• Korean Parent-Child Health Journal
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• v.4 no.1
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• pp.35-55
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• 2001

Recently attention has been focused on the effects of early intervention, or its lack, on both normal and preterm infants. Particularly numerous studies suggest that premature infants are not necessarily understimulated but instead are subjected to inappropriate stimulation. Developmental support and sensory stimulation have become clinical opportunities in which nursing practice can impact on the neurobehavioral outcome of premature infants. Developmental care has been widely accepted and implemented in neonatal intensive care units across the country. Increasingly, attention and concern in caring for low-birth-weight infants and premature infants has led clinicians in the field to explore the effects of a complex of interventions designed to create and maintain a developmentally supportive environment; to provide age-appropriate sensory input; and to protect the infant from inappropriate, excessive and stressful stimulation. The components of developmental care include modifications of the macro-environment to reduce NICU light and sound levels, care clustering, nonnutritive sucking, and containment strategies, such as flexed positioning or swaddling. Sensory stimulation of the premature infants is presented to standardize the modification of a developmental intervention based on physiologic and behavioral cues. The most appropriate type of stimuli are those that are sensitive to infant cues. Evaluation of infant physiological and behavioral responds to specific intervention stimuli may help to identify more appropriate interventions based on infants' cues. A critical question confronting the clinician is that of determining when the evidence supporting a change in practice is sufficient to justify making that change. There are acknowledged limitations in the current studies. Many of the studies examined had small sample sizes; used nonprobability sampling; and used a phase lag design, which introduces the possibility of threats to internal validity and limits the generalizability of the results. Although many issues regarding the effects of developmental interventions remain unresolved, the available research base documents significant benefits of developmental care for LBW infants in consistent outcomes, without significant adverse effects. Particularly, although the individual studies vary somewhat in the definition of specific outcomes measured, instrumentation used, time and method of data collection, and preparaion of the care providers, in all studies, infants receiving the full protocol of individualized developmentally supportive care had improvements in some aspect of four areas of infant functioning: level of respiratory or oxygen support, the establishment of oral feeding; length of hospital stay, and infant behavioral regulation. In summary, based on the available literature, individualized developmental intervention should be incorporated into standard practice in neonatal intensive care. And this implementation needs to be coupled with ongoing research to evaluate the impact of an individualized developmental care programs on the short- and long-tenn health outcomes of LBW infants.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.3
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• pp.488-496
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• 2020

This study was based on nitrate chemical accidents at home and abroad. Toxic gases due to adverse reactions are generated in the workplace, laboratory, hospital, container damage, and chemical misinjection. Through a case review of possible situations and safety, this study analyzed various cases of accidents, accident status, accident type, cause of the accident, location of the accidents, etc. from 2014 to 2018. The plans for improvement in education and nitrate accidents were reviewed. As a result, 36 nitrate chemical accidents were investigated, including 16 careless worker accidents, eight transportation accidents, and 12 facilities shortages. Nitrate chemical accidents are occurring continuously. Based on this, the range of toxic effects using CARIS was calculated at the worst-case scenario, and the effective response range was measured through the damage impact range. For this purpose, the impact range was predicted based on the strengthening of safety education, emergency action plan and correlation, and the quantified data was identified. In addition, the reliability of the scope of impact was reviewed based on the correlation formula that could facilitate the evacuation of residents, and it was applied to actual accident scenarios of the workplace to present the effects of the accident response and preventive measures.

• The Journal of the Korea Contents Association
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• v.19 no.11
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• pp.325-336
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• 2019

The purpose of this study is to analyze the structural relationship between internal capabilities and job satisfaction using the 7S model and propose measures to improve management performance through internal factors. For this study, seven research hypotheses were set up, and the survey conducted among members of all professions working in general hospitals in small and medium-sized cities in the provinces. From September 20 to October 20, 2016, 385 people were surveyed, and 327 pieces of data (84.9%) used for the study. Multiple regression analyses were performed to verify the effects of internal capabilities on job satisfaction. The analysis results showed that the explanatory power of the research model was suitable by showing 69.1%, and among the 7S factors, the leadership style (β=.392^**), the organizational structure (β=.129^*), the membership (β=.232^**), and the management technique (β=.204^*) showed a positive influence on job satisfaction. That has been confirmed to affect job satisfaction as the standardized factor values increase. Relationships between strategies, systems, and shared values on job satisfaction could not be identified. Significantly observed in the relationship between some internal capacity factors and job satisfaction is that internal capacity can be used as an alternative to an organization's performance improvement measures. Internal capacity can be affected by various environmental variables, such as establishment classification, size, and location. Further implications will also be provided for measuring future internal satisfaction levels separately from internal and external factors.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.674-684
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• 1991

The surgical treatment of tetralogy of Fallot [TOF] was initiated by Blalock and Taussig in 1945 with the establishment of the subclavian artery to pulmonary artery anastomosis. In an imaginative and daring effort, in 1954, Lillehei and collaborators [1955] using controlled cross-circulation, carried out the first intracardiac repair of TOF by closing the ventricular septal defect [VSD] and relieving the pulmonary stenosis under direct vision. Nowadays, total correction is the ideal operation for treatment of TOF and is accomplished with extracorporeal circulation. And the results of surgery for TOF have steadily improved over the years, thanks to important contributions of many surgeons. Nevertheless because of its protean physiologic and anatomic presentation, TOF continues to offer challenges to cardiologist and cardiac surgeons. Thirty two cases of TOF have undergone total corrective surgery using extracorporeal circulation in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, Inje University, from Oct. 1985 to Feb. 1990. Clinical considerations were applied to these cases and the results were obtained as follows. 1. The heart lung machine used for extracorporeal circulation was SarnsO 7000, 5-head roller pump, and the number and type of oxygenators were 10 of bubble type and 22 of membrane type. The mean bypass time was 148.9 minutes and the mean aortic cross clamp time was 123.8 minutes. The GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 2. 20 cases were male and 12 were female, the mean age was 8 years old and the mean body weight was 25Kg. 3. The preoperative symptoms were cyanosis [29 cases], squatting [27 cases] and etc. The mean values of preoperative Hb., Hct., and SaO2 were 16.5 gm /dl, 50.3%, and 78.5%. 4. Combined anomalies were noticed in 16 cases [50%]. Among them 10 cases were PFO and 6 cases were ASD. 5. The degree of aorta overriding were 25% in 5 cases, 25 ~ 50% in 22 cases and above 50% in 5 cases. The dPA/Ao [ratio of diameter of pulmonary artery trunk to ascending aorta] were below 25% in 5 cases, 25 ~ 50% in 10 cases, 50 ~ 70% in 6 cases and above 75% in 11 cases. 6. The types of RVOT [right ventricular outflow tract] stenosis were valvular and infundibular in 14 cases [43.6%], diffuse hypoplastic type in 12 cases [37.5%], infundibular in 5 cases, and valvular and supravalvular in 1 case. 7. One stage radical corrective surgery was applied to the all cases. In widening of the RVOT, 3 types of patches were used: MVOP [monocusp ventricular outflow patch, Polystan BioprosthesesO] in 3 cases, knitted Dacron vessel patches in 2 cases, and double layer with bovine pericardium and woven Dacron prosthesis in 26 cases. 8. Postoperative complications were occurred in 15 cases. Among them, low output syndrome were occurred in 10 cases [31.3%] and 2 of them were expired postoperatively.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.61-67
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• 1997

To understand the current status of pediatric surgical practice of the members of the Korean Association of Pediatric Surgeons, a survey of the practice of the 31 members in both 1994 and 1995. Twenty five members(80%) representing 20 hospitals responded. An average of four hundred and seventy four cases pediatric surgical operations were performed at individual institution in 1995 with 40 newborn cases. Eighteen members(72%) are currently working at university hospital. Fourteen institutions(70%) are currently classified as tertiary by the health insurance agency. The majority(15 to 60%) of members are working in the metropolitan Seoul area, while five in Taegu area. Sixteen members reported having the title of department head/director. Four members reported occasional non-pediatric surgical practice. Nine members out of 20 reported having independent pediatric surgical out-patient clinic before the establishment of the association(1985). Eight out of 15 members reported being appointed chief of pediatric surgery before 1985. In 20 institutions, 34 full time physicians(27 members, reportedly) are working in pediatric surgery. In regarding to pediatric surgical training, 16 members(64%) received an average of 16 months of training abroad, 5 members trained at home and abroad, and 4 from only at home. There are no differences in length of training periods in these groups. Twenty one members received their basic pediatric surgical training before 1985, the year of inauguration of the association. Twelve members received post-pediatric surgery refresher courses averaging 11 months' duration, after 2-11 years. Thirteen participants of this study belongs to the founding members of the association.

• Journal of Digital Convergence
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• v.13 no.7
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• pp.259-268
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• 2015

This research grasped the difference of between the daily medical expenses and the medical expenses reduction rate also the cause of change. In the centre, it was conducted in order to offer the necessary basic data to a recuperation pay management solution's establishment. This research surveyed across the country's urban region 50-general hospital's the infective enteritis disease for a year. Then it was conducted the average daily medical expenses and the average medical expenses reduction rate as a distinguishable survey that is a hospitalization and an outpatient the result is followed. The inpatient daily medical expenses correlated with the total number of medical institution personnel, and the outpatient daily medical expenses correlated with the number of beds.. Inpatient medical expense reduction rate was correlated with number of beds and the total number of medical institution personnel. The interaction between medical institution information and daily medical expenses was found to have a positive (+) effect on the total number of medical institution personnel, as well as the numbers of inpatients vs. outpatient. This research about the medical expense reduction rate and daily medical expense help medical institution's efficient, rational decision making and it will be an important basis of a priority recuperation pay's policy.

• Journal of dental hygiene science
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• v.12 no.6
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• pp.624-633
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• 2012

This study was executed to provide the basic data that can be helpful for a program aiming at the enhancement of life quality or establishment of policy related to public health by analyzing the importance of health state among the middle-aged adults when it came to the decision of life quality. For 160 adults who were older than 40 years old, a survey was conducted and the results were derived by using t-test, one way ANOVA, and multiple regression analysis. Followings are the outcome of the study. According to such results, it was known that the level of general life quality and oral health related life quality were shown to be different depending on symptoms of depression and xerostomia. Therefore, it suggests that prevention and early intervention of depression and xerostomia will make a great contribution to improve the life quality among the middle-aged adults.

• Journal of the Korea Convergence Society
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• v.12 no.12
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• pp.389-399
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• 2021

The purpose of this study was to explore the domestic and overseas home modification policies, and review the direction of domestic home modification policies to enable 'Aging In Place; AIP' and the competencies required of occupational therapist as and expert in home modification. In order to expand occupational therapy for domestic home modification and strengthen occupational therapist competency, it is required to establish a clear and practical home modification process that reflects the design and intervention of occupational therapy. Appropriate selection and standardization of the evaluation tools that identifies the needs of the elderly and reflects the characteristics of domestic housing types are also required. In addition, it is necessary to understand policies and systems, and endeavour to establish a relevant knowledge base for communication and cooperation with experts in other fields. In terms of the policy, there is a need for the home modification support system that allows the elderly to adapt to their aging regardless of their income level, beyond the existing support system, which was implemented mainly for low-income people and disabled. In addition, as in overseas cases, the efforts need to be made to provide various and efficient measures, such as support for barrier-free housing, expansion of the scope of support through cooperation between the national government and local governments, low-interest loans and tax reductions, and establishment of governance with organizations and institutions related to home modification services.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.126-136
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• 2018

The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.57-72
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• 2021

Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS). Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm). Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable. Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.