• Title/Summary/Keyword: Risk Severity

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Effect Analysis of Virtual-reality Vestibular Rehabilitation based on Eye-tracking

  • Lee, Sungjin;Hong, Min;Kim, Sungyeup;Choi, Seong Jun
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.14 no.2
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    • pp.826-840
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    • 2020
  • Vertigo is one of the most common complaints encountered by physicians and the patients are steadily increasing. These patients are exposed to the risk of secondary accidents such as falls due to vertigo. There are two ways to improve this symptom: medication and rehabilitation. Although temporary symptomatic improvement may be expected in patients treated with medication, vertigo may recur and medication can delay central compensation. In contrast vestibular rehabilitation exploits central mechanisms of neuroplasticity to increase postural stability and enhance visual-vestibular interactions in situations that generate conflicting sensory information. However, vestibular rehabilitation may be compromised by incorrect performance of exercises, and there is a need for active effort and interest from the patient during rehabilitation. To solve these problems, we decided to apply FOVE HMD for eye-tracking and Unity3D to create virtual reality. The proposed eye-tracking based algorithm calculates the concentration of users with eye tracking data and calculates the motion width of the patient with nystagmus, thus the severity of the patient according to the score can be determined. According to our experimental test against healty group and patients group, this result showed the meaningful data to use define the contents result.

Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review

  • Park, Yeon-Hwan;Bang, Hwal Lan;Han, Hae-Ra;Chang, Hee-Kyung
    • Journal of Korean Academy of Nursing
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    • v.45 no.1
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    • pp.1-13
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    • 2015
  • Purpose: The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes. Methods: A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses. Results: 29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents. Conclusion: Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.

Effects of Music Therapy on Agitation in Dementia: Systematic Review and Meta-analysis (음악요법이 치매의 초조행동에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Kong, Eun-Hi;Park, Myonghwa
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.106-116
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    • 2015
  • Purpose: The purpose of this review was to assess the quality and to evaluate the effectiveness of music interventions in reducing agitation in older adults with dementia. Methods: Randomized controlled studies and randomized crossover studies were identified by searching MEDLINE, EMBASE, CINAHL, PsycINFO, AGELINE, Cochrane Central Register of Controlled Trials, Korea Med, Kmbase, RISS, National Assembly Digital Library, KISS, and RICH. Two reviewers independently retrieved articles, extracted data, and assessed the quality of studies. Results: In total, 10 studies were selected from 1095 unique citations. All included studies were conducted in long term care settings. Overall, risk of bias for included studies was low to moderate. The weighted average effect size across studies was -0.39 (95%CI [-0.69, -0.10], p=.009, $I^2=63%$). Music therapy was effective to reduce agitation of the older adults with dementia. Conclusion: Music intervention can be an effective non-pharmacological intervention for the reduction of agitation in dementia. Future studies need to use rigorous research method and to provide description of research methods in greater detail. In addition, future studies are required to explore the effects of music therapy according to severity of agitation and dementia.

A Study on the Legal Issues on Chinese Security Law (중국의 독립보증에 관한 법률문제연구)

  • SONG, Soo-Ryun
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.71
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    • pp.85-105
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    • 2016
  • Independent guarantee is new financial product developed in international commercial transaction. The nature of independent guarantee is an independent undertaking, which takes the form of documentary transaction. As long as the documents presented by the beneficiary are on their face complying with the terms and conditions of the guarantee, the guarantor is obliged to pay upon the complying presentation. Where parties choose to apply for issue of independent guarantee in international commercial transactions in China, Chinese court shall respect the autonomy of parties. If either the guarantor or the beneficiary is located outside of China, or the facts which cause the establishment, change or cancellation of independent guarantee relationship occurred outside of China, it shall be deemed as foreign related independent guarantee. If the interested parties requests for confirmation of the independence of foreign related independent guarantee, it shall be supported by Chinese court. However, parties dealing with Chinese domestic commercial transaction have not fully realized the severity of independent guarantee liability. The market credit is being cultivated and the financial innovation is being explored at present in China. In order to guard against the systematic and the regional financial risk, before relevant rules are promulgated, Chinese court shall not recognize the independence guarantees issued for the domestic commercial transaction, but treat it as joint liability surety.

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Characteristics of Cardiovascular Adverse Drug Reactions Reported to KFDA (식품의약품안전청에 보고된 심혈관계 약물유해반응의 특성 분석)

  • Rhew, Ki-Yon;Cho, Hea-Kyoung;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.1
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    • pp.41-46
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    • 2012
  • Adverse drug reaction (ADR) is a global problem of major concern in health care. ADRs can be accrued in any organs or systems. However, cardiovascular ADRs could be a more serious problem if they are irreversible or severe. For this reason, this study was conducted to analyze pattern and severity of cardiovascular ADRs, and suspicious medication. Total 646 reports including cardiovascular ADRs reported to the KFDA between January and June 2010 were analyzed. Amlodipine besylate (36 reports, 3.3%), iopromide (29 reports, 2.7%), tramadol HCl (28 reports, 2.6%) were most suspicious drugs that occurred cardiovascular ADRs. The most common cardiovascular ADRs were hypotension( 236 reports, 33.1%), palpitation (134 reports, 18.8%), and hypertension (89 reports, 12.5%). The most frequent ADRs were occurred in the age group of more than 60. This result could be of help to prescribers and other healthcare providers to predict and prevent cardiovascular ADRs. Also this study suggested that patients with cardiovascular ADR risk factors should be intensively monitored during the medications.

Gambling Subgroups among Korean Out-of-school Adolescents

  • Kang, Kyonghwa;Ha, Yi Kyung;Bang, Hwal Lan
    • Child Health Nursing Research
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    • v.26 no.3
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    • pp.385-392
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    • 2020
  • Purpose: The number of Korean adolescents engaging in gambling is increasing, especially among out-of-school adolescents. This study aimed to identify patterns of gambling activities and factors related to specific subgroups of out-of-school adolescent gambling activities. Methods: This descriptive study analyzed secondary data from the 2015 Korea Youth Gambling Problem Survey, including 1,200 out-of-school adolescents. Latent class analysis was conducted to identify patterns of gambling activities. The factors related to gambling subgroups were verified with multinomial logistic regression. Results: Three latent classes of gambling activities were identified: rarely gambling (RG), immediate gain gambling (IGG), and broad gambling (BG). These subgroups differed significantly in terms of gender, age at and type of first gambling experience, number and type of gambling activities, gambling frequency, time and money spent on gambling, problem gambling severity, and motivation for gambling. Compared to the RG subgroup, both the IGG and BG subgroups were strongly associated with an older age at the first gambling experience. Conclusion: Out-of-school adolescents who first gambled at an older age and who gambled mainly in order to gain money immediately were at risk of problem gambling. Developing strategies for early screening and referral to professionals is necessary to prevent gambling problems from worsening.

Hippocampal Volume and Memory Function in Patients with Posttraumatic Stress Disorder (외상후 스트레스 장애 환자에서 해마용적과 기억기능)

  • Chung, Moon-Yong;Chung, Hwa-Yong;Ryu, Hyun;Chung, Hae-Gyung;Choi, Jin-Hee
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.131-139
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    • 2001
  • This study was conducted to evaluate the effect of PTSD on memory function and hippocampal volume, and to identify major variables correlated to hippocampal volume and memory function. Thirty four Vietnam veterans were collected for this study, among whom eighteen were PTSD patients and sixteen were combat control subjects. The author used Impact of Event Scale(IES), Combat Exposure Scale(CES), Hamilton Depression Rating Scale(HDRS) and Beck Depression Inventory (BDI). Korea Memory Assessment Scale(K-MAS) was assessed for memory function. Magnetic resonance imaging(MRI) was used to measure hippocampal volume. There were significant differences between PTSD and Non-PTSD veterans in IES, HDRS and BDI. Significant difference was found in verbal memory and total memory of K-MAS between PTSD and Non-PTSD veterans. There was significant difference in hippocampal volume between PTSD and Non-PTSD veterans. Short term memory, verbal memory and total memory were positively correlated to hippocampal volume. Hippocampal volume was negatively correlated to IES, HDRS, and BDI. These results suggest that PTSD severity be associated with hippocampal atrophy and memory dysfunction. Reduced or smaller hippocampal volume may be preexisting risk factor for stress exposure or the development of PTSD on combat exposure.

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Prevention of Pediatric Acute Kidney Injury

  • Cho, Heeyeon
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.71-78
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    • 2015
  • The incidence of acute kidney injury (AKI) in critically ill pediatric patients has been reported as increasing to 25 %, depending on population characteristics. The etiology of AKI has changed over the last 10-20 years from primary renal disease to the renal conditions associated with systemic illness. The AKI in pediatric population is associated with increased mortality and morbidity, and prevention is needed to reduce the consequence of AKI. It is known that the most important risk factors for AKI in critically ill pediatric patients are clinical conditions to be associated with decreased renal blood flow, direct renal injury, and illness severity. Renal hypoperfusion leads to neurohormonal activation including renin-angiotensin-aldosterone system, sympathetic nervous system, antidiuretic hormone, and prostaglandins. Prolonged renal hypoperfusion can result in acute tubular necrosis. The direct renal injury can be predisposed under the condition of renal hypoperfusion, and appropriate treatment of volume depletion is important to prevent AKI. The preventable causes of AKI include contrast-induced nephropathy, hemodynamic instability, inappropriate mediation use, and multiple nephrotoxic insults. Given the evidence of preventable factors for AKI, several actions such as the use of protocol for prevention of contrast-induced nephropathy, appropriate treatment of volume depletion, vigorous treatment of sepsis, avoidance of combinations of nephrotoxic medications, and monitoring of levels of drugs should be recommended.

Pulmonary Bone Cement Embolism Following Percutaneous Vertebroplasty (요추 압박 골절의 골 시멘트를 이용한 척추성형술 치료 후 발생한 폐동맥 시멘트 혈전증: 증례보고)

  • Cha, Yong Han
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.202-205
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    • 2015
  • Purpose: Pulmonary cement embolization after vertebroplasty is a well-known complication. The reported incidence of pulmonary cement emboli after vertebroplasty ranges frome 2.1% to 26% with much of this variation resulting from which radiographic technique is used to detect embolization. Onset and severity of symptoms are variable. Case description: We present the case of a 83-year-old women who underwent fourth lumbar vertebroplasty and subsequently had dyspnea several days later. Posteroanterior chest radiography showed multiple linear densities. Computed tomography of thorax revealed also multiple bilateral, linear hyperdensities within the lobar pulmonary artery branches are detected in axial and coronal views. Literature Reviews: Operative management of vertebral compression fractures has included percutaneous vetebroplasty for the past 25 years. Symptoms of pulmonary cement embolism can occur during procedure, but more commonly begin days to weeks, even months, after vertebroplsty. Most cases of pulmonary cement emboli with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation. Endovascular removal of large cement emboli from the pulmonary arteries is not without risk and sometimes requires open surgery for complete removal of cement pieces. Conclusion: Pulmonary cement embolism is a potentially serious complication of vertebroplasty. If a patient has chest pain or respiratory difficulty after the procedure, chest radiography and possibly advanced chest imaging studies should be performed immediately.

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Surgical Management of Thoracic Empyema.* - 330 cases - (농흉의 외과적 치료330)

  • 김치경
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.65-70
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    • 1987
  • Empyema thoracis following pneumonia, pulmonary tuberculosis, trauma and surgical procedures continues to be a source of major morbidity and mortality. We retrospectively reviewed the hospital records of 330 patients [child:87, adult243] treated for empyema thoracis at Catholic Medical Center between 1964 and 1986. The causes of empyema in these patients were as follows: pneumonia [C***:66%, A***:30%], pulmonary tuberculosis [C:2%, A:20%], lung abscess [C:3%, A:5%], postoperative complication [C:0%, A:13%], trauma [C:1%, A:4%] and unknown origin [C:23%, A:17%]. Three patients in this series died of sepsis from necrotizing pneumonia. Staphylococcus [29.3%], Streptococcus [8.8%], E. coli [8%], Mycobacterium tuberculosis [7.9%], Klebsiella [7.4%], Pseudomonas [6.4%], Bacteroides [3.4%] were the organisms most commonly isolated. Bacterial isolates were single in 68.3%, multiple 7.5% and absent 24.2%. The type of organism did not correlate with severity of disease or eventual requirement for closed thoracotomy drainage, open thoracotomy drainage [Modified Eloesser*s procedure], thoracoplasty, decortication or pleuropneumonectomy. Successful methods of treatment included aspiration in 44%, tube thoracotomy in 66%, open thoracotomy drainage in 98.7%, thoracoplasty in 98%, decortication in 96% and pleuropneumonectomy in 73%. Initial mode of management in empyema thoracis are thoracentesis and closed thoracotomy drainage. If the initial management was failed, we performed another surgical procedures. Before 1973, we manage with Schede`s thoracoplasty in the postpneumonectomy empyema patients. But thoracoplasty, with or without the use of muscle flaps, is a hazardous operation in the poor-risk patients. The permanent, open thoracotomy drainage is a relatively minor operation which is well tolerated even by cachexic, septic patients. It controls infection, and sometimes results in the bronchopleural fistula closing spontaneously.

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