• Title/Summary/Keyword: post assessment and management

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Reassessment on the Four Major Rivers Restoration Project and the Weirs Management (4대강 살리기사업의 재평가와 보의 운용방안)

  • Lee, Jong Ho
    • Journal of Environmental Impact Assessment
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    • v.30 no.4
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    • pp.225-236
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    • 2021
  • The master plan for the Four Rivers Restoration Project (June 2009) was devised, the procedure of pre-environmental review (June 2009) and environmental impact assessment (Nov. 2009), and post-environmental impact survey were implemented, and 4 times audits also inspected. and finally the Ministry of Environment's Four Rivers Investigation and Evaluation Planning Committee proposed the dismantling or partial dismantling of the five weirs of the Geum River and Yeongsan River. But controversies and conflicts are still ongoing. Therefore, this study intend to reestablish the management plan for the four major rivers by reviewing and analyzing the process so far. The results are as follows. First, a cost-benefit analysis should be performed by comparing the water quality impact of weir operation and weir opening. Therefore, it is inevitably difficult to conduct cost-benefit analysis. Second, according to the results of cost-benefit analysis on the dismantling of the Geum River and the Yeongsan River, the dismantling of the weir and the regular sluice gate opening was decided. However, there is a problem in the validity of the decision to dismantle the weir because the cost-benefit analysis for maintaining the weir is not carried out. Third, looking at the change in water quality of 16 weirs before and after the Four Major Rivers Restoration Project, COD and Chl-a were generally deteriorated, and BOD, SS, T-N, and T-P improved. However, in the cost-benefit analysis related to water quality at the time of weir dismantling, only COD items were targeted. Therefore, the cost of BOD, SS, T-N, and T-P items improved after the project were not reflected in the cost-benefit analysis of dismantling weirs, so the water quality benefits were exaggerated. Fourth, in the case of Gongju weir and Juksan weir, most of them are movable weirs, so opening the weir alone can have the same effect as dismantling when the water quality deteriorates. Since the same effect can be expected, there is little need to dismantle the weirs. Fifth, in order to respond to frequent droughts and floods, it is desirable to secure the agricultural water supply capacity to the drought areas upstream of the four majorrivers by constructing a waterway connected to the weir. At present it is necessary to keep weirs rather than dismantling them.

Dental alloplastic bone substitutes currently available in Korea

  • Ku, Jeong-Kui;Hong, Inseok;Lee, Bu-Kyu;Yun, Pil-Young;Lee, Jeong Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.2
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    • pp.51-67
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    • 2019
  • As dental implant surgery and bone grafts were widely operated in Korean dentist, many bone substitutes are commercially available, currently. For commercially used in Korea, all bone substitutes are firstly evaluated by the Ministry of Health and Welfare (MOHW) for safety and efficacy of the product. After being priced, classified, and registration by the Health Insurance Review and Assessment Service (HIRA), the post-application management is obligatory for the manufacturer (or representative importer) to receive a certificate of Good Manufacturing Practice by Ministry of Food and Drug Safety. Currently, bone substitutes are broadly classified into C group (bone union and fracture fixation), T group (human tissue), L group (general and dental material) and non-insurance material group in MOHW notification No. 2018-248. Among them, bone substitutes classified as dental materials (L7) are divided as xenograft and alloplastic bone graft. The purpose of this paper is to analyze alloplastic bone substitutes of 37 products in MOHW notification No. 2018-248 and to evaluate the reference level based on the ISI Web of Knowledge, PubMed, EMBASE (1980-2019), Cochrane Database, and Google Scholar using the criteria of registered or trademarked product name.

Internet Use Motivations and Problem Behaviors of Vocational High School Students according to Internet Addiction and Family System Type (실업계 고등학생의 인터넷 중독 수준과 가족체계유형에 따른 인터넷 사용동기 및 문제행동)

  • Shin, Soo-Jung;Jang, Yoon-Ok
    • Journal of Families and Better Life
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    • v.25 no.5
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    • pp.31-46
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    • 2007
  • The purpose of this study was to determine the differences in internet use motivations and problem behaviors among vocational high school students according to internet addiction and family system type. Five hundred vocational high school students from Daegu took part in the survey. The questionnaire survey consisted of an internet addiction self-assessment scale, a family system type scale, an internet use motivation scale, and a problem behavior scale. The data was analysed using MANOVA and Cronbach a, and the $Scheff\acute{e}$ test was used for post-hoc analysis. The major findings of this study were as follows: First, the study found significant differences in adolescent internet use motivation according to internet addiction. Adolescents in the high dangerous user group showed higher communicative, experiential, and addictive motivations than adolescents in potentially dangerous and normal user groups. Also, there were no significant differences in informative motivation according to internet addiction. Regardless of internet addiction, adolescents tend to use the internet to search for information and to solve problems. Second, there were significant differences in adolescents' problem behaviors according to internet addiction. More specifically, adolescents who were in the high dangerous user group displayed more problem behaviors toward their body, family, school, and society than adolescents in the potentially dangerous and the normal user groups. Third, an adolescent's family system type significantly influenced his/her internet use motivation. Adolescents from an extreme family showed higher communicative and addictive motivations than adolescents from middle and balanced families. Fourth, there were significant differences in the problem behaviors of adolescents according to family system types. Adolescents from an extreme family showed more problem behaviors toward their body, family, school, and society than adolescents from middle and balanced families.

Radiographic evaluation of infra-bony defects treated by bone graft procedures (골 이식술에 의해 치료된 골연하 결손부의 방사선학적 변화 양상의 관찰)

  • Ryu, Sang-Ho;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.38 no.3
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    • pp.437-444
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    • 2008
  • Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed $1.15{\pm}1.95\;mm$ of bone fill, $0.40{\pm}1.19\;mm$ of crestal resorption, $1.55{\pm}1.77\;mm$ of defect resolution, and $40{\pm}44%$ of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects.

Risk factors associated with repeated epidural blood patches using autologous blood

  • Oh, Ah Ran;Park, Jungchan;Jeong, Ji Seon;Lee, Jin Young;Choi, Ji Won;Kim, Hara;Sim, Woo Seog
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.224-230
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    • 2022
  • Background: An epidural blood patch (EBP) is a procedure to treat intracranial hypotension that does not respond to conservative treatment. EBPs are commonly repeated when the symptoms persist. In this study, we used a large single-center retrospective cohort and evaluated the factors associated with repeated EBPs. Methods: From January 2010 to December 2020, a total of 596 patients were treated with EBPs for intracranial hypotension. We evaluated the factors associated with repeated EBPs in the entire population, in patients with spontaneous intracranial hypotension (SIH), and in those with available myelographies. Results: In a total of 596 patients, 125 (21.1%) patients required repeated EBPs, and 96/278 (34.5%) in SIH and 29/314 (9.2%) in iatrogenic population. In patients with SIH, international normalized ratio (INR) and cerebrospinal fluid (CSF) leakage on myelographies consistently exhibited significant associations (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.02-1.87; P = 0.043 and OR, 2.18; 95% CI, 1.28-3.69; P = 0.004). In patients with iatrogenic injury, INR and CSF leakage on myelogram did not show difference in repeated EBPs. Conclusions: Repeated EBPs may be more frequently required in patients with SIH. Prolonged INR and CSF leakage were associated with repeated EBPs in patient with SIH. Further studies are needed to determine factors associated with repeated EBP requirements.

Current Radiopharmaceuticals for Positron Emission Tomography of Brain Tumors

  • Jung, Ji-hoon;Ahn, Byeong-Cheol
    • Brain Tumor Research and Treatment
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    • v.6 no.2
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    • pp.47-53
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    • 2018
  • Brain tumors represent a diverse spectrum of histology, biology, prognosis, and treatment options. Although MRI remains the gold standard for morphological tumor characterization, positron emission tomography (PET) can play a critical role in evaluating disease status. This article focuses on the use of PET with radiolabeled glucose and amino acid analogs to aid in the diagnosis of tumors and differentiate between recurrent tumors and radiation necrosis. The most widely used tracer is $^{18}F$-fluorodeoxyglucose (FDG). Although the intensity of FDG uptake is clearly associated with tumor grade, the exact role of FDG PET imaging remains debatable. Additionally, high uptake of FDG in normal grey matter limits its use in some low-grade tumors that may not be visualized. Because of their potential to overcome the limitation of FDG PET of brain tumors, $^{11}C$-methionine and $^{18}F$-3,4-dihydroxyphenylalanine (FDOPA) have been proposed. Low accumulation of amino acid tracers in normal brains allows the detection of low-grade gliomas and facilitates more precise tumor delineation. These amino acid tracers have higher sensitivity and specificity for detecting brain tumors and differentiating recurrent tumors from post-therapeutic changes. FDG and amino acid tracers may be complementary, and both may be required for assessment of an individual patient. Additional tracers for brain tumor imaging are currently under development. Combinations of different tracers might provide more in-depth information about tumor characteristics, and current limitations may thus be overcome in the near future. PET with various tracers including FDG, $^{11}C$-methionine, and FDOPA has improved the management of patients with brain tumors. To evaluate the exact value of PET, however, additional prospective large sample studies are needed.

Corelation between Nurses' Posttraumatic Stress Disorder, Depression and Social Stigma in Nursing COVID-19 Patients (COVID-19 환자 간호한 간호사들의 외상 후 스트레스 장애, 우울 및 사회적 낙인 간의 관계)

  • Lee, Eun Ja;Cho, Ok Yeon;Wang, Keum Hyun;Jang, Myung Jin
    • Journal of East-West Nursing Research
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    • v.27 no.1
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    • pp.14-21
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    • 2021
  • Purpose: This study aims to examine the levels of posttraumatic stress disorder (PTSD), depression and social stigma among nurses caring for Corona Virus Disease-19 (COVID-19) patients. Methods: 169 nurses caring for COVID-19 patients participated in this study. Data collection was conducted at university hospitals from March 1 to August 31, 2020. Data analysis was performed for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients using SPSS/WIN 24.0 program. Results: The mean scores of PTSD, depression and social stigma were 25.16±16.80, 17.26±8.63 and 5.83±2.84, respectively. The PTSD scores were significantly different between the department (F=2.89, p=.037). Depressive scores were significantly different between the marital status (t=2.27, p=.024) and the department (F=4.91, p=.003). Social stigma scores were significantly different between age (F=6.49, p=.002), marital status (t=-3.30, p=.008), having or not having children (t=3.82, p=.001), department (F=5.82, p=.001) and clinical experience (F=7.43, p=.001). Positive correlations were found between PTSD and depression (r=.70, p<.001) and social stigma (r=.22, p<.004). Conclusion: Integrated assessment and management are required to address the psychological and emotional problems faced by nurses caring for COVID-19 patients, and active follow-up measures should be considered.

Surgical Management with Radiation Therapy for Metastatic Spinal Tumors Located on Cervicothoracic Junction : A Single Center Study

  • Park, Ho-Young;Lee, Sun-Ho;Park, Se-Jun;Kim, Eun-Sang;Lee, Chong-Suh;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.42-49
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    • 2015
  • Objective : The cervicothoracic junction (CTJ) is a biomechanically and anatomically complex region that has traditionally posed problems for surgical access. In this retrospective study, we describe our clinical experiences of the treatment of metastatic spinal tumors at the CTJ and the results. Methods : From June 2006 to December 2011, 23 patients who underwent surgery for spinal tumors involving the CTJ were enrolled in our study. All of the patients were operated on through the posterior approach, and extent of resection was classified as radical, debulking, and simple neural decompression. Adjuvant radiation therapy (RT) was also considered. Visual analog scale score for pain assessment and Medical Research Council (MRC) grade for motor weakness were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Almost all of the patients were operated using palliative surgical methods (91.3%, 21/23). Ten complications following surgery occurred and revision was performed in four patients. Of the 23 patients of this study, 22 showed significant pain relief according to their visual analogue scale scores. Concerning the aspect of neurological and functional recovery, mean MRC grade and ECOG score was significantly improved after surgery (p<0.05). In terms of survival, radiation therapy had a significant role. Median overall survival was 124 days after surgery, and the adjuvant-RT group (median 214 days) had longer survival times than prior-RT (63 days) group. Conclusion : Although surgical procedure in CTJ may be difficult, we expect good clinical results by adopting a palliative posterior surgical method with appropriate preoperative preparation and postoperative treatment.

Comparison of Job Tasks and Task Elements of Korean Nurse Anesthetists by Type of Medical Institution: Hospital, General Hospital and Higher General Hospital (의료기관 규모에 따른 마취전문간호사의 직무관련 특성, 직무 및 직무요소의 수행빈도 차이 비교)

  • Bai, Chungsim;Yoon, Haesang
    • Journal of Korean Academy of Nursing Administration
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    • v.19 no.2
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    • pp.239-253
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    • 2013
  • Purpose: This study was done to identify job tasks and task elements of Korean nurse anesthetists according to type of medical institution. Methods: A job task scale which consisted of 9 job tasks and 40 task elements was developed. Data were collected from December, 2009 to February, 2010 from 182 nurse anesthetists who were working in medical institutions (response rate: 75.8%). Results: Forty-eight percent of nurse anesthetists were independent from anesthesiologists in anesthetic practice. Preanesthetic nursing assessment was much more frequent in small hospitals than in general hospitals (p<.05), and anesthetic nursing intervention, administering the anesthetics, monitoring the patient's status during anesthesia, and provision of safety and compliance with anesthetic ethics were much more frequent in general hospitals than medical centers (p<.001). There were no differences among the medical institutions for job tasks in post-anesthetic nursing interventions (p=.229), administering anesthetics (p=.354) and monitoring patients' status during anesthesia (p=.099), providing safe anesthetic environment (p=.896), and management of ancillary personnel/equipment (p=.617). Conclusion: Results indicate that nurse anesthetists contribute significantly to anesthetic practice in small hospitals and general hospitals. Therefore, it recommended that nursing leaders make efforts to enact legal nurse anesthetist-related policies for safe and high quality anesthetic nursing care.

Implementing Best Practice in Critically Ill Organophosphate Poisoned Patient Through Simulation-Based Learning Program (중환임상중독환자의 상황 인지와 대처 방법에 대한 시뮬레이션 교육의 효과 연구)

  • Lee, Ji Hwan;Chung, Sung Phil;Chung, Hyun Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.31-39
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    • 2017
  • Purpose: Despite the clinical and socio-economic impact of acute poisoned patients, many of the treatments are not standardized in Korea. Moreover, no formal training that is specifically focused on clinical toxicology exists. Rather, training and education are conducted case by case in various institutions. This study was conducted to develop a standardized simulation-based clinical toxicology training curriculum for healthcare providers. This program will focus on specific assessment and treatment of critical toxicology patients, specifically those who have been poisoned with organophosphate. Methods: The study was performed using a pre- and post-design to determine the effects of implementation of this program. The study was conducted at eight different urban teaching hospitals in a simulated room in the clinical area. The study was targeted to 19 groups composed of emergency residents and nurses. Simulation-based learning was conducted for each group. Results: All 19 groups achieved the minimum passing score of 75%. Implementation of the program led to improved performance rates for overall management and cooperative moods competency (p<0.01). Inter-rater agreement between the two evaluators was excellent. In general, the participants thought the program was realistic and were able to recognize and improve the competencies needed to care for organophosphate poisoned patients. Conclusion: Simulation-based learning is an effective educational strategy that can be applied to improving and understanding proper care for rare but critical patients. This program was effective at improving team performance and cooperative moods when managing an organophosphate poisoned patient in the Emergency Department.