This paper suggests a new policy for consolidating a company's profits by segregating the clients using the contents service and allocating the media server's resources distinctively by clusters using the cluster analysis method of CRM, which is mainly applied to marketing. In this case, CRM refers to the strategy of consolidating a company's profits by efficiently managing the clients, providing them with a more effective, personalized service, and managing the resources more effectively. For the realization of a new service policy, this paper analyzes the level of contribution $vis-\acute{a}-vis$ the clients' service pattern (total number of visits to the homepage, service type, service usage period, total payment, average service period, service charge per homepage visit) and profits through the cluster analysis of clients' data applying the K-Means Method. Clients were grouped into 4 clusters according to the contribution level in terms of profits. Likewise, the CRFA (Client Request Filtering algorithm) was suggested per cluster to allocate media server resources. CRFA issues approval within the resource limit of the cluster where the client belongs. In addition, to evaluate the efficiency of CRFA within the Client/Server environment the acceptance rate per class was determined, and an evaluation experiment on network traffic was conducted before and after applying CRFA. The results of the experiments showed that the application of CRFA led to the decrease in network expenses and growth of the acceptance rate of clients belonging to the cluster as well as the significant increase in the profits of the company.
Background: The total aortic arch replacement is one of the most difficult operations with high mortality rate. But the arch first technique with subclavian arterial perfusion has been reported to be a safe methods for arch replacement. Material and Method: Between Feb 2003 and July 2004, 18 patients, 10 men and 8 women, underwent total aortic arch replacement with arch first technique. Their mean age was $59.3\pm12.9$ years. The patietns received 11 acute aortic dissections, 3 chronic aortic dissectiong aneurysms, and 4 ruptured aortic arch aneurysms. Result The mean admission period was $20.2\pm7.4$ days. There was one early mortality case which died of low cardiac output syndrome and another late mortality case which died of cerebral hemorrhage. The others were discharged without any sequelae and they were followed up for an average period of $180\pm156.3$ days. Conclusion: The total aortic arch replacement with arch first technique and subclavian arterial perfusion is a good method that will reduce the surgical mortality and the possibility of secondary late reoperation from the remnant distal aortic problems.
Background : Monoplegia is the paralysis of a limb. It is commonly caused by an injury to the cerebral cortex, and rarely caused by injury to the internal capsule, brain stem, or spinal cord. Most problems with cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. Objectives : This study is to see if there is a significance in thermal differences of acupoints in diagnosis and treatment of monoplegia on an upper extremity to test the validity of acupuncture and herbal treatment for it. Methods : By using Digital Infrared Thermographic Imaging(DITI), thermal differences$({\Delta}T)$ of acupoints on the upper extremity in a patient with monoplegia on the right upper extremity were measured after an attack of the disease. By giving Mangeum-tang(萬金湯) and treating the patient with acupuncture. the temperature changes of the upper extremity were examined through DITI and improvement was observed. Results : Compared with the left arm which suffered no such injury, the right recovered about 80% of sensation, and the grade of monoplegia improved from Grade O to Grade V. Also, the temperatures of right palmar-dorsal hand and the region of Weiguan(外關, Waiguan, TE5) were $1^{\circ}C$ and $1.45^{\circ}C$ higher than the same left region on admission day, but the thermal differences$({\Delta}T)$ narrowed to $0.5^{\circ}C$ by the last day. Conclusions : Results suggest that DITI screening is a reliable method of prognosis and that the time required for treatment can be estimated through this method in cases of monoplegia to an upper extremity. Also, progress in treatment is reflected in thermal differences of acupoints of the monoplegic upper extremity in accordance with the theory of meridian. This supports a role for acupuncture and herbal treatment for monoplegia.
Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.
These days, as the society has been in the trends of highly industrialized and the family has been downsized, there is remarkably increasing number of women who follow occupation. These changes have made it more difficult for the family to help post-partum mother, which had been performed in side of house. By the help of social believe that during at least 1 month after childbirth professional nursing program is indispensable for both maternity protection and physical-mental recuperation, now many post-partum care centers for post-partum mother have been in operation. Although these post-partum care center have in use for a long time, no study was performed before this study on the same subject. Data were analyzed using by SAS. The results of study are as follow : 1. The general features of the user of the post-partum care center. The predominant band of user's age is extended from 26 to 30. The users are mainly housewives and they are in higher level of incomes and educations. As for the feature of delivery methods, they performed the normal spontaneous vaginal delivery method by 58.0% and the Caesarean operation method by 42.0%. As for the sexuality for babies, 59.3% of infants are male, and 40.7% are female. The highest delivery order of users is first and admission after 1-3days delivery is highest. 2. The results for the investigation into the actual condition of the post-partum care center are as follow : About the main reason for entrance of the post-partum care center was found to be the needs for the better nursing programs for recuperation after childbirth. This demands are also supported by their husbands. The average length of stay in the post-partum care center is 17.6 days and the besides promised expense ; powdered milk, milk-suckers, disposable dippers, skin cares, body shape cares, entrophics, injections. The post-partum have private rooms for mother and infants. Over the half of average expense is 229 million won. They are paying accessory fees the post-partum care center have similar step organization : the nurses, the skin carers, the cleaners. Mostly both ways of feeding powdered milk and breast feeding are in use, and mother's milk is preserved in the night time to be given to infant by nurse in charge. 3. The results of the investigation on users' nursing demand to the post-partum care center and satisfaction are as follow : The ranking order of nursing demand of mothers who used the is that ; infant care demands, environmental demands, emotional and mental care demands, education and training demands. As much as 70% of the respondents have dissatisfaction in nursing program, The ranking order of service satisfaction of mothers who used appears to be higher following order ; satisfaction in infant care demand, satisfaction in physical nursing demand, satisfaction in emotional and mental nursing demand, satisfaction in education and training demand, satisfaction in environment nursing demand. The results of pearson correlation. between nursing demand and service satisfaction of mothers who used are found to be relative noticeable in the level of 0.05. only infant care. The 61.7% of the women who used the post-partum care center. are responding that they will reuse the same post-partum care center again.
Jo, Choong Hyun;Jung, Yong Sik;Kim, Wook Hwan;Cho, Young Shin;Ahn, Jung Hwan;Min, Young Gi;Jung, Yoon Seok;Kim, Sung Hee;Lee, Kug Jong
Journal of Trauma and Injury
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v.22
no.1
/
pp.77-86
/
2009
Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.
Background: There are many retreatment failure patients admitted in National Kongju Tuberculosis Hospital. But there is not satisfactory treatment method for them at present. We think that more attentions and active measures for them are needed. Method: We reviewed sex and age, duration of illness, previously used antituberculosis drugs, drug resistance, extent of disease, reasons for early stopping or irregular medication and schooling of 50 retreatment failure patients admitted in National Kongju Tuberculosis Hospital from April 1992 to February 1993. Results: 1) The male to female ratio was 3:2 and 62% of the patients were between 21 and 40 years of age. 2) Twenty eight cases (56%) had the duration of illness over 10 years. 3) All cases had used most of the antituberculosis drugs. 4) Drug sensitivity test showed resistance to RMP in 46 cases (96%), INH in 40 cases (83%) and other drugs in 3-32 cases (6-67%). 5) Forty eight cases (96%) had far advanced disease on chest P-A film. 6) Twenty eight cases (56%) in primary chemotherapy and twenty one cases (42%) in retreatment had the histories of premature stopping or irregular ingestion of the drug. The reasons for premature stopping or irregular ingestion of the drug were as follows; in primary chemotherapy, 29 cases (75%) were due to 'having no symptoms', while in retreatment, 6 cases (29%) were due to 'having no symtoms', 6 cases (29%) were 'too, busy' and 3 cases (14%) were for 'financial problem'. 7) Twenty seven cases (54%) had at least graduated from high school. Conclusion: Greater efforts are needed to prevent tratment failure. More supports and admission treatment for retreatment failure patients are needed to prevent infection and to treat properly.
The Journal of Sustainable Design and Educational Environment Research
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v.18
no.3
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pp.1-15
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2019
This study analyzes universities in Japan, which haves many similarities with those in Korea in certain aspects of the educational system and a common problem of reduced university admission resources, Korea's national university facility standards, policy related to nation-level university facility, and practical campus case. Through this, the study aims to examine the difference in the national approach and basic philosophy about university facilities in Korea and Japan, and also identify the major planning factors and improvement directions when establishing plans for university campuses in the future. The results of this study are as follows. First, Korea tends to promote policies related to university facilities by individual projects centered on a major pending problem or issue, while Japan has been shown to promote national university facility policies under a comprehensive mid-to-long-term plan by establishing a maintenance plan aimed at national university facilities every five years. Second, In the case of the university facility areas, the average university facility area of the examined universities in Japan is about 5.6% larger than the average university facility area in Korea. Additionally, the university facility area per student in Japan is about 13% wider than that of Korea. The total floor area of university facilities in Japan is also about 20.7% larger than that of Korea, and the university facility area per student in Japan is about 56.7% wider than that of Korea as well. Among support facilities, the total floor area of dormitories in Korea was 2.5 times wider than that of Japan, however, the acceptance rate of dormitory in Korea was 5.6% higher than Japan. Third, the university facility criteria items and systems of two countries are similar. but there are slight differences in the content such as the method of calculating student capacity, division classification, and the method of calculating the number of teachers.
The Journal of Korea Institute of Information, Electronics, and Communication Technology
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v.13
no.6
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pp.597-604
/
2020
This is a narrative research study conducted on the subject in order to understand the relationship between the meta-cognition, learning flow, and problem solving ability of nursing students in online class, and to find out the factors that influence problem solving ability, 88 students enrolled in 2nd and 3rd grade students who participated in online classes at G city universities. The analysis method was analyzed by means, standard deviation, t-test, one-way ANOVA, Pearson correlation, and stepwise multiple regression using SPSS version WIN 23.0. As a result of the study, the difference between learning flow and problem-solving ability according to general characteristics was significantly different depending on the perception of nurses after learning and the motivation for admission to the department of nursing, and the problem-solving ability was positively correlated with metacognition and learning flow. There was a relationship, and metacognition and learning flow were significant variables that influenced problem solving ability. The conclusion of the study is considered to be the basic data for the development of a systematic program that can increase the learning flow and meta-cognition to increase problem solving ability amid the change from nursing education to online classes, and to change the teaching method.
Purpose: This study was conducted to investigate newly admitted nursing home resident's experience and adjustment problems in the early stage of institutionalization. Method: In depth interviews was done on 6 elderly residents who were newly admitted. Data from the interview were analyzed using theme analysis method. Results: Results showed that reasons for Institution admission were decreasing physical health and cognitive functioning. Residents reported that difficulties they experienced in institution life were lack of individualized care, loss of autonomy and privacy associated with the demands of group living, and loss of control over activities of daily living. Conclusion: Efforts need to be made to maintain the residents' decision-making and autonomy. Listening intentionally, offering choices, and promoting personal identity might be utilized to reduce relocation stress and enhance adaptation to nursing home living.
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