A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis (조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구)
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- Journal of Korean Academy of Nursing
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- v.24 no.4
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- pp.545-556
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- 1994
Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.
Histopathological changes and methemoglobinemia of the eels (Anguilla japonica) reared at six culture farms in the vicinity of Y
The comparison of climate's character of Yunqi(運氣) with the data of meterological observation were made in the research of climate. 1. The comparison of the average velocity of wind, temperature, rainfall, humidity of Seoul, by late 1954 to 1983, with Yunqi(運氣) was made. Fire-Chi(火氣) and moisture-qi(濕氣) were matched with the attribute of Taiyun(大運). Cold-qi(寒氣) was had some relationship. Dry-qi(燥 氣) and Wind-qi(風氣) were not matched. About the relationship of Spirit-of-official-sky(司天之氣) with climate, when the Moisture-soil(濕土) was added, they were matched and when the King-fire(君火) was added, they have some relationship. But Wind-tree(風木), Dry-metal(燥金), Buble-fire(相火), Cold-water(寒水) was added they were not matched. 2. According to the observation data of rainfall by late 180 years of Seoul; about Taiyun(大運), when the Water-Yun(水運) was greatly exceeded and Fire-Yun(火運) was shorted, in the case of Official-sky(司天), when Wind-Tree(風木) was added, the frequency was highly. So when the Soil-Yun(土運) was greatly exceeded and when Official-sky(司天)was added to the Moisture-soil(濕土), the rainfall was not matched. 3. The relationship of the frequency of the abnormal climate occurrences between Yunqi-promotion-weak(運氣盛衰)and Yunqi-Harmony(運氣同化) and Yunqi-soft-attacking(運氣順逆) in the weather of Korean Peninsula was compared by 1564 to 1863. They were not matched except the case of Yunqi-Harmony(運氣同化). 4. There were some cases which were not matched exactly between the climate predicted by the theory and real climate in 1984, the year of Kap-ga(甲子年). But many correspondence between the observation by the office of meteorology and the prediction by the analysis from Yun-qi-sang-hab(運氣相合) theory. 5. Because meterological phenomena of real world and analysis from the hypothesis of Yunqi(運氣) have no relationship with each other, some of Doctor denied Yunqi(運氣) in the way of matching mechanically. But the thought of Doctor who denied Fortune-spirit(運氣) made promotion for the theory of divination by bringing deeper insight. And it was not only the negative side. 6. In the point of geographical difference, the climate of China, the origination Yunqi theory, is different from the Korea's. Thus some observation errors should be considered. From the basis of this thesis, I hope that the deeper advance would be made into the Korean Yunqi theory.
It is generally accepted that there are momentum effects in the short term and reversal effects in the long term, which makes abnormal excess returns in the major stock markets in the world. In Korea stock market, however, the previous studies demonstrate that contrarian strategies based on reversal effects are more effective than momentum strategies following momentum effects in the short term as well as in the long term. This paper examines wether contrarian strategies are still effective In Korea stock market from 1980 to 2009, and the short term reversals may be changed after the foreign exchange crisis in 1997-1998. Moreover, this paper investigates how contrarian profits are shown considering the state of market. In my research, unlike previous studies, I find that both of contrarian strategies using price change and price level cannot gain excess risk adjusted returns in Korea stock market from 1980 to 2009, but this result is due to the fact that reversal effects existed before the foreign exchange crisis but momentum effects does after the foreign exchange crisis in 1997-1998. Specially, after the foreign exchange crisis, it is confirmed momentum strategies using 52 week high price, that is, price level are more effective than momentum strategies using price change. And following the strategies using 52 week high price after the foreign exchange crisis, the momentum is not only observed in the up market but also in the down market, which is different with the results of the studies regarding to American market, where the momentum is just found in the up market.
Diabetes Mellitus (DM) is a syndrome accompanied with the abnormal secretion or function of insulin, a hormone that plays a vital role in controlling the blood glucose level (BGL). Type land 2 DM are most common form and the prevalence of the latter is recently increasing, The aim of this article was to assess whet her Type 2 DM could act as a predisposing risk factor on the pulpo-periapical pathogenesis. Previous literature on the pathologic changes of blood vessels in DM was thoroughly reviewed. Furthermore, a histopathologic analysis of artificially-induced periapical specimens obtained from Type 2 diabetic and DM-resistant rats was compared. Histopathologic results demonstrate that the size of periapical bone destruction w as larger and the degree of pulpal inflammation was more severe in diabetic rats, indicating that Type 2 D M itself can be a predisposing risk factor that makes the host more susceptible to pulpal infection. The possible reasons may be that in diabetic state the lumen of pulpal blood vessels are thickened by atheromatous deposits, and microcirculation is hindered, The function of polymorphonuclear leukocyte is also impair ed and the migration of immune cells is blocked, leading to increased chance of pulpal infection. Also, lack of collateral circulation of pulpal blood vessels makes the pulp more susceptible to infection. These decrease the regeneration capacity of pulpal cells or tissues, delaying the healing process, Therefore, when restorative treatment is needed in Type 2 DM patients, dentists should minimize irritation to the pulpal tissue un der control of BGL.
Maple syrup urine disease (MSUD, OMIM#248600) is a rare and autosomal recessively-inherited metabolic disorder that is caused by mutations in the branched-chain
The safety valve (PSV) is a safety device that automatically releases a spring when the pressure generated by various causes reaches the set pressure, and is restored to a normal state when the pressure falls below a certain level. Periodic inspection and monitoring of safety valves are essential so that they can operate normally in abnormal conditions such as pressure rise. However, as the current safety inspection is performed only at a set period, it is difficult to ensure the safety of normal operation. Therefore, evaluation items were developed by finding failure modes and causative factors of safety valves required for safety management. In addition, it is intended to provide decision-making information for securing safety by deriving the priority of items. To this end, a Delphi survey was conducted three times to derive evaluation factors that were judged to be important in relation to the Failure Mode Cause Factor (FMCFs) of the safety valve (PSV) targeting 15 experts. As a result, 6 failure modes of the safety valve and 22 evaluation factors of its sub-factors were selected. In order to analyze the priorities of the evaluation factors selected in this way, the hierarchical structure was schematized, and the hierarchical decision-making method (AHP) was applied to the priority calculation. As a result of the analysis, the failure mode priorities of FMCFs were 'Leakage' (0.226), 'Fail to open' (0.201), 'Fail to relieve req'd capacity' (0.152), 'Open above set pressure' (0.149), 'Spuriously' 'open' (0.146) and 'Stuck open' (0.127) were confirmed in the order. The lower priority of FMCFs is 'PSV component rupture' (0.109), 'Fail to PSV size calculation' (0.068), 'PSV Spring aging' (0.065), 'Erratic opening' (0.059), 'Damage caused by improper installation and handling' (0.058), 'Fail to spring' (0.053), etc. were checked in the order. It is expected that through efficient management of FMCFs that have been prioritized, it will be possible to identify vulnerabilities of safety valves and contribute to improving safety.
Objective : There are four possible explanations for the sexual dysfunction of schizophrenics. The first is the possibility of a real structural aspect. The second possibility is that sexual function changes secondary to the illness. The third possibility is that there are medical and sociocultural barriers to sexual expression for chronic schizophrenics. The fourth possibility is that sexual dysfunction due to antipsychotic medication. However, we didn't know the precise cause of sexual dysfunction in schizophrenics. Therefore, the purpose of this study was to explore the mechanism of illness itself and antipsychotics on sexual dysfunction in male schizophrenics. Methods : The serum prolactin(PRL), testosterone(TST), and the plasma serotonin(5-HT) concentrations were measured by radioimmunoassay and high performance liquid chromatography method for 100 healthy male schizophrenics according to the DSM-IV. Concomitantly, the severity of psychotic symptoms using Clinical Global Impression(CGI), Brief Psychiatric Rating Scale(BPRS), Positive and Negative Syndrome Scale(PANSS), and the severity of side effects for antipsychotics using Extrapyramidal Side Effects Scale(EPSE), Anticholinergic Side Effects Scale(ACSE), the cognitive function using PANSS-Cognitive Function(PANSS-CF), Mini Mental State Exam-Korean(MMSE-K), and the sexual dysfunction using Sexual Functioning Questionnaire(SFQ), Questionnaire for Sexual Dysfunction in Men were assessed. The PRL, TST, and 5-HT levels of 50 healthy male controls who had no medical, neurological, and psychiatric illnesses were evaluated. The sexual function using SFQ(items FGa, FNa) were also assessed. Furthermore, the correlation with age, education, religion, economic status, age at onset, duration of illnesses, duration of admission, levels of PRL, TST, 5-HT, antipsychotic dosages, potency, benztropine, total duration of medication, EPSE, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K and sexual dysfunctions were identified in male schizophrenics. Results : 1) The frequencies of sexual dysfunctions for schizophrenics(80%) were significantly(p<0.001) higher than those for controls(42%). The sexual dysfunctions according to sexual response cycle were 'low sexual desire' 76%, 'impairment of achieving erection' 75%, 'impairment of maintaining erection' 75%, 'impairment of obtaining orgasm' 32%, 'impairment in the quality of orgasm' 61%, 'impairment in quantity of ejaculate' 44%, 'premature ejaculation' 15%, and 'delayed ejaculation' 50%. 2) The PRL, 5-HT levels of schizophrenics(
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70