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Incidence and Associated Factors of Delirium after Orthopedic Surgery (정형외과 수술 후 발생한 섬망의 발생 빈도와 관련 인자)

  • Lee, Si-Wook;Cho, Chul-Hyun;Bae, Ki-Cheor;Lee, Kyung-Jae;Son, Eun-Seok;Um, Sang-Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.157-163
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    • 2019
  • Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

The Difference between Short and Long Intramedullary Nailing as the Treatment for Unstable Intertrochanteric Femoral Fracture (AO/OTA 31-A2) in Elderly Patients (고령환자에서 발생한 불안정성 대퇴골 전자간부 골절(AO/OTA 31-A2)의 치료 시 골수강내 금속정의 길이에 따른 추시 결과)

  • Shin, Won Chul;Lee, Eun Sung;Suh, Kuen Tak
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.25-32
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    • 2017
  • Purpose: The purpose of this study was to analyze the radiological and clinical outcomes in elderly patients with unstable intertrochanteric femur fractures in accordance with the length of intramedullary nail. Materials and Methods: Between August 2009 and December 2014, a total of 139 patients-older than 65 years of age with AO/OTA classification of 31-A2 unstable intertrochanteric femur fracture-who has been followed-up for at least 1 year after the treatment with internal fixation by using an intramedullary nail were enrolled for this retrospective control study. The subjects were classified into two groups according to the length of intramedullary nail: 106 patients in the short group (group I) and 33 patients in the long group (group II). For radiological assessments, the reduction state, time to union, and implant related complications were examined. The clinical outcomes were assessed by preoperative hemoglobin, operating time, intraoperative bleeding amount, blood transfusion rate, hospitalization period, and Charnley hip pain scoring system at the final follow-up. Results: The postoperative radiographs showed good or acceptable reduction in all cases. The mean time of radiologic bone union was 4.8 months, and there was no difference between the two groups. With respect to surgical time, the group II was found to take longer (57.87 minutes) than the group I (45.65 minutes) (p=0.003). The bleeding amount during surgery of the group II was greater (288.78 ml) than that of the group I (209.90 ml) (p=0.046). The clinical results at the final follow-up were found to be satisfactory in both groups. Conclusion: In cases of good reduction of the fracture from the treatment of unstable intertrochanteric femur fracture accompanying the posteromedial fragment in elderly patients, both groups-long and short intramedullary nails-showed satisfactory radiological and clinical outcomes.

The Existence and Design Intention of Jeong Seon's True-View Landscape Painting <Cheongdamdo(淸潭圖)> (겸재 정선(謙齋 鄭敾) <청담도(淸潭圖)>의 실재(實在)와 작의(作意))

  • SONG Sukho;JO Jangbin ;SIM Wookyung
    • Korean Journal of Heritage: History & Science
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    • v.56 no.2
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    • pp.172-203
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    • 2023
  • <Cheongdamdo>(true-view landscape painting) was identified in this study to be a folding screen painting painted by Jeong Seon(a.k.a. Gyeomjae, 1676~1759) in the 32nd year of King Yeongjo(1756) while exploring the Cheongdam area located in Mt. Bukhansan near Seoul. Cheongdam Byeol-eop(Korean villa), consisting of Waunru Pavilion and Nongwolru Pavilion, was a cultural and artistic base at that time, where Nakron(Confucian political party) education took place and the Baegak Poetry Society met. <Cheongdamdo> is a painting that recalls a period of autumn rainfall in 1756 when Jeong Seon arrived in the Cheongdam valley with his disciple Kim Hee-sung(a.k.a. Bulyeomjae, 1723~1769) and met Hong Sang-han(1701~1769). It focuses on the valley flowing from Insubong peak to the village entrance. The title has a dual meaning, emphasizing "Cheongdam", a landscape feature that originated from the name of the area, while also referring to the whole scenery of the Cheongdam area. The technique of drastically brushing down(刷擦) wet pimajoon(hanging linen), the expression of soft horizontal points(米點), and the use of fine brush strokes reveal Jeong Seon's mature age. In particular, considering the contrast between the rock peak and the earthy mountain and symmetry of the numbers, the attempt to harmonize yin and yang sees it regarded as a unique Jingyeong painting(眞境術) that Jeong Seon, who was proficient in 『The Book of Changes』, presented at the final stage of his excursion. 「Cheongdamdongbugi」(Personal Anthology) of Eo Yu-bong(1673~1744) was referenced when Jeong Seon sought to understand and express the true scenery of Cheongdam and the physical properties of the main landscape features in the villa garden. The characteristics of this garden, which Jeong Seon clearly differentiated from the field, suppressed the view of water with transformed and exaggerated rocks(水口막이), elaborately creating a rain forest to cover the villa(裨補林), and adding new elements to help other landscape objects function. In addition, two trees were tilted to effectively close the garden like a gate, and an artificial mountain belt(造山帶), the boundary between the outer garden and the inner garden, was built solidly like a long fence connecting an interior azure dragon(內靑龍) and interior white tiger(內白虎). This is the Bibo-Yeomseung painting(裨補厭勝術) that Jeong Seon used to turn the poor location of the Cheongdam Byeol-eop into an auspicious site(明堂). It is interpreted as being devised to be a pungsu(feng shui) trick, and considered an iconographic embodiment of ideal traditional landscape architecture that was difficult to achieve in reality but which was possible through painting.

Analysis on Statistical Characteristics of Household Water End-uses (가정용수 용도별 사용량의 통계적 특성 분석)

  • Kim, Hwa Soo;Lee, Doo Jin;Park, No Suk;Jung, Kwan Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.28 no.5B
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    • pp.603-614
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    • 2008
  • End-uses of household water have been changed by a life style, housing type, weather, water rate and water supply facilities etc. and those variables can be considered as an internal and exogenous factors to estimate long-term demand forecasts. Analysis of influential factors on water consumption in households would give an explanation to cause on the change of trend and would help predicting the water demand of end-use in household. The purpose of this study is to analyze the demand trends and patterns of household water uses by metering and questionnaire such as occupation, revenue, numbers of family member, housing types, age, floor area and installation of water saving device, etc. The peak water uses were shown at Saturday among weekdays and July in a year based on the analysis results of water use pattern. A steep increase of total water volume can be found in the analysis of water demand trend according to temperature from $-14^{\circ}C$ to $0^{\circ}C$, while there are no significant variations in the phase of more than $0^{\circ}C$, with an almost stable demand. Washbowl water shows the highest and toilet water shows the lowest relation with temperature in correlation analysis results. In the results of ANOVA to find the significant difference in each unit water use by exogenous factors such as housing type, occupation, number of generation, residential area and income et al., difference was shown in bathtub water by housing type and shown in kitchen, toilet and miscellaneous water by numbers of resident. Especially, definite differences in components except washbowl and bathtub water, could be found by numbers of resident. Based on the result, average residents in a house should be carefully considered and the results can be applied as reference information, in decision making process for predicting water demand and establishing water conservation policy. It is expected that these can be used as design factors in planning stage for water and wastewater facilities.

The Change in Participation Patterns in Play Activities of Children with Autism Spectrum Disorder during COVID-19: A Scoping Review (COVID-19로 인한 자폐스펙트럼 장애아동의 놀이 활동 참여 변화: 주제범위 문헌고찰)

  • Kim, Hyang-Won;Song, Ye-Ji;Kang, Seong-Hyeon;Won, Ha-Eun;Jeong, Yun-Wha
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.1
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    • pp.59-73
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    • 2023
  • Objective : To examine changes in participation patterns of children with Autism Spectrum Disorder (ASD) in play activities during COVID-19 by reviewing relevant literature. Methods : This scoping review was conducted via five steps. we created a research question and searched for relevant literature published in English through CINAHL, PubMed, ERIC, MEDLINE, Google Scholar and Google search engine. After selecting the literature based on inclusion criteria, data were charted based on 10 items (i.e., author name, journal name, publication year, nation, authors' majors, research method, participant' age and gender as well as quantitative and qualitative results of study). The results were analyzed using descriptive numerical and thematic analyses. Results : After reviewing 437 articles and 152 websites, six articles were included. Theses articles were conducted by experts from various fields and countries. Five themes were highlighted in selected articles: COVID-19 resulted in (1) decreased time of outdoor play, (2) increased play time on screen, (3) increased time spent with family, (4) increased sensory difficulties, and (5) recommendations for services for children with disabilities and during COVID-19. Conclusion : This study suggests telerehabilitation programs about parental behavior strategies in order to solve difficulties in which children with ASD may experience when participating in play activities during disasters. Study results can be used as fundamental evidence to emphasize importance of play activities and to systematize role of occupational therapists and service guidelines for supporting play activities of children with disabilities in disasters.

A Study on the Frequency of Falls, Fear of Falling, and Perceived Health Status according to Cognitive Function in Community-dwelling Elderly Women (지역사회 여성노인의 인지기능에 따른 낙상발생빈도, 낙상두려움 및 지각된 건강상태)

  • Shin, Kyung-Rim;Kang, Younhee;Jung, Dukyoo;Kim, Miyoung;Yun, Eun-Suk;Ma, Rye-Won
    • 한국노년학
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    • v.31 no.4
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    • pp.1155-1167
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    • 2011
  • The purpose of this study was to investigate the frequency of falls, fear of falling, perceived health status, and number of disease according to cognitive function in community-dwelling the elderly women. This study utilized a descriptive survey design. Data were collected for six months with 311 elderly women who visited in public health center at S city. After obtaining Institutional Review Board(IRB) approval, a face-to-face, and private interview was conducted with each participant who was eligible and agreed to participate in this study by trained graduate-level nursing students. The questionnaires consisted of MoCA-K, K-MMSE, Fall Efficacy Scale, PHS scale. The collected data were analyzed with SPSS/WIN 17.0 program, which was used descriptive statistics, Chi-Square test and t-test, Correlation. The major findings of this study were as follows; 1) The average age of the subjects was 71.68±5.13 and cognitive function score was 22.14±4.32. approximately 35% of participants had fallen within one year. 2) there were significant differences in perceived health status according to cognitive function. 3) fear of fall and cognitive function, perceived health status and cognitive function were significant correlation. In conclusion, this study will contribute to establish strategies for preventing fall. Interventions for fall prevention and fear of fall enhancement should be developed with the consideration of the level of cognitive function in the elderly. Reducing the fear of falling through the comprehensive nursing intervention will ultimately improve the quality of life in the elderly.

A Study of the Relationships between the Employment Prospects, Life Aims and Life Satisfaction of University Students (대학생이 지각하는 취업전망, 영역별 삶의 목표 및 삶의 만족도의 관계)

  • Hyunsook Oh
    • Korean Journal of Culture and Social Issue
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    • v.14 no.4
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    • pp.19-37
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    • 2008
  • The youth unemployment issue has not shown any improvement in years. The purpose of this study was to observe how employment issues affecting university students influence their life aims, self-efficacy, view of reality, view of the future, and life satisfaction. 239 students from three universities located in Seoul and Gyeonggi province were assessed through the instrument FLL and questions about employment issues, their life aims, life satisfaction and also their employment perspective. A total of 34 items of the FLL were divided through factor analysis into six higher life aims, self-love, family love and interpersonal aims, personal-financial aims, social-public aims, moral aims and political and ideological aims. Using Cluster analysis, three group profiles were found depending on the employment perspective such as a better view of reality, better self-efficacy, and better life satisfaction. A t-test was conducted in order to compare the two groups classified according to favorable or unfavorable employment perspectives. No significant differences existed between the groups in the perception of youth unemployment or in social-demographic factors, such as gender, age, and academic year. However, in life aims, the unfavorable group showed significantly higher interest in the domains of family love and interpersonal aims, personal -financial aims, and social-public aims than the favorable perspective group. Conversely, this group showed a significantly greater negative view of reality in most life domains, as it evaluated that its aims are more poorly achieved than the comparable group. Also, the unfavorable perspective group showed a lesser degree of self-efficacy in most life domains and the same in the category of life satisfaction, i.e., lesser satisfaction in all life domains except for family love, and moral aims. However, no significant difference existed between the groups in the view of the future. The results were discussed in relation to other social-cognitive factors for life satisfaction found in preceding studies.

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Psycho-Social Determinants of Subjective Well-being and Physical Health of a Retired Elders in Korea: A Longitudinal Study on the occupational classification (은퇴 노인의 주관안녕과 신체건강에 영향을 미치는 요인들: 은퇴전 직종에 따른 종단 연구)

  • Kun-Seok Park
    • Korean Journal of Culture and Social Issue
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    • v.15 no.2
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    • pp.291-318
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    • 2009
  • The purpose of this study was to find out the impact of psycho-social factors (social relationship and personal) as well as illness history and economic status on physical health and subjective well-being among the retired Koreans elderly. Data were collected from 1,315 elders (mean age = 72.70yrs) residing in Seoul and Chuncheon regional area via interviews(Time 1), and them were re-interviewed two year later(Time 2). Multiple regression analyses indicated that the retired elders' illness history, economic status, marital satisfaction, fulfillment of self-esteem need, drinking behavior, positive affectivity, negative affectivity and physical health to predict their subjective well-being at Time 1(R2=.705). The retired elders' economic status, marital satisfaction, positive affectivity, negative affectivity and physical health to predict their subjective well-being at Time 2(R2=.418). The retired elders' illness history, economic status, expectations for one's offspring, drinking behavior and subjective well-being to predict their physical health at Time 1(R2=.364). And the retired elders' illness history, economic status, marital satisfaction, positive affectivity and negative affectivity to predict their physical health at Time 2(R2=.265). In case of retired elderly, suggested for the psycho-social determenants of subjective well-being and physical health by occupational classification. The implications of this study and the suggestions for furture study were discussed.

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The Impact of Entrepreneurship Education on Entrepreneurial Intentions and Entrepreneurial Behavior of Continuing Education Enrolled Students in University: Focusing on the Mediating Effect of Self-efficacy (창업교육이 성인학습자의 창업의지와 창업행동에 미치는 영향: 자기효능감 매개효과를 중심으로)

  • Yu, So Young;Yang, Young Seok;Kim, Myung Seuk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.1
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    • pp.107-124
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    • 2023
  • As getting in 4th Industrial Revolution Times, Continuing Education Enrolled Students(CEES) trying to find loophole for jepordized current life and need job transfer have surged their interest significantly on starting new business to bring up their post career after retirement through self-improvement. Government and university have actively initiated diverse policies of promoting startup for CEES in kicking off entrepreneurship courses and programs. However, relevant main policy, 'The 2nd University Startup Education Five-Year Plan (draft)' have too chiefly focused on theoretical start-up education rather than practical courses, causing the problem of inappropriate support for implementing real startup and business (Ministry of Education, 2018). This study is brought to empirically investigate the effect of self-efficacy as perspective of the impact of entrepreneurship education on entrepreneurial intention and behavior to come up with problem of poor entrepreneurial environment and entrepreneurship education to CEES. As to empirical research, this paper deliver on-line survey to CEES from September to October 2022, collect 207 effective feedbacks, In order to verify the reliability of the scale, the Cronbach's Alpha Coefficient (Cronbach's α) was calculated, analyzed, and measured. For hypothesis test, this paper utilize the multiple regression analysis statistical analysis method and use the SPSS 22.0 statistical processing program. Empirical results show, first, it was found that self-efficacy had a significant effect on start-up education. Second, start-up education had a significant effect on the intention to start a business of adult learners. Third, start-up education had a significant effect on the start-up behavior of adult learners. Fourth, self-efficacy had a significant effect on the intention of adult learners to start a business. Fifth, self-efficacy had a significant effect on the start-up behavior of adult learners. Sixth, self-efficacy had a mediating effect in the relationship between entrepreneurship education and adult learners' intention to start a business. Seventh, self-efficacy had a complete mediating effect in the relationship between start-up education and adult learners' start-up behavior. This paper is brought three significant implications. First, main consideration developing entrepreneurship education tools for CEES need to falls on defining potential needs of CEES as segmenting as to coming up with diversity of CEES's characteristics such as gender, age, experience, education, and occupation. Second, as to design specific entrepreneurship education program, both practical training program of utilizing CEES's career field experience benchmarking best practice startup and venture cases from domestic and global, and professional startup program of CEES initiating directly startup from ideation to develop business plan with pitching and discussing. Third, entrepreneurship education for CEES should be designed to incubate self-efficacy to enhance entrepreneurial intention of implementing entrepreneurial behavior as a real, eventually leading solid support system of self-improvement for CEES' Retirement life planning.

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Fish Community Characteristics and Distribution Aspect of Four Endangered Species in the Byekgye Stream, Korea (벽계천의 어류군집 특성 및 멸종위기 4종의 서식양상)

  • HyeongSu Kim;Myeong-Hun Ko
    • Korean Journal of Environment and Ecology
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    • v.38 no.1
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    • pp.55-66
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    • 2024
  • This study conducted a survey to investigate the characteristics of fish communities and the inhabiting status of endangered species in the Byekgye Stream, Korea from April to September 2020. A total of 3,415 fish of 9 families and 31 species were collected from 7 survey stations during the survey period. The dominant species was Zacco koreanus (relative abundance of 31.2%), and the subdominant species was Z. platypus (15.0%), followed by Pungtungia herzi (11.7%), Acheilognathus yamatsutae (5.4%), A. lanceolata intermedia (4.8%), Rhinogobius brunneus (4.4%), and Pseudopungtungia tenuicorpa (4.3%). Among the fish species collected, 19 (61.3%) were identified as Korean endemic species, and two cold-water fish species sensitive to climate change (Rhynchocypris kumgangensis and Cottus koreanus) were collected. Four species were designated as class II endangered wildlife by the Ministry of Environment: A. signifer, P. tenuicorpa, Rhodeus pseudosericeus, and C. koreanus. A. signifer and P. tenuicorpa mainly inhabited the mid to lower streams, R. pseudosericeus in the midstream, and R. pseudosericeus in the upstream. P. tenuicorpa inhabited in large numbers, and estimating the age by total length-frequency distribution in July, the total length of the 26-35 mm group was estimated as 0 years old, the 54-75 mm group as 1 year old, 82-97 mm group as 2 years old, 104-109 mm group as 3 years or older. The cluster analysis showed that the dominance index decreased from upstream to downstream, but the diversity, evenness, and richness index increased. The water quality of Byekgye Stream was evaluated as good overall since the river health (fish assessment index, FAI) using fish was evaluated as excellent (5 stations) and good (2 stations). Byekgye Stream has relatively well-preserved habitats, but conservation measures are required as habitats are disturbed by river repair work in some parts of the midstream and downstream areas where many endangered species inhabit.