• Journal of Korean Academy of Nursing Administration
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• v.6 no.3
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• pp.389-404
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• 2000

This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.393-402
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• 1997

Purpose : When an x-ray beam of small field size is irradiated to target area containing an air cavity, such as larynx, the underdosing effect is observed in the region near the interfaces of air and soft tissue. With a larynx model, air cavity embedded in tissue-equivalent material, this study is intonded for examining Parameters, such as beam quality, field size, and cavity size, to affect the dose distribution near the air cavity. Materials and Methods : Three x-rar beams, 4-, 6- and 10-MV, were employed to Perform a measurement using a 2cm $(width){\times}L$ (length in cm, one side of x-ray field used 2cm (height) air cavity in the simulated larynx. A thin window parallel-plate chamber connected to an electrometer was used for a dosimetry system. A ratio of the dose at various distances from the cavity-tissue interface to the dose at the same points in a homogeneous Phantom (ebservedlexpected ratio, O/E) normalized buildup curves, and ratio of distal surface dose to dose at the maximum buildup depth were examined for various field sizes. Measurement for cavity size effect was performed by varying the height (Z) of the air cavity with the width kept constant for several field sizes. Results : No underdosing effect for 4-MV beam for fields larger than $5cm\times5cm$ was found For both 6- and 10-MV beams, the underdosing portion of the larynx at the distal surface was seen to occur for small fields, $4cm\times4cm\;and\;5cm\times5cm$. The underdosed tissue was increased in its volume with beam energy even for similar surface doses. The relative distal surface dose to maximum dose was changed to 0.99 from 0.95, 0.92, and 0.91 for 4-, 6-, and 10-MV, respectively, with increasing field size, $4cm\times4cm\;to\;8cm\times8cm$, For 6- and 10-MV beams, the dose at the surface of the cavity is measured less than the predicted by about two and three percent. respectively. but decrease was found for 4-MV beam for $5cm\times5cm$ field. For the $4cm\timesL\timesZ$ (height in cm). varying depth from 0.0 to 4.8cm, cavity, O/E> 1.0 was observed regardless of the cavity size for any field larger than about $8cm\times8cm$. Conclusion : The magnitude of underdosing depends on beam energy, field size. and cavity size for the larynx model. Based on the result of the study. caution must be used when a small field of a high quality x-ray beam is irradiated to regions including air cavities. and especially the region where the tumor extends to the surface. Low quality beam. such as. 4-MV x-ray, and larger fields can be used preferably to reduce the risk of underdosing, local failure. In the case of high quality beams such as 6- and 10-MV x-rays, however. an additional boost field is recommended to add for the compensation of the underdosing region when a typically used treatment field. $8cm\times8cm$, is employed.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.40 no.1
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• pp.26-42
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• 2022

The purpose of this study is to examine and understand the area and the original outer boundaries of Hamchunwon(含春苑), which was the outer royal garden of Gyeonghuigung Palace, which existed before the site of the Russian legation. The results of the study are as follows. First, examining the 3 types of drawings prepared for securing the Russian legation's site and constructing a new building, it was confirmed that two low peaks, which appear to be the original terrain of Hamchunwon, existed in the north and south directions inside the site. According to the initial plan of the of the legation's site, it appears that the entrance of the legation building is connected to the Saemunan-ro in the northwest. However, according to the report made at the time when the Russian temporary minister Veber purchased the legation's site, it was recorded that the site already had a narrow entrance and a dirt road in place, and hence, it was connected to Saemunan-ro. This fact makes it possible to learn that the line of movement for officials and the original gate were located to the northwest of the site planned as the entrance of the legation building towards Hamchunwon. Second, the site was created by cutting the top of the high hill at the time of the construction of the legation building, and as a result, a two tiered staircase typed terrace was built. The ground on which the main building and the secretary's building, etc., were erected was made by cutting the highest peak and solidifying it flat, and a large quantity of soil was used for grading. In the case of the northern area of the main building, the traces of leveling the terrain by cutting the mountains are apparent, and an observation typed garden with a walking path and pavilion was formed by utilizing the physical environment equipped with an easy view. This may be considered as a use which is consistent with the topographical conditions of creating an outer royal garden to block the civilian views on a high terrain overlooking the palace. Third, Hamchunwon's fences were partially exposed in the photos from the 1880s through the 1890s, which demonstrate the spatial changes made around the US, UK, and the Russian legations. As a result of the photo analysis performed, Hamchunwon occupies the northern area of the Russian legation's site, and it is estimated that the north, west, and east walls of the legation resembled those of Hamchunwon. The area to the south of the Russian legation was originally a place made available for civilian houses, and it was possible to examine the circumstances of purchasing dozens of civilian houses and farmlands according to various materials. Fourth, Hamchunwon, which was formed as the outer royal garden of Gyeongdeokgung Palace of Lord Gwanghaegun, lost its sense of place as an outer royal garden when the entire building of Gyeonghuigung Palace was torn down and used as a construction members during the reconstruction of Gyeongbokgung Palace, and faded away as the site was sold to Russia around 1885. The area where Hamchunwon used to be located transformed into a core space of the Russian legation where the main building and garden were located after the construction of the new building. Hence, Hamchunwon, which was limited to the northern area of the Russian legation, does not carry the temporal and spatial context with Gyeongungung Palace and Seonwonjeon which were constructed after 1897, and it is determined that the view of Seonwonjeon as Baehoorim or Baegyeongrim is not valid.

• Korean Journal of Agricultural Science
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• v.30 no.1
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• pp.31-40
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• 2003

A research has been done for growing characteristics of Korean ginseng in Geumsan of Chungnam Province. It had been made to determine the transitional element concentrations of the rocks, divided by biotitic granite(GR) and phyllite(PH). The physical and chemical properties of their weathering soils and ginseng nursery soils were analyzed. The texture in the GR weathering and ginseng nursery soils were sandy clay, and the texture of the PH weathering and ginseng nursery soils were heavy or silty clay. The bulk densities of the GR and PH weathering soils were $1.21{\sim}1.32g/cm^3$ and $1.26{\sim}1.38g/cm^3$, respectively. Also, the bulk densities of the GR and PH ginseng nursery soils were $1.02{\sim}1.10g/cm^3$, respectively. The pH (4.80) of the GR weathering soil were lower than the pH of the PH(5.34) weathering soil. The pH in the 2 year and 4 year-ginseng nursery soil of the GR were 4.39 and 4.40. In addition, those of the PH were 5.24 and 5.34, respectively. The difference in pH of the two nursery soils could be from the pH difference between the two parent materials. The organic matter contents of the GR weathering soils(0.24%) were higher than those of the PH(1.02%) weathering soils. The organic matter of the 2 and 4 year-ginseng GR nursery soils were 0.87% and 1.52%, and of the PH nursery soils were 2.06% and 2.96%, respectively. The total nitrogen contents of the GR weathering soils were 259.43ppm and of the PH weathering soils were 657.22ppm. Those of 2 and 4 year-ginseng GR nursery soils were 588.04ppm and 657.22ppm and those of the PH nursery soils were 1037.72ppm and 1227.96ppm, respectively. The nitrate and ammonium contents of the GR weathering soils were the extremely small, and those of the PH weathering soils were 6.7ppm and 9.94ppm. Those of 2 year-ginseng GR nursery soils(223.09ppm and 26.96ppm) were higher than those of PH(19.46ppm and 8.23ppm) nursery soils. And those of 2 year-ginseng PH nursery soils(14.22ppm and 16.84ppm) were lower than those of PH(306.93ppm, 34.21ppm) nursery soils. The difference was due to fertilizer types and more deposits of nitrate after oxidation of ammonium. The phosphate contents of the GR and PH weathering soils were 14.41ppm and 38.60ppm. Those of GR 2 and 4 year-ginseng nursery soils were 46.89ppm and 102.44ppm and those of the PH nursery soils were 147.04ppm and 38.60ppm. The cation exchange capacities of the GR weathering soils were 12.34me/100g and those of the PH weathering soils were 15.40me/100g. Those of 2 and 4 year-ginseng GR nursery soils were 15.80me/100g and 7.70me/100g and those of PH nursery soils were 12.14me/100g and 12.83me/100g. All of exchangeable cation($K^+$, $Ca^{2+}$, $Mg^{2+}$, $Na^+$) contents in the nursery soils were higher than those in the weathering soils. The $SO_4{^2-}$ contents of the weathering soils in both of the GR(5.98ppm) and PH(9.94ppm) were higher than those of the GR and PH ginseng nursery soils. The $Cl^-$) contents of the GR and PH weathering soils were a very small and those of the nursery soils(2-yr GR: 39.06ppm, 4-yr GR: 273.43ppm, 2-yr PH: 66.41ppm, 4-yr PH: 406.24ppm) were high because of fertilizer inputs.