• Title/Summary/Keyword: Patterns of care

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Data mining approach for identifying factors impacting construction accident costs: from indirect expenses perspectives

  • Ayesha Munira CHOWDHURY;Eun-Ju HA;Jae-ho CHOI
    • International conference on construction engineering and project management
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    • 2024.07a
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    • pp.319-326
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    • 2024
  • Construction projects account for a significant proportion of workplace hazards globally. While construction cost reports typically emphasize direct accident costs such as treatment expenses, nursing care costs, or disability benefits, indirect factors like work interruption loss costs or consolation costs are frequently overlooked, because it is relatively difficult to estimate those factors in advance. Recognizing and accurately estimating the indirect costs factors associated with construction accidents would not only shed light on the monetary impact these incidents have on overall project costs but also would enable to estimate the total accident cost in advance. The current study seeks to identify factors influencing indirect costs, which ultimately govern the total accident cost, through a data mining approach. A survey was conducted in domestic construction companies, resulting in a dataset of 1038 accident records collected from construction sites. First, statistical analysis was performed to uncover characteristics and patterns of factors affecting construction accident costs from both direct and indirect perspectives. Later, this study proposes four distinct machine learning (ML) models, comparing their performances in predicting the total accident cost (including indirect costs) in advance. Additionally, this research sheds light on an important issue in construction data analysis, which is the scarcity of data in a particular class, by applying random oversampling and random undersampling techniques. The suggested framework can assist practitioners and management in estimating construction accident costs and identifying the relevant attributes that impact accidents at the construction site for future practices.

Preliminary Report of the $1998{\sim}1999$ Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea (식도암 방사선 치료에 대한 Patterns of Care Study ($1998{\sim}1999$)의 예비적 결과 분석)

  • Hur, Won-Joo;Choi, Young-Min;Lee, Hyung-Sik;Kim, Jeung-Kee;Kim, Il-Han;Lee, Ho-Jun;Lee, Kyu-Chan;Kim, Jung-Soo;Chun, Mi-Son;Kim, Jin-Hee;Ahn, Yong-Chan;Kim, Sang-Gi;Kim, Bo-Kyung
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.79-92
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    • 2007
  • [ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.

A Popular Three-Year-Old Child's Relationships with Other Children and Teacher (만3세 인기아의 친구 및 교사 관계)

  • So, Ra;Choi, Youn Chul
    • Korean Journal of Childcare and Education
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    • v.9 no.2
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    • pp.47-73
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    • 2013
  • The purpose of this study is to explore the relationships that a popular three year old child has with other children and teacher. One popular child was selected among thirteen children using peer-nomination method and participated in this study. During free choice play time, the popular child's various activities and interaction patterns were observed and analyzed. The popular child in this study had a steady intimate friendship with his best friend most of the time. However, he showed a tendency to behave as he pleased and give orders to other children who he was not in a close relationship with. He did some deliberate and premeditated acts to get praise and love from his teacher. The teacher's compensations also reinforced his intentional actions.

Prevalence and Treatment Pattern of Korean Patients with Temporomandibular Disorders (한국인 턱관절장애 환자의 유병률과 진료 양태)

  • Yang, Hee-Young;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.1
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    • pp.63-79
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    • 2009
  • While previous epidemiological studies on temporomandibular disorders (TMD) have been based on a given health center or population sample, no study has been performed on general population of Korea, especially concerning about treatment pattern such as clinician’s specialty involved in TMD treatment, types and amount of prescription medication and cost. This study aimed to investigate magnitude of health visits and treatment patterns for Korean patients with TMD through the computerized database of Health Insurance Review and Assessment Service (HIRAS). Inclusion criteria were all patients registered on the HIRAS database over 3 years' period from 2003 to 2005 and the medical records of patients with TMD as a main diagnosis were extracted. Information collected was as follows; distribution related to gender, age and region and type of hospital the patients visited, treatment duration, clinicians' specialty involved in treatment, cost, types of prescription medication and surgical treatment. The results of this study indicated that 0.15% of the population yearly sought TMD treatment, presenting with increase of incidence over the three years. Most of TMD patients were women (99.8%) and the biggest age group was second and third decades and decreased with age. Seoul and Kyeonggi province presented with higher incidence of TMD compared to the other regions of Korea, which seems to be related with magnitude of population. 56% of TMD patients visited primary care sector and the numbers of treatment visits was the highest in dental clinic (38.4%), followed by orthopedics (28%) and ENT (13.6%) clinics in order. Duration of prescription medication was the longest for anti-inflammatory analgesics, followed by antipsychotic drugs and muscle relaxants. Inpatient care related to TMD was primarily performed in dental hospital compared to medical hospital. Medical database of HIRAS provided comprehensive and vast information on epidemiologic characteristics and treatment patterns for patients seeking TMD treatment, which can be more reliable data to expect medical demand for TMD in condition that accurate diagnosis and standardized treatment is delivered in clinical settings.

Antibiotic Resistance for Common Hospital Acquired-pneumonia Pathogens in the Intensive Care Unit of Newly Opened Hospital (새로 개원한 병원 중환자실에서 주요 원내획득 폐렴 감염균의 연도별 항생제 내성율 변화)

  • Lee, Jae-Hyung;Shin, Sung-Joon;Kim, Young-Chan;Oh, Seung-Il;Kim, Mi-Ok;Park, Eun-Joo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.207-218
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    • 2002
  • Background : Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of multi-resistant bacteria outbreaks. The antibiotic resistance in newly opened intensive care unit that has no microbial colonization on and around the devices was investigated. Materials and Methods : The authors analyzed the antibiotic resistance patterns for common hospital acquired-pneumonia pathogens in the ICUs(Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp.) at the newly opened ICU of Hanyang University Medical Center, Kuri Hospital during 6 years(1995-2000). Results : 1) Regarding Staphylococcus aureus, the resistance rate to methicillin was 15% at 1995, 21% at 1996, 20% at 1997, 23% at 1998, 22% at 1999, 55% at 2000. 2) Regarding Pseudomonas aeruginosa, the resistance rate to $3^{rd}$ cephalosporin was 50% at 1995, 50% at 1996, 78% at 1997, 40% at 1998, 77% at 1999, 39% at 2000. Imipenam was 0% at 1995, 27% at 1996, 65% at 1997, 12% at 1998, 16% at 1999, 12% at 2000. Ciprofloxacin was 0% at 1996, 56% at 1997, 36% at 1998, 57% at 1999, 58% at 2000. Tobramycin was 7% at 1995, 10% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Gentamycin was 14% at 1995, 36% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Amikacin was 14% at 1995, 30% at 1996, 61% at 1997, 16% at 1998, 39% at 1999, 18% at 2000. 3) Regarding Acinetobacter spp., the resistance rate to $3^{rd}$ cephalosporin was 92% at 1996, 89% at 1997, 88% at 1998,84% at 1999, 77% at 2000. Imipenem was 50% at 1996, 48% at 1997, 45% at 1998, 49% at 1999, 50% at 2000. Ciprofloxacin was 0% at 1996, 48% at 1997, 33% at 1998, 27% at 1999, 71% at 2000. Tobramycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 77% at 2000. Gentamycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 83% at 2000. Amikacin was 33% at 1995, 83% at 1996, 82% at 1997, 88% at 1998, 75% at 1999, 69% at 2000. Conclusion : The S.aureus resistance to methicillin, the Pseudomonas aeruginosa resistance to ciprofloxacin, and the Acinetobacter spp. resistance to ciprofloxacin have rapidly increased during 6 years. There is a need to pay speicial attention when using the the antibiotics for the above pathogens. This data may be useful in antibiotic therapy in newly opened intensive care units.

A Study on Mother's Feeding Practice in a Urban Apartment Area (일부도시(一部都市) 아파트지역(地域) 어머니의 수유(授乳)에 관(關)한 조사연구(調査硏究))

  • Lee, Sung-Shoe
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.167-177
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    • 1982
  • This study was undertaken to observe relationships between patterns of feeding, supplementary-feeding and various maternal, family, and socioeconomic charactereistics in Hae Cheog Apartment area in Cheongdam-dong, Kangnamku, Seoul on July 2 to 12 in 1982. The results were based on a questionnaire from 179 mothers who have the last-born child under two years old. Results were as follows: 1) In socio-demographic characteristics, most of mothers were 25 to 30 years old and 52.0% of index children were under 6 months old. About 56.0% of families were the salaries and 47.0% of them earn over 500,000 won a month. 40.8% of mothers were college graduates and 81.6% of mothers had no occupation. 2) 89.4% of mothers received prenatal care in pregnancy of the index children and mothers who have delivered the child in medical institute were 88.3%. Mothers who recieved education of breast care and feeding technique through prenatal care were 22.4%, 31.8% respectively. 3) In the feeding method, 44.1% of mothers took the breast feeding, 24.0% of them chose the artificial feeding, and 20.7% of them chose the mixed feeding. Mothers who changed the-method from breast feeding to artificial feeding were 10.6% and only 0.6% of mothers changed from artificial feeding to breast feeding. 4) According to the questionnaire, 37 mothers have already finished lactation (no relation with. the beginning of weaning food). In breast feeding, one mother has lactated for $4{\sim}6$ months, one has lactated for $7{\sim}9$ months, four have lactated for $10{\sim}12$ months, and seven have. continued the lactation over 12 months. In artificial and mixed feeding, as the same phenomenon, most of mothers have lactated for more than 12 months. 5) The reasons for feeding method were as follows: In breast feeding, 64.6% of them took the method because they thought the breast milk nutrious, in artificial feeding, 34.9% of them chose it because they had occupation and in the mixed feeding, 67.6% of mothers took the method because of lack of their breast milk. In the case of changing the method from breast feeding to artificial feeding, 42.1% of them answered that they had to change the method because of lack of breast milk. 6) In most of cases, the 4th month was the proper period to begin the weaning food and 32.5% of breast feeding children and 27.6% of artificial feeding children began the weaning food in 4th month. After 4th month, there was no difference between breast feeding and artificial feeding in the beginning of weaning food. 7) In the matter of menstruation, 29.8% of mothers who had breast feeding started their menstruations in 3 months and the rest of them delayed until 12 months. 40% of mothers who had artificial feeding began to menstruate after 2 months and all the rest started within 5 months. 8) The birth interval between the index child and next new child (would-be-born): In breast feeding, the interval of $18{\sim}24$ months had a majority as 50.0%, and in the artificial feeding, the interval of over 24 months marked 66.7% of them. It was analyzed that the birth interval of artificial feeding was wider than that of breast feeding. 9) In the desirable number of children, the mothers who had breast feeding wanted two sons and two daughters as proper children. Those who want two children in disregard of the sex (son or daughter) were 89.3% of breast feeding, and 80.0% of artificial feeding respectively. Mothers who had breast feeding wanted two children rather than one child. 10) In the family planning practice, the rate of practice were 41.9% in breast feeding, and 58.1% in artificial feeding respectively. In the case of breast feeding, the using rate of family planning practice in men was higher than in women.

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A Study on Epidemiologic Characteristics of Recurrent Abdominal Pain in Elementary School Children (반복성 복통증 환아의 역학적 특징에 관한 조사)

  • Oh, Sang-Hyun;Yang, Eun-Seok;Park, Sang-Kee;Park, Young-Bong;Park, Jong;Park, Sang-Hak;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.21-29
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    • 1999
  • Purpose: The aims of this study are to examine clinical characteristics, patterns of medical care utilization, and factors which determine medical care utilization of elementary school children with recurrent abdominal pain (RAP), to find posssible factors influencing the onset and the course of the disorder. Method: We performed questionnaires in Kwangju on children from two primary schools from June,1 1998 to June 30 and carried out statistical analysis. Result: 1) Total number of questionnaires were 1417. 715 were male and 702 were female and the ratio of male to female was 1.02:1. Average age was 10.3 years. 2) 268 children had RAP (18.9%), boys 132 (18.4%), girls136 (19.2%). 3) The duration of the pain within 10 minutes was 68.5%. 178 children with RAP (66.3%) visited the doctor. The utilization pattern of medical facilities of the pupils with RAP; the most frequently utilized medical facility was pediatrics (35.2%) and the order ran as internal medicine (31.5%), and pharmacy (29.25). The utilization pattern of medical facilities for the older students; the utilization rate of pediatrics decreased, but internal medicine increased. The major factors affecting the selection of the medical facility were geographic accessibility, kindness of the personnel, good results and traffic convenience. 4) Symptoms which were accompanied with abdominal pain were headache (44.5%), chest pain (28.2%), dizziness (26.6%), vomiting (9%), and 119 children (44.5%) had no accompanied symptoms. 5) In 95 children (35.3%) abdominal pain, occured at postprandial time, in 55 children (20.5%) before meal and in 39 children (14.7%) at school. The highest incidence rate of RAP was observed on Monday (21.4%), and the lowest on Saturday (8.7%). 6) The most frequent involved part of the abdomen was periumbrical area (38%) and the order ran as epigastrium and suprapubic area. The most frequent characteristics of abdominal pain were burning pain (36.9%) and the order ran as dull, cramping and colicky pain. Conclusion: RAP is a frequent disease entitiy in children. Too many times children with RAP are treated by other departments instead of Pediatrics. A child has a peculiar growth and development which is different to those from an adult with advancing years. So, it is necessary to choose special medical care and an adequate medical facility.

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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

Predictability of Impending Events for Death within 48 Hours in Terminal Cancer Patients (말기암환자에서 임박사건 간 48시간 임종예측도 비교)

  • Hwang, In-Cheol;Choi, Chung-Hyun;Kim, Kyoung-Kon;Lee, Kyoung-Shik;Suh, Heuy-Sun;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.14 no.1
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    • pp.28-33
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    • 2011
  • Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

Smoking Patterns, Oral Health Behavior and Perception of the South Korean Army (육군의 복무 상황에 따른 흡연 양상과 구강보건행태 및 인식)

  • Jang, Sun-Ok;Kim, Yoon-Hee;Kang, Jung-Yun;Ko, Min-Seo;Kim, Bo-Yon;Park, Ji-Hae;Shim, Seo-Youn;Kim, Sang-Hoon;Chung, Won-Gyun
    • Journal of dental hygiene science
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    • v.10 no.3
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    • pp.131-139
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    • 2010
  • The purpose of this study was to evaluate smoking patterns, oral health behavior and perception of dental healthcare of military personnel in the South Korea Army. All 367 subjects were surveyed by the structured questionnaires with convenience sampling method. The questionnaires were consisting of 22 items. Depending on the conditions of military training, the distribution and differences of smoking patterns and oral behaviors were evaluated by frequency test, Weighted Kappa, Paired t-test and ANOVA. The differences of oral health perception on smoking were demonstrated by Mantel-Haenszel Chi-square test. In addition, Generalized Estimating Equation (GEE) was used to estimate the effects of oral behavior for the conditions of military training and smoking. The number of cigarette during military training period was similar to that during non-military training (p=0.109). The perception of smokers such as smoking effect on oral health, oral health and systemic health, and need of education for smoking cessation was significantly lower than non-smokers (p=0.0095, p=0.0007, and p<0.0001). The probability that toothbrush frequency per day was only one was associated with higher during military training period than non-military training (OR=9.29, 95% CI 5.05-17.07). Moreover, the probability that hours of toothbrush were less than one minute was associated with higher during military training than non-military training (OR=2.19, 95% CI 1.78-2.71). To improve knowledge, attitude, and behavior of oral health for the members, the army needs to develop oral health education and tobacco cessation programs. In particular, motivation and practice for oral health care are required to improve poor oral health behavior during the military training.