• Title/Summary/Keyword: Hospital safety

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Psychosocial Distress and Fatigue Symptoms Among Firemen; and Its Related Factors (일부 소방공무원의 사회심리적 스트레스 및 피로수준과 관련요인)

  • Choi, Ki-Bong;Kim, Kwang-Hwan;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.4
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    • pp.707-716
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    • 2009
  • The levels of psychosocial stresses and fatigue of firemen were analyzed to reveal the various factors related to them. The self-administered questionnaires were performed to 262 firemen ill Cheonsju City. In terms of various levels of psychosocial stresses, 12.2% were under potential stresses, 87.8% were under high-level of stress, but healthy group was not found. The levels of fatigue symptoms divided by the median of total scores was 51.1% of low levels, and 48.9% of high levels. Multiple stepwise analysis revealed that the factors or influence on psychosocial stresses with explanatory powers of 11.5% included subjective health status, job satisfaction, job demand and alcohol drinking habits. The factors of influence on fatigue symptoms with explanatory powers of 9.0% included subjective health and regular exercises. The study results indicate that the level of stress or fatigue is so complicatedly influenced by variable factors. Thus the effective strategy for stress and fatigue reduction among firemen should include additional programs focusing on health promotion.

Population-Based Intervention for Liver Fluke Prevention and Control in Meuang Yang District, Nakhon Ratchasima Province, Thailand

  • Kompor, Pontip;Karn, Rattikarn Muang;Norkaew, Jun;Kujapun, Jirawoot;Photipim, Mali;Ponphimai, Sukanya;Chavengkun, Wasugree;Paew, Somkiat Phong;Kaewpitoon, Soraya;Rujirakul, Ratana;Wakhuwathapong, Parichart;Phatisena, Tanida;Eaksanti, Thawatchai;Joosiri, Apinya;Polsripradistdist, Poowadol;Padchasuwan, Natnapa;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.685-689
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    • 2016
  • Opisthorchiasis is still a major health problem in rural communities of Thailand. Infection is associated with cholangiocarcinoma (CCA), which is found frequently in Thailand, particularly in the northeastern. Therefore, this study aimed to evaluate the effectiveness of health intervention in the population at risk for opisthorchiasis and CCA. A quasi-experimental study was conducted in Meuang Yang district, Nakhon Ratchasima province, northeastern Thailand, between June and October 2015. Participants were completed health intervention comprising 4 stations; 1, VDO clip of moving adult worm of liver fluke; 2, poster of life cycle of liver fluke; 3, microscopy with adult and egg liver fluke; and 4, brochure with the knowledge of liver fluke containing infection, signs, symptoms, related disease, diagnosis, treatment, prevention, and control. Pre-and-post-test questionnaires were utilized to collect data from all participants. Students paired t-tests were used to analyze differences between before and after participation in the health intervention. Knowledge (mean difference=-7.48, t=-51.241, 95% CI, -7.77, -7.19, p-value =0.001), attitude (mean difference=-9.07, t=-9.818, 95% CI=-10.9, -7.24, p-value=0.001), and practice (mean difference=-2.04, t=-2.688, 95% CI=-3.55, -0.53, p-value=0.008), changed between before and after time points with statistical significance. Community rules were concluded regarding: (1) cooked cyprinoid fish consumption; (2) stop under cooked cyprinoid fish by household cooker; (3) cooked food consumption; (4) hygienic defecation; (5) corrected knowledge campaign close to each household; (6) organizing a village food safety club; (7) and annual health check including stool examination featuring monitoring by village health volunteers and local public health officers. The results indicates that the present health intervention program was effective and easy to understand, with low cost and taking only a short time. Therefore, this program may useful for further work at community and provincial levels for liver fluke prevention and control.

A Study of Burn Accidents in Children towards Developing a Program for Prevention (어린이 화상사고의 실태와 예방대책 프로그램 개발에 대한 연구)

  • Han, Jeong-Seok;Seo, Mi-Hye
    • The Korean Nurse
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    • v.36 no.4
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    • pp.61-74
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    • 1997
  • This study is a descriptive study which was done to examine the circumstances surrounding burn accidents in children in order to develop a burn prevention program. The subjects for the study were the mothers of 107 children admitted to two burn specialty hospitals in seoul and the mothers of 172 healthy children attending day care or kindergarten. The tool used in the study was developed by the researchers, pretested and refined. Cronbach's alpha was 0.72. Data collection was done between November 1995 and April 1996. Statistically analysis was done using SAS Version 6.04 and the data was analyzed using test, chi square, regression and logistic analysis. A suumary of the results shows the following : Eighty percent of the children in both groups lived in nuclear families but comparatively more of the children with burn accidents lived in apartments. More of the parents in the group of healthy children had university education and held white collar or professional jobs, while the parents of the children with burn accidents were slightly younger than the parents of the healthy children. but not significantly younger. A significantly greater number of families of children with burn accidents had more than one child and the characteristics of the children with burn accidents that they were more frequently boys, either first or last born and very active. Most of the burn accidents occurred in fall or winter. sometime between noon and midnight and the majority occurred in the home and were caused by hot liquid. In 86% of the cases emergency care was not given at home but the child was brought to the hospital emergency unit. Most of the burns were second degree or greater. involved the arms or legs. required admission, and 41.5% occurred when the parents were preparing or eating meals. In a test of knowledge of preventive measures, the mothers of children who had suffered burn accidents scored slightly higher than the mothers who had no experience with burn accidents, but this was not statistically significant. As to what to do in the case of a fire, the mothers of the healthy children had more knowledge about who to notify. but 70% of the mothers in both groups did not know how to escape from the house if it was of fire. 80 to 96% did not know what do to in case of a fire, such as rolling if clothes were on fire. 80% did not know what emergency care to give for a burn, and 74 to 87% did not know when it is appropriate to try to put out a fire. It can be concluded from this study that. since the results show that the most frequent situation which resulted in burn accidents was when the parents were not aware of the danger of burns or were not paying attention to the child. and when there were no protective devices to prevent burns. and that accidents most frequently occurred at home. the most effective way of preventing accidents is to develop in the parents a "safety mind", Since burn accidents in children are usually more severe than in adults. the physical. emotional. psychological and social damage is greater. In order to develop and awareness of this in the general public. the use of mass media. books and pamphlets and other educational media that provide education on prevention of burn accidents need to be utilized.

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A Comparison of Thoracoscopic and Open Lung Biopsy for the Diffuse Infiltrative Lung Disease (미만성 침윤성 폐질환에 대한 비디오 흉강경 폐생검과 개흉 폐생검의 비교)

  • 이재익;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.164-170
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    • 1999
  • Background: The diffuse infiltrative lung disease often requires biopsy for its final diagnosis. Unlike the limited exposure that can be achieved through small thoracotomy incisions in open lung biopsy technique, the thoracoscopic approach allows visualization and biopsy of nearly entire surface of the lung without morbidity of large standard thoracotomy. The purpose of this study was to compare the diagnostic efficacy and operative safety of thoracoscopic lung biopsy(TLB) with open lung biopsy(OLB) in the diagnosis of diffuse infiltrative lung disease. Material and Method: From March 1993 to August 1997, 81 patients were referred for diagnostic lung biopsy. 51 of them underwent standard open lung biopsy and the remaining 30 patients underwent thoracoscopic lung biopsy. Result: Mean operative time was 63 minutes for TLB and 79 minutes for OLB (p=0.04). The volume of biopsy specimen was not different between two groups(TLB 7.8 cm3, OLB 6.9 cm3 : p=0.72) and the diagnostic accuracy of each methods was comparable (TLB 100%, OLB 96%). The duration of hospital stay was significantly less in TLB (TLB 13days, OLB 22days : p=0.01). The duration of parenteral narcotics administration was also less for TLB(TLB 2.5days, OLB 5.2days, p=0.05). Meanwhile, the duration of chest tube drainage, the frequency of parenteral narcotic injection were not significantly different between two groups. Complications occurred in 2 among the TLB patients (6.67%) and 4 among the OLB patients (7.84%). There was no operative mortality in both groups. Conclusion: We concluded that TLB is a good alternative procedure to OLB in the diagnosis of diffuse infiltrative lung disease with lower morbidity and comparable diagnostic accuracy.

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Comparison between Emergency Patient Poisoning Cases and the Tox-Info System Database (Tox-Info 시스템의 중독정보 데이터베이스와 응급실에 내원하는 중독 환자 분포의 비교)

  • Kim, Hyun-Jong;Kim, Yang-Weon;Kim, Hyun;Park, Chang-Bae;So, Byung-Hak;Lee, Kyeong-Ryong;Lee, Kyung-Woo;Lee, Kyung-Won;Lee, Sung-Woo;Lee, Jang-Young;Cho, Gyu-Chong;Cho, Jun-Ho;Chung, Sung-Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.1
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    • pp.8-14
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    • 2012
  • Purpose: The Tox-Info system is a poisonous substance information database developed by the Korean National Institute of Food and Drug Safety Evaluation. The aim of this study was to estimate the coverage effectiveness of the Tox-Info system by comparing the toxic substances included in the database with the distribution of the toxic substances implicated in the cases of intoxicated patients presenting to emergency departments. The secondary aim of the study was to propose any additional substances that should be added to the database. Methods: We retrospectively reviewed the medical records of patients suffering with toxic exposure who had visited any of 12 selected emergency departments in Korea from January 2010 to December 2011. The identified toxic substances were classified into groups including prescription drugs, agricultural chemicals, household products, animals or plants, herbal drugs, and others. We calculated the coverage rate of the Tox-Info database relative to the number of intoxication cases and the type of toxic substances involved. Results: A total of 5,840 intoxicated patient records were collected. Their mean age was $46.6{\pm}20.5$ years and 56.2% were female. Of the total intoxication cases, 87.8% of the identified toxic substances were included in the Tox-Info database, while only 41.6% of all of the types of identified toxic substances were included. Broken down by category, 122 prescription drugs, 15 agricultural chemicals, 12 household products, 14 animals or plants and 2 herbal drugs involved in poisoning cases were not included in the Tox-info database. Conclusion: This study demonstrated the clinical usefulness of the Tox-Info system. While 87.8% of the substances involved in the cases were included in the Tox-Info database, the database should be continuously updated in order to include even the most uncommon toxic substances.

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Salvage Chemotherapy in Recurrent Platinum-Resistant or Refractory Epithelial Ovarian Cancer with Carboplatin and Distearoylphosphatidylcholine Pegylated Liposomal Doxorubicin (Lipo-Dox®)

  • Khemapech, Nipon;Oranratanaphan, S.;Termrungruanglert, W.;Lertkhachonsuk, R.;Vasurattana, A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2131-2135
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    • 2013
  • Background: To evaluate the efficacy and safety of distearoylphosphatidylcholine pegylated liposomal doxorubicin (DPLD) combined with carboplatin for the treatment of platinum resistant or refractory epithelial ovarian cancer (EOC) or fallopian tube cancer. Materials and Methods: A retrospective analysis of women who received DPLD with carboplatin for recurrent EOC or fallopian tube cancer in King Chulalongkorn Memorial Hospital Thailand from January 2006 to August 2011 was conducted. Patients were identified from the medical records and data on demographic factors, stage, histology, surgical findings, cytoreduction status, and prior chemotherapies were abstracted. The efficacy and toxicity of DPLD/carboplatin were evaluated. Progression-free (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Results: A total of 65 patients, 64 with platinum resistant or refractory epithelial ovarian cancer and 1 with fallopian tube cancer, were enrolled. DPLD and carboplatin were given for an average of 4.46 cycles per patient with a total of 273 cycles. Among the 65 evaluable patients, 0% achieved CR, 7.69% PR, 15.4% SD and 76.% PD. The overall response rate was 23.1%. With a median follow-up of 27.4 months, the median progression-free and median overall survival in the 36 patients was 4.46 months and 8.76 months respectively. In the aspect of side effects, palmar-plantar erythrodysesthesia (PPE) occurred in 33.3% (Grade I 22.2%, Grade II 11.1%) and mucositis in 41.7% (Grade I 27.8%, Grade II 13.9%) of all treatment cycles, all Grade 1 or 2. Anemia, leukopenia and thrombocytopenia occurred in 58.3% (Grade I 41.7%, Grade II 16.7%), 66.7% (Grade I 47.2%, Grade II 19.4%), and 22.2% (Grade I 16.6%, Grade II 5.56%) of cycle respectively, and were mostly Grade 1 or 2. Conclusions: DPLD, the second-generation PLD drug combined with carboplatin every 4 weeks, is effective and has low toxicity for treatment of patients with recurrent platinum-resistant or refractory epithelial ovarian cancer.

University Students' Awareness of Radiation (대학생들의 방사선에 대한 인식도)

  • Kim, Chang-Gyu
    • Journal of the Korea Convergence Society
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    • v.3 no.1
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    • pp.27-34
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    • 2012
  • After Fukushima Nuclear Accident on Mar11, 2011, to grasp the thought of university students in Korea on radiation and medical radiation and seek for the right mass communication on the radiation safety of the people and the proper teaching method on radiation, 790 questionnaires from the universities which had a four-year department of radiological science in 5 provinces(Gyeonggi, Gangwon, Chungcheong, Jeolla, and Gyeongsang-do) all over the country were collected and analyzed. The questionnaire was composed of 36 items, and it was analyzed that one of the important causes that made them feel that radiation was dangerous was 'even if they were exposed to the small quantity of radiation, they could have trouble later.' ($3.28{\pm}1.05$). In the item of the control of radiation, there were the respondents who answered that the government should take action rather than an individual($3.87{\pm}0.89$). In the item of 'Fukushima Nuclear Accident made me think that 'We should not keep nuclear power generation', the result was $2.79{\pm}0.95$. In the item of 'My thought on the medical radiation has negatively changed since Fukushima Nuclear Accident', the students who hadn't taken the course related with radiation showed a negative thought on the medical radiation, such as, there was $2.64{\pm}1.02$ as a whole, $2.31{\pm}1.00$ in department of radiological science, $2.94{\pm}0.95$ in department of dental hygiene, and $3.13{\pm}0.82$ in other departments. And also, those who thought that the education of radiation was necessary were 82.28%, and T.V or Internet was thought as the most effective teaching method.

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 change of air lead concentrations in litharge making and smelting industries (일부 제련 및 리사지 사업장에서 공기중 납 노출농도의 변화)

  • Choi, Jae-Wook;Kim, Nam-Soo;Cho, Kwang-Sung;Ham, Jung-O;Lee, Byung-Kook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.20 no.1
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    • pp.10-18
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    • 2010
  • To provide necessary information for future environmental monitoring of smelting and litharge making industries in Korea, environmental monitoring dataset of air lead concentration of 4 lead industries(1 primary smelting, 2 secondary smelting and 1 litharge making industry) were analyzed from 1994 to 2007. Data were compared using geometric mean and standard deviation with minimum and maximum values according to year of measurement, type of lead industries and type of operation of lead industries. The geometric mean and standard deviation of air concentration for a total of 1140 samples in all lead industries for overall 14 years were 70.7${\mu}g/m^3$ and 5.51 with minimum of 1${\mu}g/m^3$ and maximum of 9,185 ${\mu}g/m^3$. The overall geometric means of air concentration were above the permissible exposure levels(PEL) until year of 2001 and thereafter they were remained at the level of half of PEL. The geometric means of primary smelting, secondary smelting and litharge making industry for overall 14 years were 21.7${\mu}g/m^3$(number of samples: 353), 82.5${\mu}g/m^3$(number of samples: 357) and 164.2 ${\mu}g/m^3$(number of samples: 430) respectively. In primary smelting industry, the highest geometric mean air concentration was 35.4 ${\mu}g/m^3$ in the secondary smelting operation; followed by casting operation (24.9 ${\mu}g/m^3$) and melting operation (14.9 ${\mu}g/m^3$), respectively. On the other hand, in secondary smelting industries, the highest geometric mean air concentration was 125.4${\mu}g/m^3$ in melting operation; followed by casting operation (90.5${\mu}g/m^3$) and pre-treatment operation (43.4${\mu}g/m^3$), respectively. However, in litharge making industries, there were no significant differences of geometric mean air concentrations between litharge operation and stabilizer operation. The proportion of over PEL (50${\mu}g/m^3$) was highest in litharge industry and followed by secondary smelting industries. However The proportions of over PEL(${\mu}g./m^3.$) were decreased by the years of environmental monitoring. The significant reduction of mean air lead concentration since year of 2000 was observed due to more active environmental engineering control and new introduction of new operation in manufacturing process, but may be also influenced by non-engineering method such as reduction of operation hours or reduction of exposure time during actual environmental measurement by industrial hygienist according to more strict enforcement of occupational and safety law by the government.

Report of the 3rd Japan-Korea Workshop on Acupuncture and EBM;Protocol development for the acupuncture trial on the osteoarthritis of the knee

  • Jang, Jun-Hyouk;Kenji, Kawakita;Hahn, Seo-Kyung;Park, Hi-Joon;Lee, Seung-Deok;Kim, Yong-Suk;Norihito, Takahashi;Toshiyuki, Shichidou;Kazunori, Itoh;Eiji, Sumiya;Eiji, Furuya;Hitoshi, Yamashita;Hiroshi, Tsukayama
    • Journal of Acupuncture Research
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    • v.23 no.6
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    • pp.239-254
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    • 2006
  • The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

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