• 제목/요약/키워드: Local Health Center

검색결과 571건 처리시간 0.03초

한반도 참나무 꽃가루 확산예측모델 개발 (Development of a Oak Pollen Emission and Transport Modeling Framework in South Korea)

  • 임윤규;김규랑;조창범;김미진;최호성;한매자;오인보;김백조
    • 대기
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    • 제25권2호
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    • pp.221-233
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    • 2015
  • Pollen is closely related to health issues such as allergenic rhinitis and asthma as well as intensifying atopic syndrome. Information on current and future spatio-temporal distribution of allergenic pollen is needed to address such issues. In this study, the Community Multiscale Air Quality Modeling (CMAQ) was utilized as a base modeling system to forecast pollen dispersal from oak trees. Pollen emission is one of the most important parts in the dispersal modeling system. Areal emission factor was determined from gridded areal fraction of oak trees, which was produced by the analysis of the tree type maps (1:5000) obtained from the Korea Forest Service. Daily total pollen production was estimated by a robust multiple regression model of weather conditions and pollen concentration. Hourly emission factor was determined from wind speed and friction velocity. Hourly pollen emission was then calculated by multiplying areal emission factor, daily total pollen production, and hourly emission factor. Forecast data from the KMA UM LDAPS (Korea Meteorological Administration Unified Model Local Data Assimilation and Prediction System) was utilized as input. For the verification of the model, daily observed pollen concentration from 12 sites in Korea during the pollen season of 2014. Although the model showed a tendency of over-estimation in terms of the seasonal and daily mean concentrations, overall concentration was similar to the observation. Comparison at the hourly output showed distinctive delay of the peak hours by the model at the 'Pocheon' site. It was speculated that the constant release of hourly number of pollen in the modeling framework caused the delay.

노인 관절염 환자의 보완.대체요법 이용실태 (Study on the Utilization of Complementary Alternative Therapy in elder Arthritics)

  • 박경숙;류언나;문경선;이원유;이성옥;김명희;윤미선;오정미;황윤영;김형애
    • 근관절건강학회지
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    • 제10권2호
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    • pp.142-155
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    • 2003
  • The purpose of this study was to investigate the rate of utilization, kinds and effective complementary-alternative therapy in elder arthritics, and then utilize the results as basic data for nursing intervention for elder arthritics. Study subjects consisted of 157 elder arthritics over 60 years old, data were collected through a structured questionnaire and face to face interviews. Data collection was done from July 2001 to August 2001. Subjects were sampled out from outpatients of department of rehabilitation of a university hospital in S city, outpatients of a local hospital in D city, and outpatient at public heath center in K and S city. Sexual distribution of subjects showed male 19.1% and the female 80.9%. The diagnosis distribution showed degenerative arthritis at 91% and reumatoid arthritis at 8.9% Duration of arthritics was 10 years over by 46.5%, duration of hospital treatment was 1-5 years by 41% The degree of pain by arthritis pointed out a mean point of 3.37 on a 5-point numeric scale 94.2% of subjects have experience complementary-alternative therapies used. Of the kind the subjects used, physiotherapy occupied 38.2%, Oriental medicine 36.3%, physical exercise 35.7%, nutritional therapy 22.3%, animal diet 8.9%, herbal diet 3.8%. The hardest thing due to arthritis represented disability in daily life by 59.8% and the pain problem by 30.5%. In conclusion, results of the study reveal that elder arthritics have used physiotherapy, Oriental medicine, physical exercise. Concrete strategies for nursing intervention about these complementary-alternative therapy are required to the established soon.

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성동구내 어린이집 원아 부모의 소아 한방치료에 대한 인식 및 이용에 관한 조사 연구 (A Survey on Parent's Recognition and Utilization Patterns of Oriental Medical Care of Preschool Students in Seong-Dong district)

  • 박유진;이슬지;윤지연;명성민
    • 대한한방소아과학회지
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    • 제25권1호
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    • pp.90-110
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    • 2011
  • Objectives: The purpose of this study is to examine the parental recognition and utilizing patterns of oriental medical care in children who live in Seong-Dong district. Methods 802 day-care center children's parents participated in the survey on recognition and utilizing patterns of oriental medical care, and 702 of the surveys were analyzed. Results: 1. 38.33% has received previous oriental medical treatments and most were received at the children's age under 12-24 months. Majority of the treatments took place in the clinical settings. By recommendation, some also received their treatment at the medical centers. One of the reasons why they receive oriental medical treatments was that they prefer to balance their treatment with the orental medical treatments along with the western's. 2. 53.85% of those who received oriental medical treatments were satisfied with their treatments. The effective treatment results were the major reason for the satisfaction. 3. 49.56% of those who had oriental medical treatments chose specific oriental medical facilities for the children's ailment. Most specific oriental medical facilities were local oriental medical clinics. Reputation fame were the main reason in choosing the clinics. 4. In 2009, 55.26% had received care in the specific oriental medical clinics for the diseases, such as respiratory symptoms, systemic symptoms, gastrointestinal symptoms, skin problems, neurological and psychiatric disease for infants, and respiratory symptoms, gastrointestinal symptoms, systemic symptoms, skin problems, neurological and psychiatric symptoms, urinary symptoms and musculoskeletal symptoms for toddlers. 5. The average duration of herbal treatment were 7-14 days, preferably 4-6 days, and preferred number of medical visits were once a week on Saturdays and preferred day for night cares were on Friday nights. Average treatment fee per treatment was less than 10,000 won which coincided with the preferred treatment fee per visit. 6. The very first medical institutions chosen by parents once their children are ill are the following; Western medical institutions, western medical clinics, pharmacies, oriental medical clinics, health centers, and lastly, oriental medical institutions. The major concerns in receiving oriental medical cares include pesticides in herbs and hazardous substances in heavy metals. Preferred form of oriental medicine was decoction, the negative feedback of oriental medicine was mostly due to the bitter taste of the oriental herbal decoctions. Preferred frequency of intake was twice a day with less than 10cc~20cc per single intake. Conclusions: Taken all together, we conclude that the growing recognition of Oriental Pediatric medicine is needed among parents.

Efficacy of medications in adult patients with trigeminal neuralgia compared to placebo intervention: a systematic review with meta-analyses

  • Peterson-Houle, Georgia M.;AbdelFattah, Magda R.;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.379-396
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    • 2021
  • Background: Trigeminal neuralgia (TN) is characterized by brief, unilateral, sharp, stabbing, and shooting pain of the fifth cranial nerve. The objective of this systematic review with meta-analysis was to determine the effect of medications compared to placebo in adult patients with TN. Methods: Review authors identified randomized placebo-controlled trials (RCTs) from PubMed, Web of Science, Cochrane, and EMBASE up to February 2021. We assessed the inclusion and exclusion criteria as well as the risk of bias of the studies based on the Cochrane Handbook. A total of 324 unduplicated references were scanned independently and reduced to eight relevant RCTs, with 89 patients included. Medications investigated included oral carbamazepine, subcutaneous sumatriptan, lidocaine (intranasal, 8% spray on the oral mucosa or intravenous), buprenorphine (ganglionic local opioid analgesia), and oral Nav1.7, a selective sodium channel blocker. Results: Meta-analyses showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain -3.8 points on a 0-10 scale (95% Cl = -4.653 to -2.873; P < 0.001). Patients who received lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (P < 0.001). In one RCT, patients receiving oral carbamazepine showed a significant improvement in pain intensity of -32% compared to the placebo (P < 0.001). In one trial, patients receiving 3 mg subcutaneous sumatriptan had a significantly lower intensity of pain on average -6.1 points on a scale of 0-10 compared to placebo (P < 0.001) and a significant improvement in pain intensity of -75% compared to the improvement in the placebo group (P < 0.001). Patients who received subcutaneous sumatriptan were 10 times more likely to have pain improvement than those who received placebo (P = 0.001) in one study. Due to the unclear/high risk of bias and small sample size, the quality of the evidence for lidocaine in the treatment of TN was low. Conclusion: Further studies are needed for carbamazepine, sumatriptan, buprenorphine, and oral Nav1.7 sodium channel blockers, as only one study reported outcomes.

COVID-19 팬데믹 상황에서 응급실 간호사의 소진에 영향을 미치는 융합적 요인 (Convergence factors Affecting Burnout of Emergency Room Nurses During the COVID-19 Pandemic)

  • 노승애;양승애
    • 사물인터넷융복합논문지
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    • 제8권6호
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    • pp.99-113
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    • 2022
  • 본 연구는 응급실 간호사를 대상으로 COVID-19 대유행 상황에서 COVID-19 스트레스, 대인관계(보호자-환자) 스트레스, 감정노동이 소진에 미치는 영향을 파악하기 위한 서술적 조사 연구이다. 자료수집은 H 의료원 산하기관 5개 상급종합병원과 종합병원 응급실 간호사를 대상으로 2021년 12월 9일부터 12월 23일까지 시행되었다. 대상자의 일반적 특성과 직무 관련 특성, COVID-19 스트레스, 대인관계(보호자-환자) 스트레스, 감정노동, 소진을 측정하기 위해 자기기입식 설문지로 진행하였다. 수집된 자료는 SPSS/WIN 25.0 통계 프로그램을 이용하여 빈도 분석, 기술통계분석, Independent sample t-test, One-way ANOVA, Scheffé test, Correlation analysis, 다중회귀분석을 실시하였다. 응급실 간호사의 COVID-19 스트레스의 평균은 3.64점, 대인관계(보호자-환자) 스트레스 4.35점, 감정노동 3.38점, 소진 3.44점이었다. 일반적 특성 및 직무 관련 특성에 따른 간호사의 소진은 성별, 결혼상태, 총 임상 경력, 근무 기관 형태에 따라 유의한 차이를 보였다. 소진은 COVID-19 스트레스, 대인관계 스트레스, 감정노동과 모두 유의한 정적 상관관계를 보였다. COVID-19 팬데믹 상황에서 응급실 간호사의 소진에 영향을 미치는 융합적 요인으로는 근무 기관 형태 중 권역 응급의료센터, 지역응급의료센터, 대인관계 스트레스, COVID-19 스트레스, 성별로 나타났고 설명력은 28.6%로 나타났다. 이와 같은 결과를 통해 신종감염병 대유행 시점에서 응급실 간호사의 소진을 예방하고 간호업무성과를 높이기 위한 중재프로그램 개발을 위한 기초자료를 제공하고자 한다.

일본 간호인력 수급방안정책의 시사점 (Suggestion of Japanese nursing staff supply and demand plan policy)

  • 권주영
    • 융합정보논문지
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    • 제11권3호
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    • pp.185-193
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    • 2021
  • 본 연구의 목적은 우리나라의 부족한 간호인력 수급방안 및 근무환경개선을 위한 실효성 있는 정책방안을 모색하여, 간호의 질을 높이고 양질의 업무환경을 만들어 적정 간호인력 수급확보방안을 제시하기 위함이다. 이를 위해 우리나라와 보건체계가 유사한 일본의 간호인력 정책과 관련된 문헌 및 정부와 지자체 자료분석을 통해 실효성 있는 간호인력 확보방안 및 지자체 사례에 대해 살펴보았다. 일본은 1974년부터 간호인력 수급정책을 마련하여, 근무환경개선 및 잦은 이직과 퇴직으로 인한 유휴 간호인력의 재취업등의 개선노력을 하고 있다. 이러한 노력으로 일본의 1년 미만의 신입간호사 이직율이 7.5%로 감소한 반면, 한국의 신입간호사는 33.9%로 큰 차이를 보였다. 이를 통해, 간호인력증원도 중요하지만, 기존의 간호인력이 지속적으로 근무할 수 있는 업무환경개선이 이루어져야할 것이다. 지방간호사들이 이탈하지 않도록 적정한 휴식 및 간호수가를 수도권지역보다 높게 책정하는 등 제도적인 강화가 필요할 것이다. 또한, 유휴인력을 적극적으로 홍보하여 채용한 의료기관에 대해서는 중앙 및 지자체 차원에서 다양한 인센티브 및 재정적 지원으로 독려하는 방안도 고려해 볼 수 있을 것이다.

Towards high-accuracy data modelling, uncertainty quantification and correlation analysis for SHM measurements during typhoon events using an improved most likely heteroscedastic Gaussian process

  • Qi-Ang Wang;Hao-Bo Wang;Zhan-Guo Ma;Yi-Qing Ni;Zhi-Jun Liu;Jian Jiang;Rui Sun;Hao-Wei Zhu
    • Smart Structures and Systems
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    • 제32권4호
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    • pp.267-279
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    • 2023
  • Data modelling and interpretation for structural health monitoring (SHM) field data are critical for evaluating structural performance and quantifying the vulnerability of infrastructure systems. In order to improve the data modelling accuracy, and extend the application range from data regression analysis to out-of-sample forecasting analysis, an improved most likely heteroscedastic Gaussian process (iMLHGP) methodology is proposed in this study by the incorporation of the outof-sample forecasting algorithm. The proposed iMLHGP method overcomes this limitation of constant variance of Gaussian process (GP), and can be used for estimating non-stationary typhoon-induced response statistics with high volatility. The first attempt at performing data regression and forecasting analysis on structural responses using the proposed iMLHGP method has been presented by applying it to real-world filed SHM data from an instrumented cable-stay bridge during typhoon events. Uncertainty quantification and correlation analysis were also carried out to investigate the influence of typhoons on bridge strain data. Results show that the iMLHGP method has high accuracy in both regression and out-of-sample forecasting. The iMLHGP framework takes both data heteroscedasticity and accurate analytical processing of noise variance (replace with a point estimation on the most likely value) into account to avoid the intensive computational effort. According to uncertainty quantification and correlation analysis results, the uncertainties of strain measurements are affected by both traffic and wind speed. The overall change of bridge strain is affected by temperature, and the local fluctuation is greatly affected by wind speed in typhoon conditions.

대구 안심연료단지 환경오염물질 노출 평가(II) - TSP, PM10, PM2.5 및 중금속 농도분포 및 노출특성 - (Exposure Assessments of Environmental Contaminants in Ansim Briquette Fuel Complex, Daegu(II) - Concentration distribution and exposure characteristics of TSP, PM10, PM2.5, and heavy metals -)

  • 정종현;피영규;이준정;오인보;손병현;이형돈;윤미라;김근배;유승도;민영선;이관;임현술
    • 한국산업보건학회지
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    • 제25권3호
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    • pp.380-391
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    • 2015
  • Objectives: The objective of this study is to assess airborne particulate matter pollution and its effect on health of residents living near Ansim Briquette Fuel Complex and its vicinities. Also, this study measured and analyzed the concentration of TSP, $PM_{10}$, $PM_{2.5}$, and heavy metals which influences on the environmental and respiratory disease in Ansim Briquette Fuel Complex, Daegu, Korea. Methods: In this study, we analyzed various environmental pollutants such as particulate matter and heavy metals from Ansim Briquette Fuel Complex that adversely affected local residents's health. In particular, we verified the concentration distribution and characteristics of exposure for TSP, $PM_{10}$, and $PM_{2.5}$ among particulate matters, and heavy metals(Cd, Cr, Cu, Mn, Ni, Pb, Fe, Zn, and Mg). In that regard, the official test method on air pollution in Korea for analysis of particulate matter and heavy metal in atmosphere were conducted. The large capacity air sampling method by the official test method on air pollution in Korea were applied for sampling of heavy metals in atmosphere. In addition, we evaluated the concentration of seasonal environmental pollutants for each point of residence in Ansim Briquette Fuel Complex and surrounding area. The sampling measured periods for air pollutants were from August 11, 2013 to February 21, 2014. Furthermore, we measured and analyzed the seasonal concentrations(summer, autumn and winter). Results: The average concentration for TSP, $PM_{10}$, and $PM_{2.5}$ by direct influence area at Ansim Briquette Fuel Complex were 1.7, 1.4 and 1.9 times higher than reference region. In analysis results of seasonal concentrations for particulate matter in four direct influence and reference area, concentration levels for winter were generally somewhat higher than concentrations for summer and autumn. The average concentrations for Cd, Cr, Mn, Ni, Pb, Fe, and Zn in direct influence area at Ansim Briquette Fuel Complex were $0.0008{\pm}0.0004{\mu}g/Sm^3$, $0.0141{\pm}0.0163{\mu}g/Sm^3$, $0.0248{\pm}0.0059{\mu}g/Sm^3$, $0.0026{\pm}0.0011{\mu}g/Sm^3$, $0.0272{\pm}0.0084{\mu}g/Sm^3$, $0.4855{\pm}0.1862{\mu}g/Sm^3$, and $0.3068{\pm}0.0631{\mu}g/Sm^3$, respectively. In particularly, the average concentrations for Cd, Cr, Mn, Ni, Pb, Fe, and Zn in direct influence area at Ansim Briquette Fuel Complex were 1.9, 3.6, 2.1, 1.9, 1.4, 2.6, and 1.2 times higher than reference area, respectively. The continuous monitoring and management were required for some heavy metals such as Cr and Ni. Moreover, the average concentration in winter for particulate matter in direct influence area at Ansim Briquette Fuel Complex were generally higher than concentrations in summer and autumn. Also, average concentrations for TSP, $PM_{10}$, and $PM_{2.5}$ were from 1.5 to 2.0 times, 1.2 to 1.8 times, and 1.1 to 2.3 times higher than reference area, respectively. In results for seasonal atmospheric environment, TSP, $PM_{10}$, $PM_{2.5}$, and heavy metal concentrations in direct influence area were higher than reference area. Especially, the concentrations in C station were a high level in comparison with other area. Conclusions: In the results, some particulate matters and heavy metals were relatively high concentration, in order to understand the environmental pollution level and health effect in surrounding area at Ansim Briquette Fuel Complex. The concentration of some heavy metals emitted from direct influence area at Ansim Briquette Fuel Complex were relatively higher than reference area. In particular, average concentration for heavy metals in this study were higher than average concentrations in air quality monitoring station for heavy metal for 7 years in Deagu metropolitan region. Especially, the residents near Ansim Briquette Fuel Complex may be exposed to the pollutants(TSP, $PM_{10}$, $PM_{2.5}$, and heavy metals, etc) emitted from the factories in Ansim Briquette Fuel Complex.

호스피스 전달체계 모형

  • 최화숙
    • 호스피스학술지
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    • 제1권1호
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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고지방식이로 비만을 유도한 생쥐에서 혈장 케모카인 발현 변화 (Alteration in plasma chemokine profile in a high-fat diet-induced obesity mouse model)

  • 김동환;조정민;서민준;임주현;배혜란
    • Journal of Nutrition and Health
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    • 제51권5호
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    • pp.369-378
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    • 2018
  • 본 연구에서 고지방식이로 비만을 유도한 생쥐는 식이 4주 후 지방조직의 형태학적 변화가 관찰되었고 생식기 지방조직의 무게가 증가하였으며, 혈장 중성지방 및 혈당치도 현저하게 증가하였다. 고지방식이 6주 후 몸무게의 유의한 증가가 관찰되기 시작하였으며, 뒤다리넙적근과 어깨사이 지방조직의 무게는 감소하고, 생식기 지방조직 및 간의 무게는 증가하였다. 지방조직의 형태학적 변화가 시작되는 고지방식이 유도 4주 후 혈장 내 40종의 시토카인 및 케모카인의 변화를 동시에 관찰하여 대조군과 비교해 본 결과, CXCL12 (SDF-1)와 CXCL13 (BLC)의 발현이 가장 현저하게 증가하였으며, G-CSF의 발현도 다소 증가하였다. 혈장 내 염증성 시토카인의 발현은 전반적으로 낮았다. 이상의 결과를 종합하면 고지방식이 유도 비만 초기에 만성 염증 상태로 진입하기 전 혈장 내 CXCL12와 CXCL13의 발현이 현저히 증가하는 것을 밝혔으며, CXCL12와 CXCL13의 증가로 B 세포, T 세포 및 단핵구가 혈관을 빠져나가 지방조직 및 지방조직 주변 림프조직으로 이동하여 지방조직 재형성과 국소 지방조직 면역에 관여할 것으로 보인다.