• Title/Summary/Keyword: Safe Behavior

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A Case of Childhood Obstructive Sleep Apnea Syndrome with Co-morbid Attention Deficit Hyperactivity Disorder Treated with Continuous Positive Airway Pressure Treatment (지속적(持續的) 상기도(上氣道) 양압술(陽壓術)을 시행(施行)하여 치료효과(治療效果)를 본 주의력(注意力) 결핍(缺乏).과잉(過剩) 운동장애(運動障碍)를 동반(同伴)한 소아기(小兒基) 폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症) 1례(例))

  • Sohn, Chang-Ho;Shin, Min-Sup;Hong, Kang-E;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.85-95
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    • 1996
  • Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

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Effect of Natural Plant Mixtures on Behavioral Profiles and Antioxidants Status in SD Rats (자생식물 혼합 추출물이 SD 흰쥐에서의 행동양상 및 항산화 체계에 미치는 영향)

  • Seo, Bo-Young;Kim, Min-Jung;Kim, Hyun-Su;Park, Hae-Ryong;Lee, Seung-Cheol;Park, Eun-Ju
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.9
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    • pp.1208-1214
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    • 2011
  • Caffeine, a psychoactive stimulant, has been implicated in the modulation of learning and memory functions due to its action as a non-selective adenosine receptors antagonist. On the contrary, some side effects of caffeine have been reported, such as an increased energy loss and metabolic rate, decrease DNA synthesis in the spleen, and increased oxidative damage to exerted on LDL particles. Therefore, the aim of this study was to develop a safe stimulant from natural plants mixture (Aralia elata, Acori graminei Rhizoma, Chrysanthemum, Dandleion, Guarana, Shepherd's purse) that can be used as a substitute for caffeine. Thirty SD rats were divided into three groups; control group, caffeine group (15.0 mg/kg, i.p.), and natural plants mixture group (NP, 1 mL/kg, p.o.). The effect of NP extract on stimulant activity was evaluated with open-field test (OFT) and plus maze test for measurement of behavioral profiles. Plasma lipid profiles, lipid peroxidation in LDL (conjugated dienes), total antioxidant capacity (TRAP) and DNA damage in white blood, liver, and brain cells were measured. In the OFT, immobility time was increased significantly by acute (once) and chronic (3 weeks) supplementation of NP and showed a similar effect to caffeine treatment. Three weeks of caffeine treatment caused plasma lipid peroxidation and DNA damage in liver cells, whereas there were no changes in the NP group. NP group showed a higher plasma HDL cholesterol concentration compared to the caffeine group. The results indicate that the natural plants mixture had a stimulant effect without inducing oxidative stress.

Survey of Sedation Practices by Pediatric Dentists (소아치과의사의 진정법 사용에 대한 실태조사)

  • Yang, Yeonmi;Shin, Teojeon;Yoo, Seunghoon;Choi, Seongchul;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.257-265
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    • 2014
  • The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children's behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + $N_2O/O_2$(67.6%), CH + Hx + Mida submucosal administration (SM) + $N_2O/O_2$(29.7%), and Mida IM + $N_2O/O_2$(23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient's safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

Site Selection of Wildlife Passage for Leopard Cat in Urban Area using Space Syntax (공간구문론을 이용한 도시 내 삵 이동통로 적지선정)

  • Park, Jong-Jun;Woo, Dong-Geol;Oh, Dae-Hyun;Park, Chong-Hwa
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.1
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    • pp.92-99
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    • 2012
  • Many wildlife habitats have been destroyed and fragmented during the rapid industrialization and urbanization process in Korea. It is essential to connect these fragmented habitats to reduce road-kill of many types of endangered urban wildlife. The site selection for wildlife passages must take into account the behavior of the wildlife species for safe crossing utilizing many artificial barriers in urban areas. This study attempted to identify potential wildlife passage sites for the endangered and protected leopard cats of Gangseo Ecological Park in Seoul, Korea. A space syntax analysis, an analytical technique to objectively evaluate the spatial configurations related to passage selection, found that the integration value represents the accessibility and connectivity of spaces. In this paper, this means that the bigger the integration value, the more frequently the leopard cat passes through. The leopard cats were captured and radio-tracked for 72 hours once a month from March to June of 2009. The ArcGIS and Animal Movement of Hawth Tools were used to analyze the home range and movement paths, and Axwoman 4.0 was used to analyze space syntax. The daily average movement distance was $2.099{\pm}1.08km$. During the survey period, the leopard cats crossed over an urban expressway more than 20 times, running the risk of road-kill. The range of global integration values was 0.458~1.834, while that of the local integration was 0.210~6.061. Five sites that met across the leopard cats' movement routes and roads were selected to measure the local and global integrate values. Among these sites, the higher the integration value, the higher the road-kill possibility. Thus, two of five sites with high global and local integration values were suggested as potential wildlife passage sites for the leopard cats. Now, three tunnel passages are under construction at the suggested sites for which local integration value was highest (LI=4.369). Further studies are scheduled to verify these potential sites as suitable wildlife passages.

Study on the Current Status of Smart Garden (스마트가든의 인식경향에 관한 연구)

  • Woo, Kyung-Sook;Suh, Joo-Hwan
    • Journal of the Korean Institute of Landscape Architecture
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    • v.49 no.2
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    • pp.51-60
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    • 2021
  • Modern society is becoming more informed and intelligent with the development of digital technology, in which humans, objects, and networks relate with each other. In accordance with the changing times, a garden system has emerged that makes it easy to supply the ideal temperature, humidity, sunlight, and moisture conditions to grow plants. Therefore, this study attempted to grasp the concept, perception, and trends of smart gardens, a recent concept. To achieve the purpose of this study, previous studies and text mining were used, and the results are as follows. First, the core characteristics of smart gardens are new gardens in which IoT technology and gardening techniques are fused in indoor and outdoor spaces due to technological developments and changes in people's lifestyles. As technology advances and the importance of the environment increases, smart gardens are becoming a reality due to the need for living spaces where humans and nature can co-exist. With the advent of smart gardens, it will be possible to contribute to gardens' vitalization to deal with changes in garden-related industries and people's lifestyles. Second, in current research related to smart gardens and users' experiences, the technical aspects of smart gardens are the most interesting. People value smart garden functions and technical aspects that enable a safe, comfortable, and convenient life, and subjective uses are emerging depending on individual tastes and the comfort with digital devices. Third, looking at the usage behavior of smart gardens, they are mainly used in indoor spaces, with edible plants are being grown. Due to the growing importance of the environment and concerns about climate change and a possible food crisis, the tendency is to prefer the cultivation of plants related to food, but the expansion of garden functions can satisfying users' needs with various technologies that allow for the growing of flowers. In addition, as users feel the shapes of smart gardens are new and sophisticated, it can be seen that design is an essential factor that helps to satisfy users. Currently, smart gardens are developing in terms of technology. However, the main components of the smart garden are the combination of humans, nature, and technology rather than focusing on growing plants conveniently by simply connecting potted plants and smart devices. It strengthens connectivity with various city services and smart homes. Smart gardens interact with the landscape of the architect's ideas rather than reproducing nature through science and technology. Therefore, it is necessary to have a design that considers the functions of the garden and the needs of users. In addition, by providing citizens indoor and urban parks and public facilities, it is possible to share the functions of communication and gardening among generations targeting those who do not enjoy 'smart' services due to age and bridge the digital device and information gap. Smart gardens have potential as a new landscaping space.

CALPUFF Modeling of Odor/suspended Particulate in the Vicinity of Poultry Farms (축사 주변의 악취 및 부유분진의 CALPUFF 모델링: 계사 중심으로)

  • Lim, Kwang-Hee
    • Korean Chemical Engineering Research
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    • v.57 no.1
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    • pp.90-104
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    • 2019
  • In this study, CALPUFF modeling was performed, using a real surface and upper air meterological data to predict trustworthy modeling-results. Pollutant-releases from windscreen chambers of enclosed poultry farms, P1 and P2, and from a open poultry farm, P3, and their diffusing behavior were modeled by CALPUFF modeling with volume sources as well as by finally-adjusted CALPUFF modeling where a linear velocity of upward-exit gas averaged with the weight of each directional-emitting area was applied as a model-linear velocity ($u^M_y$) at a stack, with point sources. In addition, based upon the scenario of poultry farm-releasing odor and particulate matter (PM) removal efficiencies of 0, 20, 50 and 80% or their corresponding emission rates of 100, 80, 50 and 20%, respectively, CALPUFF modeling was performed and concentrations of odor and PM were predicted at the region as a discrete receptor where civil complaints had been frequently filed. The predicted concentrations of ammonia, hydrogen sulfide, $PM_{2.5}$ and $PM_{10}$ were compared with those required to meet according to the offensive odor control law or the atmospheric environmental law. Subsequently their required removal efficiencies at poultry farms of P1, P2 and P3 were estimated. As a result, a priori assumption that pollutant concentrations at their discrete receptors are reduced by the same fraction as pollutant concentrations at P1, P2 and P3 as volume source or point source, were controlled and reduced, was proven applicable in this study. In case of volume source-adopted CALPUFF modeling, its required removal efficiencies of P1 compared with those of point source-adopted CALPUFF modeling, were predicted similar each other. However, In case of volume source-adopted CALPUFF modeling, its required removal efficiencies of both ammonia and $PM_{10}$ at not only P2 but also P3 were predicted higher than those of point source-adopted CALPUFF modeling. Nonetheless, the volume source-adopted CALPUFF modeling was preferred as a safe approach to resolve civil complaints. Accordingly, the required degrees of pollution prevention against ammonia, hydrogen sulfide, $PM_{2.5}$ and $PM_{10}$ at P1 and P2, were estimated in a proper manner.

MDP(Markov Decision Process) Model for Prediction of Survivor Behavior based on Topographic Information (지형정보 기반 조난자 행동예측을 위한 마코프 의사결정과정 모형)

  • Jinho Son;Suhwan Kim
    • Journal of Intelligence and Information Systems
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    • v.29 no.2
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    • pp.101-114
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    • 2023
  • In the wartime, aircraft carrying out a mission to strike the enemy deep in the depth are exposed to the risk of being shoot down. As a key combat force in mordern warfare, it takes a lot of time, effot and national budget to train military flight personnel who operate high-tech weapon systems. Therefore, this study studied the path problem of predicting the route of emergency escape from enemy territory to the target point to avoid obstacles, and through this, the possibility of safe recovery of emergency escape military flight personnel was increased. based problem, transforming the problem into a TSP, VRP, and Dijkstra algorithm, and approaching it with an optimization technique. However, if this problem is approached in a network problem, it is difficult to reflect the dynamic factors and uncertainties of the battlefield environment that military flight personnel in distress will face. So, MDP suitable for modeling dynamic environments was applied and studied. In addition, GIS was used to obtain topographic information data, and in the process of designing the reward structure of MDP, topographic information was reflected in more detail so that the model could be more realistic than previous studies. In this study, value iteration algorithms and deterministic methods were used to derive a path that allows the military flight personnel in distress to move to the shortest distance while making the most of the topographical advantages. In addition, it was intended to add the reality of the model by adding actual topographic information and obstacles that the military flight personnel in distress can meet in the process of escape and escape. Through this, it was possible to predict through which route the military flight personnel would escape and escape in the actual situation. The model presented in this study can be applied to various operational situations through redesign of the reward structure. In actual situations, decision support based on scientific techniques that reflect various factors in predicting the escape route of the military flight personnel in distress and conducting combat search and rescue operations will be possible.

Changes in the Behavior of Healthcare Organizations Following the Introduction of Drug Utilization Review Evaluation Indicators in the Healthcare Quality Evaluation Grant Initiative (의료질평가지원금 제도의 의약품안전사용서비스 평가지표 도입에 따른 의료기관의 행태 변화)

  • Hyeon-Jeong Kim;Ki-Bong Yoo;Young-Joo Won;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.2
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    • pp.178-184
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    • 2024
  • Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

Development and evaluation of Home Economics teaching·learning process plans applied Problem Based Learning focusing on 'food and nutrition' unit for students with intellectual disability (지적장애 학생을 위한 문제중심학습(PBL) 적용 가정과 식생활 교수·학습 과정안 개발과 평가)

  • Kim, yun-ju;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.30 no.2
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    • pp.39-56
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    • 2018
  • The purpose of this study was to develop Home Economics(HE) teaching and learning process plans applied Problem Based Learning(PBL) focusing on 'food and nutrition' unit for students with intellectual disability and to evaluate the effects of the HE instruction on their food choice·management knowledge and problem-solving skills after implementing the instruction for students with intellectual disability. To develop HE teaching and learning process plans applied PBL focusing on 'food and nutrition' unit for students with intellectual disability, problems that arise in daily life to trigger interest of students were firstly developed. The selected problems and teaching and learning process plans were reviewed for validity by one home economics education professor and three teachers who are experts in special education. This study used the one group pretest and posttest design, sampling 6 students who are in special-education middle school with the intellectual disability. After HE instruction of 6 sessions applied PBL method, this study tested the effects of the instruction. The first three sessions taught how to choose and keep food. The fourth session taught purchasing food ingredients and keeping them for sandwiches. The fifth and sixth sessions let the students make sandwiches and give them to others. The instruments of the study comprised of tools for food choice and management knowledge, tools for problem-solving skills evaluation, self-evaluation sheets, evaluation form of course satisfaction for students, evaluation form of behavior in class for teachers, and daily observation journal and all tools. These instruments were proved to have reliability and validity. The results of this study are as follows. First, all six students who took HE instruction applied PBL method focusing on 'food and nutrition' unit scored 30 points higher out of 100 points after taking the instruction in food choice and management knowledge and scored 5 points higher out of 14 points in problem-solving skills on average. Therefore, it was interpreted that HE instruction applied PBL affected the food choice·management knowledge and the problem solving skills of students with intellectual disability. Secondly, the students with intellectual disability participated actively in HE instruction applied PBL focusing on 'food and nutrition' unit and expressed satisfaction. Three special education experts evaluated HE teaching·learning process plans applied PBL focusing on 'food and nutrition' unit to be well-developed. This study showed that HE instruction applied PBL focusing on 'food and nutrition' unit allowed the students with intellectual disability to acquire comprehensive skills in choosing, keeping, and making safe food and helped them solve problems of their life by themselves. Therefore I suggest that Home Economics should be adopted as a formal subject matter in special school curriculum for students with intellectual disability.