• Title/Summary/Keyword: public health emergency

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Overview of management of children with COVID-19

  • Wati, Dyah Kanya;Manggala, Arya Krisna
    • Clinical and Experimental Pediatrics
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    • v.63 no.9
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    • pp.345-354
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    • 2020
  • The widespread and contagious coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has become a burden in the global health domain. The subsequent discovery of the virus features and pathogenesis, and prompt and adequate management are still lacking and remain inconclusive. Children usually present milder symptoms than adults, and management focuses on providing symptomatic and respiratory supports. Several treatment modalities, including the utilization of mechanical ventilation (MV), antivirals, immune-modulating drugs, or other agents, may present promising results in reducing the symptoms of COVID-19, particularly in severe cases. Although no randomized clinical trials have been published to date, it is interesting to explore potential modalities for treating COVID-19 in children, based on review articles, case reports, and recent guidelines.

COVID-19 and IRB Review (코로나19와 IRB 심의)

  • Shin, Hee-Young
    • The Journal of KAIRB
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    • v.2 no.2
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    • pp.33-36
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    • 2020
  • In December 2019, coronavirus disease 2019 (COVID-19) was discovered in Wuhan, China. The disease was so severe that as early as 30 January 2020 COVID-19 was declared by WHO as a Public Health Emergency of International Concern. There have been a lot of concerns about conducting COVID-19 clinical researches scientifically and ethically in pandemic. This article is directed at addressing these issues from the perspective of IRB. First of all, the urgency of COVID-19 research requires prompt IRB process through efficient ethics review and oversight system. IRB should determine whether the risks that will be presented to human subjects are justified after assessing possible harm and anticipated benefits. The safety of subjects should not be compromised. Furthermore, informed consent should be voluntarily obtained by sufficient information in consideration of special circumstances during a pandemic.

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Current Status of Organizational Citizenship Behavior Awareness Among Firefighters (소방공무원의 조직시민행동 의식실태 분석)

  • Hyeon-Gyeong Lee;Kyong-Jin Park
    • Journal of the Korean Society of Industry Convergence
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    • v.27 no.3
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    • pp.501-508
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    • 2024
  • Organizational citizenship behavior refers to the behavior of faithfully performing one's duties and being faithful to other roles. Firefighters' awareness of organizational citizenship behavior is closely related to national and individual safety and is very important. The smooth communication and cooperative attitude of fire department employees means organic unity at the disaster site. The purpose of this study was to analyze the awareness of organizational citizenship behavior among firefighters. As a result of analyzing the overall level of organizational citizenship behavior of firefighters, the average score was 3.83 points (out of 5). In particular, significant implications emerged regarding work-related appointment times and words and actions between co-workers. In the future, we hope that firefighting policy authorities will make a lot of efforts and academic research by subsequent generations will be conducted to make firefighting more trustworthy to the public.

Infection Control and Management Strategy for COVID-19 in the Radiology Department: Focusing on Experiences from China

  • Qian Chen;Zi Yue Zu;Meng Di Jiang;Lingquan Lu;Guang Ming Lu;Long Jiang Zhang
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.851-858
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    • 2020
  • Coronavirus disease 2019 (COVID-19) is a new infectious disease rapidly spreading around the world, raising global public health concerns. Radiological examinations play a crucial role in the early diagnosis and follow-up of COVID-19. Cross infection among patients and radiographers can occur in radiology departments due to the close and frequent contact of radiographers with confirmed or potentially infected patients in a relatively confined room during radiological workflow. This article outlines our experience in the emergency management procedure and infection control of the radiology department during the COVID-19 outbreak.

Multilevel Analysis of Factors Related to Cost and Length of Stay in Acute Myocardial Infarction Patients with Coronary Stenting: Based on Korean National Health Insurance Service's Customized Database in 2010 and 2015 (관상동맥 스텐트를 삽입한 급성 심근경색 환자의 진료비 및 재원일수 관련 요인에 대한 다수준분석: 2010년과 2015년 국민건강보험공단 맞춤형 데이터베이스 자료를 바탕으로)

  • Choi, Boyoung;Lee, Hae-Jong
    • Health Policy and Management
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    • v.30 no.3
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    • pp.418-429
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    • 2020
  • Background: This study aims to analyze the cost and the length of stay (LOS) of acute myocardial infarction (AMI) patients with coronary artery stenting according to the characteristics of individuals and institutions. Methods: The data was collected from Korean National Health Insurance Service's customized database in 2010 and 2015. Chi-square test, t-test, analysis of variance, and multilevel analysis were performed. Results: The intraclass correlation coefficients for cost were 7.02% in 2010, 5.61% in 2015 and for LOS were 3.17%, 1.40%, respectively. The average costs were 9,067,000 won in 2010 and 9,889,000 won in 2015 (p<0.0001). However, the cost in 2015 was lower than the cost applying increased fee. The costs increased in aged 50-59 years, 60-69 years, and aged ≥70 years versus in aged under 49 years. The cost was higher in Charlson comorbidity index (CCI) 3 to 4 and ≥5 than in CCI 0. The costs were lower in male, medical aid recipients, metropolises, and local hospitals in other regions in 2010. LOS decreased from 8.1 days in 2010 to 7.4 days in 2015. It decreased in male, high income group, and the group of admission via emergency room. However, it increased in higher ages and medical aid recipients, and it also increased when CCI rose. The Internal Herfindahl Index was related to LOS in 2010. Conclusion: The variation of hospital level was small compared to the patient level. Therefore, it is important to implement applicable policies at the patient level in order to reduce cost and LOS of AMI patients.

The Effects of Blood Lead on Blood Pressure Among Non-smokers (혈중 납이 비흡연자들의 혈압에 미치는 영향)

  • Pak, Yun-Suk;Park, Sang-Sin;Kim, Tae-Hun;Lee, Sang-Yoon;Kho, Young-Lim;Lee, Eun-Hee
    • Journal of Environmental Health Sciences
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    • v.38 no.4
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    • pp.311-322
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    • 2012
  • Objective: The effect of lead on blood pressure remains controversial in spite of the numerous studies which have been conducted in the recent years. The aim of this study was to evaluate the effects of exposure to lead on blood pressure among non-smokers. Methods: In this cross sectional study, 1416 male and female non-smokers were enrolled, aged 20 years or older, from the Korean National Health and Nutrition Examination Survey 2008. Blood pressure, blood lead levels (BLLs), height, weight, and cotinine level were measured for all subjects. Results: Geometric mean BLLs of the participants was 2.20 ${\mu}g$/dl. BLLs were higher in the older, male, and lower education groups than the younger, female and higher education groups. After adjusting for age, sex, education and BMI through multiple regression analysis, a significant positive association between systolic blood pressure (p = 0.0357), diastolic blood pressure (p = 0.0111) and BLLs. Also, among the normal BMI group (18.5 kg/$m^2$ < BMI < 25 kg/$m^2$), we also found a significant positive association between diastolic blood pressure and BLLs (p = 0.0370). Conclusion: The present study showed that blood lead serves as a good predictor of blood pressure changes and that there was a statistically significant association between blood lead and blood pressure, especially diastolic blood pressure.

An Analytic Case Study on the Management of an Upper-level General Hospital(2010-2012)

  • Park, Hyun-Suk;Lee, Jung-Min;Baek, Hong-Suck;Lee, Jun-Ho;Park, Sang-Sub
    • Journal of Korean Clinical Health Science
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    • v.2 no.1
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    • pp.1-16
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    • 2014
  • Purpose. For a more efficient hospital management, this study aims to provide basic data so that the hospital management and staff in charge of hospital administration may systematically classify and collect hospital information, by analyzing the ordinary characters of an upper-level general hospital system and its common-type balance sheet, common-type profit and loss statement and financial ratio. Methods. By using information about an upper-level general hospital in C Province, provided by Alio(www.alio.go.kr), a public organization information provision site, Health Insurance Review & Assessment Service(www.hira.or.kr) and Ministry of Health and Welfare(www.mw.go.kr), this study analyzed 3 year's data from 2010 to 2012 and provided basic data by analyzing the ordinary characters of an upper-level general hospital system, and its common-type balance sheet, common-type profit and loss statement and financial ratio. Results. After analyzing the ordinary characters, common-type balance sheet, common-type proft and loss statement and financial ration of this general hospital, based on the 2010 to 2012 data, this study came to the following conclusions. Firstly, out of all the 1,069 hospital staff, there were 272 doctors working for 24 medical departments, out of whom the majority was 33 physicians. Most of the nurses were third-class ones, and about 2,000 outpatients and 600 inpatients on average were treated per day. Secondly, as a result of analyzing the common-type balance sheet, this study discovered that intangible assets out of fixed assets accounted for 41%, the majority, out of which usable and profitable donation asset buildings were of great importance, and the liquid assets increased more in 2012 than 2011. In the financial structure, the ratio of liquid liabilities was over 50% out of all the liabilities in 2012, and the ratio of purchase payables was high as well. The ratio of fixed liabilities reached up to 40%, out of which the retirement benefit appropriation fund was quite high. The capital was over 80%, but the surplus was in a deficit state. Compared to the capital, the ratio of total liabilities was about 90%, which indicates the financial structure of this general hospital was vulnerable. Thirdly, as a result of analyzing the common-type profit and loss statement, this study found out that the medical profits from inpatients were higher than profits from outpatients. The material cost was related to the medical quality of this general hospital, and it was as high as 30% out of the total costs and was about 45% of the labor cost. This general hospital showed 10% in the ratio of non-medical profits, and it seemed because of government subsidies. The ratios of medical profits and current net income were gradually changing for the better in 2012, compared to 2011. Lastly, as a result of analyzing the financial ratio, it was found that the liquidity ratio kept decreasing, from 110.7% in 2010 and 102.0% in 2011 to 77.2% in 2012. Besides, it was analyzed that the liquidity ratio and the net working capital ratio greatly decreased, while the quick ratio and the liquid ratio kept decreasing. Conclusions. 1. It is necessary to take the risk management into more consideration, and particularly, it is needed to differentiate and manage the levels of risk in detail. 2. By considering the fact that investments into hospital infrastructures were mostly based on liabilities, it is needed to deal with the scale of losses when evaluating risks. 3. By reflecting the character that investments into hospital infrastructures were based on liabilities, it is necessary to consider the ratio of ordinary profits as well as the ratio of operating profits to sales, and it is also important to consider sales productivity factors, such as the sales amount per a sickbed, by comparing them with other hospitals. As for limitations of this study, there may be some problems in terms of data interpretation because of the lack of information about the number of inpatients and the number of outpatients per year, which are needed for the break-even point analysis. Besides, to suggest a direction for the improvement of hospital management through analyses, non-financial factors should be reflected, such as the trend of economy, medical policies, and politic backgrounds. However, this study only focused on the common-type balance sheet, common-type profit and loss statement and financial ratio, so this study is actually limited to generalizing all the factors by analyzing public data only.

Short-term Effect of Fine Particulate Matter on Children's Hospital Admissions and Emergency Department Visits for Asthma: A Systematic Review and Meta-analysis

  • Lim, Hyungryul;Kwon, Ho-Jang;Lim, Ji-Ae;Choi, Jong Hyuk;Ha, Mina;Hwang, Seung-sik;Choi, Won-Jun
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.4
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    • pp.205-219
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    • 2016
  • Objectives: No children-specified review and meta-analysis paper about the short-term effect of fine particulate matter ($PM_{2.5}$) on hospital admissions and emergency department visits for asthma has been published. We calculated more precise pooled effect estimates on this topic and evaluated the variation in effect size according to the differences in study characteristics not considered in previous studies. Methods: Two authors each independently searched PubMed and EMBASE for relevant studies in March, 2016. We conducted random effect meta-analyses and mixed-effect meta-regression analyses using retrieved summary effect estimates and 95% confidence intervals (CIs) and some characteristics of selected studies. The Egger's test and funnel plot were used to check publication bias. All analyses were done using R version 3.1.3. Results: We ultimately retrieved 26 time-series and case-crossover design studies about the short-term effect of $PM_{2.5}$ on children's hospital admissions and emergency department visits for asthma. In the primary meta-analysis, children's hospital admissions and emergency department visits for asthma were positively associated with a short-term $10{\mu}g/m^3$ increase in $PM_{2.5}$ (relative risk, 1.048; 95% CI, 1.028 to 1.067; $I^2=95.7%$). We also found different effect coefficients by region; the value in Asia was estimated to be lower than in North America or Europe. Conclusions: We strengthened the evidence on the short-term effect of $PM_{2.5}$ on children's hospital admissions and emergency department visits for asthma. Further studies from other regions outside North America and Europe regions are needed for more generalizable evidence.

Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity

  • Aggarwal, Karun;Rastogi, Sanjay;Joshi, Atul;Kumar, Ashish;Chaurasia, Archana;Prakash, Rajat
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.5
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    • pp.351-355
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    • 2017
  • Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

A Study on Certification Method of Health and Barrier Free Environment by the BIM for Aged Person - With Sanitary Facilities of Elderly Housing Facility - (노인 주거시설의 위생공간을 중심으로 고령자의 건강과 무장애 생활환경을 위한 인증 방법에 관한 연구 - BIM기반 설계 및 응용을 통한 방법을 중심으로 -)

  • Hong, Sa-Chul;Paik, Jin-Kyung;Kim, Suk-Tae
    • Korean Institute of Interior Design Journal
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    • v.26 no.3
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    • pp.13-24
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    • 2017
  • Promoting barrier-free living environments is necessary in residential facilities on which senior citizens rely most of their lives. Safety of elder people can be reassured by a certification system based on the existing barrier-free certification program in public facilities. The range of certification does not cover all living area, but is limited to the bathroom, which is a sanitary space. Given the nature of BIM modeling, an existing multi-family building was selected and modeled, as the certification process requires all the necessary information and various viewport. BIM modeling of the bathroom was conducted in accordance with the requirements of the certification for barrier-free living environment. The results suggested that there is a need for a removal of thresholds, larger doors, better selection of finishing materials, sufficient room for a wheelchair, larger space next to the toilet, and the availability of an emergency bell and grab bars. Such information supports the potentials of BIM modeling, and it is expected that an automated certification system would be established in the foreseeable future.