• Title/Summary/Keyword: medical facilities

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Factors of Determining N-acetylcysteine Administration in Patients with Acute Acetaminophen Poisoning (급성 아세트아미노펜 중독에서 N-acetylcysteine 투여 결정 관련 인자)

  • Lee, Jeong Hwa;Choi, Sangchun;Yoon, Sang Kyu;Shin, Kyu Cheol
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.78-84
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    • 2020
  • Purpose: In acute acetaminophen poisoning, the administration of N-acetylcysteine (NAC) can effectively treat the main complications, such as kidney injury and liver failure. In the current situation, measurements of the acetaminophen concentration are not checked in the usual medical facilities. Therefore, this study examined the factors of determining the administration of NAC in addition to the stated amount of intake. Methods: The medical records of patients who visited Ajou University Hospital emergency center with acetaminophen poisoning from January 2015 to December 2019 were reviewed retrospectively. One hundred and seventy-nine patients were initially included. Among these patients, 82 patients were finally selected according to the inclusion criteria in the study. The inclusion criteria were as follows: patients who were 15 years of age or older; those whose ingested dose, ingested time, and body weight were clearly identified; and patients whose acetaminophen sampling time was within 24 hours. Patients were divided into two groups: NAC administered vs. non-NAC administered. The following variables were compared in these two groups: ingested dose, ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, psychiatric disease history, classification of toxic/non-toxic groups, duration of hospitalization, and laboratory results. Results: Univariate analysis revealed the ingested dose per body weight, hospital arrival time after ingestion, suicide attempt history, and psychiatric disease history to be the determining factors in administering NAC. Logistic regression analysis confirmed that the ingested dose per body weight was the only significant factor leading to an NAC treatment decision. (Odds ratio=1.039, 95% Confidential interval=1.009-1.070, p=0.009) Conclusion: The ingested dose per body weight was the only determining factor for administering NAC in patients with acute acetaminophen poisoning. On the other hand, additional criteria or indicators for the NAC administration decision will be necessary considering the inaccuracy of the ingested dose per body weight and the efficiency of NAC administration.

Alternative Immunossays

  • Barnard, G.J.R.;Kim, J.B.;Collins, W.P.
    • Korean Journal of Animal Reproduction
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    • v.9 no.2
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    • pp.133-139
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    • 1985
  • An immunoassay may be defined as an analytical procedure involving the competitive reaction between a limiting concentration of specific antibody and two populations of antigen, one of which is labelled or immobillized. The advent of immunoassay has revolutionised our knowledge of reproductive physiology and the practice of veterinary and clinical medicine. Radioimmunoassay (RIA) was the first of these methods to be developed, which meausred the analyte with good sensitivity, accuracy and precision (1,2). The essential components of RIA are:-(i) a limited concentration of antibodies, (ii) a reference preparation, and (iii) an antigen labelled with a radioisotope (usually tritium or iodine-125). Most procedures invelove isolating the antibody-bound fraction and measuring the amount of labelled antigen. Good facilities are available for scintilltion counting, data reduction nd statistical analysis. RIA is undergoing refinement through:-(i) the introduction of new techniques to separate the antibody-bound and free fractions which minimize the misclassification of labelled antigen into these compartments, and the amount of non-specfic binding. (3), (ii) the development of non-extration for the measurement of haptens (4), (iii) the determination of a, pp.rent free (i.e. non-protein bound) analytes (5), and (iv) the use of monoclonal antibodies(6). In 1968, Miles and Hales introduced in important new type of immunoassay which they termed immunora-diometric assay (IRMA) based on t도 use of isotopically labelled specific antibodies(7) in a move from limited to excess reagent systems. The concept of two-site IRMAs (with a capture antibody on a solid-phase, and a second labelled antibody to a different antigenic determinant of the analyte) has enabled the development of more sensitive and less-time consuming methods for the measurement of protein hormones ovar wide concentration of analyte (8). The increasing use of isotopic methos for diverse a, pp.ications has exposed several problems. For example, the radioactive half-life and radiolysis of the labelled reagent limits assay sensitivity and imposes a time limit on the usefulness of a kit. In addition, the potential health hazards associated with the use and disposal of radioactive cmpounds and the solvents and photofluors necessary for liquid scientillation counting are incompatable with the development of extra-laboratory tests. To date, the most practical alternative labels to radioisotopes, for the measurement of analytes in a concentration > 1 ng/ml, are erythrocytes, polystyrene particiles, gold sols, dyes and enzymes or cofactors with a visual or colorimetric end-point(9). Increased sensitivity to<1 pg/ml may be obtained with fluorescent and chemiluminescent labels, or enzymes with a fluorometric, chemiluminometric or bioluminometric end-point. The sensitivity of any immunoassay or immunometric assay depends on the affinity of the antibody-antigen reaction, the specific activity of the label, the precision with which the reagents are manipulated and the nonspecific background signal (10). The sensitivity of a limited reagent system for the measurement of haptens or proteins is mainly dependent upon the affinity of the antibodies and the smalleest amount of reagent that may be manipulated. Consequently, it is difficult in practice to improve on the sensitivity obtained with iodine-125 as the label. Conversely, with excess reagent systems for the measurement of proteins it is theoretically possible to increase assay sensitivity at least 1000 fold with alternative luminescent labels. To date, a 10-fold improvement has been achieved, and attempts are being made to reduce the influence of other variables on the specific signal from the immunoreaction.

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Developing Measurement Items for the Service Quality of Clinical Trials based on the Brady & Cronin Model (Brady & Cronin의 모델에 기반한 임상시험 서비스 질 측정 문항 개발)

  • Go-Eun Lee;Sanghee Kim;Sue Kim;Sang Hui Chu;Jeong-Ho Seok;So Yoon Kim
    • The Journal of KAIRB
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    • v.6 no.1
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    • pp.17-31
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    • 2024
  • Purpose: This study aims to develop preliminary items for measuring the perceived service quality of clinical trials among participants and to verify content validity. Methods: This study was designed as a methodological study. A conceptual framework was established based on Brady and Cronin's hierarchical model, and preliminary items were prepared through translation-back-translation, a review of existing instruments, and in-depth interviews with clinical trial participants and clinical research coordinators. The final items were completed through content validity testing by experts and a review of items by clinical trial participants for the prepared preliminary items. Results: Through this study, a set of 58 items across four domains (quality of interaction with researchers, the physical environment, performance procedures, and performance results) and 9 components (information·education·communication, trust, respect for participant preferences, securing facilities and space, accessibility, comfortability, informed consent, coordination of care, subjective understanding of clinical trials) on the service quality of clinical trials were completed. The scale content validity index of all preliminary items was 0.96, meeting the recommended standards. The individual-item content validity index also meets the recommended criteria for most items, excluding four items. Conclusion: This study holds significance in developing items to measure the quality of clinical trial execution from the perspective of participants. By verifying the reliability and validity of these items through subsequent research, it is expected that they can be utilized as a valuable instrument to devise strategies for improving the quality of clinical trials.

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Measuring Spatial Accessibility to the Hospitals for Infants, Children, Adolescents, and Elderly Population Using 2SFCA: A Case Study of Chuncheon-si, Gangwon-do (2SFCA를 활용한 노인과 소아청소년에 대한 병원 접근성 분석: 강원도 춘천시를 사례로)

  • Jung, Nan-Ju;Kang, Jeon-Young
    • Journal of Cadastre & Land InformatiX
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    • v.54 no.1
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    • pp.49-61
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    • 2024
  • South Korea faces a declining population and rural areas vanishing due to urbanization. Infrastructure, especially medical facilities, may not be sustainable for a long-term. This may impact vulnerable groups like children, teens, and the elderly, worsened by an aging population and low birth rates. Gangwon-do, notably Chuncheon-si, suffers from rural depopulation and poor healthcare self-sufficiency. In this paper, using 2SFCA(Two-Step Floating Catchment Area), we analyze healthcare access in Chuncheon-si, identifying gaps and vulnerable areas. LISA analysis helps map medical vulnerability, considering patient demand and supply. The Gini coefficient assesses spatial inequality. We propose distributing healthcare services and personnel based on age and region. The aim is to identify locations for additional hospitals catering to the elders, Infants, Children, and Adolescents,considering spatial accessibility.

Oral Health Behavior Changes Based on Oral Health Education of Mental Disabilities (정신지체 장애인의 구강보건 교육에 따른 구강보건 행태 변화)

  • Choi, Ju-Hyun;Lee, Myeng-Hee;Seo, Hwa-Jeong
    • Journal of dental hygiene science
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    • v.12 no.4
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    • pp.404-412
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    • 2012
  • The main object of this study is to render a better dental education to mental disabilities, teachers, and their parents. By providing a better dental education to them, mental disabilities would understand the importance of their oral hygiene. The study was held in Seoul at two different locations, named H and E mental welfare facilities. Ninety Three mental disabilities were studied by observing their oral behavior, simple oral hygiene index and plaque index prior and post to dental education. At the end of education, following result were gathered from two mental facilities. First, the level of oral behavior in Class 1,2, and 3 mental disabilities were observed prior and post to the dental education. Overall, there was no significant difference among Class 1 mental disabilities with the dental education. Second, in simple oral hygiene index, the severity of mental illness has affected on their oral behavior (F=6.322, p<.001). Third, in simple oral hygiene index, the frequency of dental education, regardless of severity of mental illness has affected on their oral hygiene (F=5.961, p<.01). Fourth, the plaque index also illustrated that the frequency of dental education, regardless of severity of dental illness has affected on their oral hygiene (F=5.126, p<.05). Finally, the general characteristics of mental disabilities according to changes in oral health awareness to gender, age, disability type, educational level do not statistically significant in all variables. Their simple oral hygiene index and plaque index advanced, although after a while they started to lose focus, which brought back their old habits. Nevertheless, in conclusion I believe that helping mental disabilities more frequently to constant reminder, will not only keep them entertained, but help them realize how important oral hygiene practice is, hopefully increasing and benefiting those with mental disabilities for future reference.

Survey on Counseling about Infant Nutrition Among Doctors on Practicing Pediatric Patients in Primary Medical Facilities (소아 환자를 진료하는 의사들의 영아기 영양에 대한 상담 실태 조사)

  • Doe, Eun Jung;Lee, Eun Sil;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1332-1339
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    • 2002
  • Purpose : Through a survey undertaken among doctors practicing pediatric patients in primary medical facilities on nutrition during infancy, the present study was done to determine whether these doctors were giving appropriate advice on infant nutrition. Methods : We visited pediatric specialists(group one) and non-pediatric specialists or general practitioners(group two) who were practicing in Daegu to ask them to fill out a questionaire on infant nutrition. Results : When 10 points were given to each question for a total of 100 points, the results of the evaluation showed that the score in group one was $73.0{\pm}15.8$ points and $45.1{\pm}18.4$ points in group two, showing a significant difference. No statistical difference was seen in the scores between non-pediatric specialists and general practitioners. Each answer to each question on the feeding period of breast milk, on loose stools during breast milk feeding, methods to deal with jaundice during breast milk feeding, choice of commercial baby food, criteria on directing soy milk, and criteria of guiding infant cereal was different between group one and two. Conclusion : The results of the present investigation showed that specialists in other fields or general practitioners were giving inappropriate advice on nutrition during the infant stage compared with pediatric specialists; thus, we need to confirm methods to prevent inappropriate consultations by specialists of other fields, together with continued education of pediatric specialists.

A Survey on Status of Pregnancy and Delivery at a Rural Village, Nepal(Dolakha Bazar Area) (네팔 돌카지역의 임신분만 환경)

  • Ahn, Young-Woo;Kang, Yune-Sik;Kam, Sin;Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.721-732
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    • 1996
  • This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year$(1994.4.13\sim1995.4.12)$ at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows ; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8 % of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.

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A Study on Improvement of Laws regarding Welfare for the Aged (노인복지 관련법제의 발전방향)

  • Park, Ji-Soon
    • Journal of Legislation Research
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    • no.41
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    • pp.87-123
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    • 2011
  • Korea is expected to become an 'aged society' with more than 14 percent of the public aged 65 years or more by 2018. The rapid aging is giving rise to various problems within the society along with falling birthrate in a short period of time. In this context, the role and function of laws on welfare for the aged must be particularly emphasized. Also the Senior Citizens Welfare Act is of great importance as it provides social welfare service on the basis of functional connection with social insurance and public assistance. First, this paper looks into the history of laws related to welfare for the elderly such as the Senior Welfare Act, the Act on Long-term Care Insurance for Senior Citizens and the Basic Old Age Pension Act as well as the findings of earlier studies. In the second place, it will break down such laws by main components aiming to examine details of the laws and questions raised regarding them and to seek ways to achieve improvement with an emphasis on health care, old age income security, housing welfare(assisted living facilities), job security for the aged. The Senior Welfare Act offers substance of social welfare service for the elderly. Income security, health and medical care, welfare measures through long-term care and assisted living facilities, social participation by working are the key elements and all of them should be closely associated to ensure citizens get sufficient public support in their old age. For this purpose, the Senior Welfare Act is under a normative network with laws such as Act on Long-term Care Insurance for Senior Citizens and Basic Old Age Pension Act. Current laws on welfare for the aged including Senior Welfare Act are not sufficiently responsive to the aged society of the 21st century. Income security combined with decent social participation, health and medical care closely connected with long-term care system, efficient expense sharing between government and local government, enhancement of effectiveness of welfare measures can be considered as means to improve current welfare system so that the elderly can enjoy their old age with dignity and respect.

The Relationship between the Nurse's Reward Fit and Job Involvement${\cdot}$Organizational Commitment (간호사의 보상적합도와 직무몰입 ${\cdot}$ 조직몰입정도간의 관계 연구)

  • Kim, Jung-A
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.41-59
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    • 1997
  • This study surveyed nurses' value of reward and recognition level of organizational reward, and measured the fit of both. It also looked into the relationship between the reward fit and attitude of nurses toward their job and organization (job involvement${\cdot}$organizational commitment). It was planned to suggest the alternative of a future reward system. The sample consisted of 625 nurses of 8 private University Hospitals. Data for this study was collected from Mar. 25 to Apr. 17 by structured questionnaire. This study examined the differences of nurses' value of reward by their demographic characteristics, and looked into the relationship between the reward fit and job involvement${\cdot}$organizational commitment. Four instruments and a demographic questionnair were used to collect the data. Developed for myself and repaired by panel of judges, the value of reward scale and organizational reward scale consisted of 34 items on five points Likert-type scale. Developed by Kanungo and repaired by panel of judges, the job involvement scale measured overall job involvement on 7 items. The organizational commitment scale was developed by Mowday et al and repaired by panel of judges on 10 items. The data was analyzed by frequency, percentage, ranking, one-way ANOVA, Pearson's correlation coefficient, Chronbach alpha coefficient, t-test, SNK test, factor analysis with SPSS/PC+ progra,.Major findings are as follows 1. The mean of nurses' value of reward is 4.2435 and job content rewards are seen as the most important(M=4.5532). The following orders are seen as follows; financial rewards(M=4.4181), human realtion rewards(M=4.4130), establishment ${\cdot}$ facilities rewards(M=4.1632), professional rewards(M=4.1117), social status or prestige rewards(M=3.9228), career rewards(M=3.8816). Of 34 indivisual reward factors, the retainment allowance is seen to be thought of as the most important thing. 2. The mean of nurses' actual reward is 2.6035. The actual reward responded to the most extremely offered is job content rewards. The following orders are seen as follows ; human relation rewards(M=2.9420), financial rewards(M=2.7682), professional rewards(M=2.4601), social status or prestige rewards(M=2.3696), career rewards(M=2.3466), establishment ${\cdot}$ facilities rewards(M=1.9364). Of 34 indivisual reward factors, medical insurance benefits are felt to be most extremely offered. 3. The mean of fit of reward is -1.6874 and that means actual reward doesn't egual the value of the reward. What is offered mostly to nurses' value of reward is human relation rewards. The following orders are seen as follows; job content rewards(M=-1.5938), career rewards(M=-1.6381), social status of prestige rewards(M=-1.6382), financial rewards(M=-1.6836), professional rewards(M=-1.6854), establishment${\cdot}$facilities rewards(M=-2.3130). Of 34 indivisual factors, the item of fered most closely to nurses' value of reward is seen as the participation in educational programs at the nursing department of the hospital. 4. The mean of nurses' job involvement is 3.1987 and SD is 0.5667. 5. The mean of murses' organizational commitment is 2.9348 and SD is 0.6124, that is seen as a little lower than job involvement. 6. Significant value of reward differences were found among nurses by their demographic characteristics such as married status, tenure, academic career. 7. The fit of reward was significant related to job involvement and organizational commitment. When generalizing the result of this study, the value of reward, which nurses consider important and appropriate offers a reward that corresponds to the nurses' value of reward. This increases nurses' job and organization devotion further, as well as hospital effectiveness. It appears that nurses have recognized that the present reward offered in hospitals doesn't come up to their expectations so I think it is urgent to plan and perform the new reward system which is in accord with the nurses' reward fit.

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Evaluation of SUV Which was Estimated Using Mini PACS by PET/CT Scanners (PET/CT 장비 별 mini PACS에서 측정한 표준섭취계수(SUV)의 유용성 평가)

  • Park, Seung-Yong;Ko, Hyun-Soo;Kim, Jung-Sun;Jung, Woo-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.47-52
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    • 2011
  • Purpose: Facilities use own sever or mini PACS system for storage and analysis of the PET/CT data. Mini PACS can storage scan data as well as measuring SUV. Therefore, the study was performed to confirm whether or not measured SUV on mini PACS is measured equally on PET/CT workstation. Materials and Methods: In February 2011, 30 patients who were performed $^{18}F$-FDG wholebody PET/CT scan in Biograph 16, Biograph 40 and Discovery Ste 8 were enrolled. First, using each workstation, SUV in liver and aorta of mediastinum level was measured. Second, using mini PACS, SUV was measured by same method. Result: The correlation coefficient of SUV in liver between PET/CT scanner and min PACS in Biograph 16, Biograph 40, Discovery Ste 8 was 0.99, 0.98, 0.64 respectably, the correlation coefficient of SUV in aorta was 0.98, 0.98, 0.66, and these were showed positive correlation coefficient. Difference of SUV between Biograph workstation and mini PACS was not showed statistical significant difference at 5% level of significance. Difference of SUV between Discovery Ste 8 workstation and mini PACS was showed statistical significant difference at 5% level of significance. Conclusion: In case that patient was scanned by the other scanner, if the correction of SUV formula in mini PACS for each scanners is performed, mini PACS will be usefully used to provide consistently quantitative assessment.

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