• 한국응급구조학회지
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• 제27권3호
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• pp.47-58
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• 2023

Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

• 한국국방기술학회 논문지
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• 제5권3호
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• pp.1-7
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• 2023

최근 국방 분야에서는 인공지능 기술을 접목하기 위해 데이터센터를 구축하여 데이터를 모으려 한다. 무기체계 훈련 데이터는 인공지능 모델의 입력 데이터로 사용되어 훈련 성과를 극대화하고 군 전략을 발전시킬 수 있는 양질의 데이터로 사용될 수 있다. 하지만 훈련 데이터에는 그 장비를 운용했던 인원의 이름과 군번 등의 개인적인 정보와 무기체계의 특징을 알 수 있는 훈련 기록들을 담고 있다. 이런 데이터가 적군에게 넘어간다면 무기체계의 제원 및 성능뿐만 아니라 운용자별 숙련도도 노출될 수 있다. 본 논문에서는 교육훈련 데이터 보안을 위해 가명처리 방법론을 제안하고 관련 법령의 개정 방향도 제언한다.

• 한국식품영양과학회지
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• 제34권7호
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• pp.1008-1017
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• 2005

본 연구는 구미지역 보육시설 2개소의 $3\~6$세 아동 57명(남아 24명, 여아 33명 )을 대상으로 3일간의 식이섭취 상태를 조사하고 영양소를 분석하여 이들의 영양섭취상태를 양적, 질적으로 파악하였으며 그 결과는 다음과 같다. 유아들의 1일 식품섭취량은 992.7 g이었으며 식물성 식품으로 $55\%$, 동물성 식품으로 $45\%$를 섭취하였고 식물성 식품 중에서는 곡류, 동물성 식품 중에서는 우유 및 유제품을 가장 많이 섭취하였다. 유아들의 1일 평균 열량섭 취 량은 1249.2 kcal였으며 열량영양소의 비율은 권장 비율과 비교하여 탄수화물의 섭취는 약간 낮았고 지방의 섭취는 높았다. 영양소 섭취량의 권장량에 대한 비율이 $75\%$ 미만을 섭취하는 비율이 $20\%$를 초과하는 영양소로는 열량$(29.8\%)$, 철분$(35.1\%)$, 나이아신$(28.1\%)$, 칼슘$(21.1\%)$으로 조사되었다. 섭취열량에 대한 식품군별 기여도는 전체열량의 $68\%$를 식물성 식품으로부터, $32\%$를 동물성 식품으로부터 얻는 것으로 조사되었다. 또한 칼슘의 경우에는 전체의 $22\%$를 식물성 식품으로부터, $78\%$를 동물성 식품으로부터 얻었으며, 철분의 경우에는 전체의 $78\%$를 식물성 식품으로부터, $22\%$를 동물성 식품으로부터 얻는 것으로 나타났다. 식품섭취량의 끼니별 분포는 아침:점심:저녁:간식이 13:15:13:59로 전체 $59\%$의 식품을 간식으로 섭취하였고, 섭취 열량의 끼니 별 분포도 아침:점심:저녁:간식이 15:20:19:46으로 간식의 비중이 높은 편이었다. 영양소별 적정도(NAR)를 분석한 결과 단백질, 비타민 A, 인은 0.95이상으로 높았고 칼슘(0.84)과 철분(0.85)은 낮았으며, 평균영양소 적정도(MAR)는 0.92로 양호한 편이었다 INQ는 모두 1을 넘어 식사의 질이 양호한 것으로 나타났다. 유아들 중 6가지 식품군(곡류, 육류, 과일류, 채소류, 우유 및 유제품, 유지류 및 당류)을 모두 섭취하는 유아는 $29.5\%$였고 과일류만을 섭취하지 않는 유아가 $31.6\%$로 가장 많았다. 식품군점수(DDS)가 증가함에 따라 영양소 적정도(NAR)도 유의하게 증가되어 식품섭취가 다양할수록 영양섭취의 질적 수준이 높아지는 것으로 나타났다. 신체성장 발육이 왕성한 보육시설 유아들에게 열량공급이 부족되지 않도록 하며, 특히 칼슘, 철분, 나이 아신이 풍부한 식단을 개발하여 필수영양소의 부족이 없도록 해야 하겠다 또한 다양한 식품들을 이용하여 모든 영양소가 권장량에 충족되는 질적으로 우수한 식사가 제공되도록 해야 할 것이며 열량 및 영양소의 높은 간식 비중을 막기 위해서 세끼 식사의 적절한 공급에 더욱 힘써야 할 것으로 사료된다.

• 대한간호학회지
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• 제30권5호
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.115-122
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• 2015

Purpose: To calculate Preventable Trauma Death Rate (PTDR), Trauma and Injury Severity Score (TRISS) is the most utilized evaluation index of the trauma centers in South Korea. However, this method may have greater variation due to the small number of the denominator in each trauma center. Therefore, we would like to develop new indicators that can be used easily on quality improvement activities by increasing the denominator. Methods: The medical records of 1005 major trauma (ISS >15) patients who visited 2 regional trauma center (A center and B center) in 2014 were analyzed retrospectively. PTDR and PARK Index (Preventable Major Trauma Death Rate, PMTDR) were calculated in 731 patients with inclusion criteria. We invented PARK Index to minimize the variation of preventability of trauma death. In PTDR the denominator is all number of deaths, and in PARK Index the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths from patients who have Ps larger than 0.25. Results: The size of denominator was 40 in A center, 49 in B center, and overall 89 in PTDR. The size of denominator was significantly increased, and 287 (7.2-fold) in A center, 422 (8.6-fold) in B center, and overall 709 (8.0-fold) in PARK Index. PARK Index was 12.9% in A center, 8.3% in B center, and overall 10.2%. Conclusion: PARK Index is calculated as a rate of mortality from all major trauma patients who have Ps larger than 0.25. PARK Index obtain an effect that denominator is increased 8.0-fold than PTDR. Therefore PARK Index is able to compensate for greater disadvantage of PTDR. PARK Index is expected to be helpful in implementing evaluation of mortality outcome and to be a new index that can be applied to a trauma center quality improvement activity.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.446-457
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• 2019

본 연구의 목적은 청소년 남학생 흡연과 가족구성원의 흡연의 관련성을 분석하기 위함이다. '제14차(2018년) 청소년건강행태조사'에 응답한 27,276명을 이용하여 빈도분석, 교차분석, 다중 로지스틱 회귀분석을 실시하였다. 남학생 중 비흡연율은 91.5%, 흡연율은 8.5%(가끔 흡연함 2.5%, 자주 흡연함 6.0%)이다. 연구결과, 가족구성원의 흡연자 수에 따른 남학생의 흡연 상태는 유의한 차이가 있다(p<0.001). 인구사회학적 특성에 따른 흡연은 학년, 학업성적, 경제상태, 아버지 학력, 어머니 학력에서 유의한 차이가 있고(p<0.001), 건강행태관련 특성에 따른 흡연은 음주 정도, 자살 생각률, 우울감 경험률, 스트레스 정도, 아침식사 빈도, 수면 후 피로회복 정도, 주관적 건강 인지 정도에서 유의한 차이가 있다(p<0.001). 남학생의 흡연가능성은 가족구성원 흡연자가 1명일 때보다 가족구성원 흡연자가 2명이상일 때 더 높다(p<0.001). 본 연구의 의의는 남학생 흡연이 가족구성원 흡연상태에 따라 영향을 받는다는 것을 확인하였으며 이러한 연구결과는 청소년 흡연의 예방 및 금연사업을 구성할 때 가족 흡연자의 금연 사업을 병행하여 설계한다면 좋은 효과를 거둘 수 있음을 시사한다.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.37-44
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• 2011

Purpose: Recently, social interest in an organized trauma system for the treatment of patients has been increasing in government and academia and the establishment of trauma center is being considered across the country. However, establishing such a system has not been easy in Korea, because enormous experiences and resources are necessary. The objectives of this study were (1) to estimate a trauma patient's demands during the course of treatment and (2) to provide appropriate direction for trauma centers to be established in Korea. Methods: The records of 207 patients who were admitted to the Department of Trauma Surgery in Ajou University Medical Center due to trauma were retrospectively reviewed for a 1 year period from March 2010 to February 2011. Patients were reviewed for general characteristics, number of hospital days, numbers and kinds of surgeries, numbers and kinds of consultations, ISS (Injury Severity Score) and number of patients with ISS more than 15. Results: All 207 patients were enrolled. The average number of hospital days was 36.7 days. The ICU stay was 15.9 days, and the general ward stay was 20.8 days. Admitted patients occupied 9.02 beds in ICU and 11.80 beds in the general ward per day. The average number of surgeries per patient was 1.4, and surgery at the Department of Trauma Surgery was most common. Number of consultations per patient was 14.23, and consultations with orthopedic surgeons were most common. The average ISS was 18.6. The number of patients with ISS more than 15 was 141 (61.8%) and the average number of patients treated per trauma surgeon as a major trauma patient was 94.3. The number of mortalities was 20, and the mortality rate was 9.7%. Conclusion: To reduce mortality and to provide proper treatment of patients with major trauma, hospitals need some number of beds, especially in the ICU, to treat patients and to prepare them for emergent surgery. An appropriate number of trauma surgeons and various specialists for consultation are also needed.

• Journal of Trauma and Injury
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• 제33권2호
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• pp.74-80
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• 2020

Purpose: This study was conducted to investigate whether rapid and efficient administration of blood products was achieved and whether clinical outcomes were improved by applying a massive transfusion protocol (MTP). Methods: From January 2016 to September 2019, the medical records of trauma patients who received at least 10 units of packed red blood cells (PRBC) at Pusan National University Hospital (level I trauma center) were retrospectively reviewed. The patients treated from January 2016 to January 2018 were designated as the non-MTP group, and those treated from February 2018 to September 2019 were designated as the MTP group. Results: During the study period, 370 patients received massive transfusions. The non-MTP and MTP groups comprised 84 and 55 patients, respectively. No significant between-group differences were found in the units of PRBC (23.2 vs. 25.3, respectively; p=0.46), fresh frozen plasma (FFP) (21.1 vs. 24.4, respectively; p=0.40), and platelets (PLT) (15.4 vs. 17.0, respectively; p=0.54) administered in the first 24 hours. No statistically significant differences between the non-MTP and MTP groups were found in the FFP-to-PRBC ratio (0.9 vs. 0.94, respectively; p=0.44) and or the PLT-to-PRBC ratio (0.72 vs. 0.72, respectively; p=0.21). However, the total number of cryoprecipitate units was significantly higher in the MTP group than in the non-MTP group (7.4 vs. 15.3 units, respectively; p=0.003) and the ratio of cryoprecipitate to PRBC in the MTP group was significantly higher than in the non-MTP group (0.31 vs. 0.62, respectively; p=0.021). The time to transfusion was significantly reduced after MTP implementation (41.0 vs. 14.9 minutes, respectively; p=0.003). Conclusions: Although no significant differences were found in the clinical outcomes of patients who had undergone severe trauma, rapid and balanced transfusion was achieved after implementing the MTP.

• 농촌의학ㆍ지역보건
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• 제8권1호
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• pp.28-34
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• 1983

농약사용량(農藥便用量)의 증가(增加)에 따라 농약중독자(農藥中毒者)가 전 세계적으로 증가(增加)하는 추세인데 우리나라에서는 아직까지 농약중독자(農藥中毒者)에 대한 역학조사(疫學調査) 보고(報告)가 없는 실정이다. 1981년(年)부터 1982년(年)까지 2년간(年間) 경상북도(慶尙北道) 전지역(全地域)을 대상으로 의원(醫院), 병원(病院) 및 보건소(保健所)의 의무기록(醫務記錄)을 조사(調査)하여 농약중독자(農藥中毒者)를 파악하여 그 실태를 분석(分析)하였다. 1981년(年)에 765명, 1982년에 853명의 중독자(中毒者)가 발생(發生)하였다. 연령별(年令別)로는 20대(代)가 제일 많았고 성별(性別)로는 남자가 70% 여자가 30%였다. 중독경위별로는 직업적인 중독이 27.8%, 우연에 의한 사고(事故)가 5.6%였고 자살목적(自殺目的)이 66.6% 였다. 월별(月別)로는 6, 7, 8, 9월(月)에 발생(發生)이 많고 7월(月)이 제일 많고, 월평균(月平均) 67명이 발생(發生)하였다. 의료기관이용(醫療機關利用)은 개인의원이 49%, 병원이 43%였다. 치명율(致命率)은 직업적인 중독이 0.9%, 사고(事故)에 의한 중독(中毒)이 5.6% 자살목적(自殺目的)의 중독(中毒)에서 20.3%로 평균(平均) 14.1%였다. 인구 100,000 당 농약중독(農藥中毒) 발생(發生)은 년간(年間) 25.4였다.

• 한국임상약학회지
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• 제24권1호
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• pp.26-32
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• 2014

Purpose: The aim of this study was to investigate drug prescription patterns for the treatment of asthma and chronic obstructive pulmonary disease (COPD) patients in Korea. Methods: Ambulatory adult patients who were diagnosed and received treatment for the asthma (ICD-10 code J45) or COPD (ICD-10 code J44) from January 2009 to September 2011 in two independent secondary hospitals in Korea were enrolled in this study. Prescribed drug lists were generated based on the evidence-based guidelines and prescribed drug dosage forms were identified from the patient medical records and computerized drug prescription databases of the study centers. Results: Total numbers of asthma and COPD patient enrolled in this study were 2,432 and 2,615, respectively. Individual prescription-based accumulated numbers of patient were 12,021 for asthma and 16,584 for COPD. The most commonly prescribed three drugs were oral predisolone, oral formoterol and oral montelukast for asthma and oral formoterol, oral doxofylline and inhaled tiotropium for COPD. Frequencies of oral drugs were 83.4% and 63.3% while inhalers were 16.4% and 30.2%, for asthma and COPD, respectively. Conclusion: The oral treatment was prescribed more in asthma and COPD patients than inhalers. To enhance the compliance of evidence-based guidelines for these chronic airway diseases, more realistic and specific strategies to increase the use of inhalers recommended as primary treatment options for asthma and COPD would be required.