• 보건교육건강증진학회지
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• 제27권1호
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• pp.21-34
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• 2010

Objectives: The objective of this study was to investigate risk factors for falls in the elderly by life-cycle. Methods: This study used the data on 435 male and female elderly generated from a survey taken at 21 Welfare Centers for the Elderly in Seoul. The incidence of demographic characteristics, physical changes brought about with ageing, health-related behavior, chronic diseases, and environmental characteristics on falls in the elderly was analyzed. Hierarchical Logistic Regression analysis was also conducted to investigate the incidence by life-cycle (early-mid-late stage) and the results were used for predicting falls. Results: The incidence of risk factors on falls varied across life-cycle. Among the elderly in the early (ages from 65 through 74), marital status, the existence of a companion, the quality of sleep, the chronic diseases, and the condition of the bathroom floor were found to be related to falls. Among those in the mid-stage (ages from 75 through 84), sex, marital status, the existence of a companion, hearing capacity, sense of balancing, chronic diseases, the exclusive use of rooms, and the side bar with bath tub were found to affect falls. Finally, for the elderly in their late stage (85 years of age and older), drinking and vision were found to be related to falls. Conclusion: The incidence of risk factors on falls was found to vary according the stage in the elderly. A key implication of this finding is that falls prevention programs and interventions must be catered to specific age sub-groups.

• 대한지리학회지
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• 제48권5호
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• pp.615-628
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• 2013

하천의 유로가 급격하게 변경되는 하도 변위로 형성된 신하도에서는 상 하류간의 고도차로 인해 폭포 가 발생될 수 있다. 본 연구는 우리나라의 7개 폭포를 대상으로 하여, 하도 변위에 의한 폭포의 형성 유형과 과정을 설명하고, 폭포의 후퇴 속도와 영향 요인을 분석하였다. 울진군 불영 폭포, 영덕군 용추 폭포, 양구군 직연 폭포, 울진군 광품 폭포는 자연적인 감입 곡류 절단에 의해 형성되었다. 태백시 삼형제 폭포, 남원시 구룡 폭포는 하천 쟁탈의 과정에서 형성된 것이고, 충주시 팔봉 폭포는 농경지 확보를 위한 인위적인 하도 절단으로 형성되었다. 폭포는 두부 침식으로 인해 시간이 갈수록 위치가 상류 쪽으로 이동하였는데, 폭포의 형성 시기를 추정할 수 있는, 불영, 용추, 직연, 삼형제 폭포의 후퇴 속도는 3~4m/ka로 측정되었다. 이들 4개 폭포의 후퇴 속도는 유역 면적, 강수량, 기반암의 용식 및 풍화 가능성, 초기 폭포의 높이와 뚜렷한 양의 상관관계를 갖는 것으로 분석되었다.

• 한국의료질향상학회지
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• 제24권2호
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• 한국전문물리치료학회지
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• 제28권2호
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• pp.123-131
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• 2021

Background: Only 2% of falls in older adults result in serious injuries (i.e., hip fracture). Therefore, it is important to differentiate injurious versus non-injurious falls, which is critical to develop effective interventions for injury prevention. Objects: The purpose of this study was to a. extract the best features of surface electromyography (sEMG) for classification of injurious falls, and b. find a best model provided by data mining techniques using the extracted features. Methods: Twenty young adults self-initiated falls and landed sideways. Falling trials were consisted of three initial fall directions (forward, sideways, or backward) and three knee positions at the time of hip impact (the impacting-side knee contacted the other knee ("knee together") or the mat ("knee on mat"), or neither the other knee nor the mat was contacted by the impacting-side knee ("free knee"). Falls involved "backward initial fall direction" or "free knee" were defined as "injurious falls" as suggested from previous studies. Nine features were extracted from sEMG signals of four hip muscles during a fall, including integral of absolute value (IAV), Wilson amplitude (WAMP), zero crossing (ZC), number of turns (NT), mean of amplitude (MA), root mean square (RMS), average amplitude change (AAC), difference absolute standard deviation value (DASDV). The decision tree and support vector machine (SVM) were used to classify the injurious falls. Results: For the initial fall direction, accuracy of the best model (SVM with a DASDV) was 48%. For the knee position, accuracy of the best model (SVM with an AAC) was 49%. Furthermore, there was no model that has sensitivity and specificity of 80% or greater. Conclusion: Our results suggest that the classification model built upon the sEMG features of the four hip muscles are not effective to classify injurious falls. Future studies should consider other data mining techniques with different muscles.

• 대한간호학회지
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• 제34권6호
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• pp.1081-1091
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• 2004

Purpose: This study was done to identify the risk factors associated with falls among patients with Parkinson's Disease(PD). Method: A retrospective study design was used through the collection of physiological and physical health, and psychosocial functions. Results: Of the 100 participants, fifty-nine(59%) reported one or more falls and seventy-one(71%) reported one or more near-falls. Anaverage 34.7 falls and 150.3 near-falls were reported in the previous year per person. Stage of PD, foot problems, balance, fear of falling, and activities of daily living were significantly associated with an increased risk of falls. Conclusion: The findings confirm the high risk of falling in PD patients. Also these results have implications for developing fall prevention programs for PD patients.

• 한국전통조경학회지
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• 제33권1호
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• pp.65-75
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• 2015

관폭도를 대상으로 폭포에 대한 인식적 측면에 대한 기초연구를 수행한 결과 다음과 같은 결론을 도출하였다. 첫째, 폭포의 비율에 따라 물이 가져다주는 미감의 차이가 있는데 화면에 폭포가 20%이상 차지하는 관폭도는 폭포를 한층 더 집중시킴으로써 자연과 직접적인 교감을 통한 경관의 인식을 가져다준다. 둘째, 화면에 나타나는 폭포의 대각구도는 폭포와 폭포를 관조하는 인물이 대칭되어서 표현되어지며, 그 영향으로 조망점이 뚜렷하게 나타난다. 또한 조선후기는 진경산수화의 영향으로 화면의 여백이 점점 없어지며 화면을 전체적으로 사용하는 전면구도가 성행하게 되는데, 이는 안정감 있는 구도로 편파구도와 중립구도로 배치함으로써 균형감과 폭포가 갖는 의미를 고조시킨다. 셋째, 조선시대 관폭도에는 원경에서 폭포를 관조하는 형태가 다수 나타났는데, 조선 후기로 갈수록 폭포와 그림 속 인물은 가까워지면서 폭포는 더 이상 관념속의 이상향이 아닌 실재하는 자연과의 직접적인 교감을 통한 미감과 미적관조를 표현하게 되었다. 넷째, 조선시대 관폭도에는 폭포를 바라보는 인물의 표현한 그림이 다수 나타났으며, 수평경, 앙감경, 부감경, 그리고 언뜻 보는 조망행동이 나타났다. 다섯째, 관폭도에 나타난 산수요소 중 바위는 폭포에 생동감을 부여해주고, 음(陰), 양(陽)으로 표현되어 폭포와 암벽의 대비로 폭포가 쏟아지는 절경을 극대화시킨다. 여섯째, 관폭도에 표현 된 식생 중 소나무가 표현된 그림의 비율이 가장 높았다. 소나무는 당대 사대부들의 지조와 절개를 상징화하는 것으로 폭포의 상징성과 부합되어 자연을 초탈한 굳은 의미를 강조하고 있다.

• 한국산학기술학회논문지
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• 제11권5호
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• pp.1564-1572
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• 2010

본 연구에서는 3축 가속도 신호를 이용하여 낙상과 낙상 방향을 검출하는 시스템을 구현하였다. 가속도 신호는 3축 가속도 센서로부터 획득하였으며, 획득된 신호를 USB 인터페이스를 통하여 PC에 전달하였다. PC에 전송된 신호를 제안한 알고리즘을 사용하여 낙상을 검출하였으며, 퍼지 분류기를 사용하여 낙상의 방향을 분류하였다. 실험을 위하여 실험대상군 6명 선정하였으며, 가슴에 가속도계를 부착한 후 실험을 수행하였다. 실험대상자는 5초 동안 정상 보행을 한 후 4 가지 방향(전 후 좌 우)으로 낙상이 발생하도록 하였으며, 낙상에 소요되는 시간은 최소 2초로 설정하였다. 본 연구에서 제안된 알고리즘을 이용하여 낙상을 검출하였으며 낙상 발생 후 1초부터 데이터를 분석하고 퍼지 분류기를 이용하여 낙상방향을 분류하였다. 낙상 검출율은 평균 94.79%이었다. 낙상 방향에 따른 분류율은 front_fall은 95.83%, back_fall은 100%, left_fall 은 87.5%, right_fall은 95.83%이었다.

• 대한간호학회지
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• 제43권5호
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• pp.595-604
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• 2013

Purpose: The purpose of this study was to identify risk factors for pediatric inpatients falls. Methods: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. Results: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. Conclusion: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

• 기본간호학회지
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• 제19권4호
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• pp.444-452
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• 2012

Purpose: To explore the usefulness of previous fall history as a triage variable for inpatients. Methods: Medical records of 21,382 patients, admitted to medical units of one tertiary hospital, were analyzed retrospectively. Inpatient falls were identified from the hospital's self-report system. Non-falls in 1,125 patients were selected by a stratified matching sampling with 125 patients with falls (0.59%). A comparative and predictive accuracy analysis was conducted to describe differences between the two groups with and without a history of falls. Logistic regression was used to measure the effect size of the fall history. Results: The fall history group showed higher prevalence by 9 fold than the non-fall history group. The relationships between falls and relevant variables which were significant in the non-fall history group, were not significant for the fall history group. Falls in the fall history group were 25 times more likely than in the non-fall group. Predictive accuracy of the risk assessment tool showed almost zero specificity in the fall history group. Conclusion: The presence of fall history, the fall prevalence, variables relevant to falls, and the accuracy of the risk tool were different, which support the usefulness of the fall history as a triage variable.

• 임상간호연구
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• 제25권2호
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• pp.142-150
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• 2019

Purpose: The aim of this study was to evaluate the efficiency of the Humpty Dumpty Falls Scale as one of the falls risk assessment tools, and also to evaluate risk factors as predictors of falls in pediatric patient populations. Methods: In a retrospective, case-control design with data from the electronic medical records of 13 pediatric patients who fell and 1,941 who did not fall before matching and 429 who did not fall after matching by gender, age, diagnosis, and length of stay. Results: All the variables showed no significant differences after matching. At the cutoff score of 13, sensitivity, specificity, negative and positive predictive values were 92.3%, 37.1%, 99.9%, and 0.01%, respectively. The area under the Receiver Operating Characteristics was 0.597. The results from the logistic regression showed that the pediatric inpatient population who had higher risk scores was significantly associated with falls. The odds ratios ranged from 1.31 to 4.71 with 90% confidence interval. Conclusion: The saturation impairments criterion as one of the diagnostic parameter was negatively associated with falls, but the relative risk score was higher than the other criteria. Therefore, it seems that the diagnostic parameter seems to be required to verify results through large sample studies.