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Guidelines for dental clinic infection prevention during COVID-19 pandemic (코로나 바이러스 대유행에 따른 치과 의료 관리 가이드라인)

  • Kim, Jin
    • Journal of Korean Academy of Dental Administration
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    • v.8 no.1
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    • pp.1-7
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    • 2020
  • Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

The Effect of Horticultural Occupational Therapy Using Healing Garden on Fall Efficacy in the Elderly (치료정원을 이용한 원예작업치료가 노인의 낙상효능감에 미치는 효과)

  • Park, Woo Kuon;Kim, Mi Young
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.3
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    • pp.359-363
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    • 2021
  • The purpose of this study is to investigate the effect of gardening programs using therapeutic gardens on the fall efficacy of the elderly. This study was applied to 31 elderly facility users from April to August 2019 at a nursing home P located in Gyeonggi-do. Among the 31 participants who participated in the program, 16 subjects in the experimental group and 15 subjects in the control group were randomly selected. As for the experimental group program, a fall program consisting of fall education and strength training four times a week and a horticultural occupational program were implemented once a week in a healing garden for a total of 15 weeks. The control group performed fall program for 30 minutes 5 times a week for a total of 15 weeks. The fall efficacy of the tested group increased by 5.50 points from 29points before the program to 34.50points after the program, and statistically significant results were obtained (p=0.000). The control group who only progressed the fall program increased 3.63 points from 28.87points before the trial to 32.50points after the trial, and statistically significant results were obtained (p=0.000). From this result, it can be confirmed that the horticultural program using the treatment garden has the potential as a program related to falls. In the future, various studies are needed so that gardening programs using gardens can be applied to prevent falls of the elderly.

Assessment on Impact Factor for Dehydration of Mine Drainage Sludge Using Flocculant and Dewatering Tube(KOMIR-Tube System) (응집제 및 탈수튜브(KOMIR-Tube 시스템)를 활용한 광산배수 슬러지 탈수 영향인자 평가)

  • Misun Park;Juin Ko;Gwanin Bak;Seunghan Baek
    • Economic and Environmental Geology
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    • v.57 no.2
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    • pp.263-270
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    • 2024
  • In this study, impact factors for dehydration with KOMIR-Tube system using flocculant and dewatering tube were evaluated for mine drainage sludges. The experiments were conducted on semi-active facility sludges with water contents above 90 % using KOMIR-Tube system. The flocculant and input amount were determined from laboratory experiment and the dewatering efficiency was verified onsite experiment. The sludge characteristics were identified by instrumental analysis such as zeta potential measurement, particle size analysis, XRD, XRF and SEM-EDS. Selection of flocculants for sludge dewatering treatment need to consider not only precipitated rate but also filterated rate. Floc size has to keep at least 0.7 mm. From on-site experiments, sludge dewatering using KOMIR-Tube system suggests to carry out April and May that is low rainfall and humidity considering to climate conditions. Also, dewatering rate depends on the crystal degree of mineral that mainly makes up sludges. Particularly, goethite of the iron hydroxides has better dewatering rate than ferrihydrite. Ferrihydrite is low degree of crystallinity and uncleared or broad shaped crystal, goethite is good crystallinity with needle shaped crystal so that the effect of flocculation and dewatering showed to depend on the crystal. In results, impact factors of dewatering for mine drainage sludges are related to flocculant, climate, crystallinity and shape of iron hydroxides.

Development of an Efficiency Calibration Model Optimization Method for Improving In-Situ Gamma-Ray Measurement for Non-Standard NORM Residues (비정형 공정부산물 In-Situ 감마선 측정 정확도 향상을 위한 효율교정 모델 최적화 방법 개발)

  • WooCheol Choi;Tae-Hoon Jeon;Jung-Ho Song;KwangPyo Kim
    • Journal of Radiation Industry
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    • v.17 no.4
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    • pp.471-479
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    • 2023
  • In In-situ radioactivity measurement techniques, efficiency calibration models use predefined models to simulate a sample's geometry and radioactivity distribution. However, simplified efficiency calibration models lead to uncertainties in the efficiency curves, which in turn affect the radioactivity concentration results. This study aims to develop an efficiency calibration optimization methodology to improve the accuracy of in-situ gamma radiation measurements for byproducts from industrial facilities. To accomplish the objective, a drive mechanism for rotational measurement of an byproduct simulator and a sample was constructed. Using ISOCS, an efficiency calibration model of the designed object was generated. Then, the sensitivity analysis of the efficiency calibration model was performed, and the efficiency curve of the efficiency calibration model was optimized using the sensitivity analysis results. Finally, the radiation concentration of the simulated subject was estimated, compared, and evaluated with the designed certification value. For the sensitivity assessment of the influencing factors of the efficiency calibration model, the ISOCS Uncertainty Estimator was used for the horizontal and vertical size and density of the measured object. The standard deviation of the measurement efficiency as a function of the longitudinal size and density of the efficiency calibration model decreased with increasing energy region. When using the optimized efficiency calibration model, the measurement efficiency using IUE was improved compared to the measurement efficiency using ISOCS at the energy of 228Ac (911 keV) for the nuclide under analysis. Using the ISOCS efficiency calibration method, the difference between the measured radiation concentration and the design value for each simulated subject measurement direction was 4.1% (1% to 10%) on average. The difference between the estimated radioactivity concentration and the design value was 3.6% (1~8%) on average when using the ISOCS IUE efficiency calibration method, which was closer to the design value than the efficiency calibration method using ISOCS. In other words, the estimated radioactivity concentration using the optimized efficiency curve was similar to the designed radioactivity concentration. The results of this study can be utilized as the main basis for the development of regulatory technologies for the treatment and disposal of waste generated during the operation, maintenance, and facility replacement of domestic byproduct generation facilities.

Recognition and Request for Medical Direction by 119 Emergency Medical Technicians (119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도)

  • Park, Joo-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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    • pp.31-44
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    • 2011
  • Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital (3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구)

  • Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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Study of Solidification by Using Portland and MSG(micro silica grouting) Cements for Metal Mine Tailing Treatment (금속 광미 처리를 위한 포틀랜드 시멘트와 MSG(micro silica grouting) 시멘트 고형화 실증 실험 연구)

  • Jeon, Ji-Hye;Kim, In-Su;Lee, Min-Hee;Jang, Yun-Young
    • Economic and Environmental Geology
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    • v.39 no.6 s.181
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    • pp.699-710
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    • 2006
  • Batch scale experiments to investigate the efficiency of the solidification process for metal mine tailing treatment were performed. Portland and MSG (micro silica pouting) cements were used as solidifier and three kinds of mine tailings (located at Gishi, Daeryang, and Aujeon mine) were mixed with cements to paste solidified matrices. Single axis com-pressible strengths of solidified matrices were measured and their heavy metal extraction ratios were calculated to investigate the solidification efficiency of solidified matrices created in experiments. Solidified matrices ($5cm{\times}5cm{\times}5cm$) were molded from the paste of tailing and cements at various conditions such as different tailing/cement ratio, cement/water ratio, and different cement or tailing types. Compressible strengths of solidified matrices after 7, 14, and 28 day cementation were measured and their strengths ranged from 1 to $2kgf/mm^2$, which were higher than Korean limit of compressible strength for the inside wall of the isolated landfill facility ($0.21kgf/mm^2$). Heavy metal extractions from intact tailings and powdered matrices by using the weak acidic solution were performed. As concentration of extraction solution for the powdered solidified matrix (Portland cement + Gishi tailing at 1:1 w.t. ratio) decreased down to 9.7 mg/L, which was one fifth of As extraction concentration for intact Gishi tailings. Pb extraction concentration of the solidified matrix also decreased to lower than one fourth of intact tailing extraction concentration. Heavy metal extraction batch experiments by using various pH conditions of solution were also performed to investigate the solidification efficiency reducing heavy metal extraction rate from the solidified matrix. With pH 1 and 13 of solution, Zn and Pb concentration of solution were over the groundwater tolerance limit, but at pH $1{\sim}13$ of solution, heavy metal concentrations dramatically decreased and were lower than the groundwater tolerance limit. While the solidified matrix was immerged Into very acidic or basic solution (pH 1 and 13), pH of solution changed to $9{\sim}10$ because of the buffering effect of the matrix. It was suggested that the continuous extraction of heavy metals from the solidified matrix is limited even in the extremely high or low pH of contact water. Results of experiments suggested that the solidification process by using Portland and MSG cements has a great possibility to treat heavy metal contaminated mine tailing.

A Study on Process Optimization for CSOs Application of Horizontal Flow Filtration Technology (수평흐름식 여과기술의 CSOs 적용을 위한 공정 최적화 연구)

  • Kim, Jae-Hak;Yang, Jeong-Ha;Lee, Young-Shin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.56-63
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    • 2018
  • The management of Combined Sewer Overflows(CSOs) and Separated Sewer Overflows(SSOs) discharge directly to the effluent system in an untreated state, which occurs when the facility capacity is exceeded due to heavy rain, has become an important issue in recent years as the heavy rain becomes a regular phenomenon. Despite the continuous development of filtration technology, targeting densely populated urban areas, CSOs are rarely applied. Therefore, this study was carried out to optimize the process to apply CSOs in a pilot-scale horizontal flow filtration system with a rope-type synthetic fiber. The research was carried out in two steps: a preliminary study using artificial samples and a field study using sewage. In the preliminary study using an artificial sample, head loss of the filter media itself was analyzed to be approximately 1.1cm, and the head loss was increased by approximately 0.1cm as the linear velocity was increased by 10m/hr. In addition, the SS removal efficiency was stable at 81.4%, the filtration duration was maintained for more than 6 hours, and the average recovery rate of 98% was obtained by air backwashing only. In the on-site evaluation using sewage, the filtration duration was approximately 2 hours and the average removal efficiency of 83.9% was obtained when belt screen (over 450 mesh) was applied as a pre-treatment process to prevent the premature clogging of filter media. To apply the filtration process to CSOs and SSOs, it was concluded that the combination with the pre-treatment process was important to reinforce the hydraulic dimension for the stable maintain of operation period, rather than efficiency. Compared to the dry season, the quality of incoming sewage was lower in the rainy season, which was attributed to the characteristics of the drainage area with higher sanitary sewerage. In addition, the difference in removal efficiency according to the influent quality of the wet season and dry season was small.

Evaluation and Improvement Measures on the Status of the Installation and Operation of Facilities for Recycling Food Waste into Resources (음식물 자원화시설의 설치·운영에 대한 일반현황의 평가 및 개선 방안)

  • Ryu, Ji-Young;Kong, Kyu-Sik;Shin, Dae-Yewn;Phae, Chae-Gun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.12 no.3
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    • pp.63-75
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    • 2004
  • This research sought to determine the status of the installation and operation of domestic public resource-making facilities of resource-making facilities and come up with corresponding improvement measures. Currently compost is most numerous set-up out of facilties already established ever since, then the rest of them are feeds, anaerobic degradation, sewage combination, and combination of compost and feeds in order. As such, food waste is processed more into compost than into feeds, presumably because relevant facilities, which were originally designed for processing into feeds, were converted into composting facilities due to little demand for the processed feeds. The finding says that many related firms had yet to register their businesses in accordance with feeds and fertilizers management laws, and that food waste resources-making facilities used various basic facilities but few of them treated food waste in linkage with leaching water, bad odors, and energy. Some of current facilities were found to be 7 years old and thus outdated. Due to lack of skilled operational manpower, many facilities had less than 300 days of normal operation yearly, and some needed minor and serious repairs periodically. In overall facilities, 87% of the planned food waste was rolled in, thus requiring measures to treat the whole planned volume. For costs of resource-making facilities, some with a capacity of below 50 tons topped 100 million won, and facilities with a capacity of over 50 tons required less installation costs. Overall, installation costs ranged from 10 million to 20 million, and to 200 million won per ton, and this suggests a need to establish the installation cost calculation criteria, as well as to reshape the facility criteria. With operating costs varying greatly according to the size and treatment methods of facilities, the finding indicates a need to rationalize the operating costs, and to plan appropriate-size installation and operation of facilities to ensure economic operation.

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A Study on Laboratory Treatment of Metalworking Wastewater Using Ultrafiltration Membrane System and Its Field Application (한외여과막시스템을 이용한 금속가공폐수의 실험실적 처리 및 현장 적용 연구)

  • Bae, Jae Heum;Hwang, In-Gook;Jeon, Sung Duk
    • Korean Chemical Engineering Research
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    • v.43 no.4
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    • pp.487-494
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    • 2005
  • Nowadays a large amount of wastewater containing metal working fluids and cleaning agents is generated during the cleaning process of parts working in various industries of automobile, machine and metal, and electronics etc. In this study, aqueous or semi-aqueous cleaning wastewater contaminated with soluble or nonsoluble oils was treated using ultrafiltration system. And the membrane permeability flux and performance of oil-water separation (or COD removal efficiency) of the ultrafiltration system employing PAN as its membrane material were measured at various operating conditions with change of membrane pore sizes and soil concentrations of wastewater and examined their suitability for wastewater treatment contaminated with soluble or insoluble oil. As a result, in case of wastewater contaminated with soluble oil and aqueous or semi-aqueous cleaning agent, the membrane permeability increased rapidly even though COD removal efficiency was almost constant as 90 or 95% as the membrane pore size increased from 10 kDa to 100 kDa. However, in case of the wastewater contaminated with nonsoluble oil and aqueous or semi-aqueous cleaning agent, as the membrane pore size increased from 10 kDa to 100 kDa and the soil concentration of wastewater increased, the membrane permeability was reduced rapidly while COD removal efficiency was almost constant. These phenomena explain that since the membrane material is hydrophilic PAN material, it blocks nonsoluble oil and reduces membrane permeability. Thus, it can be concluded that the aqueous or semi-aqueous cleaning solution contaminated with soluble oil can be treated by ultrafiltration system with the membrane of PAN material and its pore size of 100 kDa. Based on these basic experimental results, a pilot plant facility of ultrafiltration system with PAN material and 100 kDa pore size was designed, installed and operated in order to treat and recycle alkaline cleaning solution contaminated with deep drawing oil. As a result of its field application, the ultrafiltration system was able to separate aqueous cleaning solution and soluble oil effectively, and recycle them. Further more, it can increase life span of aqueous cleaning solution 12 times compared with the previous process.