• Title/Summary/Keyword: Classification System Development

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A basic research for evaluation of a Home Care Nursing Delivery System (가정간호 서비스 질 평가를 위한 도구개발연구)

  • Kim, Mo-Im;Cho, Won-Jung;Kim, Eui-Sook;Kim, Sung-Kyu;Chang, Soon-Bok;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.33-45
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    • 1999
  • The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

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Clinical Manifestation and Treatment Outcome of Lupus Nephritis in Children (소아 루프스 신염의 임상양상 및 치료결과)

  • Park Jee-Min;Shin Jae-Il;Kim Pyung-Kil;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.155-168
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    • 2002
  • Purpose; Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. Methods: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. Results: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1(2-18) years old. FANA(95.0%), anti-ds DNA antibody(87.5%), malar rash(80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria(75.0%), nephrotic syndrome(55.0%), and microscopic hematuria alone(15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was $51.8{\pm}40.5$ months. During $51.8{\pm}40.5$ months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. Conclusion: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.

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An Analysis for the Economic Impact of Forest Road Investment (임도시설 투자의 경제적 파급효과 분석)

  • Lee, Seung-Jung;Jung, Byung-Heon;Kim, Ki-Dong;Jeon, Hyon-Sun;Jo, Min-Woo
    • Journal of Korean Society of Forest Science
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    • v.106 no.2
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    • pp.219-229
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    • 2017
  • Forest road is an essential infrastructure for forest management such as the composition and management of forest resources, timber and forest byproduct production & transportation. It has recently been utilized forest recreation and forest sports as well as also forest pest control, forest fire prevention and evolution. When you build a forest road, the economic function in the forest is activated, so that it can result in the ripple effect of induced employment, value-added creation and production inducement. The purpose of this study is to analyze the impact caused by forest road construction occurring as the overall economy. For analysis it was applied to inter industry analysis method that is a method for analyzing the quantitative cross-correlation. The data were used in the Input-Output Tables In 2014, the Bank of Korea. When you build a forest road, economic effect due to the construction of the forest road is generated and economic effects are also generated due to the increase in the production of forest products after the construction of the forest road. Therefore, we will analyze the economic impact of the two effects. The estimated economic value of forest products, which is the economic effect of forest product cultivation, was calculated through some assumptions and the economic ripple effect was analyzed. The forest road construction sector is defined as land clearing and reclamation, and irrigation project construction and the forestry forest products sector is defined as the sum of raw timber, edible forest products and misc. forest products. In total, 32 sectors were classified, and except for the two sectors defined as forest road construction and forestry forest products, the remaining sectors were integrated according to the classification system of 30 integrated classifications of the Bank of Korea. As a result, the production inducement coefficient for forest construction was analyzed to be 2.767 and the production inducement coefficient for forestry forest products was analyzed to be 1.565. This means that 2,767 times the production of forest road construction investment is induced in the whole industry and the production of 1.562 times the amount of forestry forest products is caused by the whole industry as the production of forestry forest products increases. The value added inducement coefficient for forest road construction was 0.977 and the value added inducement coefficient for forestry forest products was 0.985. Forest road are essential infrastructure for forestry development and should be continuously invested because they are essential elements of timber production and forest byproduct production with functions such as forest management, forest recreation, forest sports, and town connection.

Development of Volume Growth Rate Model for Major Quercus Species in Korea (우리나라 주요 참나무류 수종의 재적생장률 추정 모델의 개발)

  • Shin, Man Yong;Kim, Sung Ho;Jeong, Jin-Hyun;Kim, Chong Chan;Jeon, Eo Jin
    • Journal of Korean Society of Forest Science
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    • v.97 no.6
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    • pp.627-633
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    • 2008
  • This study was conducted to estimate volume growth rates for major Quercus species distributed in Korea, and based on the data collected from the 5th National Forest Inventory. Volume growth rates were estimated by each age class for each species, and their similarity or distinction was statistically analyzed. It was also intended to compare the resulted volume growth rates with the existing growth rates, and to develope a volume growth rate estimation model for the Quercus species. Six major Quercus species were considered in this study; Quercus acutissima, Quercus aliena, Quercus serrata, Quercus variabilis, Quercus dentata, and Quercus mongolica. Based on the data collected from the 5th National Forest Inventory, the diameter growth rates and the height growth rates were estimated for each species, and then the volume growth rates were estimated with the given diameter and height growth rates. To examine the distinction between species or age classes, statistical analyses such as ANOVA and Duncan's multiple range test were applied. The results indicated that the volume growth rate was 10% in the age class II, 6% in the age class III, and lower in the subsequent classes. In addition, the volume growth rates of Quercus acutissima, Quercus aliena, and Quercus serrata were relatively high compared to those of Quercus variabilis, Quercus dentata, and Quercus mongolica. According to their growth rates, the six Quercus species were classified into two groups; high-growth-rate group and low-growth-rate group. Statistical analysis conducted to examine the difference between and within the groups showed that there is no significant difference within groups, while significant between groups. Based on the results, volume growth rate estimation model were finally developed for each group. The classification of the Quercus species suggested in this study was not the same with that of existing volume growth estimation. Thus, it is necessary to improve the existing volume growth rate or its estimation system.

An Economic Factor Analysis of Air Pollutants Emission Using Index Decomposition Methods (대기오염 배출량 변화의 경제적 요인 분해)

  • Park, Dae Moon;Kim, Ki Heung
    • Environmental and Resource Economics Review
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    • v.14 no.1
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    • pp.167-199
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    • 2005
  • The following policy implications can be drawn from this study: 1) The Air Pollution Emission Amount Report published by the Ministry of Environment since 1991 classifies industries into 4 sectors, i. e., heating, manufacturing, transportation and power generation. Currently, the usability of report is very low and extra efforts should be given to refine the current statistics and to improve the industrial classification. 2) Big pollution industries are as follows - s7, s17 and s20. The current air pollution control policy for these sectors compared to other sectors are found to be inefficient. This finding should be noted in the implementation of future air pollution policy. 3) s10 and s17 are found to be a big polluting industrial sector and its pollution reduction effect is also significant. 4) The effect of emission coefficient (${\Delta}f$) has the biggest impact on the reduction of emission amount change and the effect of economic growth coefficient (${\Delta}y$) has the biggest impact on the increase of emission volume. The effect of production technology factor (${\Delta}D$) and the effect of the change of the final demand structure (${\Delta}u$) are insignificant in terms of the change of emission volume. 5) Further studies on emission estimation techniques on each industry sector and the economic analysis are required to promote effective enforcement of the total volume control system of air pollutants, the differential management of pollution causing industrial sectors and the integration of environment and economy. 6) Korea's economic growth in 1990 is not pollution-driven in terms of the Barry Commoner's hypothesis, even though the overall industrial structure and the demand structure are not environmentally friendly. It indicates that environmental policies for the improvement of air quality depend mainly on the government initiatives and systematic national level consideration of industrial structures and the development of green technologies are not fully incorporated.

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Nodal Status of the Head and Neck Cancer Patients (두경부 암 환자의 경부 림프절 전이 분석)

  • Yang, Dae-Sik;Choi, Myung-Sun;Choi, Jong-Ouck
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.321-329
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    • 1997
  • Purpose : It is well known that the risk of lymph nodes metastases to head and neck cancers are influenced by the location and size of the Primary tumor. as well as the degree and types of histological differentiation. However, data on the statistical analyses of lymph node metastases from the head and neck cancers among Korean Population are not available at present. In order to obtain current status of such data, we have analyzed cancer patients at the department of radiation oncology, korea universityhospital for radiation treatment. Materials and Methods : We have evaluated nine-hundred and ninetyseven (997) head and neck cancer Patients who visited to the Department of radiation oncology, between November 1981 to December 1995. After careful physical examinations and CAT scan, Patients were divided into two groups, those with positive lymph node metastases and with negative lymph node metastases. The nodal status were classified according to the TNM system of American Joint Committee on Cancer (AJCC) Besults : Four-hundred and sixteen Patients out of the 997 patients were lymph node positive $(42\%)$ and 581 patients were lymph node negative $(58\%)$ when they were first presented at the department of radiation oncelogy. According to the AJCC classification, the distribution of positive lymph node is as follow: Nl:106 $(25.5\%),\;N2a:100\;(24\%),\;N2b:68\;(16.4\%),\;N2c:69\;(16.6\%),\;3:73\;(15\%).$ respectively. The frequency of lymph node metastases according to the primary sites is as follow : larynx 283 $(28.5\%)$, paranasal sinuses: 182 $(18\%),\;oropharynx:144\;(14.5\%)\;nasopharynx:122(12\%),\;oral\;cavity\;92\;(9\%),\;hypopharynx:71\;(7\%),\;falivary\;gland:58\;(6\%)$ unknown primary:31 $(3\%),\;skin:\;14(2\%)$,. The most frequent Primary site for the positive Iymph node metastases was nasopharynx $(71\%)$ followed by hypopharynx $(69\%),\;oropharynx\;(64\%),\;oral\;cavity\;(39\%)$ The most common histologic type was squamous cell carcinoma (652/997: $65.4\%$). followed by malignant lymphoma $(109/997:11\%)$. Conclusion : Statistical results of lymph node metastases from head and neck cancer at our department were very similar to those obtained from other countries. It is concluded that the location of Primary cancer influences sites of metastases on head and neck, and stage of the primary cancer also influences the development of metastatic lesions. Since the present study is limited on the data collected from one institute. further statistical analyses on Korean cancer Patients are warrented.

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Relationship Between MC1R and ASIP Genotypes and Basic Coat Colors in Jeju Horses (제주마의 기본모색과 MC1R과 ASIP 유전자형 조합의 상관관계)

  • Kim, Nam-Young;Han, Sang-Hyun;Lee, Sung-Soo;Lee, Chong-Eon;Park, Nam-Geon;Ko, Moon-Suck;Yang, Young-Hoon
    • Journal of Animal Science and Technology
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    • v.53 no.2
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    • pp.107-111
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    • 2011
  • This study was undertaken to reveal the relationship between genetic variations and the basic coat color classification system in Jeju horses. Genetic variations of the melanocortinreceptor 1 (MC1R) and agouti signaling protein (ASIP) genes were investigated using pyrosequencing technique. A nucleotide substitution mutation for MC1R g.901C>T and an ASIP 11-bp deletion mutation were screened. Black horses had MC1R $E^+$/- ($E^+/E^+$ or $E^+/E^e$) and ASIP $A^a/A^a$ genotypes. In contrast, chestnut horse genotypes were MC1R $E^e/E^e$ and ASIP -/-. Thus, black and bay horses have at least one dominant MC1R allele, $E^+$, whereas chestnut horses have homozygous recessive alleles $E^e/E^e$. This suggests that the MC1R genotypes determine chestnut or black/bay coat color, regardless of the genotype distribution of ASIP. In addition, the horses with MC1R $E^+$/- and a dominant ASIP $A^A$/- allele showed bay coat color, but not black, suggesting that the ASIP $A^A$ allele represses black coat color development in the hairs of the body, but not in the mane and all four legs. Pedigree analysis showed a consistent relationship between the genotype distribution of the MC1R and ASIP genes and basic coat color patterns, even in the $F_1$ progeny. The results of this study revealed the relationship between the coat color phenotype and genetic background and suggested that useful information may be provided for molecular breeding of Jeju horses.

Choledochal Cyst in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담관낭종 -대한소아외과학회회원 대상 전국조사-)

  • Choi, Kum-Ja;Kim, D.Y.;Kim, S.Y.;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.J.;Park, K.W.;Park, W.H.;Park, J.Y.;Paek, H.K.;Seo, J.M.;Song, Y.T.;Oh, S.M.;Yoo, S.Y.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Park, Y.S.;Lee, T.H.;Chung, S.Y.
    • Advances in pediatric surgery
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    • v.9 no.1
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    • pp.45-51
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    • 2003
  • A nationwide survey on choledochal cyst was undertaken among 39 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the five year period of 1997 to 2001. Three hundred and forty eight patients were registered from 32 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:3.4. The age of patients on diagnosis was $49.0{\pm}44.4$ months. The geographic distribution was 34.8% in Seoul and Kyoungki-do, 33.3% in Kyoungsang-do, 17.9% in Cholla-do, and 8.5% in Choongchung-do, in order of frequency. The three common clinical presentations were abdominal pain (63.8%), vomiting (35.3%), and jaundice (29.1%). Only seven patients (2%) presented with classic triad, and 25 patients were diagnosed by antenatal ultrasonographic examination. According to the Todani Classification, 238 patients (7l.3%) were type 1, 3 (0.9%) type 11, and 93 (27.8%) type IV. At the time of the operation, three important associated conditions were choledocholithiasis in 45 patients (15.1%), liver fibrosis (Grade 1-4) in 35, and previous operative procedure for biliary diseases in 10. Associated anomalies were observed in 13 patients (3.8%). Three hundred thirty nine (98.8%) of 343 lesions were treated by Cyst excision and Roux-Y hepaticoiejunostomy. One hundred seventy-six patients had an anomalous arrangement of the pancreatobiliary ductal system (APBD): APBD was not in 92 patients, biliary duct joined to the pancreatic duct in 51, and pancreatic duct joined to the biliary duct in 26. There were 8.5% early, and 7.7% late phase operative complications. The major complications were bleeding, anastomotic leakage, and acute pancreatitis. The combination of acute abdomen and choledochal cyst may suggest spontaneous rupture. Because of the development of late intrahepatic bile duct stones, long term follow up after cyst excision and hepaticojejunostomy is required. The optimal time of surgical intervention should also be considered in the situation of routine use of antenatal ultrasonographic examination. This is the first review of the choledochal cyst in Korea and provides baseline data for future comparisons.

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Radiotherapy Incidents Analysis Based on ROSIS: Tendency and Frequency (ROSIS 자료 기반 방사선 사고 사례 분석 : 경향과 빈도)

  • Koo, Jihye;Yoon, MyongGeun;Chung, Won Kuu;Kim, Dong Wook
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.298-303
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    • 2014
  • In this study, we examine the trends and types of incidents frequently occur during radiation therapy by using the data from the radiation oncology safety information system (ROSIS), according to discovery method explores the development direction of future research accident cause factor control method. This study was carried out analysis of incident data in ROSIS nearly 1163 cases in last 11 years from 2003 to 2013. We categorized into treatment methods, found the time, discoverer of occupations and finding ways to analyze the data. Then, we calculate the percentage and the classification for each item. About 1163 cases of incident cases including the near miss cases, external radiation therapy, brachytherapy and other were 97%, 2% and 1%. In the case was improperly planned dose delivery was 44% (497 cases) which 429 cases (86%) was found before 3 fractions and 13 cases were found after 11 fractions. The investigation was found to be distributed in various a found times. Approximately 42% of found time was during treatment and 29% of patients were found the problem during inspection chart. Occupation to discover the most radiation accidents was the radiation therapist (53%) who works in treatment room. Among 1163 incidence cases, 24% cases were found the accident before the treatment, therefore most of accident were found after of during the treatment (70%, 813 cases). This trend is acquired through ROSIS analysis, is expected to be not significantly different in the case of Korea, so it is necessary more diverse and systematic research for the prevention and early detection by using the ROSIS data.

A Study on the Planning Methods of Community Greenway in Nam-Gu, Incheon (인천광역시 남구 커뮤니티형 그린웨이 조성방안 연구)

  • Park, Suk-Hyeon;Han, Bong-Ho;Choi, Jin-Woo;Choi, Tae-Young
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.1
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    • pp.16-28
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    • 2015
  • This study is suggested to enlarge the green area and to connect and improve the present green areas by deriving the lines of community greenway using living areas and community spaces close to the life of residence in Nam-gu. The purpose of this paper is to suggest the method of establishing greenway for the formation of community in which the residence can grow the community spirit and love their living space much more. Land-use status, green coverage ratio, and impermeability paving ratio are investigated. The community facilities are classified. The highest is educational facility, which is 7.7%, the green facility is 1.9% and the total area of community facilities which is 21.4%. The total area of Nam-gu is divided into 31 zones in total according to the administrative districts, the mail roads and reserved land of railroad and urban development. The total 20 lines of community greenway lines are chosen and the total length of lines is 18.2km. Finally, the characteristics of community greenway lines are analysed, the characteristics of community greenway lines are overall estimated according to the land-use, the street environment and the community facility. The classification system of community greenway is established on the basis on the function and purpose of greenway, the present status of land-use and the type of community facility. Based on the field investigation, the 6 greenway types are suggested considering the interconnection. The method of establishment of community greenway is suggested according to the principle of function and purpose, the principle of land-use and the principle of use of the facilities. Furthermore, the planting methods suitable to each greenway type are suggested in the building planting case of wall planting, roof planting, veranda planting, etc., and in the complex planting of parks, schools, roads, parking lots and other small areas.