• Title/Summary/Keyword: 호흡 일

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A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System (의료전달체계 실시 전후의 3차 진료기관 외래환자 이용양상 비교)

  • Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.88-100
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    • 1992
  • This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

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Effects of Shelf Temperature on the Quality of Red Pepper (Capsicum annuum L.) after Low Temperature Storage (홍고추의 저온저장 후 모의 유통온도가 품질에 미치는 영향)

  • Park, Sung Min;Kang, Won Hee;Lee, Yun Soo;Kim, Il Seop;Jeong, Cheon Soon
    • Horticultural Science & Technology
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    • v.19 no.4
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    • pp.526-529
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    • 2001
  • The study was conducted to investigate quality changes of red pepper by different shelf temperatures after storage at $7^{\circ}C$ for 30 days. Red pepper fruits produced high volume of $C_2H_4$ and $CO_2$ when alternating temperatures exceeded $10^{\circ}C$. Total sugar contents were not different among all the treatments. In contrast, sucrose content decreased about half at higher shelf temperature conditions than at $7^{\circ}C$. Capsaicinoid content was not influenced by alternating temperature, but ascorbic acid content tended to decrease by high shelf temperature after storage at $7^{\circ}C$. Decay did not occur under $13^{\circ}C$, while it occurred in 22.2% of hits at $15^{\circ}C$ and 68.8% at room temperature, respectively. From this results, it is suggested that the optimum shelf temperature of red pepper after low temperature storage should be under $13^{\circ}C$ and that fruits of red pepper stored at $7^{\circ}C$ for 30 days could be sold within 10 days on the shelf.

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The Development of the Smart Sensibility Mat with Kangaroo Mother Care (캥거루 케어를 반영한 스마트 감성 매트의 개발)

  • Cho, Soo-Min
    • Science of Emotion and Sensibility
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    • v.20 no.2
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    • pp.171-178
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    • 2017
  • 'Smart Sensibility Mat (SSM)' was developed and manufactured for positive sensibility of newborn with fiber, digital, and sensibility technology to reflect features and advantages of kangaroo care. For tactile stimuli, the tube of the silicon material to provide a constant temperature of $32^{\circ}C$ was inserted into the mat and connected to the water-thermostat. To provide a uniform temperature throughout the mat, the fabric by the inserting conductive yarn was attached to the mat surface. After wrapping the mat with cotton pad, the polyurethane foam used as medicine in order to similar to the human skin was bonded to the surface of the mat. To provide the auditory stimuli of a level of 30dB with mother's heartbeat sounds and voice recorded in advance, the Bluetooth speaker was inserted into the mat. To investigate the effects of SSM, 10 newborns who born within two weeks were involved in this experiment. While the baby was lying on each of the general mat (GM) and SSM, the baby's physiological signals-heart rate, breathing rate, temperature- were measured and then, those were conducted t-test to examine the difference between the signals of SSM and GM. The results were as follows: heart rate (t=8.131, p<.001) and respiratory rate (t=7.227, p<.001) among the physiological signals of SSM decreased significantly than GM within the normal range. Temperature (t=1.062, p=0.292) at SSM showed a tendency to decrease than GM within the normal range. This means the tactile stimuli and the auditory stimuli providing from SSM give stable physiological responses. Thus, SSM leads to have psychological comfort and stability of newborns.

Outbreak of Acinetobacter septicemia in a neonatal intensive care unit (신생아 집중치료실에서 집단 발생한 Acinetobacter septicemia)

  • Kim, Myo Jing;Lee, Hye Jin;Son, Sang Hee;Huh, Jae Won
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.494-499
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    • 2006
  • Purpose : Acinetobacter baumannii is increasingly recognized as an important cause of nosocomial infection, especially in neonatal intensive care units. But little is known about the clinical significance and hospital epidemiology of Acinetobacter species other than A. baumannii. The objective of this study is to describe the clinical characteristics and epidemiology of septicemia due to Acinetobacter species other than A. baumannii. Methods : We retrospectively reviewed 11 cases of blood culture proven nosocomial infection which occured in our neonatal intensive care unit from $4^{th}$ to $24^{th}$, February, 2004. To establish epidemiological analysis, we performed environmental cultures and an antibiogram was obtained from susceptability tests of isolated Acinetobacter species. Results : Clinical manifestations including fever, poor feeding, abdominal distension, diarrhea, bloody stool passage, vomiting, tachypnea and apnea were similar to other infectious diseases. Benign clinical courses were compared with poor prognose, including a high mortality rate in septicemia due to A. baumannii. The major predisposing factor among our patients was the presence of a peripheral intravascular catheter. Antibiogram was similar, but surveillance cultures of environmental specimens failed to identify the source of infection. Conclusion : Acinetobacter species other than A. baumannii were often considered relatively avirulent bacteria, but could be pathologic organisms if cultured in patients with clinical symptoms.

Effects of 1-MCP and Storage Condition on Shelf Life and Quality of 'Janghowon Hwangdo' Peach (Prunus persica Batsch) (1-MCP 및 수확 후 처리가 복숭아(Prunus persica Batsch) '장호원황도' 저장 유통 중 품질에 미치는 영향)

  • Chun, Jong-Pil;Seo, Jeong-Seok;Kim, Myung-Surn;Lim, Byung-Sun;Ahn, Young-Jik;Hwang, Yong-Soo
    • Horticultural Science & Technology
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    • v.28 no.4
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    • pp.585-592
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    • 2010
  • This study was conducted to investigate the effect of 1-MCP, an ethylene action inhibitor, and several postharvest treatments including ethylene scrubbing on fruit quality and respiration for keeping marketability in 'Janhowon Hwangdo' peach ($Prunus$ $persica$ Batsch). 1-MCP at the rate of $1.0{\mu}L{\cdot}L^{-1}$ showed best results in maintenance of fruit firmness and external appearance such as skin color. The ethylene production was strongly reduced by 1-MCP treatment at 0.5 or $1.0{\mu}L{\cdot}L^{-1}$ but respiration rate was only suppressed at $1.0{\mu}L{\cdot}L^{-1}$ during 6 days of shelf life at $20^{\circ}C$. Mature fruits (harvested 1 week before full commercial maturity) were much highly responsive to $1.0{\mu}L{\cdot}L^{-1}$ of 1-MCP compared to those of commercial maturity. At the concentration of $0.5{\mu}L{\cdot}L^{-1}$ of 1-MCP did not affect fruit marketability compared to untreated control. Beneficial effects of carbon ceramic as an ethylene scrubber were also found such as delay of firmness loss and deterioration of external appearance at $10^{\circ}C$, but these positive effects on fruit quality remained for only 5 days. The application of ethylene scrubber on the shipping carton boxes was effective on keeping firmness of immature fruit pretreated with 1-MCP when compared with mature fruit.

Changes of Fruit Quality and Reduction of Physiological Disorders during Shelf-life in Early-season Pear (Pyrus pyrifolia Nakai) Fruits Treated with Aminoethoxyvinylglycine (Aminoethoxyvinylglycine 처리에 따른 조생종 배 유통기간 중 품질변화 및 생리장해 경감)

  • Lee, Ug-Yong;Oh, Kwang-Suk;Choi, Jin-Ho;Ahn, Young-Jik;Chun, Jong-Pil
    • Horticultural Science & Technology
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    • v.32 no.2
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    • pp.193-201
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    • 2014
  • We investigated the effect of preharvest spray of aminoethoxyvinylglycine (AVG) on the fruit quality and incidence of physiological disorders during shelf-life of 'Hanareum' and 'Wonhwang' pear (Pyrus pyrifolia Nakai). AVG applications (0, 75, 150 and $300mg{\cdot}L^{-1}$) made 30 days before anticipated harvest of respective cultivar. AVG did not influence the fruit development and quality parameters including starch content, soluble solids and acidity at harvest time in two pear cultivars although the flesh firmness of the fruits treated with $300mg{\cdot}L^{-1}$ AVG were higher than that of control in 'Hanareum' pear. Among the three AVG concentrations, only $300mg{\cdot}L^{-1}$ AVG showed effectiveness on maintaining flesh firmness in 'Hanareum' pear during shelf-life. Meanwhile, competitive high flesh firmness was attained in 'Wonhwang' pear treated with $150mg{\cdot}L^{-1}$ AVG (27.7 N) and $300mg{\cdot}L^{-1}$ AVG (28.2 N) when compared with untreated control (17.8 N) during 21 days of shelf-life at $25^{\circ}C$. AVG did not cause any significant difference at skin color development relative to control in two pear cultivars. AVG decreased ethylene production and respiration rate at $300mg{\cdot}L^{-1}$ level in two pear cultivars during the entire shelf-life. During shelf-life, low incidence of physiological disorders including internal and core browning and mealiness were attained in the fruits treated at $300mg{\cdot}L^{-1}$ AVG in two cultivars when we compared with the untreated control.

Pre-post comparison Analysis of Patient assessment education for Emergency Medical Technicians(EMTs) (구급대원을 대상으로 한 환자평가 교육 전·후 수행도의 비교)

  • Lee, Moo-Sang;Lee, Seul-Ki;Kim, Gi-Woon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.211-219
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    • 2016
  • The current study was conducted to make pre-post comparisons of education done for 119 emergency medical technicians (EMT) on the patient assessment performance. The data are expected to offer applicable training methods and educational resources for emergency medical services. Twenty six EMT from four cities and provinces participated in the study, which was carried out from 14 to 17 December, 2015. The technicians performed a patient assessment and marked reports on simulated patients. In the course of the assessment, a pre-post evaluation of education was done using a checklist regarding the respective symptoms, such as headache, chest pain, and dyspnea. The median value (quartile value) was used as the descriptive analysis. While patient assessment scores marked 66 points (54.00-80.25) out of 100 (p<0.01) before education, there was a significant increase in the after-education scores, which reached 88.5 points (80.00-93.00). The patient assessment performances revealed a significant increase (p<.0.01) in 5 chest pain, 7 headache, and 9 dyspnea items after education. Similarly, there was an increase in wanting to meet the EMT again scale in regards to categories involved in developing positive relations with patients. Moreover, the adequacy in the patient condition reports all marked a significant increase (p<0.01) in assessment categories. The present study shows that education based on simulation practices are necessary for improvements in patient assessment performance of 119 EMT. Therefore, practical and systematic patient assessment educations may serve as a prerequisite. Further opportunities should be provided for the EMT consistently.

HOME NURSING CARE NEEDS IN RURAL KOREA (한국 농촌 지역의 가정간호 요구에 관한 연구)

  • KIM, SUNG SILL
    • Journal of Korean Academy of Nursing
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    • v.18 no.1
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    • pp.44-69
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    • 1988
  • 보건의료기술이 고도로 발달되었다 하더라도 의료의 혜택이 필요할 때 누구에게나 언제든지 제공될 수 없는한 전체 국민의 건강요구를 포괄적으로 충족시킬 수 있는 제도나 방법이 필요하게 된다. 본 연구는 사회 집단의 최소 단위인 가정을 중심으로 수행되고 있는 지역사회 가정간호의 합리적 수행에 필요한 기초자료를 얻기 위하여 가정간호 요구의 사정 및 가정간호 수행에 관하여 연구하였다. 가정 간호(Home Nursing Care, Home Health Care)는 추후관리를 받아야 할 대상자, 고령자, 만성질환자에게 규격화되어 있는 병원간호를 가정이라는 친숙한 분위기에서 개별적으로 제공되는 가정 중심의 심리적 안정은 물론 시간과 경비를 절감하는 효과적 간호수단이다. 본 연구의 목적은 첫째 우리나라 농촌가정의 가정간호의 요구는 무엇이며 그 요구의 원인은 무엇인가\ulcorner 둘째, 농촌가정에서 가지고 있는 상병에는 어떠한 것이 있으며 행하여 지고 있는 가정간호의 내용에는 어떤 것들이 있는가\ulcorner 셋째, 가정간호 수행자는 누구이며 이에 대한 수혜자의 만족도는 어느 정도인가\ulcorner 본 연구의 방법은 1985년 6월 18일 부터 8월 7일 까지 C군에 거주하는 주민중 11개소 보건진료소가 소재한 반의 주민 전체 1,027명 중 상병자 159명과 30세 이상의 인구 440명, 가구주 239명을 대상으로 가정방문을 통한 면접으로 질문지를 기록케 하여 자료를 수집하였다. 연구의 도구는 첫째 간호요구의 측정을 위한 도구로 Virginia Henderson의 기본간호활동 14가지를 기초로 지역주민 50명과 현직 간호원 50명에게 개방질문으로 얻은 내용을 중심으로 제작하였으며 둘째, 가정간호수행에 대한 도구로 Orem의 간호이론 중 간호방법 5가지를 근거로 개발하였다. 본 연구의 내용은 보건진료원에 의하여 사정된 간호요구와 그 원인들을 인간의 기본요구 영역별로 분류하여 가정간호진단을 위한 지역사회 가정간호사정 및 진단도구로 쓸 수 있도록 개발하였으며, 상병자에 대한 가정간호 수행은 수행빈도와 수행내용에 따른 수행자와 수행 만족도를 측정하였다. 1. 가정간호요구에 대하여 1) 가정간호요구 측정은 신체영역 중 몸을 청결히 하고 몸차림을 단정히 하여 피부를 보호하기 내용에서 더위나 추위에 대하여 옷을 맞추어 조절하기의 요구, 적절한 식사와 수분섭취하기 내용에서 배변의 요구, 또한 몸을 움직이고 바람직한 체위를 유지하기 내용에서 한가지 자세를 계속하기의 요구가 높았고 정상호흡하기 내용에는 일상활동시 호흡에 대한 요구가 높은 편이었다. 사회, 심리, 영적 간호요구 영역에서는 자신이 신앙에 따라 예배하기 내용에서 신앙으로 어려움을 극복하려는 요구가 높았으며 여러가지 오락의 형태를 취하여 이에 참여하기 내용에서는 취미생활의 요구가 높았다. 2) 가정간호요구는 연령이 높을수록 높았고 성별로는 여자의 가정간호요구가 남자보다 높았으나 내용별 요구의 차이는 없었다. 2. 가정간호수행에 대하여 1) 가정에서 수행되는 가정간호내용으로는 직접간호가 가장 많이 수행되었으며 내용으로는 구강청결, 옷 갈아 입기, 투약, 음식투여, 대ㆍ소변보기의 빈도가 많았다. 건강한 환경제공의 간호수행내용에서는 적당한 실내온도 유지하기의 빈도가 많았으며 안내와 지도내용에서는 투약요령 알기의 빈도가 많았으며, 보호와 지지내용과 교육의 간호수행내용에서는 현 상태 인정하기와 투약 방법에 대한 교육하기의 간호수행빈도가 가장 많았다. 2) 간호수행자에 있어서 직접간호 수행은 본인 스스로 하는 빈도가 가장 많았으며 안내와 지도 및 교육의 간호수행은 전문가가 많았고 보호와 지지간호는 가족이 많았고 건강한 환경제공간호는 배우자에서 더 많았다. 3) 간호수행자에 대한 만족도는 직접간호 방법에서는 가족이, 안내와 지도는 배우자가, 보호지지, 건강한 환경제공 및 교육에서는 전문가에 의한 간호수행 만족도가 높았다. 4) 상병상태에 따른 주 증상은 관절통 요통이 가장 많았고 상병자는 남자가 많았고 주 중상에 대한 성별간의 큰 차이는 없었다. 이상 가정간호요구와 정도 및 가정간호 수행의 내용을 기반으로 가정간호사업의 시행이 시급하다는 결론을 내릴 수 있었으며 가정간호사업의 시행을 위한 제도적 보완개선책이 요구된다고 결론을 지을 수 있다.

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Combined Foliar Spray of Boron, Calcium, and Silicon can Influence Quality and Shelf Life of Cherry Tomato in Modified Atmosphere Packaging (붕소, 칼슘, 규소의 복합 엽면시비가 방울토마토의 품질과 MAP 조건에서 저장성에 미치는 영향)

  • Islam, Mohammad Zahirul;Mele, Mahmuda Akter;Han, Su Jeong;Kim, Ju Young;Choi, In-Lee;Yoon, Jae Su;Yoon, Hyuk Sung;Park, Jong-Man;Kim, Il-Seop;Choi, Ki-Young;Kang, Ho- Min
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.310-316
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    • 2017
  • This study was analyzed the effects of boron (B), calcium (Ca), silicon (Si) on quality and shelf life of 'Unicorn' cherry tomato at the light red maturity-stage. The storage conditions were modified atmosphere packaging (MAP) by oxygen transmission rate (OTR) packaging film at $5^{\circ}C$, $11^{\circ}C$, and $24^{\circ}C$. Respiration and ethylene production were the lowest in B + Ca + Si -treated tomato fruits. The lowest fresh weight loss and the longest shelf life resulted from the B + Ca + Si treatment. And the firmness was enhanced by B + Ca + Si treatment at harvest time, and it was retained after storage at $5^{\circ}C$, $11^{\circ}C$, and $24^{\circ}C$. Significantly lower soluble solids, lycopene, and color development were found at B + Ca + Si-treated tomato fruits compared with control after storage. Moreover, the highest titratable acidity and vitamin C content were observed in B + Ca + Si-treated tomato fruits after storage. From the above results, it was concluded that B + Ca + Si combined treatment can delay the maturity of cherry tomato after harvesting, and retained the firmness and prolong the shelf life.

A Study of the Effects of Air Pollution on Health -Emphasizing on the Aspects of Respiratory Diseases in Medical Insurance Recipients- (대기오염이 건강에 미치는 영향에 관한 조사연구 -의료보험환자에서의 호흡기질환 발생양상 분석을 중심으로-)

  • 차철환;고응린;송동빈
    • Journal of Korean Society for Atmospheric Environment
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    • v.4 no.1
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    • pp.58-70
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    • 1988
  • 대기오염이 건강에 미치는 영향의 유무를 알아보고 그 영향의 정도를 반영해 줄 수 있는 지표의 개발을 목적으로 우리나라 전역을 서울, 대도시, 중소도시, 농어촌 등 4개 지역으로 구분하고 의료보험대상자 3,922,027명에 대한 호흡기질환 외래수진률을 지역별로 비교해 보았다. 조사대상 질환군으로서는 다음 7가지의 호흡기질환을 채택하기로 하였다. 1) 결핵성 질환 2) 호흡기 및 흉곽내장기의 악성신생물 3) 급성호흡기 감염 4) 폐염 및 인플루엔자 5) 만성폐색성 폐질환 및 유사증 6) 진폐증 및 외인성의 기타 폐질환 7) 상기도의 기타질환 상기 질환으로 인한 외래수진에 관한 정보는 1983년 1월 1일 부터 12월 31일 사이에 제출된 보험의료비 청구서에 나타난 자료를 이용하여 수집하였으며, 그 분석을 통해 다음과 같은 결론을 얻었다. 1) 지역별 연간종합외래수진률을 비교해 본 결과 농촌지역에서 가장 낮은 수준을 나타내고 있는 질환은 조사대상 7개 호흡기질환군중 다음 4개 질환군이 해당되고 있다. (1) 결핵질환 (2) 호흡기 및 흉곽내장기의 악성 신생물 (3) 상기도의 기타질환 (4) 진폐증 및 외인성의 기타 폐질환 한편 이 종합외래수진률이 가장 높은 지역은 대도시 지역으로서 5가지 호흡기질환군의 수진률이 다른 지역에 비해 훨씬 높게 나타나 있다. 이와같은 결과는 의료보험환자들의 "외래수진률"을 이용하여 대기오염과 건강과의 관련도를 측정할 수 있는 "대기오염 - 건강" 지표의 개발이 가능할 것임을 뒷받침해 주고 있다. 그러나 가장 오염도가 높다고 예상되는 서울지역에서의 외래수진율이 대도시 지역보다 높지 않다는 것은 오염도와 외래수진률과의 관계에서 일관성있는 결과를 보여주지 못하고 있음을 뜻하는데 과거의 자료로서는 외래수진률만 가지고 대기오염과 건강과의 관계를 표시해주는 지표로 삼기에는 미흡함을 알 수 있다. 2) 월별 외래수진률의 경향을 보면 거의 모든 호흡기질환군에서 계절적인 특이성을 나타내지 못하고 있다. 단 이 경우도 농촌지역이 연중 계속 최하위를 유지하고 있는 질환군이 7개 대상질환군 중에 4개군에 달하고 있다. 3) 보험환자들의 "외래수진률"은 아직은 미흡한 점이 있으나 앞으로 "대기오염 - 건강" 지표로서 개발 활용할 가치는 있다고 볼 수 있으며 서울, 대도시, 중소도시, 농어촌 등 4개 지역에 대한 월별 외래 수진률을 다음 4가지 질환군에 대하여 계속 관측하여 그 경향을 분석할 것을 권장한다. (1) 호흡기 및 흉곽내장기의 악성 신생물 (ICD. 160-165) (2) 급성호흡기 감영 (ICD. 460-466) (3) 폐염 및 인플루엔자 (ICD. 480-487) (4) 만성폐색성 폐질환 및 유사증 (ICD. 490-496) 4) 외래수진률은 진료방식 즉, 투약기간의 장단등으로 인한 통원 (通院) 빈도 차이의 영향을 받게 되므로 지역별 병 $\cdot$ 의원의 보험환자 진료방식에 대한 비교검토가 요구된다.

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