• Title/Summary/Keyword: Standard of Care

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A study on the optimum range of reinforcement in tunneling adjacent to structures (구조물 근접 터널시공시 최적의 보강범위에 관한 연구)

  • Lee, Hong-Sung;Kim, Dae-Young;Chun, Byung-Sik;Jung, Hyuk-Sang
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.11 no.2
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    • pp.199-211
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    • 2009
  • Development of underground space is actively performed globally for better life in the surface, and the scale of the space is increasing. Extreme care should be taken in the construction of the underground space in urban areas in order to avoid damage of adjacent structures and interference with existing underground space. In case of shallow tunnels, reinforcement of ground and structures is necessary to minimize the damage to structures due to excavation but any standard for optimum range of the reinforcement has not been established yet. In this paper, a series of numerical analyses have been performed for a 20 m diameter tunnel excavated underneath a structure to investigate the degree of damage of the structure according to vertical and horizontal spacing between the tunnel and structure. In addition to that, optimum range of reinforcement is presented for each case where reinforcement is required. It has been observed that the reinforcement is necessary for the ground condition adapted in the analyses as follows: (1) if horizontal spacing ($S_{H}$) approaches to 0D (D: equivalent diameter of tunnel) for vertical spacing (Sv) of 0.5D, and (2) if tunnel exists underneath the structure for vertical spacing (Sv) of 0.75D. The reinforcement is not necessary for Sv of 10 regardless of $S_{H}$. It also has been obtained that the optimum ranges of the reinforcement around structure foundation are 7 m in depth and whole width of the structure and 5 m beyond tunnel sidewall. These reinforcememt ranges have been confirmed to be enough for stability of the structure if types of reinforcement method is appropriately selected.

SELF-INJURIOUS BEHAVIOR IN A PATIENT WITH AUTISM : A CASE REPORT (자폐 환자의 자해로 인한 구강 내 손상 : 증례 보고)

  • Ji, Eun-Hye;Lee, Hyo-seol;Choi, Hyung-Jun;Kim, Seong-Oh;Choi, Byung-Jai;Son, Heung-Kyu;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.1
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    • pp.10-14
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    • 2012
  • Self-injurious behavior (SIB) has been defined as the deliberate destruction or alteration of body tissue without conscious suicidal intent. It occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavior is destructive and causes concern and distress to all involved in the care and treatment of the affected individual. A 13-year-old girl with autism, mental retardation and delayed development was reffered from her pediatrician because of severe and painful lower lip biting. An intraoral examination revealed a diffuse swelling of lower lip. It was covered with necrotic slough and the ulcer and scarring of the lower lip was observed. We chose to use an oral removable prosthesis for Conservative treatment. It was decided to use a soft silicone mouthguard in the maxillary arch. Initially, she could not tolerate the appliance inside her mouth but soon adapted with the appliance. After one month, she lost the mouth guard and started lip biting. So we made mouth guard again. There are no standard methods for preventing self-injurious behavior in a patient who is developmentally disabled. Appropriate preventive methods must be developed for each individual patient based on close observation and clinical findings. Behavior modification techniques, pharmacological treatment, extraction of teeth, orthognathic surgery and intra/extra oral appliances can be performed for adjust self-injurious behavior. A suitable oral guard could be tried initially before employing more invasive approaches.

A Review on Stress and Coping Level at Dysmenorrhea Perceived by Middle School Girls in Seoul (월경곤란시 여자중학생이 지각하는 스트레스 및 그 대응에 관한 소고)

  • Jung Moon-Hee
    • Journal of Korean Public Health Nursing
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    • v.5 no.2
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    • pp.45-51
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    • 1991
  • The purpose of this study is to investigate the stress and coping level as a result of dysmenorrhea which was experienced by girls. For the collection of data, the girls from the 1st to the 3rd grade in middle school in Seoul were selected through a random sampling technique. The survey was conducted from the 1st. to the 14th of June, 1991 by the use of questionnaires made after a pilot study. The final subjects for analysis were restricted to only those who had experienced me~arche, the number of which totaled 1,131. The stress, coping level, and other variables, were tested and analysed by descriptive statistics (eg, frequency, percentage, mean and standard deviation), t-test, ANOVA and Pearson's correlation coefficients. The obtained results are summarized as follows. 1. The chronological start for menarche was at a mean age of 13.1 The respondents who had experienced menarche numbered $70.9\%$ of the 1st grades and $96.2\%$ of the 2nd grades in middle school, otherwise the starting age for menarche was in the 4th grade in primary school. 2. Their menstrual cycle and period were longer than adult's one. The number of students studied who had experienced dysmenorrhea during their menstrual cycle were 860, and 650 of those revealed that their mothers or sisters had experienced similar problems. 3. The subjects who were late or head left early rather than being absent from school every menstruation cycle were more stressful. The results are thought to show that the girl's perception of dysmenorrhea seems to be more sensitive than adult's one. 4, A significant negative correlation was found between the perception of menstrual flow and strees level. It means that an increase in the stress of dysmenorrhea was associated with decreased menstrual bleeding. The degree of hypochondrical concern assessed by the girls was significantly correlated to stress and coping level. When the girls perceived high stress as a result of dysmenorrhea, they worried about their physical health more. The above results lead us to the suggestion that the starting point of early education with a school program is appropriate for the 4th grade in primary school. Especially if the girls in middle school should be required to give the information about correct knowledge and sufficient self -care management of menstruation monthly, if this could be implemented the loss in school days among the students due to dysmenorrhea would be minimized with more ease.

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Conventional versus Doxorubicin-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: a Tertiary Medical Centre Experience in Malaysia

  • Rahman, F Abdul;Naidu, J;Ngiu, CS;Yaakob, Y;Mohamed, Z;Othman, H;Jarmin, R;Elias, MH;Hamid, N Abdul;Mokhtar, N Mohd;Ali, RA Raja
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4037-4041
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    • 2016
  • Background: Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre. Materials and Methods: A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups. Results: A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were $4.9{\pm}3.2$ months and $8.3{\pm}2.0$ months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria. Conclusions: DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.

Availability of the Time and Change Test in Screening for Dementia in the Elderly (노인에서 치매 조기선별을 위한 시각.금전계산 검사의 유용성)

  • Chung, Eun-Kyung;Shin, Min-Ho;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.2
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    • pp.101-107
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    • 2003
  • Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.

A Study on Clothing Buying Pattern of Korean High School Girls by their Self-concept (여고생의 자아개념에 따른 의복구매행동 특성)

  • 황춘섭
    • Journal of the Korean Society of Costume
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    • v.43
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    • pp.169-186
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    • 1999
  • The objectives of the present study were to investigate the relationship between self-concept and clothing buying pattern in accordence with their self-concept. The method employed to conduct this study was normative-descriptive survey using questionnaires. Subjects were 438 high school girls in Seoul and the survery was implemented from the begining of May 1998 to the end of June 1998. The questionnaires were completed by students during class. Mean Standard Deviation Chi-Squeare and t-test were employed to analize the data gathered. The results are summarzed as follows: (1) The group who has the higher score in total positive self, self identity self satisfacton self behavior physcial self moral ethical self personal self and family self cares more about economical efficiency of clothing than the group who has the lower score. (2) The group who has the higher score in total positive self, self satisfaction personal self and family self attachs greater importance to the practical use of clothing than those who scored lower with in said categories of self concept. (3) The group who has the higher total positive self score cares originality more than the group who has the lower score when they purchase outdoor garment. (4) The group who has the lower social self score cares modesty and ostentation more than the group who scored higher in social self. (5) The group who has the higher score in positive self behavior personal self and family self cares about convenence in care and maintenance of the clothing than the group has the lower score. (6) Friends buying and use experiences of herself and the observation of other's attire are the main source of fashion information for the present Korean high school girls. The group who has the higher score in total positive self personal self family self, self identity self satisfactio self behavior used their own experiences more often as a source of fashion information than those who scored lower with in said categories of self concept. The group who has the higher score of total positive self personal self family self, self identity self satisfaction self behavior uses family members more often as a source of fashion information than those who scored lower with in said categories of self concept. The group who has the higher score in self identity and self behavior uses store displays more often than the group who scored lower. (7) Bonded processing goods stores or fancy goods shops(haberdashery) located in trendy shopping district discount stores and outlet stores of the famous manufactures are main places where Korean high school girls buy their outdoor garments. The group who has the higher score in social self, self identity and personal self uses department stores more often and rerely shops at bonded processing goods stores of fancy goods shops located in thendy shopping district compared to those who scored lower with in said categories of self concept.

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Comparison of Health-Related Quality of Life(EQ-5D) between Working and Non-Working Older Adults: Based on the 8th Korea National Health and Nutrition Examination Survey(2020) (근로노인과 비 근로노인의 건강관련 삶의 질(EQ-5D) 비교: 제8기 2차년도(2020) 국민건강영양조사 자료를 이용하여)

  • Yang, Hye kyung;Kim, Seong Ui
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.5
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    • pp.177-184
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    • 2022
  • This study is tried to contribute to the development of nursing intervention for the health promotion of the elderly by comparing the health-related quality of life (EQ-5D) of the working and non-working elderly using the data from the 8th National Health and Nutrition Survey (2020). The subjects of the study were the elderly aged 65 or older, 512 working elderly and 862 non-working elderly, with a total of 1,374 people. As a result of the study, it was found that the quality of life of the working elderly was higher than that of the non-working elderly in all five areas of health-related quality of life. In particular, the non-working elderly had a lower health-related quality of life at twice (95%CI=1.32-3.14) in the area of self-care compared to the working elderly. Anxiety/depression was found to be 1.6 times (95%CI=1.19-2.35), daily activity 1.6 times (95%CI=1.18-2.25), mobility 1.5 times (95%CI=1.19-1.92), and pain/discomfort 1.2 times (95%CI=1.02-1.64). Therefore, based on this, it is suggested that it is necessary to develop a program that can maintain and promote the independent standard of living and mental health of the elderly.

Review of 2022 Major Medicla Decisions (2022년 주요 의료판결 분석)

  • Lee Jeongmin;Yoo Hyunjung;Park Taeshin;Jeong Heyseung;Cho Woosun;Park Nohmin
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.79-117
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    • 2023
  • Among the healthcare-related judgments handed down in 2002, there was a significant ruling on the timing of the duty of explanation, stating that, in order to ensure the exercise of the patient's right to self-determination, the patient must be given time to consider and decide on the risks and side effects of a medical procedure in specific circumstances. In addition, in a case where an insurance company claimed unjust enrichment against a medical institution on behalf of its insureds, the court provided a clear standard by distinguishing between active and passive requirements regarding the need to preserve the right of subrogation of creditors. In the area of medical administration, there was a ruling that clarified that a medical institution's business suspension under the National Health Insurance Act is directed against the medical institution, a ruling that broadly recognized causation in a case of compensation for side effects of corona vaccination, and a ruling on the scope of a medical practitioner's license, such as the use of ultrasound devices by an oriental medicine practitioner. In a case involving a patient's claim for eviction from a medical institution, the court reviewed a ruling on just cause for termination of a hospitalization contract in relation to Article 15(1) of the Medical law.

Health Promotion Behavior and Related Factors on the High School Students Who Live in a Dormitory (고등학생의 기숙사생활 여부에 따른 건강증진행위와 관련요인)

  • Han Chang-Hyun;Park Jong-Ok;Park Jae-Yong
    • Korean Journal of Health Education and Promotion
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    • v.23 no.2
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    • pp.63-76
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    • 2006
  • Objectives: The purpose of this study is to find out practicing the health promotion behaviors and the factors relating their health promotion behavior between high school students who live in dormitory and the one who live in their house. Method: This study was carried out by using with questionnaire answered by 1,572 students. Some students are from two academic high schools, and the others are from two girl's high schools in Northern Kyungpook Province from the 27th through 30th of June 2005. Among them, 1,562were included in final analysis. The collected data was analyzed through frequency and percentage, mean and standard deviation, chi-square test, t-test and multiple regression. The data was analyzed using a SPSS/win ver. 12.0. Results: Analysis showed that the total score of practicing health promotion behaviors was 115.1. In case of male students, the score for students in dormitory was 119.6 and the one attending school from house was 114.9(p<0.05). In case of female students, score for students in dormitory was 113.7, and the score for students who live in house was 114.7. According to the data from multiple regression of analysis which has the health promotion behavior practice as a subordinate variable, in male students' case the degree of health promotion behavior practice becomes type of live in a dormitory, high in proportion to their parents' interest in health, disease of student and family, perceived health status, and the perceived self efficacy and the perceived benefit of the health promotion behavior. As to the female students, their health behavior practice becomes level of family economics, high in proportion to their parents' interest in health, perceived health status, and the perceived self efficacy and the perceived benefit of the health promotion behavior. Conclusions: On consideration of above findings, through the systematic development of health education program, we induced to desirable direction for the changeable factors of actions to health promotion for the health. and through the connective guidelines between the school and the home, we have to adapt to effective health promotion program for the health management of the young boys and girls.

Uniformity Evaluation of Elderly Hospital Outpatients' Waiting Space using Discrete Event Simulation (이산사건 시뮬레이션을 이용한 요양병원 외래부 대기공간 균일성 평가)

  • Yoon, So-Hee;Kim, Suk-Tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.490-499
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    • 2017
  • In recent years, the introduction of complex systems analysis based on various variables has become more active in order to identify and analyze complex problems of Modern Society. Prediction of patients' spatial perception and usability according to the spatial arrangement of the outpatient department is a very important factor for providing high quality hospital service. For objective analysis, the standard program procedure and analysis index for the diseases of the elderly were prepared and the uniformity of the atmospheric space was evaluated through heat map analysis and quantitative analysis. In this study, 73 cells were installed and simulated to analyze the uniformity of the four alternatives according to the change of the arrangement of the medical care space, receiving space, and consultation space using the complex system analysis method for the nursing hospitals. The resulting density was derived. The results are as follows. 1)The layout of the reception space has the greatest influence on the total spatial density of the waiting space. 2) The uniformity of the waiting space can be increased by separating the examination space and the examination space. 3)The closer the location of the receiving space is from the entrance, the greater the density of the waiting space. Finally, this study applied discrete event simulation to the evaluation of uniformity of atmosphere space, and proved that the actor - based model can be utilized for utilization and evaluation as spatial analysis methodology.