• Title/Summary/Keyword: Assessment of deterioration

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Effect of Systematic Educational Program for the Application of National Institutes of Health Stroke Scale (NIHSS) as a Neurologic Assessment Tool in Stroke Patients (뇌졸중의 신경학적 사정 도구인 NIHSS 적용을 위한 체계적인 간호사 교육 프로그램의 효과)

  • Han, Jung Hee;Lee, Gee Eun;An, Young Hee;Yoo, Sung Hee
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.57-68
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    • 2013
  • Purpose: In assessing patients' neurological status following a stroke it is very important to have a valid tool for early detection of neurological deterioration. NIHSS is considered the best tool to reflect neurological status in patients with ischemic stroke. An education program on use of NIHSS was planned for nurses caring for these patients and the effects of the program were evaluated. Methods: The NIHSS education program (NEP) which includes online and video lectures, and practical education was provided to the nurses from April to July, 2010. To examine the effect of NEP, nursing records of patients with ischemic stroke who were admitted to a stroke center were analyzed. Two groups, a historical control group (n=100) and the study group (n=115) were included. Results: Nursing records for neurologic symptoms for each patient increased (41.0% versus 100.0%, p<.001), and especially, visual disturbance, facial palsy. limb paralysis and ataxia, language disturbance, dysarthria, and neglect symptoms significantly increased (all p<.001). Nurse notification to the doctor of patients with neurological changes increased (21.0% versus 39.1%, p=.004), and nurses' neurological deterioration detection rates also increased (37.5% versus 84.6%, p=.009). Conclusion: NEP improved the quality of nursing records for neurological assessment and the detection rate of neurological deterioration.

Assessment of interhospital transport care for pediatric patients

  • Chaichotjinda, Krittiya;Chantra, Marut;Pandee, Uthen
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.184-188
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    • 2020
  • Background: Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur. Purpose: To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors. Methods: This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017. Results: There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipment-related adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; P=0.028). Conclusion: The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.

Highway Bridge Inspection Period Based on Risk Assessment (위험도평가에 의한 고속도로 교량의 점검주기)

  • Lee, Il-Keun;Kim, Dong-Hyawn
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.19 no.3
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    • pp.64-72
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    • 2015
  • Risk Based Inspection (RBI) Period was proposed for highway bridges in Korea. Hazard factors affecting bridge condition deterioration were found by analyzing condition data from Highway Bridge Management System (HBMS). Certain level of correlations between those factors and condition deterioration were found. They are used to evaluate hazard score. Summarizing several hazard factors, final hazard is classified as three level;high, moderate, low. Vulnerability is assessed only by the current state of bridge. Then, risk matrix is suggested for inspection periods. Inspection periods of the bridges with grade C, D, and E are maintained the same as before. But, those of grade A and B with moderate and high hazard score are elongated to maximum 6 years while the maximum inspection period is three years at present. By adjusting inspection period according to risk assessment, it was shown that 27% of average inspection manpower can be saved.

A Durability Assessment on Complex Deterioration of Concrete with Ground Granulated Blast-Furnace Slag Replacement (복합열화 환경하에서의 고로슬래그미분말 사용 콘크리트의 내구성능 평가)

  • Lee, Seung-Hoon;Kim, Hyung-Doo
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.14 no.2
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    • pp.171-175
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    • 2010
  • This paper presents the experimental results of frost durability characteristics including freezing-thawing and de-icing salt scaling of the concrete for gutter of the road and marine structure. Mixtures were proportioned with the three level of water-binder ratio(W/B) and three binder compositions corresponding to Type I cement with 0%, 30% and 50% GGBS(Ground granulated blast furnace slag) replacement. Also, two different solutions of calcium chloride were used to evaluate their effect on the frost durability resistance. Specially, in case of complex of freezing and thawing with salt and carbonation, the deterioration of concrete surface is evaluated. Test results showed that the BFS30 and BFS50 mixture exhibited higher durability and lower mass loss values than those made with OPC mix and the use of GGBS can be used effectively in terms of economy and frost durability of the concrete to be in complex deterioration. Therefore, the resistance to complex deterioration with freezing-thawing was strongly influenced by the strength and the type of cement.

Pre- and Post-Transplant Nutritional Assessment in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation (동종 조혈모세포 이식 전후 영양상태 평가)

  • Park, Mi-Young;Park, Jeong-Yun
    • Asian Oncology Nursing
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    • v.12 no.1
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    • pp.110-116
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    • 2012
  • Purpose: This study was performed to identify the pre-and post-transplant nutritional assessment for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Methods: The subjects of this study were 25 patients undergoing allogeneic HSCT. The data collection was performed from January 31st to March 31st, 2011. The Patient-Generated Subjective Global Assessment (PG-SGA), anthropometrics and biochemical test were collected from the time they entered the isolation unit until they left. Results: Pre-transplant nutritional assessment status indicated moderate malnutrition which scored $7.32{\pm}1.68$ in PG-SGA. There were 22 patients (88.0%) with moderate malnutrition and 3 patients (12.0%) with severe malnutrition. Post-transplant nutritional assessment indicated severe malnutrition status which scored $11.92{\pm}3.26$ in PG-SGA. Pre-and post-transplant nutritional assessment displayed significant differences (p<.001) in PG-SGA score. Hematopoietic stem cell transplantation led to a deterioration of patients' nutritional status. Pre-transplant patients were already in malnutrition status and patients undergoing allogeneic HSCT were at risk for malnutrition. Conclusion: Pre-and post-transplant patients were categorized as having undernutritional and malnutritional status. Pre-transplant nutrition status impacted on post-transplant nutritional status. Health care personnel should pay attention to patient's nutrition status when undergoing allogeneic HSCT with appropriate nutritional assessment tools.

Impact of multiple component deterioration and exposure conditions on seismic vulnerability of concrete bridges

  • Ghosh, Jayadipta;Padgett, Jamie E.
    • Earthquakes and Structures
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    • v.3 no.5
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    • pp.649-673
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    • 2012
  • Recent studies have highlighted the importance of accounting for aging and deterioration of bridges when estimating their seismic vulnerability. Effects of structural degradation of multiple bridge components, variations in bridge geometry, and comparison of different environmental exposure conditions have traditionally been ignored in the development of seismic fragility curves for aging concrete highway bridges. This study focuses on the degradation of multiple bridge components of a geometrically varying bridge class, as opposed to a single bridge sample, to arrive at time-dependent seismic bridge fragility curves. The effects of different exposure conditions are also explored to assess the impact of severity of the environment on bridge seismic vulnerability. The proposed methodology is demonstrated on a representative class of aging multi-span reinforced concrete girder bridges typical of the Central and Southeastern United States. The results reveal the importance of considering multiple deterioration mechanisms, including the significance of degrading elastomeric bearings along with the corroding reinforced concrete columns, in fragility modeling of aging bridge classes. Additionally, assessment of the relative severity of exposure to marine atmospheric, marine sea-splash and deicing salts, and shows 5%, 9% and 44% reduction, respectively, in the median value bridge fragility for the complete damage state relative to the as-built pristine structure.

The influence of concrete degradation on seismic performance of gravity dams

  • Ahmad Yamin Rasa;Ahmet Budak;Oguz Akin Duzgun
    • Earthquakes and Structures
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    • v.26 no.1
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    • pp.59-75
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    • 2024
  • This paper presents a dam-reservoir interaction model that includes, water compressibility, sloshing of surface water, and radiation damping at the far-end reservoir, to investigate the influence of concrete deterioration on seismic behavior along with seismic performance of gravity dams. Investigations on seismic performance of the dam body have been conducted using the linear time-history responses obtained under six real and 0.3 g normalized earthquake records with time durations from 10 sec to 80 sec. The deterioration of concrete is assumed to develop due to mechanical and chemical actions over the dam lifespan. Several computer programs have been developed in FORTRAN 90 and MATLAB programming languages to analyze the coupled problem considering two-dimensional (2D) plane-strain condition. According to the results obtained from this study, the dam structure shows critical responses at the later ages (75 years) that could cause disastrous consequences; the critical effects of some earthquake loads such as Chi-Chi with 36.5% damage and Loma with 56.2% damage at the later ages of the selected dam body cannot be negligible; and therefore, the deterioration of concrete along with its effects on the dam response should be considered in analysis and design.

A Study about the Impact of Atmospheric Environmental Changes by Urban Development on Human Health (도시개발에 따른 대기환경 변화가 건강에 미치는 영향연구)

  • Kim, Jea-Chul;Lee, Chong-Bum;Cheon, Tae-Hun;Jang, Yun-Jung
    • Journal of Environmental Impact Assessment
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    • v.19 no.1
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    • pp.15-28
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    • 2010
  • Because deterioration of air quality and urban heat island directly harm health of citizens, Health Impact Assessment (HIA) and Environmental Impact Assessment (EIA) for urban development projects needs to conduct analysis of their impacts objectively. This study aims to review appropriate methods for assessment of air quality used at each stage of urban development and to investigate prediction and assessment methods of urban heat island. In addition, by evaluating impacts of climate change following supposed urban construction performed in the central area of Korea on public health, it examines usefulness of HIA for urban construction. When urban heat island prediction and HIA method suggested in this study are applied to an imaginary city, they predict urban heat island properly and the impacts of climate changes on public health inside the city could be determined clearly by calculating life-climate index and bio-climate index related with thermal environment from the model.

Study of Rehabilitation Priority Order of Pipes for Water Distribution Systems using Utopian Approach (Utopian Approach를 이용한 상수관망 개별관로 개량우선순위 산정에 관한 연구)

  • Yoo, Do-Guen;Jun, Hwan-Don;Kim, Joong-Hoon
    • Journal of Korean Society of Water and Wastewater
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    • v.24 no.2
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    • pp.183-193
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    • 2010
  • Well planned rehabilitation order of pipes is essential for efficient maintenance and management of Water Distribution Systems. In this study, not only deterioration rate of pipes but also structural and nonstructural failure which causes abnormal condition of WDS is considered to determine rehabilitation order. Probabilistic Neural Network is used for calculating deterioration rate at present and the importance of pipes is computed under structural and nonstructural failure by using Pipe by Pipe Failure Analysis and Effect Index. Utopian Approach, one of the Multi-Criteria Decision Making methods, is used for assessment of final rehabilitation order based on distance measure between utopian point and alternative one. Developed model in this study shows that it gives more reliable results than existing methods considering hydraulic relative importance does in application to real networks. In this point, the newly developed model, which gives advantages over existing models, can make a credible decision and simple application.

Analysis of Safety Evaluation Guidelines for Practical Maintenance of Existing Concrete Structures (노후 콘크리트 구조물의 실용적 유지관리를 위한 콘크리트 구조물 안전진단 지침 분석)

  • Lee, Joo-Hyung;Cho, Jae-Yeol
    • Land and Housing Review
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    • v.11 no.3
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    • pp.83-92
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    • 2020
  • In South Korea, problems caused by material deterioration of time-worn concrete structures have been increased recently. Because severe material deterioration could damage the structure's safety, it's important to evaluate the old structure's condition and structural capacity regularly to keep its proper performance. The safety evaluation of concrete structures has been initiated and performed periodically since 1995 according to a guideline in accordance with a law in Korea. The guideline prescribes the evaluation types, intervals and methods of the target structure. A lot of cost and labor have been invested every year to carry out the regular safety evaluation. However, it's not clear that the current manual could inspect the old structure's condition and assess the structural capacity precisely. Thus, the verification study initiated to figure out the Korean safety evaluation manual's practicalness. First, the Korean manual was analyzed and then compared with that of other countries for concrete bridges which are representative concrete structure. After that, the previously written evaluation reports were collected and analyzed to find out how the safety evaluation has been carried out. Based on the study results, the parts requiring verification of the manual were drawn. A research program is in progress in order to verify the parts by performing tests with actual structural members from decommissioned concrete bridges.