• Title/Summary/Keyword: 3-shift system

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A Clinical Study for Promoting Quality Nusing Care in a University Hospital (질적 간호제공을 위한 간호단위 시범 운영 효과에 관한 임상적 연구)

  • Lee, A.J.;Kim, S.H.;Seong, Y.H.;Yoo, S.A.;Kwon, I.G.;Jeong, Y.I.;Nam, H.K.;Kwon, E.J.
    • The Korean Nurse
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    • v.32 no.5
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    • pp.66-77
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    • 1994
  • The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower. For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remedies to the problems a hospital-wide survey and a workshop were performed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of bed-side nursing care were adopted as main principles for operating model unit, This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992. To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other. The results of the study were as follows; 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 ; 70.4 and that of the control unit was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body temperature, hygiene, and communication and health education were longer than that of the con" trol unit. 2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than that of the control unit. 3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=-0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were significantly higher than before. 4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit(Z=2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before (Z=-2.0732, P=.0382). 5. After operating the model unit, quality care index was increased from 89 to 93. With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial increase in direct nursing care hours, nurses satisfaction to their job and patients' satisfaction to nursing care. In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be considered sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.

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Evaluation of Electron Boost Fields based on Surgical Clips and Operative Scars in Definitive Breast Irradiation (유방보존술 후 방사선치료에서 수술 흉터와 삽입된 클립을 이용한 전자설 추가 방사선 조사야 평가)

  • Lee, Re-Na;Chung, Eun-Ah;Lee, Ji-Hye;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.23 no.4
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    • pp.236-242
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    • 2005
  • Purpose: To evaluate the role of surgical clips and scars in determining electron boost field for early stage breast cancer undergoing conserving surgery and postoperative radiotherapy and to provide an optimal method in drawing the boost field. Materials and Methods: Twenty patients who had $4{\sim}7$ surgical clips in the excision cavity were selected for this study. The depth informations were obtained to determine electron energy by measuring the distance from the skin to chest wall (SCD) and to the clip implanted in the most posterior area of tumor bed. Three different electron fields were outlined on a simulation film. The radiological tumor bed was determined by connecting all the clips implanted during surgery Clinical field (CF) was drawn by adding 3 cm margin around surgical scar. Surgical field (SF) was drawn by adding 2 cm margin around surgical clips and an Ideal field (IF) was outlined by adding 2 cm margin around both scar and clips. These fields were digitized into our planning system to measure the area of each separate field. The areas of the three different electron boost fields were compared. Finally, surgical clips were contoured on axial CT images and dose volume histogram was plotted to investigate 3-dimensional coverage of the clips. Results : The average depth difference between SCD and the maximal clip location was $0.7{\pm}0.55cm$. Greater difference of 5 mm or more was seen in 12 patients. The average shift between the borders of scar and clips were 1.7 1.2, 1.2, and 0.9 cm in superior, inferior, medial, and lateral directions, respectively. The area of the CF was larger than SF and IF in 6y20 patients. In 15/20 patients, the area difference between SF and if was less than 5%. One to three clips were seen outside the CF in 15/20 patients. In addition, dosimetrically inadequate coverage of clips (less than 80% of prescribed dose) were observed in 17/20 patients when CF was used as the boost field. Conclusion: The electron field determined from clinical scar underestimates the tumor bed in superior-inferior direction significantly and thereby underdosing the tissue at risk. The electron field obtained from surgical clips alone dose not cover the entire scar properly As a consequence, our technique, which combines the surgical clips and clinical scars in determining electron boost field, was proved to be effective in minimizing the geographical miss as well as normal tissue complications.

A Study on Bone Formation & Osteoporosis by Taeyoungion-Jahage Extracts

  • Kim, Yi-Geun;Seong, Jun-Ho;Kim, Dong-Il;Lee, Tae-Kyun;Kim, Jun-Ki;Park, Young-Duck
    • The Journal of Korean Obstetrics and Gynecology
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    • v.15 no.4
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    • pp.45-60
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    • 2002
  • Mouse calvarial osteoblast cells were isolated and cultured. To examine whether the cells produce active gelatinases in culture medium or not,the cells were analyzed using by zymograsphic analysis on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). We show that mouse calvarial osteoblasts in culture constitutively synthesize progelatinase- A. Then, mouse osteoblasts, which were stimulated by PTH, $1,25(OH)_2D_3$, mononuclear cell conditioned medium (MCM) and IL-1 as bone resorption agent's, showed increased collagenolysis by producing the active gelatinase. However, treatment of indomethacin and dexamethasone significantly decreased those effects of collagenolysis in mouse osteoblastic cells. On the other hand, IL-1 in stimulating bone resorption was examined using fetal mouse long bone organ culture. IL-1 stimulated bone resorption and produced marked resorption when present simultaneously. Furthermore, when it was examined the effects of indomethacin and dexamethasone on the dose dependent responses of $IL-1{\alpha}$, indomethacin and dexametasone produced a rightward shift in the IL-1 dose response curve. The results of in vitro cytotoxicities showed that Taeyoungjon-Jahage water extracts(T.Y.J-J.H.G extracts) have no any cytotoxicities in concentrations of $1-200\;{\mu}g/ml$ and furthermore there is no any cytotoxicity even in concentration of $300\;{\mu}g/ml$ on mouse calvarial bone cells. T.Y.J.-J.H.G. extracts had protective activity against PTH (2 units/mI), or MCM (5%, v/v), or $rhIL-1{\alpha}$ (1 ng/mI) or $1,25(OH)_2D3$ (10 ng/ml) , $IL-1{\alpha}$ and $IL-1{\beta}-induced$ collagenolysis in the mouse calvarial cells. Pretreatment of the T.Y.J.-J.H.G.extracts for 1 h, which by itself had little effect on cell survival, did not enhance the collagenolysis, nor significantly reduced the collagenolysis by pretreatment. Furthermore. the medicinal extracts were shown to have the protective effects against collagenolysis induced by $IL-1{\alpha}$ and $IL-1{\beta}$. Pretreatment of the extracts for 1 h significantly reduced the collagenolysis. Interestingly, the T.Y.J.-J.H.G. extracts were shown to have the inhibiting effects against gelatinase enzyme and processing activity induced by the bone resortion agents of PTH, $1,25(OH)_2D_3$, $IL-1{\beta}$ and $IL-1{\alpha}$, with strong protective effect in pretreatment with the extracts. T.Y.J.-J.H.G. extracts were shown to have the inhibiting effects against $IL-1{\alpha}-$ and $IL-1{\beta}-stimulated$ bone resorption and the effect of the pretreatment with a various concentrations of the medicinal extracts were significant. The inhibition extent and phenomena of IL-1 stimulated bone resorption by nonsteroidal anti-inflammatory agents of indomethacin and dexamethasone were similar to those obtained by T.Y.J.-J.H.G. extracts treatment in the mouse calvarial tissue culture system. These results indicated that the T.Y.J.-J.H.G.-water extracts are highly stable and applicable to clinical uses in osteoporosis.

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Genetic Environments of Hydrothermal Vein Deposits in the Pacitan District, East Java, Indonesia (인도네시아 동부자바 빠찌딴(Pacitan) 광화대 열수 맥상 광상의 성인 연구)

  • Choi, Seon-Gyu;So, Chil-Sup;Choi, Sang-Hoon;Han, Jin-Kyun
    • Economic and Environmental Geology
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    • v.28 no.2
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    • pp.109-121
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    • 1995
  • The hydrothermal vein type deposits which comprise the Kasihan, Jompong and Gempol mineralized areas are primarily copper and zinc deposits, but they are also associated with lead and/or gold mineralization. The deposits occur within the Tertiary sedimentary and volcanic rocks in the Southern Mountain zone of the eastern Java island, Indonesia. Mineralization can be separated into two or three distinct stages (pre-and/or post- ore mineralization stages and main ore mineralization stage) which took place mainly along pre-existing fault breccia zones. The main phase of mineralization (the main ore stage) can be usually classified into three substages (early, middle and late) according to ore mineral assemblages, paragenesis, textures and their chemical compositions. Ore mineralogy and paragenesis of the three areas in the district are different from each other. Pyrite, pyrrhotite (/arsenopyrite), iron-rich (up to 20.5 mole % FeS) sphalerite and (Cu-)Pb-Bi sulfosalts are characteristic of the deposits in the Kasihan (/Jompong) area. On the other hand, pyrite + hematite + magnetite + iron-poor (2.7 to 3.6 mole % FeS) sphalerite assemblage is restricted to the Gempol area. Fluid inclusion data suggest that fluids of the main ore stage evolved from initial high temperatures (near $350^{\circ}C$) to later lower temperatures (near $200^{\circ}C$) with salinities ranging from 0.8 to 10.1 equiv. wt. percent NaCl. Each area represents a separate hydrothermal system: the mineralization at Kasihan and Jompong were largely due to early fluid boiling coupled with later cooling and dilution, whereas the mineralization at Gempol was mainly resulted from cooling and dilution by an influx of cooler meteoric waters. Fluid inclusion evidence of boiling indicates that pressures of ${\geq}95$ to 255 bars (${\geq}95$ bars for the Gempol area: $\approx$ 120 to 170 bars for the Jompong area: $\approx$ 140 to 255 bars for the Kasihan area) during portions of main ore stage mineralization. Equilibrium thermodynamic interpretation indicates that the evolution trends of the temperature versus fS2 variation of ore stage fluids in the Pacitan district follow two fashions: ore fluids at Kasihan and Jompong changed from the pyrite-pyrrhotite sulfidation stage towards pyritehematite- magnetite state, whereas those at Gempol evolved nearly along pyrite-hematite-magnetite reaction curve with decreasing temperature. The sulfur isotope compositions of sulfide minerals are consistent with an igneous source of sulfur with a ${\delta}^{34}S_{{\Sigma}s}$ value of about 3.3 per mil. The oxygen and hydrogen isotopic compositions of the fluids in each area indicate a progressive shift from the dominance of highly exchanged meteoric water at early hydrothermal systems towards an un- or less-exchanged meteoric water at later hydrothermal systems.

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Sports Biomechanical Analysis of Physical Movements on the Basis of the Patterns of the Ready Poses (준비동작의 형태 변화에 따른 신체 움직임의 운동역학적 분석)

  • Lee, Joong-Sook
    • Korean Journal of Applied Biomechanics
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    • v.12 no.2
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    • pp.179-195
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    • 2002
  • The purpose of this research is to provide a proper model by analyzing the sports biomechanical of physical movements on the basis of the two patterns(open-stance and cross-stance) at the ready-to-start pose. The subjects for this study are composed of five male handball players from P university and five female shooting players from S university. Three-way moving actions at start(right, left, and forward) are recorded with two high-speed video cameras and measured with two Force platforms and a EMG system. Three-dimensional action analyzer, GRF system, and Whole body reaction movement system are used to figure out the moving mechanisms at the start pose. The analytic results of the moving mechanism at the start pose were as follows. 1. Through examining the three-way moving actions at start, I have found the cross-stance pose is better for the moving speed of body weight balance than the open-stance one. 175 degree of knee joint angle at "take-off" and 172 degree of hip joint angle were best for the start pose. 2. The Support time and GRF data shows that the quickest center of gravity shift was occurred when cross-stanced male subjects started to move toward his lefthand side. The quickest male's average supporting time of left and right foot is 0.19${\pm}$0.07 sec., 0.26${\pm}$0.06sec. respectively. The supporting time difference between two feet is 0.07sec. 3. Through analyzing GRF of moving actions at start pose, I have concluded that more than 1550N are overloaded on one foot at the open-stance start, and the overloaded force may cause physical injury. However, at the cross-stance pose, The GRF are properly dispersed on both feet, and maximum 1350N are loaded on one foot.

Implantable Flexible Sensor for Telemetrical Real-Time Blood Pressure Monitoring using Polymer/Metal Multilayer Processing Technique (폴리머/ 금속 다층 공정 기술을 이용한 실시간 혈압 모니터링을 위한 유연한 생체 삽입형 센서)

  • Lim Chang-Hyun;Kim Yong-Jun;Yoon Young-Ro;Yoon Hyoung-Ro;Shin Tae-Min
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.599-604
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    • 2004
  • Implantable flexible sensor using polymer/metal multilayer processing technique for telemetrical real-time blood pressure monitoring is presented. The realized sensor is mechanically flexible, which can be less invasively implanted and attached on the outside of blood vessel to monitor the variation of blood pressure. Therefore, unlike conventional detecting methods which install sensor on the inside of vessel, the suggested monitoring method can monitor the relative blood pressure without injuring blood vessel. The major factor of sudden death of adults is a disease of artery like angina pectoris and myocardial infarction. A disease of circulatory system resulted from vessel occlusion by plaque can be preventable and treatable early through continuous blood pressure monitoring. The procedure of suggested new method for monitoring variation of blood pressure is as follows. First, integrated sensor is attached to the outer wall of blood vessel. Second, it detects mechanical contraction and expansion of blood vessel. And then, reader antenna recognizes it using telemetrical method as the relative variation of blood pressure. There are not any active devices in the sensor system; therefore, the transmission of energy and signal depends on the principle of mutual inductance between internal antenna of LC resonator and external antenna of reader. To confirm the feasibility of the sensing mechanism, in vitro experiment using silicone rubber tubing and blood is practiced. First of all, pressure is applied to the silicone tubing which is filled by blood. Then the shift of resonant frequency with the change of applied pressure is measured. The frequency of 2.4 MHz is varied while the applied pressure is changed from 0 to 213.3 kPa. Therefore, the sensitivity of implantable blood pressure is 11.25 kHz/kPa.

Usages and Religious Takes on the Concept of Haewon (해원 개념의 용례와 종교적 전환)

  • Ko, Byoung-chul
    • Journal of the Daesoon Academy of Sciences
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    • v.39
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    • pp.1-32
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    • 2021
  • The purpose of this article is to explain the conceptual changes that the notion of Haewon (解冤) has undergone by examining the evolution of the usages of Haewon. In order to achieve this purpose, I reviewed the conceptual connotations and denotations of Haewon contained in data from the Joseon Dynasty (Section 2), the Japanese colonial period (Section 3), and the scriptures and major preceding research of Daesoon Jinrihoe (Section 4). The research results described in this article are as follows. First, Haewon is a term with historical, social, and cultural characteristics. This means that Haewon, a term that has been used since the Joseon Dynasty, was a concept used to solve collective problems but could also be applied on the individual level. This further means that, if culture is regarded as a collective consciousness or as a collection of material products, Haewon would be a term that contained social and cultural aspirations. Second, Haewon is not a concept that has been impervious to innovation throughout its history. This can be confirmed by the fact that Haewon's scope of application has changed depending on the problem domain (legal, natural disasters, an institutional domain, etc.). Third, Haewon has converted into religious language a doctrinal system that came about after the emergence of Jeungsan. This means that previously the concept of Haewon was mainly used at the legal level in the Joseon Dynasty, but after the emergence of Jeungsan, it became a term in religious language and in doctrine. The materials of Daesoon Jinrihoe show that this concept of Haewon was expanded to be included at the doctrinal level. These research results show a historical shift in the ideological thought contained in the concept of Haewon. As a term in religious language that is included in a doctrinal system, Haewon has an extension of denotations that is applied to the world beyond individuals and societies, yet it maintains connotations of resolving grievances. This concept of Haewon mediates the transformation of the world and creates a rationale by which training and ethical practice are necessary components of that process of transformation.

Policy Direction for The Farmland Sizing Suitable to Regional Trait (지역특성을 반영한 영농규모화사업의 발전방향-충남지역을 중심으로-)

  • Shim, Jae-Sung
    • The Journal of Natural Sciences
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    • v.14 no.1
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    • pp.83-121
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    • 2004
  • This study was carried out to examine how solid the production foundation of rice in Chung-Nam Province is, and, if not, to probe alternative measures through the size of farms specializing in rice, of which direction would be a pivot of rice industry-oriented policy. The results obtained can be summarized as follows : 1. The amount of rice production in Chung-Nam Province is highest in Korea and the size of paddy field area is the second largest : This implying that the probability that rice production in Chung-Nam Province would be severely influenced by a global trend of market conditions. The number of farms specializing in rice becoming the core group of rice farming account for 7.7 percent of the total number of farm household in Korea. Average field area financial support which had been input to farm household by Government had a noticeable effect on the improvement of the policy of farm-size program. 2. Farm-size program in Chung-Nam Province established from 1980 to 2002 in creased the cultivation size of paddy field to 19,484 hectares, and this program enhanced the buying and selling of farmland and the number of farmland bargain reached 6,431 household and 16,517 hectares, respectively, in 1995-2002. Meanwhile, long-term letting and hiring of farmland appeared so active that the bargain acreage reached 6,970 hectares, and farm involved was 7,059 households, however, the farm-exchange-and-unity program did not satisfy our expectation, because the retirement farm operators reluctantly participated to sell their farms. Another reason that had delayed the bargain of farms rested on the general category of social complication attendant upon the exchange and unity operation for scattered farm. Such difficulties would work negative effects out to carry on the target of farm-size work in general. 3. The following measures were presented to propel the farm-size promotion program : a. Occupation shift project, followed by the social security program for retirement and elderly farm operators, should be promptly established and also a number of types of incentives for promoting the letting and hiring work and farm-exchange-and-unity program would also be set up. b. To establish the effective key system of rice production, all the farm operators should increase the unit area yield of rice and lower the production cost. To do so, a great deal of production teams of rice equipped with managerial techniques and capabilities need to be organized. And, also, there should be appropriate arrays of facilities including information system. This plan is desirable to be in line with a diversity of the structural implement of regional integration based on farm system building. c. To extend the size of farm and to improve farm management, we have to devise the enlargement of individual size of farm for maximized management and the utilization of farm-size grouping method. In conclusion, it can be said that the farm-size project in Chung-Nam Province which has continued since the 1980s was satisfactorily achieved. However, we still have a lot of problems to be solved to break down the barrier for attainment of the desirable farm-size operation work.. Farm-size project has fairly close relation with farm specialization in rice and, thus, the positive support for farm household including the integrated program for both retirement farmers and off-farm operators should be considered to pursue the progressive development of the farm-size program, which is key means to successful achievement of rice farming enforcement in Chung-Nam Province.

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Copper Mineralization in the Haman-Gunbuk Area, Gyeongsangnamdo-Province: Fluid Inclusion and Stable Isotope Study (경상남도 함안-군북지역의 동광화작용: 유체포유물 및 안정동위원소 연구)

  • 허철호;윤성택;최상훈;최선규;소칠섭
    • Economic and Environmental Geology
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    • v.36 no.2
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    • pp.75-87
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    • 2003
  • The Haman-Gunbuk mineralized area is located within the Cretaceous Gyeongsang Basin along the southeastern part of the Korean peninsula. Major ore minerals, magnetite, scheelite, molybdenite and chalcopyrite, together with base-metal sulfides and minor sulfosalts, occur in fissure-filling tourmaline, quartz and carbonates veins contained within Cretaceous sedimentary and volcanic rocks anu/or granodiorite (118{\pm}$3.0 Ma). The ore and gangue mineral paragenesis can be divided into three distinct stages: Stage 1, tourmaline+quartz+Fe-Cu ore mineralization; Stage II, quartz+sulfides+sulfosalts+carbonates; Stage 111, barren calcite. Earliest fluids are recorded in stage I and early por-tions of stage II veins as hypersaline (35~70 equiv. wt.% NaCl+KCl) and vapor-rich inclusions which homogenize from ~30$0^{\circ}C$ to $\geq$50$0^{\circ}C$. The high-salinity fluids are complex chloride brines with significant concentrations of sodium, potassium, iron, copper, and sulfur, though sulfide minerals are not associated with the early mineral assemblage produced by this fluid. Later solutions circulated through newly formed fractures and reopened veins, and are recorded as lower-salinity(less than ~20 equiv. wt.% NaCl) fluid inclusions which homogenize primarily from ~200 to 40$0^{\circ}C$. The oxygen and hydrogen isotopic compositions of fluid in the Haman-Gunbuk hydrothermal system represents a progressive shift from magmatic-hydrothermal dominance during early mineralization stage toward meteoric-hydrothermal dominance during late mineralization stage. The earliest hydrothermal fiuids to circu-late within the granodiorite stock localiring the ore body at Haman-Gunbuk could have exsolved from the crystal-lizing magma and unmixed into hypersaline liquid and $H_2O$-NaCl vapor. As these magmatic fluids moved throughfractures, tourmaline and early Fe, W, Mo, Cu ore mineralization occurred without concomitant deposition of othersulfides and sulfosalts. Later solutions of dominantly meteoric origin progressively formed hypogene copper and base-metal sulfides, and sulfosalt mineralization.

Knowledge, Attitude and Practice according to Types of Occupational Health Management (보건관리형태에 따른 산업보건에 대한 지식, 태도 및 실천)

  • Kim, Sung-Hee;Shin, Hae-Ryeun;Kim, Sang-Woo;Woo, Kuck-Hyeun;Park, Wan-Seoup;Park, Jae-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.579-596
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    • 1996
  • The first purpose of this study was to compare the mean Knowledge, Attitude & Practice(KAP) scores concerning major occupational health between two types of occupational health management in small & medium-scale textile factories. Sample number was 1,138 workers. In small & medium factories with 300 workers or less, they have two alternatives for occupational health management ; Individual Health Management or Vicarious Health Management. The second purpose was to determine if there was a relationship between duration of Vicarious health management and mean KAP scores for 694 workers from the Vicarious Health Management group. We used self-administered questionnaires for measuring KAP. The results of this study were; 1. There was significant difference concerning all socioeconomic & occupational variables (gender, age, education level, marital status, Blue/White collar, working duration of present factory, working duration of total factories) except for shift. 2. There was no significant difference of mean scores of Knowledge and Attitude between the Individual Health Management Group and the Vicarious Health Management. But, the mean score of Practice was significantly different. 3. According to multiple regression analysis, the mean score of Knowledge significantly increased with age, education level, working duration of all factories increased. The mean score of Attitude significantly increased with age, education level and married. The mean score of Practice significantly increased with age, education level, working duration of all factories, married and men. 4. In conclusion, The type of Health management did not significantly affect the mean KAP scores concerning major occupational Health problems. 5. But, the Duration of Vicarious Health management significantly increased the mean KAP scores.

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