• Title/Summary/Keyword: ASSESSMENT INDICATOR

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CQI Action Team Approach to Prevent Pressure Sores in Intensive Care Unit of an Acute Hospital Korea (중환자의 욕창 예방 연구 : 욕창 예방 QI팀을 중심으로)

  • Kang, So Young;Choi, Eun-Kyung;Kim, Jin-Ju;Ju, Mi-Jung
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.50-63
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    • 1997
  • Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

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The Trend and Assessment of Water Pollution from Midstream to Downstream of the Kum River (금강 중 ${\cdot}$ 하류의 오염 양상과 수질평가)

  • Rim, Chang-Soo;Cho, Kyung-Je;Shin, Jae-Ki
    • Korean Journal of Ecology and Environment
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    • v.33 no.1 s.89
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    • pp.51-60
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    • 2000
  • In order to understand the trend and assessment of water pollution, seasonal water quality was determined in the main river and the tributaries from midstream to downstream of the Kum River from March 1998 to June 1999. Among environmental factors, the variation of nitrogen, phosphorus and chlorophyll-a was distinctive on an aspect of increase and decrease relatively to others, and particularly the impact of inorganic N ${\cdot}$ P inflowing into the main river was observed to be more significant at the Kapchon, Mihochon and Soksongchon among the tributaries. Water quality was highly related to hydrologic factor, and it was more deteriorated when water discharge maintains for a long time below normal flow or relatively at low condition of minimum and drought flow. These phenomena were remarkablee from December to March of the next year. $NH_4$ and SRP were decreased dramatically flowing toward the lower part of the river and chl-a was increased exponentially. While, the variations of $NO_3$ and $BOD_5$ were regular from midstream to downstream and there was no significant difference between the stations. Limiting nutrient for Phytoplankton growth seemed to be P than N because the ratio of TN/TP or DIN/SRP was relatively high as 42 or 544 in the main river, respectively. The main river and tributaries were ranked to be third grade, based on the assessment of BOD as an indirect indicator of organics, but particularly Kapchon was ranked to be over fifth grade. In addition, the inflow of high N ${\cdot}$ P nutrients from tributaries including Kapchon and Mihochon seemed to be major factor of the development of water pollution of the Kum River. On the other hand, persistent bloom of phytoplankton in lower part of the river was observed. As a conclusion, management of water quality for main source of pollution is urgent.

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Application of Stable Isotopic Niche Space to Large River Monitoring: Analysis of Benthic Macroinvertebrates of the Seongchon Wier (안정동위원소비를 활용한 생태지위면적 분석의 수생태계 평가 가능성 분석: 영산강 승촌보의 저서성 대형무척추동물을 대상으로)

  • Seo, Dong-Hwan;Oh, Hye-Ji;Jin, Mei-Yan;Oda, Yusuke;Kim, Hyun-Woo;Jang, Min-Ho;Choi, Bohyung;Shin, Kyung-Hoon;Lee, Kyung-Lak;Lee, Su-Woong;Chang, Kwang-Hyeon
    • Journal of Environmental Impact Assessment
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    • v.27 no.6
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    • pp.685-694
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    • 2018
  • We measured ecological niche space (ENS) using carbon and nitrogen stable isotope ratios of benthic macroinvertebrates to estimate its applicability for large river assessment. In particular, we compared ENSs of selected macroinvertebrates between upper and lower area of Seungchon Weir in Yeongsan River to estimate the impact of weir on biological community. We also measured basic water quality and community indices including benthic macroinvertebrates index (BMI) to estimate their correlations with calculated ENS. ENS was calculated using the Bayesian Stable Isotope in R statistics (package "SIBER"). The results showed that seasonal variations in water quality and community indices were found, but there was no apparent tendency between upper and lower area of the Seungchon Weir in June (before rainy season) and August (after rainy season). However, ENS of benthic macroinvertebrates markedly decreased across the weir in both June and August regardless of changes in water quality. This means the physical change of the stream due to the weir cause decrease of ecological isotopic niche space of benthic macroinvertebrates regardless of water quality, suggesting physical modification by the weir can affect the interaction between habitat condition and macroinvertebrates. Therefore, the ecological isotopic niche space can be a useful supplementary indicator for the river ecosystem assessment.

Community Structure and Health Assessment of Macrobenthos in Tidal Flats along the West Coast of Korea in Spring and Summer (서해안 갯벌의 춘·하계 대형저서동물의 군집구조 및 건강도 평가)

  • Ong, Giho;Jeon, Seung Ryul;Koo, Jun Ho;Park, Jong-Woo;Jeung, Hee-Do;Kang, Jung-Ha;Cho, Yoon-Sik
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.27 no.4
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    • pp.500-509
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    • 2021
  • This study investigated the characteristics of a macrobenthos community and sediment environment and assessed the health of tidal flats along the west coast of Korea. A survey was conducted from Ganghwa-do to Mokpo, Jeollanam-do in April (spring) and August (summer) 2017, and April (spring) 2018. The sediment grain sizes in the Chungcheongnam-do region were coarser, and the sediment in the Gyeonggi-do·Incheon, Jeollanam-do, and Jeollabuk-do regions were finer. A total of 140 macrobenthic species were collected from this study and using a cluster similarity analysis of the macrobenthos community, they were divided into four groups. Group2 was associated with Manila clam farm stations, and Ruditapes phillipinarum, Nephtys polybranchia and Lumbrineris nipponica were dominant. Group4 included some sites with finer sediment composed relatively, and Eteone longa and Nemertea unid. appeared at a high frequency. From the health assessment of the western tidal flat, the ISEP and BHI indices had a "High status," and the AMBI index had a "Good status." In conclusion, the tidal flats along the west coast of Korea have good ecological health. However, pollution indicator species such as Theora lata and Capitella capitata have appeared in some areas. Therefore, periodic administration and interventions are necessary to prevent deterioration of the tidal flat environment.

Self-Regulatory Mode Effects on Emotion and Customer's Response in Failed Services - Focusing on the moderate effect of attribution processing - (고객의 자기조절성향이 서비스 실패에 따른 부정적 감정과 고객반응에 미치는 영향 - 귀인과정에 따른 조정적 역할을 중심으로 -)

  • Sung, Hyung-Suk;Han, Sang-Lin
    • Asia Marketing Journal
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    • v.12 no.2
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    • pp.83-110
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    • 2010
  • Dissatisfied customers may express their dissatisfaction behaviorally. These behavioral responses may impact the firms' profitability. How do we model the impact of self regulatory orientation on emotions and subsequent customer behaviors? Obviously, the positive and negative emotions experienced in these situations will influence the overall degree of satisfaction or dissatisfaction with the service(Zeelenberg and Pieters 1999). Most likely, these specific emotions will also partly determine the subsequent behavior in relation to the service and service provider, such as the likelihood of complaining, the degree to which customers will switch or repurchase, and the extent of word of mouth communication they will engage in(Zeelenberg and Pieters 2004). This study investigates the antecedents, consequences of negative consumption emotion and the moderate effect of attribution processing in an integrated model(self regulatory mode → specific emotions → behavioral responses). We focused on the fact that regret and disappointment have effects on consumer behavior. Especially, There are essentially two approaches in this research: the valence based approach and the specific emotions approach. The authors indicate theoretically and show empirically that it matters to distinguish these approaches in services research. and The present studies examined the influence of two regulatory mode concerns(Locomotion orientation and Assessment orientation) with making comparisons on experiencing post decisional regret and disappointment(Pierro, Kruglanski, and Higgins 2006; Pierro et al. 2008). When contemplating a decision with a negative outcome, it was predicted that high (vs low) locomotion would induce more disappointment than regret, whereas high (vs low) assessment would induce more regret than disappointment. The validity of the measurement scales was also confirmed by evaluations provided by the participating respondents and an independent advisory panel; samples provided recommendations throughout the primary, exploratory phases of the study. The resulting goodness of fit statistics were RMR or RMSEA of 0.05, GFI and AGFI greater than 0.9, and a chi-square with a 175.11. The indicators of the each constructs were very good measures of variables and had high convergent validity as evidenced by the reliability with a more than 0.9. Some items were deleted leaving those that reflected the cognitive dimension of importance rather than the dimension. The indicators were very good measures and had convergent validity as evidenced by the reliability of 0.9. These results for all constructs indicate the measurement fits the sample data well and is adequate for use. The scale for each factor was set by fixing the factor loading to one of its indicator variables and then applying the maximum likelihood estimation method. The results of the analysis showed that directions of the effects in the model are ultimately supported by the theory underpinning the causal linkages of the model. This research proposed 6 hypotheses on 6 latent variables and tested through structural equation modeling. 6 alternative measurements were compared through statistical significance test of the paths of research model and the overall fitting level of structural equation model and the result was successful. Also, Locomotion orientation more positively influences disappointment when internal attribution is high than low and Assessment orientation more positively influences regret when external attribution is high than low. In sum, The results of our studies suggest that assessment and locomotion concerns, both as chronic individual predispositions and as situationally induced states, influence the amount of people's experienced regret and disappointment. These findings contribute to our understanding of regulatory mode, regret, and disappointment. In previous studies of regulatory mode, relatively little attention has been paid to the post actional evaluative phase of self regulation. The present findings indicate that assessment concerns and locomotion concerns are clearly distinct in this phase, with individuals higher in assessment delving more into possible alternatives to past actions and individuals higher in locomotion engaging less in such reflective thought. What this suggests is that, separate from decreasing the amount of counterfactual thinking per se, individuals with locomotion concerns want to move on, to get on with it. Regret is about the past and not the future. Thus, individuals with locomotion concerns are less likely to experience regret. The results supported our predictions. We discuss the implications of these findings for the nature of regret and disappointment from the perspective of their relation to regulatory mode. Also, self regulatory mode and the specific emotions(disappointment and regret) were assessed and their influence on customers' behavioral responses(inaction, word of mouth) was examined, using a sample of 275 customers. It was found that emotions have a direct impact on behavior over and above the effects of negative emotions and customer behavior. Hence, We argue against incorporating emotions such as regret and disappointment into a specific response measure and in favor of a specific emotions approach on self regulation. Implications for services marketing practice and theory are discussed.

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Seasonal and Inter-annual Variability of Water Use Efficiency of an Abies holophylla Plantation in Korea National Arboretum (국립수목원의 전나무(Abies holophylla) 조림지의 물 이용 효율의 계절 및 경년 변동)

  • Thakuri, Bindu Malla;Kang, Minseok;Zhang, Yonghui;Chun, Junghwa;Kim, Joon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.18 no.4
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    • pp.366-377
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    • 2016
  • Water use efficiency (WUE) is considered as an important ecological indicator which may provide information on the process-structure relationships associated with energy-matter-information flows in ecosystem. The WUE at ecosystem-level can be defined as the ratio of gross primary productivity (GPP) to evapotranspiration (ET). In this study, KoFlux's long-term (2007-2015) eddy covariance measurements of $CO_2$ and water vapor fluxes were used to examine the WUE of needle fir plantation in Korea National Arboretum. Our objective is to ascertain the seasonality and inter-annual variability in WUE of this needle fir plantation so that the results may be assimilated into the development of a holistic ecological indicator for resilience assessment. Our results show that the WUE of needle fir plantation is characterized by a concave seasonal pattern with a minimum ($1.8-3.3g\;C{\cdot}(kg\;H_2O)^{-1}$) in August and a maximum ($5.1-11.4g\;C{\cdot}(kg\;H_2O)^{-1}$) in February. During the growing season (April to October), WUE was on average $3.5{\pm}0.3g\;C\;(kg\;H_2O)^{-1}$. During the dormant seasons (November to March), WUE showed more variations with a mean of $7.4{\pm}1.0g\;C{\cdot}(kg\;H_2O)^{-1}$. These values are in the upper ranges of WUE reported in the literature for coniferous forests in temperate zone. Although the growing season was defined as the period from April to October, the actual length of the growing season (GSL) varied each year and its variation explained 62% of the inter-annual variability of the growing season WUE. This is the first study to quantify long-term changes in ecosystem-level WUE in Korea and the results can be used to test models, remote-sensing algorithms and resilience of forest ecosystem.

Comparative Analysis of COVID-19 Pandemic Crisis Response Capacities by Countries (코로나19 팬데믹 위기 대응 역량의 국가별 비교분석)

  • Yoon Hyeon Lee
    • The Journal of Korean Society for School & Community Health Education
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    • v.25 no.2
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    • pp.59-70
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    • 2024
  • Objectives: The purpose of this study is to analyze each country's infectious disease response capacities and, based on this, find areas for improvement in Korea's infectious disease management response. Methods: First, the capacity to respond to the COVID-19 infectious disease was analyzed by country using the SPAR scores of 96 countries around the world released by WHO in 2022. Second, we analyzed each country's specific COVID-19 quarantine performance using Our World in Data and the Global Health Security Index (GHSI). Results: First, the quarantine intensity index on January 24, 2021 was the highest in the Southeast Asia branch at 67.6, which had strong quarantine measures, and the lowest at 44.5 in the Africa branch. As of December 31, 2022, the quarantine intensity index in Europe was significantly lowered to 11.6. Second, the factor that influenced the SPAR indicator on the total number of patients per million population was national laboratory (C4), p=.027, and the factor that influenced the total number of deaths per million population was infection prevention and control (C9), p=.005., Risk Communication and Community Participation (C10) p=.040. The influential factor on GDP per capita was infection prevention and control (C9) p=.009, and the influential factor on GHSI was infection prevention and control (C9) p=.002. Conclusion: The research findings indicate that it was difficult to find a correlation between the SPAR, which is each country's self-assessment of their infectious disease capacities, and the number of COVID-19 cases or the intensity of pandemic responses. However, mortality rates, as well as factors such as the Global Health Security Index (GHSI) and national income, appear to be somewhat influenced. For future improvements in infectious disease management and response in our country, it is necessary to develop pandemic strategies that can reduce socio-economic costs based on more scientific and reliable data like JEE or GHSI, especially in preparation for potential unknown emerging infectious diseases. Based on this, proactive decision-making led by a control tower of experts and effective health communication are also required to respond to public health crises at a national level.

Stability Analysis of Concrete Liner installed in a Compressed Air Storage Tunnel (압축공기 저장용 터널에 설치된 콘크리트 라이닝의 안정성 해석)

  • Lee, Youn-Kyou;Park, Kyung-Soon;Song, Won-Kyong;Park, Chul-Whan;Choi, Byung-Hee
    • Tunnel and Underground Space
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    • v.19 no.6
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    • pp.498-506
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    • 2009
  • The stability assessment of a concrete liner of a compressed air storage tunnel should be performed by an approach which is different from that commonly used for the liners of road tunnels, since the liner is exposed to high air pressure. In this study, the stability analysis method for the liner of compressed air storage tunnel is proposed based on the elastic and elasto-plastic solutions of the thick-walled cylinder problem. In case of elastic analysis, the yield initiation condition at the inner boundary is considered as the failure condition of the liner, while the condition which results in the extension of yielding zone to a certain depth is taken as a failure indicator of the liner in the elasto-plastic analysis taking Mohr-Coulomb criterion. The application of the proposed method revealed that the influence of the relative magnitude of boundary loads on the stability of liner is considerable. In particular, noting that the estimation of the outer boundary load may be relatively difficult, it is thought that the precise prediction of outer boundary load is very important in the analysis. Accordingly, the emphasis is put on the selection of the liner installation time, which may govern the magnitude of outer boundary load.

Changes in Oxygen Consumption Rates of Embryos in Korean Cattle (한우 수정란의 발달 단계별 산소 소비량 변화)

  • Choe, Chang-Yong;Cho, Sang-Rae;Son, Jun-Kyu;Choi, Sun-Ho;Cho, Chang-Yeon;Kim, Jae-Bum;Kim, Sung-Jae;Kang, Da-Won;Son, Dong-Soo
    • Journal of Embryo Transfer
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    • v.24 no.3
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    • pp.231-235
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    • 2009
  • Oxygen consumption has been regarded as a useful indicator for assessment of mammalian embryo quality. However, there was no standard criterion to measure the oxygen consumption of embryos. Here, we measured oxygen consumption of bovine embryos at various developmental stages was measured using a scanning electrochemical microscopy (SECM). We found that the oxygen consumption significantly increased in blastocyst-stage embryos compared to other stage embryos (from 2-cell-stage to morula-stage), indicating that oxygen consumption reflects the cell number ($5.2{\sim}7.6{\times}10^{14}/mol\;s^{-1}$ versus $1.2{\sim}2.4{\times}10^{14}/mol\;s^{-1}$, p<0.05). In the morula-stage embryos, the oxygen consumption of in vivo derived embryos was significantly higher than that of in vitro produced embryos ($4.0{\times}10^{14}/mol\;s^{-1}$ versus $2.4{\times}10^{14}/mol\;s^{-1}$, p<0.05). However, there was no significant difference in consumption of oxygen by in vivo and in vitro-derived bovine blastocyst-stage embryos (p>0.05). In the frozen-thawed blastocyst-stage embryos, live embryos showed significantly higher oxygen consumption than dead embryos ($4.7{\times}10^{14}/mol\;s^{-1}$ versus $1.0{\times}10^{14}/mol\;s^{-1}$, p<0.05). These results indicate that the measuring oxygen consumption by SECM can be used to evaluate bovine embryo quality.

Determination of Short-term Bioconcentration Factor and Partition Coefficient on Chlorothalonil in Carassius auratus(goldfish) (Carassius auratus(goldfish)를 이용한 Chlorothalonil의 단기간 생물농축계수와 분배계수의 측정)

  • 차춘근;전봉식;민경진
    • Journal of Environmental Health Sciences
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    • v.21 no.3
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    • pp.38-47
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    • 1995
  • The Bioconcentration factor (BCF) is used as an important criterion in the risk assessment of environmental contaminants. Also it can be used as indicator of biomagnification of environmentally hazardous chemicals through food-chain as well as a tool for ranking the bioconcentration potential of the chemicals in the environment. This paper reports the measured BCF value on Chlorothalonil in Carassius auratus(goldfish), under steady state, and examined correlation between the BCF value and the partition coefficient or acute toxicity or physicochemical properties. Carassius auratus(goldfish) was chosen as test organism and test period were 3-day, 5-day. Experimental concentrations were 0.005, 0.01 and 0.05 ppm. Chlorothalonil in fish tissue and in test water were extracted with n-hexane and acetonitrile. GC-ECD was used to detecting and quantitating of Chlorothalonil. Partition coefficient was determined by stir-flask method. $LC_{50}$ was determined on Chlorothalonil. Carbaryl and BPMC. The obtained results were as follows. 1. It was possible to determine short term BCFs of Chlorothalonil through relatively simple procedure in environmental concentrations. 2. $BF_3$ of Chlorothalonil in concentration of 0.005, 0.01 and 0.05 ppm were 2.1866$\pm$0.23446, 3.5269$\pm$0.23517, 10.2045$\pm$0.18053 and BCFs were 6.6543$\pm$0.55257, 6.9774$\pm$0.02500, 23.4576$\pm$2.06884, respectively. 3. Chlorothalonil concentration in fish extract and BCFs of Chlorothalonil were increased as increasing test concentration and prolonging test period. 4. Fate of test-water concentration on Chlorothalonil was greater than that of control-water con-centration. It is considered that greater fate of test-water concentration on Chlorothalonil is due to hydrolyzing nitrile group under the mild condition and substituting chloro group by some aromatic compounds in test water. 5. Determined logP of Chlorothalonil was 2.80. And determined $LC_{50}$ of Chlorothalonil in time of 24, 48, 72 and 96 hr were 0.1684, 0.1402, 0.1400, 0.1352(mg/l) respectively. And $LC_{50}$ of Carbaryl in above times were 19.918, 18.635, 18.466, 18.12(mg/l) respectively. $LC_{50}$ of BPMC were 10.248, 9.166, 9.087, 8.921(mg/l) respectively. 6. It is suggested that the BCF of Carbamates depend on partition coefficients. But BCF of Chlorothalonil, organochlorine pesticide, would be strongly influenced by steric, electronic effect of substituents than partition coefficient.

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