• Journal of Korean Neurosurgical Society
• /
• 제65권2호
• /
• pp.269-275
• /
• 2022

Objective : The coronavirus disease 2019 (COVID-19) pandemic is affecting the characteristics of patients with head injuries. This study aimed to evaluate the effect of the COVID-19 pandemic on patients with head injuries at a regional emergency medical center in South Korea. Methods : From April 2019 to November 2020, 350 patients with head injuries were admitted to our hospital. The study period was divided into the pre-COVID-19 (n=169) and COVID-19 (n=181) eras (10 months each). Patients with severe head injuries requiring surgery (n=74) were categorized into those who underwent surgery (n=41) and those who refused surgery (n=33). Results : Head injuries in pediatric patients (<3 years) were more frequent in the COVID-19 era than in the pre-COVID-19 era (8.8% vs. 3.6%, p=0.048). More patients refused surgery in the COVID-19 era than in the pre-COVID-19 era (57.9% vs. 30.6%, p=0.021). Refusal of surgery was associated with old age (67.7±14.5 vs. 52.4±19.1, p<0.001), marital status (married, 84.8% vs. 61.0%, p=0.037), unemployment (42.4% vs. 68.3%, p=0.034), COVID-19 era (66.7% vs. 39.0%, p=0.021), and lower Glasgow coma scale scores (6.12±3.08 vs. 10.6±3.80, p<0.001). Multivariable logistic regression analysis revealed that refusal of surgery was independently associated with old age (adjusted odds ratio [OR], 1.084; 95% confidence interval [CI], 1.030-1.140; p=0.002), COVID-19 era (adjusted OR, 6.869; 95% CI, 1.624-29.054; p=0.009), and lower Glasgow coma scale scores (adjusted OR, 0.694; 95% CI, 0.568-0.848; p<0.001). Conclusion : We observed an increased prevalence of head injuries in pediatric patients (<3 years) during the COVID-19 pandemic. Additionally, among patients with severe head injuries requiring surgery, more patients refused to undergo surgery during the COVID-19 pandemic.

• 농촌의학ㆍ지역보건
• /
• 제47권2호
• /
• pp.99-108
• /
• 2022

본 연구는 19세 이상 성인들을 대상으로 B형간염 백신 접종률, 백신 접종이유 및 미접종 이유, 백신 접종 관련 요인을 파악하고자 하였다. B형간염 백신 접종률은 사후가중치를 적용 후 1차 38.0%, 2차 32.5%, 3차 26.9%로 나타났다. B형간염 백신 접종 관련 요인으로는 여자가, 저연령에서, 군부 거주자가, 직업이 있을 때, 고학력자가, 건강보험 가입자가, 배우자가 있을 때, 동거가족이 있을 때, 국가 권고 성인 예방접종을 인지하고 있을 때, 의사에게 성인 예방접종의 필요성을 설명 받은 경험이 있을 때, 본인의 성인 예방접종 기록 보관하고 있을 때, 성인 예방접종이 감염병 예방에 도움이 된다고 높게 인지하고 있을 때, 국가나 지방자치단체의 성인 예방접종 홍보 경험이 없을 때에 백신 접종률이 높게 나타났다. 결론적으로 우리나라 성인의 B형간염 백신 접종률은 양적 향상 및 질적인 측면에서의 개선을 위한 국가 정책 마련이 필요함을 발견하였다. 또한 성인의 B형간염 항체 형성률을 함께 파악하여 감염병 발생 감소나 퇴치를 위해서 국가수준의 예방접종률 목표치 선정과 함께 달성 정도 평가를 위한 정기적인 성인 예방접종률 산출이 필요하다. 더욱이 국가의 예방접종통합관리시스템을 통하여 안정적으로 성인의 예방접종 기록을 관리할 수 있도록 전산등록률 향상 방안을 마련할 필요가 있다.

• 대한기관윤리심의기구협의회지
• /
• 제5권1호
• /
• pp.21-32
• /
• 2023

Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

• 한국콘텐츠학회논문지
• /
• 제22권5호
• /
• pp.446-455
• /
• 2022

본 연구는 우리나라 소방공무원의 코로나바이러스감염증-19(COVID-19) 대응 업무 실태를 파악하고 COVID-19와 관련된 경험이 우울증에 미치는 영향을 알아보았다. 소방공무원 53,557명이 온라인 설문조사에 참여하여, 본인 및 동료의 COVID-19 감염 경험, COVID-19 대응 업무 경험 및 업무 강도, 사회적 낙인의 두려움, 불안 및 우울 증상에 대한 설문에 답했다. 자료 분석 결과, 2021년 3월 기준으로 전체 53,557명 중 45.76%가 COVID-19 대응 업무 경험을 한 것으로 나타났다. 주요 직무군 별로는 구급 업무군에서 COVID-19 대응 업무의 수행 비율이 가장 높았고, 대응 업무 강도와 사회적 낙인의 두려움 역시 다른 직무군에 비해 컸다. 위계적 회귀분석 결과, 동료의 감염, 대응 업무 강도, 사회적 낙인의 두려움이 COVID-19 팬데믹 중 소방공무원의 우울증을 설명하는 유의한 변수인 것으로 확인되었다. 본 연구 결과는 COVID-19 팬데믹 시대에 소방공무원들에게서 우울증을 발생시킬 수 있는 위험 요인을 제시하며, 감염병과 관련된 소방공무원 직군의 우울증 발생 예방과 증상 완화를 위한 노력에 실질적인 토대를 제공한다.

• 한국과학예술포럼
• /
• 제24권
• /
• pp.277-287
• /
• 2016

본 연구는 증가하는 전시시설 고령관람자들의 신체 특성을 반영한 환경디자인 체크리스트를 이용하여 한국과 일본 전시시설의 적용현황을 비교분석하는 것을 목적으로 한다. 한국과 일본을 대표하는 국·공립 박물관 8곳 (역사계 4곳, 미술계 4곳)을 선정하고 전시 시설을 직접 방문하여 체크리스트 적용 현황을 파악하였다. 전시시설의 공간범위는 진입공간, 전시공간, 교육활동공간, 공공서비스공간, 이동공간으로 구분되며 고령자의 신체특성은 감각영역(시각, 청각, 촉각, 후각, 미각), 운동영역(골격, 근력, 체력)으로 구분된다. 체크리스트에 근거하여 설치, 부분설치, 미설치로 구분하여 해당점수를 부여하여 평균값으로 분석하였다. 연구결과는 다음과 같다. 첫 번째, 한국과 일본 전시시설 모두 평균값 이상의 비슷한 수준으로 나타나 전반적으로 고령자의 신체특성을 반영한 환경디자인이 시설 내에 적용되고 있는 것으로 나타났다. 두 번째, 평가 점수가 낮게 나타난 전시공간과 교육활동공간은 대부분 권장항목으로 구성되어 있었고 대부분 부분설치 또는 미설치로 나타나 이에 대한 대비가 필요할 것으로 사료된다. 세 번째, 고령자의 신체특성 중 감각영역(청각)에 해당하는 항목의 설치가 특히 미비한 것으로 나타났고 음성안내, 긴급호출벨, 보청설비 등 추가 시설이 보완이 이루어져야 할 것으로 판단된다. 네 번째, 전시시설의 건립시기, 리모델링 시기에 따라 체크리스트 평가점수가 다르게 나타나며, 역사계와 미술계 전시시설의 특성에 따라서도 점수가 다소 차이를 보이는 것으로 나타났다.

• 한국항행학회논문지
• /
• 제26권6호
• /
• pp.496-503
• /
• 2022

어업인의 감소와 단독조업 어선이 증가되는 현실에서, 어선의 해상안전을 위한 항해 및 무선설비의 의무장비는 계속 증가되어 왔다. 따라서 협소한 조타실에는 항해, 통신, 어로 등의 많은 장비가 설치되므로 혼잡한 상태이며, 다수의 모니터가 전면에 배치되므로 해상견시 능력을 저하시키는 요인으로 된다. 문제의 해결책으로 디지털선택호출-초단파대무선설비(VHF-DSC), 선박자동 식별장치(AIS), 어선위치발신장치(V-Pass) 등의 무선설비를 LAN 기반으로 하나의 MFD(multi function display)에 통합하여 운용하는 인터페이스를 구현하였다. 또한, MFD와 무선설비들 간의 연동으로 데이터의 교환을 위하여 IEC61162-450의 UDP 패킷과 IEC61162 센텐스를 적용하였고, 장비와 기능별로 필요한 메시지를 추가로 정의하였다. 통합된 MFD 모니터는 메뉴방식으로 쉽게 조작되며, 해상안전 관련 조난 및 긴급통신 기능과 장비별 메시지전송 상태의 확인으로 인터페이스 성능을 평가하였다.

• 한국컴퓨터정보학회논문지
• /
• 제28권12호
• /
• pp.155-166
• /
• 2023

이 연구는 치매안심센터 인지재활 프로그램의 현황 및 실태분석을 통한 활성화 방안과 다차원적 치료레크리에이션 프로그램에 대한 개발방향과 내용을 도출하고자 D시의 치매안심센타 인지재활 치료프로그램 참여 노인 각 50명씩(5개구)을 선정하였고, 9명을 전문가 집단 의견수렴 대상으로 선정하였다. 수집된 자료는 SPSS ver. 18.0 통계 프로그램을 이용하여 기술통계와 구성요소별 중요도 및 우선순위는 계층구조분석을 시행함으로써, 첫째, 현재 제공되고 있는 인지재활 지원 프로그램은 이용자의 요구와는 달리 지원프로그램이 충분하지 않아 경험이 상당히 낮게 나타났으며, 이에 대한 개선점으로는 돌봄이나 보호시설 확대와 이용자의 요구를 충족할 다양한 프로그램 개발이 중요하다고 나타났고, 둘째, 치료레크리에이션 구성요소별 중요도와 우선순위는 대분류(6개) 운동요법, 중분류(16개) 운동요법의 행동중심 접근법, 소분류(47개) 힘뇌체조, 실버건강체조가 가장 높게 나타났다. 이는 치료레크리에이션 프로그램 개발시 각 영역의 우선순위를 고려한 다차원적 프로그램 계획이 이루어져야 함을 보여주는 결과라 할 수 있다.

• Korean Journal of Radiology
• /
• 제22권6호
• /
• pp.994-1004
• /
• 2021

Objective: To extract pulmonary and cardiovascular metrics from chest CTs of patients with coronavirus disease 2019 (COVID-19) using a fully automated deep learning-based approach and assess their potential to predict patient management. Materials and Methods: All initial chest CTs of patients who tested positive for severe acute respiratory syndrome coronavirus 2 at our emergency department between March 25 and April 25, 2020, were identified (n = 120). Three patient management groups were defined: group 1 (outpatient), group 2 (general ward), and group 3 (intensive care unit [ICU]). Multiple pulmonary and cardiovascular metrics were extracted from the chest CT images using deep learning. Additionally, six laboratory findings indicating inflammation and cellular damage were considered. Differences in CT metrics, laboratory findings, and demographics between the patient management groups were assessed. The potential of these parameters to predict patients' needs for intensive care (yes/no) was analyzed using logistic regression and receiver operating characteristic curves. Internal and external validity were assessed using 109 independent chest CT scans. Results: While demographic parameters alone (sex and age) were not sufficient to predict ICU management status, both CT metrics alone (including both pulmonary and cardiovascular metrics; area under the curve [AUC] = 0.88; 95% confidence interval [CI] = 0.79-0.97) and laboratory findings alone (C-reactive protein, lactate dehydrogenase, white blood cell count, and albumin; AUC = 0.86; 95% CI = 0.77-0.94) were good classifiers. Excellent performance was achieved by a combination of demographic parameters, CT metrics, and laboratory findings (AUC = 0.91; 95% CI = 0.85-0.98). Application of a model that combined both pulmonary CT metrics and demographic parameters on a dataset from another hospital indicated its external validity (AUC = 0.77; 95% CI = 0.66-0.88). Conclusion: Chest CT of patients with COVID-19 contains valuable information that can be accessed using automated image analysis. These metrics are useful for the prediction of patient management.

• Journal of Periodontal and Implant Science
• /
• 제54권2호
• /
• pp.75-84
• /
• 2024

Purpose: This study investigated the relationship between the number of days that hospital visits were postponed and changes in clinical parameters due to the spread of coronavirus disease 2019 (COVID-19), after the Japanese government declared a state of emergency in April 2020. Methods: Regarding the status of postponement of appointments, we analyzed the patients who had visited the Nihon University Hospital at Matsudo for more than 1 year for supportive periodontal therapy (SPT) and classified them into low-, moderate- and high-risk subgroups according to the periodontal risk assessment (PRA). Clinical parameters for periodontal disease such as probing depth (PD), full-mouth bleeding score (FMBS), full-mouth plaque score, periodontal inflamed surface area (PISA), and periodontal epithelial surface area (PESA) were analyzed in 2 periods, from October 2019 to March 2020 and after April 2020. Correlation coefficients between days of deferral and the degree of changes in clinical parameters were calculated. Results: The mean age of the 749 patients was 67.56±10.85 years, and 63.82% were female. Out of 749 patients, 33.24% deferred their SPT appointments after April 2020. The average total of postponement days was 109.49±88.84. The number of postponement days was positively correlated with changes in average PD (rs=0.474) and PESA (rs=0.443) in the high-risk subgroup of FMBS, and average PD (rs=0.293) and PESA (rs=0.253) in the highrisk subgroup of tooth number (TN). Patients belonging to the high-risk subgroups for both FMBS and TN had a positive correlation between postponement days and PISA (rs=0.56). Conclusions: The findings, the spread of COVID-19 appears to have extended the visit interval for some SPT patients. Moreover, longer visit intervals were correlated with the worsening of some clinical parameters for SPT patients with high PRA.

• Journal of Preventive Medicine and Public Health
• /
• 제57권1호
• /
• pp.37-46
• /
• 2024

Objectives: The objective of this study was to characterize mental health issues among Vietnamese healthcare workers (HCWs) and to identify related factors. Methods: A cross-sectional study was conducted with 990 HCWs in 2021. Their mental health status was measured using the Depression, Anxiety, and Stress Scale. Results: In total, 49.9%, 52.3%, and 29.8% of respondents were found to have depression, anxiety, and stress, respectively. The multivariable linear regression model revealed that factors associated with increased anxiety scores included depression scores (β, 0.45; 95% confidence interval [CI], 0.39 to 0.51) and stress scores (β, 0.46; 95% CI, 0.41 to 0.52). Factors associated with increased depression scores included being frontline HCWs (β, 0.57; 95% CI, 0.10 to 1.10), stress scores (β, 0.50; 95% CI, 0.45 to 0.56), and anxiety scores (β, 0.41; 95% CI, 0.36 to 0.47), while working experience was associated with reduced depression scores (β, -0.08; 95% CI, -0.16 to -0.01). Factors associated with increased stress scores included working experience (β, 0.08; 95% CI, 0.00 to 0.16), personal protective equipment interference with daily activities (β, 0.55; 95% CI, 0.07 to 1.00), depression scores (β, 0.54; 95% CI, 0.48 to 0.59), and anxiety scores (β, 0.45; 95% CI, 0.39 to 0.50), while age was associated with reduced stress scores (β, -0.12; 95% CI, -0.20 to -0.05). Conclusions: Specific interventions are necessary to enhance and promote the mental health of HCWs so they can successfully cope with the circumstances of the pandemic.