• Title/Summary/Keyword: compliance center

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A Comparative Study on Trends and Efficacy of Erythropoietin Stimulating Agents in Patient Receiving Peritoneal Dialysis (복막투석 환자의 빈혈 관리에 있어 에리스로포이에틴 자극제의 사용현황 및 비교평가)

  • Lim, Soo Yeon;Jin, Hye Kyung;Kim, Sun Ah;Lee, Eun Kyung;Rhie, Sandy
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.3
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    • pp.206-212
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    • 2014
  • Objectives: This was to evaluate the current usage of three erythropoietin stimulating agents (ESA) and their efficacy for management of anemia in peritoneal dialysis (PD) patients with chronic kidney disease. Methods: It was a retrospective comparative study through review of electronic medical records of chronic kidney disease patients undergoing PD at a tertiary teaching hospital from January 1998 to June 2013. Results: Average administration frequency was 1.66 times/week in EPO group, 0.75 times/week in DA group, and 0.19 times/week in MPG-EPO group. At the first 4 weeks, there were significant differences in mean hemoglobin levels between EPO and DA groups ($9.25{\pm}1.28g/dL$, $10.02{\pm}0.95g/dL$ each, p = 0.018) and also in hemoglobin response rates (10.0%, 45.2% each, p = 0.008), but since after 4 week, there had been no significant differences. There also showed no significant differences in achievement of hemoglobin target between the two groups. When converted to MPG-EPO in EPO/DA groups, there showed a slight increase in hemoglobin levels of both groups. MPG-EPO was the highest compared with two other drugs by the average cost based on the average weekly dose. Conclusion: EPO, DA, and MPG-EPO showed similar effects in treatment of anemia of PD patients based on hemoglobin target range (11.0~12.0 g/dL) which NFK-K/DOQI guidelines suggest. Though the average cost of MPG-EPO was higher than the other two drugs, the number of PD patients using MPG-EPO has increased and it is thought that long half-life and low administration frequency of MPG-EPO have improved the compliance of PD patients who have to self-administrate.

Optimal Vehicle Rear Suspension through Integration of Analysis and Design Process (해석 및 설계 프로세스 통합을 통한 차량 후륜 현가장치 최적화)

  • Kim, Dowon;Park, Dohyun;Lee, Jinhwa;Shin, Sangha;Choi, Jin-Ho;Choi, Byung-Lyul;Choi, Dong-Hoon
    • Transactions of the Korean Society of Automotive Engineers
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    • v.22 no.4
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    • pp.72-81
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    • 2014
  • In this study, we perform the optimization of trailing arm bush in a vehicle rear suspension to improve the ride and handling performance. A design problem was formulated considering 2 objective functions and 7 constraints related to vehicle ride and handling performance. PIAnO, one of the PIDO (Process Integration and Design Optimization) tool, was used to automate analysis procedures and perform a design optimization. In order to assess relation between performances and design variables, we perform the DOE (Design of Experiments). To find the optimal solution, we used Progressive quadratic response surface method (PQRSM), one of the design optimization techniques equipped in PIAnO. As an optimization result, we got an optimal solution and could improve lateral force steer off-center by 43.0% while decreasing brake compliance at wheel center by 8.1%.

Antihypertensive Drug Medication Adherence of People with Disabilities and its Affecting Factors in Korea (고혈압약 투약을 시작한 장애인의 투약 순응도와 이에 영향을 미치는 요인)

  • Park, Jong-Hyock;Shin, Young-Soo;Lee, Sang-Yi;Park, Jae-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.3
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    • pp.249-258
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    • 2007
  • Objectives : The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. Methods : The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. Results : The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence $(CMA{\geq}80%)$ rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. Conclusions : The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.

Oral rehabilitation of Papillon-Lefèvre syndrome patients by dental implants: a systematic review

  • Atarbashi-Moghadam, Fazele;Atarbashi-Moghadam, Saede;Kazemifard, Setare;Sijanivandi, Soran;Namdari, Mahshid
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.4
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    • pp.220-227
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    • 2020
  • Objectives: Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder. These patients lose their teeth at a young age and are in need of prosthetic rehabilitation. The aim of this systematic review was to assess the success of dental implant placement in these patients. Materials and Methods: An electronic search was performed in PubMed Central, Scopus, and Web of Science using the keyword "Papillon-Lefèvre syndrome" AND "dental implant" OR "prosthodontics". Articles reporting implant placement in patients with PLS until July 2019 were included. Results: Assessment of the included 11 articles reporting 15 cases showed 136 implant placements in these patients. Implant failure occurred in 3 patients (20 implants). The peri-implantitis and failure rate was higher in the maxilla. Meta-analysis showed the probability of failure to be 7% (95% confidence interval [CI] 0%-31%) for maxillary implants and 2% (95% CI 0%-9%) for mandibular implants. The follow-up time ranged between 1 and 20 years. Healing after bone graft and implant placement in these patients was uneventful. Conclusion: Dental implants may be a viable treatment option for PLS patients. Implantation can help preserve alveolar bone if the patients' immunological and growing conditions are well-considered and proper oral hygiene and compliance with the maintenance program are continued.

Evaluation of Respiratory Protection Program in Petrochemical Industries: Application of Analytic Hierarchy Process

  • Kolahi, Hadi;Jahangiri, Mehdi;Ghaem, Haleh;Rostamabadi, Akbar;Aghabeigi, Mandana;Farhadi, Payam;Kamalinia, Mojtaba
    • Safety and Health at Work
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    • v.9 no.1
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    • pp.95-100
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    • 2018
  • Background: Respiratory protection equipment (RPE) is the last resort to control exposure to workplace air pollutants. A comprehensive respiratory protection program (RPP) ensures that RPE is selected, used, and cared properly. Therefore, RPP must be well integrated into the occupational health and safety requirements. In this study, we evaluated the implementation of RPP in Iranian petrochemical industries to identify the required solutions to improve the current status of respiratory protection. Methods: This cross-sectional study was conducted among 24 petrochemical industries in Iran. The survey instrument was a checklist extracted from the Occupational Safety and Health Administration respiratory protection standard. An index, Respiratory Protection Program Index (RPPI), was developed and weighted by analytic hierarchy process to determine the compliance rate (CR) of provided respiratory protection measures with the RPP standard. Data analysis was performed using Excel 2010. Results: The most important element of RPP, according to experts, was respiratory hazard evaluation. The average value of RPPI in the petrochemical plants was $49{\pm}15%$. The highest and lowest of CR among RPP elements were RPE selection and medical evaluation, respectively. Conclusion: None of studied petrochemical industries implemented RPP completely. This can lead to employees' overexposure to hazardous workplace air contaminants. Increasing awareness of employees and employers through training is suggested by this study to improve such conditions.

A Meta-Analysis on Factors Related to Quality of Life in Heart Transplant Recipients (심장이식 수혜자의 삶의 질 관련 요인에 대한 메타분석)

  • Jang, Mi Ra;Im, Se Rah;Choi, Mona
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.251-264
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    • 2019
  • Purpose: This study was a systematic review and meta-analysis to explore the factors related to quality of life in heart transplant recipients. Methods: To identify studies that suggested the factors related to the quality of life in heart transplant recipients, we searched the articles published from 1974 to November 2018 using Six databases, PubMed, CINAHL, EMBASE, Cochrane, KMBASE and RISS. A total of 22 studies were selected out of 5,234 for the systematic review and meta-analysis on the basis of the PRISMA flow. The quality of study was assessed by assessment tool form the NIH and meta-analysis was performed using the 'R 3.5.2' version to analyze the correlated effect sizes. Results: Factors related to quality of life in heart transplant recipients were categorized into six domains based on the health-related quality of life model introduced by Ferrans: individual, environmental, biological function, symptoms, functional status, and general health perception. In the meta-analysis, 34 factors were used and 17 factors having significant effect sizes were as follows: self-efficacy, demoralization, perceived control, current occupational status, age, marital status, health promotion life style in the individual characteristics; stress in environmental characteristics; physical function status, creatinine level, left ventricular ejection fraction (LVEF) in biological function; anxiety, depression, symptom frequency and distress in symptoms domain; coping, self-care compliance in functional status. Conclusion: The findings indicate that the multi-dimensional factors influencing the quality of life in heart transplant recipients and provide the evidence for developing effective interventions for improving the quality of life of recipients.

Impact of the Ventilator-associated Pneumonia Bundle in a Medical Intensive Care Unit (내과계중환자실에서 인공호흡기관련 폐렴 번들 적용의 효과)

  • Yoo, Song Yi;Jeong, Jae Sim;Choi, Sang Ho;Kim, Mi Na
    • Journal of Korean Biological Nursing Science
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    • v.20 no.4
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    • pp.205-213
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    • 2018
  • Purpose: The purpose of this study was to confirm the compliance of the application of a ventilator-associated pneumonia bundle and understand its effects on the decrease in the incidence of ventilator-associated pneumonia. Methods: This was a retrospective observational study with history control group design. Subjects were selected from January to June 2014, prior to the intervention using the ventilator-associated pneumonia bundle. Subjects were also selected from October 2014 to March 2015, 3 months after the intervention. The number of subjects was 112 before the intervention, and 107 after the intervention. Results: The number of nurses who followed the bundles increased from 8 out of 29 (27.6%) before the intervention to 19 out of 29 (65.5%) after the intervention (odd ratio= 4.99, confidence interval= 1.63-15.25, p= .004). There were 3 cases of ventilator-associated pneumonia before the intervention and 1 case after the intervention. The ventilator days were 2,143 days before the intervention and 2,232 days after the intervention. The ventilator-associated pneumonia rate of the 1,000 ventilator days was 1.40 before the intervention and decreased to 0.45 after the intervention. Conclusion: This study is meaningful, as there has been little research conducted regarding the application of the ventilator-associated pneumonia bundle in South Korea.

Adherence to the Clean Intermittent Catheterization Following a Customized Intensive Education Program for Patients with Emptying Failure

  • Lee, Sang Rim;Lee, In Sook;Oh, Seung-June;Kim, Sung Hwa;Chin, Young Ran
    • Research in Community and Public Health Nursing
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    • v.29 no.4
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    • pp.467-475
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    • 2018
  • Purpose: The purpose of this study is to investigate adherence to the clean intermittent catheterization (CIC) and influencing factors on the adherence following a customized intensive education program (CIEP). Methods: This work is a retrospective descriptive study. The subjects were 226 emptying failure patients who learned in a CIEP from January 2012 to July 2014. The program developed in 2011 and consisted of 1) customized theoretical education; based on the results of urologic tests, underlying disease, or surgery of the patients, 2) hands-on practice until the trainees were able to master the techniques, 3) questions about the process of catheterization and what he/she needs to know. 4) at follow-up, the survey about adherence and barrier to CIC. Clinical characteristics; the level of satisfaction, understanding, and self-confidence; the barrier in medical records were reviewed. Results: The short-term adherence rate (median 22 days) is 87.6% and the long-term adherence rate (median 112 days) is 50.4%. The biggest obstacle is time management. The levels of satisfaction, understanding, and self-confidence are very high. The variable of Income is the only factor that has influence on adherence. Conclusion: Despite the CIEP, the adherence rate is relatively low. In addition to the education, emotional and psychological supports and regular follow-up are needed to improve long-term adherence.

Tensile Bond Characteristics between Underwater Coating Materials and Concrete Substrate (수중코팅제와 콘크리트 모재 간의 인장 부착 특성)

  • Kim, Min Ook;Jeong, Yeonung;Kang, Sung-Hoon;Moon, Juhyuk;Yi, Jin-Hak
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.30 no.6
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    • pp.298-305
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    • 2018
  • In this study, we investigated the tensile bond characteristics of underwater coating materials, in order to obtain useful information in support of repair work for marine and coastal concrete structures. Test variables included type of underwater coating, surface conditions of the concrete substrate, and environmental conditions. Pull-off tensile bond strength was measured at 24 h after applying underwater coatings to concrete substrates, in compliance with the procedures specified in ASTM C1583. Failure modes (coating, interface, and parent concrete) for each coating were identified through visual inspection, and comparisons were made based on measured bond strength. The tensile bond strength decreased underwater compared to that under dry conditions, while no significant effect of surface roughness on the measured bond strength was observed in underwater tests. Key aspects that need to be considered regarding selection and use of underwater coating materials for marine and coastal concrete structures were discussed.

Climate Warming and Occupational Heat and Hot Environment Standards in Thailand

  • Phanprasit, Wantanee;Rittaprom, Kannikar;Dokkem, Sumitra;Meeyai, Aronrag C.;Boonyayothin, Vorakamol;Jaakkola, Jouni J.K.;Nayha, Simo
    • Safety and Health at Work
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    • v.12 no.1
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    • pp.119-126
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    • 2021
  • Background: During the period 2001 to 2016, the maximum temperatures in Thailand rose from 38-41℃ to 42-44℃. The current occupational heat exposure standard of Thailand issued in 2006 is based on wet bulb globe temperature (WBGT) defined for three workload levels without a work-rest regimen. This study examined whether the present standard still protects most workers. Methods: The sample comprised 168 heat acclimatized workers (90 in construction sites, 78 in foundries). Heart rate and auditory canal temperature were recorded continuously for 2 hours. Workplace WBGT, relative humidity, and wind velocity were monitored, and the participants' workloads were estimated. Heat-related symptoms and signs were collected by a questionnaire. Results: Only 55% of the participants worked in workplaces complying with the heat standard. Of them, 79% had auditory canal temperature ≤ 38.5℃, compared with only 58% in noncompliant workplaces. 18% and 43% of the workers in compliant and noncompliant workplaces, respectively, had symptoms from heat stress, the trend being similar across all workload levels. An increase of one degree (C) in WBGT was associated with a 1.85-fold increase (95% confidence interval: 1.44-2.48) in odds for having symptoms. Conclusion: Compliance with the current occupational heat standard protects 4/5 of the workers, whereas noncompliance reduces this proportion to one half. The reasons for noncompliance include the gaps and ambiguities in the law. The law should specify work/rest schedules; outdoor work should be identified as an occupational heat hazard; and the staff should include occupational personnel to manage heat stress in establishments involving heat exposure.