiety, Depression, and Suicide Ideation, the subscales were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Physiological Depression, and Psychotic Experiences. Conclusion:These results suggest that the patients with MTBI had more somatic and anxiety symptoms, depressed mood, and suicidal ideation than the patients with STBI. These characteristics are generally consistent with clinical observation and findings from previous studies of the patients with TBI, and the PAI seems to be a beneficial adjunctive assessment tool for the evaluation of patients with traumatic brain injury.

• The Journal of the Korea Contents Association
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• v.20 no.10
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• pp.326-337
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• 2020

The purpose of this study is to analyze the effect of social participation types on cognitive impairment degree(normal, mild, severe cognitive function) by urban and rural difference. The research was performed by multinomial logistic regression with the data of elderly 5,668 over 55 years of age from the sixth wave(2016) and the seventh wave(2018) of the Korean Longitudinal Study of Ageing. Results show that social participation reduces the risk of cognitive impairment on both urban and rural older adults regardless of types, but the types of social participation, which are effective to reduce the risk of cognitive impairment, are different between urban and rural area. According to residential area, types of social participation, which are effective to decline the risk of being mild or severe cognitive impairment and the risk of being severe cognitive impairment relative to mild, are different. These findings suggest that, in order to prevent cognitive impairment and reduce the severity, social participation is strongly recommended and appropriate supports are required. This implies policy and intervention efforts considering the urban and rural difference are needed.

• Journal of Korean Public Health Nursing
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• v.32 no.2
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• pp.304-318
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• 2018

Purpose: This study examined the characteristic of the Injury Severity Score (ISS) of Korean geriatric patients with a traumatic injury in a nationally representative sample to determine the optimal cutoff of ISS of mortality according to age. Methods: The subjects were 3,018 non-elderly patients and 1,584 elderly patients with an ISS and Korean Triage and Acuity Scale (KTAS) in 2016 from the data of the Health Insurance Review and Assessment Service. The traumatic characteristics of the elderly and non-elderly were compared by stratifying the ISS. Receiver Operating Characteristic (ROC) curve analysis was used to find the optimal cutoff of ISS of mortality according to age. Results: The elderly were more prone to severe trauma than the non-elderly were. The distribution of KTAS grades was lower, even though the severity of ISS was as high as that of the non-elderly. The optimal cutoff score of the ISS for mortality in the ROC curve was lower in elderly over 65 years than in the other age group. Conclusion: The elderly are more prone to severe trauma and death than non-elderly, even though their ISS is low. Therefore, a strategy to prevent elderly from experiencing serious trauma and managing their geriatric trauma actively is needed.

• Clinical and Experimental Pediatrics
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• v.48 no.12
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• pp.1330-1336
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• 2005

Purpose : It has been suggested that changes in cerebral blood flow by ventilator care could be a risk factor in periventricular leukomalacia(PVL) and severe periventricular-intraventricular hemorrhage(PV-IVH). The study aims to assess the relationship between perinatal clinical events, including ventilator care, and the development of PVL and severe PV-IVH; especially, whether ventilator care could be causers of PVL and severe PV-IVH as an individual risk factor. Methods : Among 255 very low birth weight infants who survived in the Fatima neonatal intensive care unit from January 1999 to December 2003, 15 infants with PVL and eight infants with severe PV-IVH were classified as a study group, while 231 infants were enrolled as a control group. The analysis was performed retrospectively with medical records. Results : Twenty four infants were diagnosed with PVL or severe PV-IVH. Asphyxia, recurrent apnea, sepsis, acidosis and ventilator care were significantly increased in the PVL goup. Asphyxia, recurrent apnea, RDS, acidosis and ventilator care were significantly increased in the severe PV-IVH group. Conclusion : Infants with PVL or severe PV-IVH may have multiple perinatal risk factors including asphyxia, recurrent apnea, sepsis, acidosis, RDS and ventilator care. Because most patients with ventilator care have multiple perinatal risk factors, ventilator care does not cause PVL and severe PV-IVH independently. Therefore, incidences of PVL and severe PV-IVH can be decreased by not only gentle ventilation, but also more professional antenatal care.

• Journal of Digital Convergence
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• v.17 no.12
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• pp.345-352
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• 2019

This study aims to analyze the factors affecting the length of stay in elderly pediatric inpatients in traffic accidents. We used Korean National Hospital Discharge In-depth Injury data on the discharged from 2012 to 2016. Statistically significant factors affecting the length of stay are admission route, Charlson Comorbidity Index(CCI), injury parts, operation, results, hospital area, and beds for hospitals. The length of stay was shorter in the case of the admission route of the outpatient department than the emergency room, the results were not improved or death rather than improved, and the bed size was 500-999 beds or over 1000 beds rather than 100-299 beds. However, the length of stay was longer in the case of CCI score was 1-2 or over 3 rather than 0, injury parts were other parts rather than head/neck, when the operation was yes, and when the hospital area was a province, metropolitan rather than Seoul. This study intends to understand the medical characteristics of inpatient to prevent pedestrian traffic accidents in accordance with the population aging. Based on this finding, we wish to be used as the basic data for the establishment of policies to effectively manage traffic safety and medical resources in consideration of the characteristics of the elderly people.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.15-20
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• 2011

A person with neurological disorder is defined as a person with limitation of ambulation or basic life activity due to the cerebral palsy or traumatic brain damage, stroke. Recently, the DMFT of the children with neurological disorders is similar or lower than the DMFT of the children with no disability. But, this article is about the severe-early childhood caries in children with grade 1 neurological disorder. It is supposed that the primary motor impairment and secondary physical weakness, frequent hospitalization, sugar- rich food and drugs, lack of oral care, delayed dental visit made high caries susceptibility. In case of treatment of the children with severe neurological disorders, dentists should make a thorough caries preventive plan based on individualized caries risk assessment. Also parents and medical doctors should recognize the importance of oral care and do the early dental visit and home care.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.777-780
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• 2009

We reported here on 2 cases of aortic regurgitation (AR) that were due to avulsion of the aortic valve commissure. Aortic valvuloplasty was attempted in both cases. In the 1st case, valvuloplasty was performed with reattaching the commissure using the 5-0 polypropylene continuous suture technique. However, aortic regurgitation recurred and this lead to reoperation on the postoperative $14^{th}$ day. The intraoperative finding revealed a completely re-detached commissure that required mechanical valve replacement. In the second case, we attempted to reattach the commissure using pledgetted multiple transverse mattress sutures with 5-0 polypropylene. Because the leaflet coaptation was incomplete, the aortic valve was replaced with a tissue valve.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.3
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• pp.1234-1243
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• 2011

Our study was carried out to develop the severity-adjustment model for length of stay in hospital for community-acquired pneumonia so that we analysed the factors on the variation in length of stay(LOS). The subjects were 5,353 community-acquired pneumonia inpatients of the Korean National Hospital Discharge In-depth Injury Survey data from 2004 through 2006. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. There are differences according to gender, age, type of insurance, type of admission, but there is no difference of whether patients died in hospital. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for community-acquired pneumonia. There was variation of LOS in regional differences and insurance type, though there was no variation according whether patients receive their care in their residences. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.