• Hip & pelvis
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• 제30권4호
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• pp.260-268
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• 2018

Purpose: This study was performed to assess the clinical and radiological outcomes following one-stage hip reconstruction, consisting of open reduction femoral shortening and pelvic osteotomy, for neglected developmental dislocation of the hip (DDH). Materials and Methods: This is a retrospective analysis of 77 hips in 65 patients (46 females and 19 males; 12 had bilateral dislocations), operated at a Ghurki Trust Teaching Hospital in Pakistan between 2013 and 2015. The average age at surgery was $11.02{\pm}3.43$ years. According to the Tonnis classification, there were 10, 14, 22, and 31 patients in grades 1, 2, 3, and 4, respectively. The pelvic procedure utilized in this study was triple osteotomy (47 hips) followed by double and Salter osteotomy (18 and 12 hips, respectively). Postoperative evaluations were conducted using the modified MacKay's scoring system (functional outcomes) and Severin's scoring method (radiological assessment). Results: Postoperatively, there were 38 (49.4%), 19 (24.7%), 14 (18.2%), and 6 (7.8%) hips in Severin grade I, II, III and IV, respectively. According to the modified McKay criteria, there were 22 hips (28.6%) in excellent condition, 44 (57.1%) in good condition, 9 (11.7%) in fair condition and 2 (2.6%) in poor condition. Both patients with poor outcomes had an unstable, painful hip with evidence of avascular necrosis of the femoral head. Conclusion: Based on the results presented here, we recommend the single stage procedure of open reduction, femoral shortening and pelvic osteotomy for treatment of DDH in older children with good to excellent functional and radiological outcomes.

• Acute and Critical Care
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• 제33권4호
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• pp.216-221
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• 2018

Background: In this study, we analyze the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiology Score (SAPS) 3, and Mortality Probability Model $(MPM)_0$ III in order to determine which system best implements data related to the severity of medical intensive care unit (ICU) patients. Methods: The present study was a retrospective investigation analyzing the discrimination and calibration of APACHE II, APACHE IV, SAPS 3, and $MPM_0$ III when used to evaluate medical ICU patients. Data were collected for 788 patients admitted to the ICU from January 1, 2015 to December 31, 2015. All patients were aged 18 years or older with ICU stays of at least 24 hours. The discrimination abilities of the three systems were evaluated using c-statistics, while calibration was evaluated by the Hosmer-Lemeshow test. A severity correction model was created using logistics regression analysis. Results: For the APACHE IV, SAPS 3, $MPM_0$ III, and APACHE II systems, the area under the receiver operating characteristic curves was 0.745 for APACHE IV, resulting in the highest discrimination among all four scoring systems. The value was 0.729 for APACHE II, 0.700 for SAP 3, and 0.670 for $MPM_0$ III. All severity scoring systems showed good calibrations: APACHE II (chi-square, 12.540; P=0.129), APACHE IV (chi-square, 6.959; P=0.541), SAPS 3 (chi-square, 9.290; P=0.318), and $MPM_0$ III (chi-square, 11.128; P=0.133). Conclusions: APACHE IV provided the best discrimination and calibration abilities and was useful for quality assessment and predicting mortality in medical ICU patients.

• Nutrition Research and Practice
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• 제11권5호
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• pp.402-411
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• 2017

BACKGROUND/OBJECTIVES: The role of a school's nutrition environment in explaining students' eating behaviors and weight status has not been examined in an Asian setting. The purpose of this study was to create a school nutrition environment index and to pilot test the index in elementary and middle schools in urban South Korea. SUBJECTS/METHODS: This study used a mixed-methods approach. Environment assessment tools were developed based on formative research, which comprised literature reviews, in-depth interviews, and focus group discussions. Key elements from the formative research were included in the assessment tool, which consisted of a structured survey questionnaire for school dietitians. Fifteen school dietitians from 7 elementary and 8 middle schools in Seoul completed the questionnaire. RESULTS: The formative research revealed four main sections that guided a summary index to assess a school's nutrition environment: resource availability, education and programs, dietitians' perceptions and characteristics, and school lunch menu. Based on the literature reviews and interviews, an index scoring system was developed. The total possible score from the combined four index sections was 40 points. From the 15 schools participating in the pilot survey, the mean school nutrition-environment index was 22.5 (standard deviation ${\pm}3.2$; range 17-28). The majority of the schools did not offer classroom-based nutrition education or nutrition counseling for students and parents. The popular modes of nutrition education were school websites, posters, and newsletters. CONCLUSIONS: This paper illustrates the process used to develop an instrument to assess a school's nutrition environment. Moreover, it presents the steps used to develop a scoring system for creation of a school nutrition environment index. As pilot testing indicated the total index score has some variation across schools, we suggest applying this instrument in future studies involving a larger number of schools. Future studies with larger samples will allow investigation of the validity and reliability of this newly developed tool.

• 대한정형외과스포츠의학회지
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• 제8권1호
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• pp.19-25
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• 2009

목적: 동종 반월상 연골판 이식술 후 중.장기 추시 결과를 보고하고, 예후 인자를 알아보고자 하였다. 대상 및 방법: 1999년 12월부터 2002년 9월까지 신선 동결 동종 연골판을 이식한 24명 환자, 25례를 대상으로 하였다. 외측 반월상 연골판 19례, 내측 반월상 연골판 6례였다. 평균 연령은 33.6세 (17~50세)였으며, 추시 관찰은 평균 54.8개월 (6~116개월)이었다. 술 전 방사선 사진에 mm 표시된 전.후방 사진을 얻어 반월상 연골판의 크기를 측정하였다. 외측 반월상 연골판은 열쇠 구멍 고정 방법으로(Key hole method) 고정하였으며, 내측 반월상 연골판은 양 골 조각 고정술(double bone plug) 방법으로 고정하였다. 전례에서 KASS (knee assessment scoring system)과 Lysholm knee score를 이용하여 임상적 결과를 평가하였고 Tegner activity scale을 이용하여 스포츠 회복력을 조사하였다. 결과: 모든 환자에서 술 전 증상은 호전되었다. KASS score는 술 전 평균 61.7점(34~80점)에서 술 후 평균 83.8점(61~95점)으로 호전되었으며, Lysholm knee score는 술 전 평균 77.7점(48~79점)에서 술 후 평균 87.7점(63~97점)으로 향상되었다.(우수 3례, 양호 17례, 보통 4례, 불량 1례). 통증을 동반한 부종이 2례, 감각 이상 1례, 비흡수성 봉합사에 의한 육아종이 1례 발생하였다. 총비골신경 마비가 1례 발생하였으나 술 후 6주에 회복이 되었다. 결론: 반월상 연골판 아전 또는 전 절제술을 시행한 환자에서 동종 반월상 연골판 이식술은 동통을 완화시키고, 슬관절의 기능을 향상시킨다. 술 전 정확한 반월상 연골판의 크기 측정과 술 중 견고한 고정은 좋은 임상적 결과를 위한 중요한 인자로 사료된다.

• 보건행정학회지
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• 제24권4호
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• pp.312-321
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• 2014

Background: To evaluate the quality of chronic care provided by public health centers located in a South Korean metropolitan city using a modified Assessment of Chronic Illness Care (ACIC). Methods: We conducted self-evaluation surveys and collected data using a modified ACIC from twenty five public health centers. Cultural validity of the original ACIC was examined by the public health and nursing science experts. Based on expert reviews, cognitive interviews, pre-test results, five items of the original ACIC that were not relevant were deleted. The response scale was changed from twelve-point Likert scale to Guttman scale but its scoring system was maintained. Results: Eighty eight percent of public health centers in this study reported that their overall quality of chronic care was at a limited or basic level. About 68% of the centers reported that the organization was as reasonably good or fully developed to provide chronic care. On the other hand, 96% of the public health centers reported that the clinical information system was at a very limited or basic support level. The decision support, the integration of Chronic Care Model components, the delivery system design, the community linkages, and the self-management support were evaluated as limited or basic level of support by more than half of the public health centers, respectively. Conclusion: In a metropolitan area of South Korea, quality of chronic care in public health centers was not found to reach acceptable levels of services. It is critical to enhance the quality of chronic care in public health centers.

• 대한안전경영과학회지
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• 제25권4호
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• pp.57-65
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• 2023

The public safety management guidelines were introduced in 2019 and continue to be dedicated to advancing comprehensive measures for public safety management, with a primary focus on prioritizing the safety and well-being of the public within governmental institutions. To achieve this goal, our previous study developed a establishment procedure of risk assessment-based safety inspection system for public institutions that order construction projects and applied it to highway construction projects to evaluate its effectiveness. To enhance the practicality of the establishment procedure, it is essential to collect and analyze feedback from stakeholders regarding its performance and suitability. This study conducted a survey involving 200 participants who had experience with the establishment procedure, and performed statistical analyses to evaluate its performance and applicability. The survey results indicated that the participants reported a high level of satisfaction (scoring 4 and above on a 5-point Likert scale) in several areas: specialization of safety inspection items for different types of work (with a satisfaction rate of 65%), the evaluation process for safety ratings (64.5%), and their willingness to recommend the procedure to other institutions (75.5%). In the factor analysis with Varimax rotation, two factors emerged: (1) a specialization factor related to safety inspection items, and (2) a grading factor associated with safety evaluation results. Regression analyses of these factors unveiled significant positive relationships with improvements in safety and health performance, including the prevention of fatal accidents, heightened safety responsibility, and raised safety inspection standards. The establishment procedure of safety inspection system developed in our previous study can play a crucial role in reducing accidents resulting in fatalities and injuries at construction sites, ultimately contributing to a safer working environment for all involved parties.

• 한국토양비료학회지
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• 제37권6호
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• pp.357-364
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• 2004

우리나라 논과 밭토양의 질의 현황에 대한 평가방법을 개발하고자 2000년부터 2003년까지 실시한 농업환경변동조사사업의 결과를 이용하여 세부지표 즉 토양의 주요특성의 선정, 선정된 각 지표의 점수화 또는 등급화와 정량화 방법과 각 세부지표를 종합하여 한개의 토양의 질 지표로 만드는 방법을 검토하였다 한편, 본 시안을 이용하여 전국수준에서 우리나라 논 밭 시설원예지 토양의 질 현황에 대한 평가를 시도한 결과 논토양은 매우 높음, 밭토양은 높음, 그리고 시설원예지 토양은 보통으로 나타났다.

• Safety and Health at Work
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• 제9권2호
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• pp.140-143
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• 2018

Background: The Occupational Safety and Health Monitoring and Assessment Tool (OSH-MAT) is a practical instrument that is currently used in the German woodworking and metalworking industries to monitor safety conditions at workplaces. The 12-item scoring system has three subscales rating technical, organizational, and personnel-related conditions in a company. Each item has a rating value ranging from 1 to 9, with higher values indicating higher standard of safety conditions. Methods: The reliability of this instrument was evaluated in a cross-sectional survey among 128 companies and its validity among 30,514 companies. The inter-rater reliability of the instrument was examined independently and simultaneously by two well-trained safety engineers. Agreement between the double ratings was quantified by the intraclass correlation coefficient and absolute agreement of the rating values. The content validity of the OSH-MAT was evaluated by quantifying the association between OSH-MAT values and 5-year average injury rates by Poisson regression analysis adjusted for the size of the companies and industrial sectors. The construct validity of OSH-MAT was examined by principle component factor analysis. Results: Our analysis indicated good to very good inter-rater reliability (intraclass correlation coefficient = 0.64-0.74) of OSH-MAT values with an absolute agreement of between 72% and 81%. Factor analysis identified three component subscales that met exactly the structure theory of this instrument. The Poisson regression analysis demonstrated a statistically significant exposure-response relationship between OSH-MAT values and the 5-year average injury rates. Conclusion: These analyses indicate that OSH-MAT is a valid and reliable instrument that can be used effectively to monitor safety conditions at workplaces.

• 디지털융복합연구
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• 제18권9호
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• pp.323-329
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• 2020

현재 중소기업의 기술혁신을 촉진하기 위해 일정 비율 이상을 중소기업에 의무적으로 지원하도록 제도화하고 있다. 이에 따라 매년 3조원 이상의 정부 예산이 투입되는 중소기업 R&D 사업의 성공 가능성 여부를 판단하기 위하여 전문가의 기술적인 평가를 통해 해당 기술의 기술적 난이도에 대한 상용화 및 성공 가능성을 면밀히 검토하게 된다. 이를 검토하기 위한 방법으로 AHP(Analytic Hierarchy Process) 기법은 평가 항목에 대한 평가 기준을 객관적으로 판단할 수 없었으며, 해당 평가 기준이 모호성 및 불확실성이 내포되어 있어 중소기업 R&D 사업의 전문성 및 공정성을 확보할 수 없었다. 본 연구에서는 중소기업 R&D 사업의 성공 가능성을 판단할 수 있도록 평가 항목에 대한 가중치를 객관적으로 제시할 수 있는 Fuzzy-AHP 기반 중소기업 R&D 평가 시스템을 제안하였다. 삼각 퍼지 수를 이용하여 해당평가 기준을 구간 값으로 적용하여 객관화하였으며, 중소기업 기술개발 지원사업 관리지침에 따른 가중치를 배정하여 실제 평가에 반영될 수 있도록 이를 적용하였다. 본 연구를 통해 새로운 사업에 대한 전문가를 위촉하였을 때 위의 평가항목의 배점 가중치를 재반영할 수 있으며, 이를 이용하여 중소기업 R&D 사업의 전문성 및 공정성을 확보할 수 있을 것이다.

• 한국터널지하공간학회 논문집
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• 제21권4호
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• pp.479-499
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• 2019

공용중인 터널의 조사 및 평가는 시설물안전법의 안전점검 및 정밀안전진단 세부지침(터널)편에 따라 외관조사와 내구성조사를 근거하여 상태평가를 수행하고 있다. 본 연구에서는 종방향균열의 발생요인 파악을 위해 준공 후 10년이 경과되어 최초 정밀안전진단이 실시된 NATM터널 12개에 대해 균열과 라이닝의 두께를 검토하여, 이를 반영한 상태평가 수정사항을 모색하였다. 종방향균열에 대한 굴착지반의 영향을 검토하기 위해 지보패턴, 이를 구성하는 지보재 시공 조건, 라이닝의 재료적 특성, GPR탐사를 통한 라이닝 두께 등을 터널 형상 및 용도에 따라 4개의 그룹으로 나누어 자료를 분석하였다. 균열발생밀도는 숏크리트, 록볼트, 강지보재의 지보재 지지능력에 따라 변화되나 굴착지보패턴에 따른 균열발생과의 연관성은 낮은 것으로 나타났다. 라이닝 재료적인 특징인 물-시멘트비, 시멘트함유량, 강도 등이 균열발생에 영향을 주는 것으로 나타났다. 또한, GPR탐사의 라이닝 두께를 반영한 상태평가에서는 평균 0.03 정도(분포, 0.001~0.071)의 점수증가를 야기하는 것으로 확인되어 향후 라이닝 두께 부족을 고려하는 현실적인 상태평가 방안에 대한 검토가 필요하다.