• Journal of Trauma and Injury
• /
• 제37권2호
• /
• pp.106-113
• /
• 2024

Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.

• Journal of Trauma and Injury
• /
• 제25권4호
• /
• pp.188-195
• /
• 2012

Purpose: An increase in the demand for specialized Trauma Centers led to a government-driven campaign, that began in 2009. Our hospital was selected as one of the Trauma Centers, and we reviewed data on trauma patients in order to correlate the mortality at a regional Trauma Center with its contributing factors, such as the severity of the injury, the means of arrival, and the time duration before arrival at our center. Methods: Data on the patients who visited our Trauma Center from January 2010 to November 2011 were retrospectively reviewed using electronic medical records. The patients who had revised trauma scores (RTSs) less than 7 or injury severity scores (ISSs) greater than 15 were included. The patients were categorized as survivors and non-survivors, and the means of arrival as transferred or visited directly. Time durations before arrival of less than one hour were also taken intoconsideration. Results: Two hundred(200) patients were enrolled, and the mortality rate was 36.5%. The most common cause of the accident was an automobile accident, and the most common cause of death was brain injury. The RTSs and the ISSs were significantly different in the non-survivor and the survivor groups. The mortality rate of the patients who were transferred was not statistically different from that of patients who visited directly. However, a time duration before arrival of less than one hour was statistically meaningful. Conclusion: The prognosis of the trauma patients were correlated with the severity of the trauma as can be expected, but the time between the incidence of accident and the arrival at hospital and whether the presence of transfer to trauma center were not statistically significant to the prognosis.

• 농촌계획
• /
• 제22권2호
• /
• pp.121-129
• /
• 2016

A disaster can be defined in many ways based on perspectives, in addition, its types are able to classify differently by various standards. Considering the different perspectives, the disaster can be occurred by natural phenomenon that is like typhoon, earthquake, flood, and drought, and by the accident that is like collapse of facilities, traffic accidents, and environmental pollution, etc. Into the modern society, moreover, the disaster includes the damages by diffusion of epidemic and infectious disease in domestic animals. The disaster was defined by natural and man-made hazards in the past. As societies grew with changes of paradigm, social factors have been included in the concept of the disaster according to new types unexpected by new disease and scientific technology. Change the concept of social disasters, Ministry of Public Safety and Security (MPSS) has provided the regional safety index, which measures the safety level of a local government. However, this regional safety index has some limitation to use because this index provides the information for city unit which is a unit of administrative districts of urban. Since these administrative districts units are on a different level with urban and rural areas, the regional safety index provided by MPSS is not be able to direct apply to the rural areas. The purpose of this study is to determine the regional safety index targeting rural areas. To estimate the safety index, we was used for 3 indicators of the MPSS, a fire, a crime, and an infectious disease which are evaluable the regional safety index using an accessibility analysis. For determining the regional safety index using accessibility from community centers to public facilities, the safety index of fire, crime, and infectious disease used access time to fire station, police office, and medical facility, respectively. An integrated Cheongju, targeting areas in this study, is mixed region with urban and rural areas. The results of regional safety index about urban and rural areas, the safety index in rural area is relatively higher than in the urban. Neverthless the investment would be needed to improve the safety in the rural areas.

• 디지털융복합연구
• /
• 제20권4호
• /
• pp.469-482
• /
• 2022

본 연구의 목적은 코로나19에서 고혈압 치료율의 지역 간 변이요인을 분석하는 것이다. 이를 위해 생태학적 분석에 적합한 데이터를 2020년 질병관리청 지역건강통계, 각 지자체 코로나19 확진자 현황 자료, 국민건강보험공단, 건강보험심사평가원의 건강보험통계, 한국사회보장정보원의 복지통계, 한국교통연구원의 교통접근성 지표 자료를 수집하였다. 고혈압 치료율의 지역 간 변이와 관련 요인을 SPSS Statistics 23을 활용하여 기술통계, 상관분석을 실시하였으며, 지역 간 변이 요인을 Arc GIS를 이용하여 지리적 가중회귀분석을 실시하였다. 연구결과로 지리적 가중회귀모형의 전반적인 설명력은 27.6%였으며, 지역별로는 23.1%에서 33.4%까지 분포하는 것으로 나타났고, 고혈압 치료율에 영향을 미치는 요인으로 기초생활보장 의료급여 수급자 비율, 당뇨병 치료율, 인구10만 명당 보건기관 수가 높을수록 고혈압 치료율이 높았으며, 코로나19 확진자수, 코로나19 유행으로 감소된 신체활동 비율, 코로나19 유행으로 감소된 음주 비율이 낮을수록 고혈압 치료율이 높은 것으로 분석되었다. 이러한 결과를 기반으로 코로나19에서 고혈압 치료율의 지역 간 변이요인 분석은 효과적인 고혈압 치료율 관리 사업을 기대할 수 있을 것이며, 더 나아가 지역사회 중심의 건강증진 정책 수립에 활용될 것으로 기대된다.

• 대한지역사회영양학회지
• /
• 제6권5호
• /
• pp.773-788
• /
• 2001

The purpose of this study was to investigate the difference in nutrient intake according to the level of self-perception of health status, aging status and life satisfaction of the rural elderly. The factors for the study were surveyed by interview method. The subjects were 270 people(71 male, 129 female) aged over 65 years(73.5 $\pm$ 5.6ys) in the Ham-an area. The obtained results as follows : By evaluation of self-perception of health status, 57.5% of subjects answered they are in a bad health condition. The 91.5% of subjects had diseases(rheumatitis & arthritis 31.4%, cardiovascular disease 20.2%, gastric disease 10.2%). The women had more diseases than the men(p < 0.01). The subjects took medical treatment in private hospital(40.5%) and public health centers(35.0%). The men showed better level of aging status(p < 0.001) and life satisfaction index(p < 0.01) than the worsen. Living with spouse influenced the aging status(p < 0.05) and the more pocket money influenced life satisfaction(p < 0.05) and aging status(p < 0.05). The elderly who eat regularly 3 times a day(p < 0.05) and have a good appetite(p < 0.001) appeared to have positive effect on the self perception of health status and aging status. An increasing level of the self-perception of health status and regular exercise worked to improve aging status(p < 0.001). The habits of smoking and alcohol drinking, however had no effect on any index. The self-perception of health status affected the nutrient intake, but only in female elderly. The aging status and the life satisfaction index related overall positively to the intake of nutrients. In conclusion, the study shows that gender did influence nutrient intake in the elderly. The women who live alone rated lowest in social resources and health condition therefore their nutrient intake was also extremely in deficit. For successful aging, a program for rural elderly is needed, i.e. actions to provide minimum economic life, food delivery and psychological/physical health care through regional public health centers.

• Perspectives in Nursing Science
• /
• 제11권1호
• /
• pp.1-9
• /
• 2014

Purpose: The purpose of this study was to demonstrate a two-year global health project to improve maternal and child health (MCH) in Ethiopia. Methods: This is a descriptive case study. The target area is Kilte Awlaelo Woreda in Tigray Regional State, Ethiopia. A baseline survey was conducted to identify the needs of community residents and health care professionals. A MCH program was developed according to a project design matrix that included: infrastructure renovation of health centers; continuing education for midwives, nurses, and health extension workers (HEWs); and improvement of residents' MCH awareness. Project evaluation will examine the structure, process, and outcomes of the program. Results: The baseline survey showed low rates of family planning (31%) and antenatal and postnatal care use (36.1% and 69%, respectively). The institutional birth rate was 13.5%. Midwives and nurses received 2~4 educational programs about family planning and perinatal care. HEWs were also given practical education. Water and electrical infrastructure of all five health centers in the Kilte Awlaelo Woreda were renovated. Additionally, medical supplies and equipment were provided. Community health education on perinatal care, family planning, and personal hygiene was presented. Conclusion: This study highlights the role of nursing in global health and provides basic information on the development and outcomes of the global health project.

• Journal of Trauma and Injury
• /
• 제35권2호
• /
• pp.76-83
• /
• 2022

Purpose: Ventilator-associated pneumonia is the most common nosocomial infection in patients with mechanical ventilation. In 2013, the new concept of ventilator-associated events (VAEs) replaced the traditional concept of ventilator-associated pneumonia. We analyzed risk factors for VAE occurrence and in-hospital mortality in trauma patients who received mechanical ventilatory support. Methods: In this retrospective review, the study population comprised patients admitted to the Jeju Regional Trauma Center from January 2020 to January 2021. Data on demographics, injury characteristics, and clinical findings were collected from medical records. The subjects were categorized into VAE and no-VAE groups according to the Centers for Disease Control and Prevention/National Healthcare Safety Network VAE criteria. We identified risk factors for VAE occurrence and in-hospital mortality. Results: Among 491 trauma patients admitted to the trauma center, 73 patients who received ventilator care were analyzed. Patients with a chest Abbreviated Injury Scale (AIS) score ≥3 had a 4.7-fold higher VAE rate (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.46-17.9), and those with a glomerular filtration rate (GFR) <75 mL/min/1.73 m² had 4.1-fold higher odds of VAE occurrence (OR, 4.15; 95% CI, 1.32-14.1) and a nearly 4.2-fold higher risk for in-hospital mortality (OR, 4.19; 95% CI, 1.30-14.3). The median VAE-free duration of patients with chest AIS ≥3 was significantly shorter than that of patients with chest AIS <3 (P=0.013). Conclusions: Trauma patients with chest AIS ≥3 or GFR <75 mL/min/1.73 m² on admission should be intensively monitored to detect at-risk patients for VAEs and modify the care plan accordingly. VAEs should be closely monitored to identify infections early and to achieve desirable results. We should also actively consider modalities to shorten mechanical ventilation in patients with chest AIS ≥3 to reduce VAE occurrence.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권5호
• /
• pp.2667-2672
• /
• 2016

Background: Virtually all cases of cervical cancer are caused by persistent infections with a restricted set of human papillomaviruses (HPV). Cancer of the cervix is the third or even the second most common cancer in women worldwide, more than 85% of the cases occurring in developing countries, such as China and India, including the Republic of Kazakhstan. The purpose was to determine the HPV type distribution to evaluate efficacy of vaccination and adjust cancer prevention strategy in Western Kazakhstan in the future. Materials and Methods: A retrospective analysis was conducted of data obtained from PCR laboratories in 4 regional centers for the time period covering 12 months, 2013-2014, using AmpliSens$^{(R)}$ Real-Time PCR kits for HPV testing of 12 genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59). Results: A total of 1,661 persons were HPV tested within 2013-14, but a proprotion examined for 16 and 18 genotypes only (563) was not been included for statistic analysis of distribution and ratio of the most common genotypes. Males accounted for only a small number (N=90 in total). Conclusions: Total number of the HPV-positive appeared to be 26.0%, or 286 of N=1098. Types distribution was as follows: type 16 (10.7%), 39 (5.83%), 51 (5.27%), 31 (4.85%), 56 (4.58%), 18 (3.61%), 59 (2.64%), 58 (2.22%), 35 (1.94%), 33 (1.25%). Overall the HPV infection was highest in 16-29 years old (62.4%) and decreased with age. Total prevalence of the HR-HPVs amongst male population was 21.4% with top five types 16, 18, 39, 51, 31. Trends forcorrelations between Aktau site and type 33 (Cramer's V 0.2029), between Caucasian ethnicity and type 33 (Cramer's V .1716), and between European ethnicities in Uralsk and type 45 (Cramer's V .1752) were found. Of N 563 tested separately for 16 or 18 types, 13.6% were positive. As a whole, the distribution of 16/18 types had a ratio of 3.53:1. Given the vaccine-targeted type 16 is widely spread amongst this regional population, HPV immunization program of adolescent girls 10-13 years should be implemented appropriately.

• Journal of Preventive Medicine and Public Health
• /
• 제29권2호
• /
• pp.311-329
• /
• 1996

This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

• 근관절건강학회지
• /
• 제22권1호
• /
• pp.40-47
• /
• 2015

Purpose: The purpose of this study was to identify factors influencing on performance of preventive actions to be exposed to infection in emergency nurses. Methods: Participants were 200 emergency nurses working in a regional emergency medical center, 4 local emergency medical centers, and 5 local emergency medical facilities in B city. The data were analyzed with descriptive statistics, independent t-test, ANOVA, Scheff$\acute{e}$'s test, Pearson's correlation coefficients, and stepwise multiple regression analysis using SPSS/WIN 21.0 programs. Results: There was no difference in performance of preventive actions to be exposed to infection by socio-demographic and job-related characteristics. The results of stepwise multiple regression analysis showed that levels of perception of preventive actions to be exposed to infection (${\beta}$=.40, p<.001) and protective environment on exposure to infection (${\beta}$=.22, p<.001) were significantly associated with performance of preventive actions, explaining 26.3% of the variance. Conclusion: In conclusion, improving performance of preventive actions to be exposed to infection is important to protect emergency nurses from exposure to infection. Thus, efforts to enhance protective environment on exposure to infection and to improve perceptions of preventive actions to be exposed to infection are necessary to improve the performance of preventive actions in emergency nurses.