• Title/Summary/Keyword: Compliance rate

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A Study on the Physiological and Psychological Factors related to Successful Weaning from a Mechanical Ventilator (기계환기기 이탈의 성공과 관련된 생리적${\cdot}$심리적 요인에 관한 조사 연구)

  • Kim, Cho-Ja;Kim, Hwa-Soon;Jang, Yeon-Soo;Kim, Eun-Sung
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.995-1005
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    • 2000
  • This study was performed to identify the physiological and psychological variables related to successful weaning from a mechanical ventilator. The subjects of this study were 22 patients who received mechanical ventilation therapy for more than 3 days in intensive care units. Before the weaning trial, baseline data for following physiologic variables were obtained: spontaneous respiration rate, blood pressure, pulse rate, PaO2, PaCO2, PEEP, static compliance, minute ventilation, tidal volume, rapid shallow breathing index(f/VT), SaO2, PaO2/FiO2 and mean arterial pressure. During spontaneous breathing, physiologic and psychologic variables such as vital signs, ABG, perspiration, chest retraction, paradoxical respiration, dyspnea, anxiety, confidence and efficacy were measured. Successful weaning was defined as sustaining spontaneous respiration over 24 hours after extubation. Weaning failure was defined as the development of more than one of following signs: (1) hypoxemia, (2) CO2 retention or (3) perspiration, tachypnea, chest retraction, tachycardia, arrhythmia, hypotension or hypertension. Subjects (N=18) who successfully weaned from mechanical ventilator were compared with subjects (N=4) who failed. The results are as follows; Eighteen percents of the subjects failed during the weaning trial. Most subjects in the failed group were mechanically ventilated for long-time. This result shows that the success of weaning is more difficult in long-term ventilation patients. In the baseline data that was measured before weaning trial, the mean score of PaO2 in the successfully weaned group was 121mmHg. This is significantly higher than the mean score of PaO2 in the failed group(95mmHg). However, the scores of pH, tidal volume, f/VT, pulse rates, blood pressure, mean airway pressure, SaO2, and PaCO2 were similar between the two groups. Specially the scores of f/VT index as a predominant predictor for successful weaning were not significant (f/VT=44.4) and (f/VT=47). During spontaneous breathing, the scores of dyspnea and anxiety level in the successfully weaned group were less than those of the failed group. On the contrary, the scores of confidence and efficacy in the successful group were greater than those of the failed group. In conclusion, the baseline data that were measured before weaning trial were similar between the both groups, therefore future studies are needed to focus on searching other variables besides physiological parameters related to weaning outcome.

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Preoperative Chemotherapy in Advanced Stomach Cancer (Pros) (위암에서의 수술 전 선행항암화학요법(in the View of Pros))

  • Park, Sook Ryun
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.57-64
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    • 2008
  • In gastric cancer, the only potentially curative treatment is surgery that attempts to achieve curative (R0) resection. However, despite the use of curative resection, a recurrence develops in a high percentage of patients, especially in cases of serosa and/or lymph node involvement. As a strategy to improve the survival of the patients with resectable advanced gastric cancer, neoadjuvant chemotherapy has been evaluated in several phase II trials and a few phase III trials. The results of these trials have confirmed the feasibility and safety of this approach with no apparent increase in surgical complications. Recently, the findings of a large phase III randomized trial (MAGIC trial) have indicated that compared to the use of surgery alone, perioperative chemotherapy, using both a neoadjuvant and adjuvant strategy, decreased the number of T and N stage cancers and improved survival. The results of another recent phase III trial (FNLCC 94012/FFCD 9703) also showed that compared to the use of surgery alone, perioperative chemotherapy improved the R0 resection rate and survival. In both trials, the improved outcomes may be attributed to the use of neoadjuvant chemotherapy because of poor compliance with adjuvant chemotherapy. These results cannot be directly translated to clinical practice in Korea due to differences in surgical techniques and outcomes. However, the findings of a few small phase II and III trials performed in patients with locally advanced gastric cancer in Korea have also suggested that neoadjuvant chemotherapy would result in the improvement of the R0 resection rate and down-staging of the disease. More effective chemotherapy regimens are needed in future large randomized trials to determine the subset of patients that will benefit from neoadjuvant chemotherapy and to determine the extent of benefit.

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The Trend of Acute Respiratory Tract Infections and Antibiotic Prescription Rates in Outpatient Settings using Health Insurance Data (건강보험청구자료를 이용한 외래 급성 호흡기계 질환 방문과 항생제 처방률 변화 분석)

  • Kim, Jee-Ae;Park, Juhee;Kim, Bo-Yun;Kim, Dong-Sook
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.3
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    • pp.186-194
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    • 2017
  • Objectives: A significant concern has been raised about the emerging resistance that is largely caused by the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study investigated the trend of respiratory tract infections (RTIs) and the use of antibiotics. Methods: Utilizing the national level health insurance claims data from 2005 to 2008, we examined encounter days, antibiotic use, and the prescription rate for respiratory tract infections including upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), and otitis media in outpatient settings. The antibiotic use was measured as defined daily dose per 1,000 patients per day (DDD/1,000 patients/day). Results: The visit for URTI increased from 141,693,465 in 2005 to 120,717,966 in 2008 and the visit for LRTI decreased from 61,778,718 to 66,930,122. For RTIs, prescription rates of antibiotics decreased from 65.2% to 58.5% for URTIs and 76.9% to 68.3% for LRTIs from 2005 to 2008. The antibiotic use decreased to 20.85 DDD/1,000 patients/day after a significant increase of 22.01 DDD/1,000 patients/day in 2006. Among antibiotics, J01CR had the highest use- 7.93 DDD/1,000 patients/day followed by J01DC of 3.71 DDD/1,000 patients/day and J01FA of 3.2 DDD/1,000 patients/day. One notable trend is that J01FA presented a continuous increase in antibiotic use from 2.3 in 2005 to 3.26 DDD/1,000 patients/day in 2008. Conclusion: The use of antibiotics had poor compliance to guidelines for RTIs. Despite decrease in the use of antibiotics, prescription rates for URTIs were still about 50% indicating that the delayed prescribing antibiotics (or wait-and-see) were not observed.

5 YEARS EVALUATION OF COMPOSITE RESIN RESTORATION ON PERMANENT FIRST MOLAR IN CHILDREN (어린이 제 1 대구치 복합 레진 수복물의 5년 후 임상평가)

  • Kim, In-Young;Kim, Jae-Moon;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.110-117
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    • 2008
  • Clinical performance of resin-based composite material depends on case selection and on the proficiency of the operator. Especially, composite resin restoration on permanent first molar in children have more limitations clinically than adult patients according to stage of tooth eruption and patient's compliance. This study was designed to evaluate the clinical performance of posterior composite resin restoration in children after 5 years. 35 teeth of 16 patients who were received composite resin restoration on permanent first molar in Department of Pediatric dentistry, Pusan National University Hospital between January 2001 and December 2001 were evaluated based on Modified USPHS criteria. From the finding in this study, following conclusions can be made. 1. 6 teeth(17%) of 35 teeth was replaced, so 5-years survival rate of posterior composite resin restoration is 82.9%. 2. As results of each evaluation criteria, on color match, anatomic form, surface roughness, sensitivity/ discomfort, ideal A grade score was 86.2%, 93.1%, 86.2%, 86.2%, clinically accepted B grade score was 13.8%, 0%, 13.8%, 10.3%. On marginal adaptation and marginal discoloration, A grade score was 13.8%, 44.8% and B grade score was 79.3%, 34.5% and secondary caries rate was 20.7%. 3. 69.1% of teeth (20 teeth) was clinically accepted on all evaluation criteria.

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Drug Consumption and Nutritional Status of the Elderly in Chung-Buk Area - I. Diseades and Drug Consumption- (충북지역 노인들의 약물복용 및 영양상태 - I. 질병 및 약물복용실태-)

  • 한경희;김기남;박동연
    • Korean Journal of Community Nutrition
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    • v.3 no.1
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    • pp.76-93
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    • 1998
  • Three hundred sixty-two(male 131, female 231) elderly aged over 65 in Chungb- uk area were interviewed to determine the disease states and drug usage patterns. The prebalence of disease was 78% and women reported more chronic diseases(83%) than men(71%). Elderly who live with spouse and have an occupation have a lower rate of disease. Average number of diseases of the elderly was $1.8\pm{1.1}$, and women$(2.1\pm{1.3)}$ have significantly higher average number of diseases than that of men$(1.4\pm{0.7)}$. Also the elderly in urban areas$(2.1\pm{1.4)}$ have significantly higher number of diseases than that of the elderly in rural areas$(1.6\pm{0.9)}$. Arthritis, hypertension, cardiovascular and gastric diseases were the most frequently listed chronic diseases in order for both men and women. Anemia and fracture of bone were relatively higher in women than in men. Particularly, the arthritis of the urban elderly have a rate of 1.5 times higher than that of the rural elderly. Fifty-two percent of the elderly were currently using drugs ; among drug users 71.2% used prescription drugs and 20.5% used nonprescription drugs. The average number taken per person was 2.1$\pm$1.4 and there was no sex or age difference. However, the elderly in rural areas $(2.7\pm{1.7)}$ consumed a significantly higher number of drugs than those in urban areas$(1.7\pm{0.7)}$. The average number of prescripti- on drugs taken was 2.0$\pm$1.4 while the average of nonprescription drugs taken was $(1.3\pm{0.6)}$. Analgesics and antihypertensive drugs were most commonly used. Vitamin and analgesics were the most frequently used self-prescribed drugs. It was noted that potential adverse drug interaction by concominant drug consumption for arthritis and antihypensive drug, abuse of digestants and antiacid without treatment of the underlying disease, and misuse of quick-acting bowel medications were problematic for the elderly. In addition drugs used for the elderly have some adverse effect on the digestive system. The types and composition of drugs used by the elderly were identified and presented. Medication compliance was poor and 13.5% reported adverse reactions such as edema, heartburn, nausea, and difficulty with eating. Seventeen percent of the elderly obtained drugs arranged by those other than medical staff. Also, even among those elderly who obtained drugs prescribed by a doctor, 69.1% of subjects had not receive instruction about potential adverse reactions. These results suggest that nutritional problems related to drug usage might exist and so dietitians, either individually or as members of health teams, need to have a better understanding of drug-nutrient interaction and closer supervision, and drug information/education service should therefore be provided to prevent or minimize adverse drug reaction in elderly users of medication.

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Experiences of Latent Tuberculosis Infection Treatment for the North Korean Refugees

  • Kim, Beong Ki;Kim, Hee Jin;Kim, Ho Jin;Cha, Jae Hyung;Lee, Jin Beom;Jeon, Jeonghe;Kim, Chi Young;Kim, Young;Kim, Je Hyeong;Shin, Chol;Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.82 no.4
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    • pp.306-310
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    • 2019
  • Background: Tuberculosis (TB) is increasing in immigrants. We aimed to investigate the current status of latent tuberculosis infection (LTBI) treatment for North Korean Refugees (NKR) compared to South Koreans Contacts (SKC). Methods: TB close contacts in a closed facility of SKC and NKR who underwent LTBI screening in a settlement support center for NKR were analyzed retrospectively. Results: Among tuberculin skin test (TST) ${\geq}10mm$ (n=298) reactors, the males accounted for 72.2% in SKC (n=126) and 19.5% in NKR (n=172) (p<0.01). The mean age was higher in South Korea ($42.8{\pm}9.9years$ vs. $35.4{\pm}10.0years$, p<0.01). Additionally, the mean TST size was significantly bigger in NKR ($17.39{\pm}3.9mm$ vs. $16.57{\pm}4.2mm$, p=0.03). The LTBI treatments were initiated for all screened NKR, and LTBI completion rate was only 68.0%. However, in NKR, LTBI treatment completion rate was significantly increased by shorter 4R regimen (odds ratio [OR], 9.296; 95% confidence interval [CI], 4.159-20.774; p<0.01) and male (OR, 3.447; 95% CI, 1.191-9.974; p=0.02). Conclusion: LTBI treatment compliance must be improved in NKR with a shorter regimen. In addition, a larger study regarding a focus on LTBI with easy access to related data for NKR should be conducted.

Study on Anomaly Detection Method of Improper Foods using Import Food Big data (수입식품 빅데이터를 이용한 부적합식품 탐지 시스템에 관한 연구)

  • Cho, Sanggoo;Choi, Gyunghyun
    • The Journal of Bigdata
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    • v.3 no.2
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    • pp.19-33
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    • 2018
  • Owing to the increase of FTA, food trade, and versatile preferences of consumers, food import has increased at tremendous rate every year. While the inspection check of imported food accounts for about 20% of the total food import, the budget and manpower necessary for the government's import inspection control is reaching its limit. The sudden import food accidents can cause enormous social and economic losses. Therefore, predictive system to forecast the compliance of food import with its preemptive measures will greatly improve the efficiency and effectiveness of import safety control management. There has already been a huge data accumulated from the past. The processed foods account for 75% of the total food import in the import food sector. The analysis of big data and the application of analytical techniques are also used to extract meaningful information from a large amount of data. Unfortunately, not many studies have been done regarding analyzing the import food and its implication with understanding the big data of food import. In this context, this study applied a variety of classification algorithms in the field of machine learning and suggested a data preprocessing method through the generation of new derivative variables to improve the accuracy of the model. In addition, the present study compared the performance of the predictive classification algorithms with the general base classifier. The Gaussian Naïve Bayes prediction model among various base classifiers showed the best performance to detect and predict the nonconformity of imported food. In the future, it is expected that the application of the abnormality detection model using the Gaussian Naïve Bayes. The predictive model will reduce the burdens of the inspection of import food and increase the non-conformity rate, which will have a great effect on the efficiency of the food import safety control and the speed of import customs clearance.

A Classification Model for Customs Clearance Inspection Results of Imported Aquatic Products Using Machine Learning Techniques (머신러닝 기법을 활용한 수입 수산물 통관검사결과 분류 모델)

  • Ji Seong Eom;Lee Kyung Hee;Wan-Sup Cho
    • The Journal of Bigdata
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    • v.8 no.1
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    • pp.157-165
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    • 2023
  • Seafood is a major source of protein in many countries and its consumption is increasing. In Korea, consumption of seafood is increasing, but self-sufficiency rate is decreasing, and the importance of safety management is increasing as the amount of imported seafood increases. There are hundreds of species of aquatic products imported into Korea from over 110 countries, and there is a limit to relying only on the experience of inspectors for safety management of imported aquatic products. Based on the data, a model that can predict the customs inspection results of imported aquatic products is developed, and a machine learning classification model that determines the non-conformity of aquatic products when an import declaration is submitted is created. As a result of customs inspection of imported marine products, the nonconformity rate is less than 1%, which is very low imbalanced data. Therefore, a sampling method that can complement these characteristics was comparatively studied, and a preprocessing method that can interpret the classification result was applied. Among various machine learning-based classification models, Random Forest and XGBoost showed good performance. The model that predicts both compliance and non-conformance well as a result of the clearance inspection is the basic random forest model to which ADASYN and one-hot encoding are applied, and has an accuracy of 99.88%, precision of 99.87%, recall of 99.89%, and AUC of 99.88%. XGBoost is the most stable model with all indicators exceeding 90% regardless of oversampling and encoding type.

Analysis of Applicability of Rapid Hardening Composite Mat to Railway Sites (초속경 복합매트의 철도현장 적용성 분석)

  • Jang, Seong Min;Yoo, Hyun Sang;Oh, Dong Wook;Batchimeg, Banzragchgarav;Jung, Hyuk Sang
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.44 no.1
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    • pp.109-116
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    • 2024
  • The Rapid Hardening Composite Mat (RHCM) is a product that improves the initial strength development speed of conventional Geosynthetic Cementitious Composite Mats (GCCM). It offers the advantage of quickly securing sufficient strength in railway slopes with insufficient formation level, and provides benefits such as preventing slope erosion and inhibiting vegetation growth. In this study, an analysis of the practical applicability of RHCM in railway settings was conducted through experimentation. The on-site applicability was assessed by categorizing it into fire resistance, durability, and stability, and conducting combustibility test, ground contact pressure test, and daily displacement analyses. In the case of South Korea, where a significant portion of the territory is composed of forested areas, the prevention of slope fires is imperative. To analyze the fire resistance of RHCM, combustibility tests were conducted as an essential measure. Durability was assessed through ground contact pressure tests to analyze the deformation and potential damage of RHCM caused by the inevitable use of small to medium-sized equipment on the construction surface. Furthermore, daily displacement analysis was conducted to evaluate the structural stability by comparing and analyzing the displacement and behavior occurring during the application of RHCM with railway slope maintenance criteria. As a result of the experiments, the RHCM was analyzed to meet the criteria for heat release rate and gas toxicity. Furthermore, the ground contact pressure was observed to be consistently above 50 kPa during the curing period of 4 to 24 hours under all conditions. Additionally, the daily displacement analyzed through field site experiments ranged from -1.7 mm to 1.01 mm, confirming compliance with the criteria.

The Respiratory and Hemodynamic Effect of Prone Position in Patients with ARDS (급성호흡부전증후군에서 Prone Position의 호흡 및 혈류역학적 효과)

  • Lim, Chae-Man;Koh, Youn-Suck;Jung, Bok-Hyun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1105-1113
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    • 1997
  • Background : Prone position improves oxygenation in some patients with ARDS. According to some authors, prone position can also improve the deteriorated hemodynamics induced by PEEP. But these respiratory and hemodynamic effects of prone position has not yet been fully established. Methods : Twentythree consequtive patients with ARDS(M : F= 11 : 12, $62.1{\pm}20.8yrs$) were the subjects for this study. ABGA, static compliance of the respiratory system, mean arterial pressure and pulse rate were obtained in supine position and at 5min, 0.5h and 2h of prone position. Positive respiratory response was defined as 20mmHg or more increase in $PaO_2/FIO_2$ within 2h of prone position. Early of late respiratory responses were defined if the positive response was observed within of after 3 day of ARDS onset, respectively. Positive hemodynamic response was defined as 10mmHg or more increase in mean arterial pressure at 5min of prone position. Results : Fifteen patients (65%) showed positive respiratory response. In the respiratory responders, $PaO_2$ was $69.8{\pm}17.6mmHg$ in supine position, $83.2{\pm}22.6mmHg$ in prone position 0.5h, $96.8{\pm}22.7mmHg$ in prone position 2h(p<0.001), and $PaO_2/FIO_2$ was $108{\pm}41mmHg$, $137{\pm}57mmHg$, $158{\pm}50mmHg$, respectively(p=0.001). Age, sex, cause of ARDS, supine $PaO_2$ and $PaO_2/FIO_2$ were not different between the respiratory responders and the nonresponders. The respiratory responders, however, showed higher mean arterial pressure than the nonresponders($91.1{\pm}13.1mmHg$ vs. $76.0{\pm}18.7mmHg$, p=0.035), and tendency of higher survival rate(9/15 vs. 2/8, p=0.074). Static compliance of the respiratory system was decreased in prone position 0.5h($28.4{\pm}7.9ml/cm$ $H_2O$ vs. $23.8{\pm}7.6ml/cm$ $H_2O$, p=0.007). The overall rate of early response(n=23) and late response(n=11) were similar(14/23 vs. 7/11, p>0.05). But patient without early response showed late response only in 25%(1/4), while patient with early response showed late response in 85.7%(6/7)(p=0.072). Five patients(22%) showed positive hemodynamic response, two of them being respiratory nonresponders. There were no differences in the baseline mean arterial pressure or the level of PEEP applied in supine between the hemodynamic responders and the hemodynamic nonresponders. Conclusions : Prone position either improved oxygenation or increased arterial pressure in significant proportion of patients with ARDS. And the respiratory response to prone position was thought to be determined in the early stage of ARDS.

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