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A Comparision on Frailty, Health Promotion Behavior, and Perceived Health Status in the Elderly according to the Type of Residency (거주유형별 노인의 허약정도, 건강증진 행위 및 주관적 건강상태 비교)

  • Kwon, Sang-Min;Park, Jeong-Sook
    • Journal of agricultural medicine and community health
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    • v.35 no.1
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    • pp.1-12
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    • 2010
  • Objectives: The purpose of this study was to classify frail and non-frail elderly and to investigate health promoting behaviors and perceived health status in the elderly according to the type of residency. Methods: This was a descriptive study. Data collection was performed from June 15th, 2009 to August 2nd, 2009. The subjects were selected at D city in Korea. Data was analyzed by descriptive statistics, $x^2$-test, and ANCOVA test with SPSS/Win 15.0 program. Results: 20.8% of the elderly living at home and 49.2% of those living in institution were frail. Frailty of the elderly living in institution was severer than those living at home. Non-frail elderly according to the type of residency showed higher scores of health promotion behavior and perceived health status than frail elderly. The elderly living at home showed higher scores of health promotion behavior than those living in institution. Conclusions: In the comparison study between the elderly living at home and institution, ratio of frail elderly among the elderly living in institution is high and health promotion behaviors are deficient as well. Frail preventive program for the elderly is needed to develop and apply in consideration of these findings.

Factors Related to the Resolution of Primary Vesicoureteral Reflux (요로감염 영아에서 일차성 방광요관역류)

  • Jung, Jae-Won;Woo, Mi-Kyoung;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.40-48
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    • 2009
  • Purpose : This study was performed to identify factors related to the resolution of primary vesicoureteral reflux (VUR) in infants. Methods : We reviewed 183 infants (M : F=149 : 34) diagnosed as urinary tract infection (UTI) between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture (n=97), catheterization (n=83), or collection bag method (n=3, twice positive culture of same organism). All of the infants were performed renal ultrasonography, DMSA scan and voiding cystourethrography (VCUG) study. Follow-up imaging consisted of contrast VCUG or direct isotope VCUG at interval of 1 year. We evaluated the relationship of clinical and laboratory finding, radiologic finding in infants with VUR. Results : Among 51 VUR patients, 18 infants had grade I-II, 12 infants had grade III and the other 21 patients had grade IV-V. Abnormal findings including hydronephrosis on renal ultrasonography were not correlated with severity of VUR. However, the incidence of renal defect in the first DMSA scan showed a tendency of direct correlation with severity of VUR in female patients only (P<0.001). There was significant difference of resolution rate in three VUR groups (grade I-II, III, IV-V) in male patients only (P=0.025). Resolution rate was higher for male patients with unilateral VUR than bilateral (P<0.001). But unilaterality had not any affect on VUR resolution in female VUR patients (P=0.786). Resolution rate was higher for VUR patients without renal scar than VUR patients with renal scar (P<0.001). Conclusion : According to our findings, grade of VUR, laterality and renal scar are the factors that contribute to resolution of primary VUR in male and female infants differently.

A study of the impact of using a nursing care standards on the quality of nursing care in gastrectomy patients (위절제술환자의 간호실무표준 사용이 간호의 질에 미치는 영향)

  • Woo, Young-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.2
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    • pp.97-107
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    • 1996
  • Nursing standards determine the type and extent of services that are delivered to the patients and define quality care and communicate the institution's expectations of care. Thus, taking the standard of care and incorporating it into a welldefined indicator of excellent patient care becomes one of the first activities in setting up the nursing service's quality assurance process. The purpose of this study was to determine the impact of using a nursing care standards for the quality of nursing care in gastrectomy patients. The subjects were composed of fourty-two under going gastrectomy patients with stomach cancer in general surgery nursing care unit of K University Hospital in Pusan. The data was collected from January 3 to April 13,1996. The subjects were divided into a control group - those admitted from Jan.3 to Feb.12 and an experimental group those admitted from Feb.18 to April 13. The instruments used for this study were a nursing care standards in gastrectomy patients developed by the investigator and an evaluation tool for the quality of nursing care in abdominal surgery patients developed by Byoung-Sook Lee in 1995. The data was analized by means of chi-square test, t-test and Cronbach-alpha test with the SAS System. The result was as follows : The hypothesis, that scores of the quality of nursing care in the experimental group would be higher than that of the control group. was supported(t=-6.12, p=0.00). The detailed results of each standards of evaluation tool were as follows : The mean score of the experimental group was significantly higher than that of the control group in audit standard 1:'Collection of basic data of the patients', (t=-3.76, p=0.00). The mean score of the experimental group was significantly higher than that of the control group in audit standard 2 : 'Defining nursing diagnoses(or nursing problems)', (t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit standard 3:'Estabilishment of nursing care plan according to nursing diagnoses(or nursing problems)',(t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit stndard 4:'Implimentation of nursing care plan', (t=-2.38, p=0.01). The mean score of the experimental group was significantly higher than that of the control group in audit standard 8 : 'Increase of the knowledge of health related to surgery',(t=-2.40, p=0.01). No significant differences between the mean scores of the experimental group and that of the control group in audit standard 5 : 'Recover and maintain of the physical function', audit standard 6:'Prevention of the post-operative complication', audit standard 7 : 'Decrease of discomfort caused by operation', and audit standard 9 : 'Patient satisfaction in nursing care' were found. The standards of evaluation tool were devided into two dimension. One was process dimension which contains four standards(audit standard 1 to 4), the other was outcome dimension which contains five standards(audit standard 5 to 9). The mean score of the experimental group was significantly higher than that of the control group in process dimension (t=-12.30, p=0.00), but no significant difference between the mean scores of the experimental group and that of the control group in outcome dimension was found. From these results, it is concluded that using a nursing care standards in gastrectomy patients promotes quality of nursing care and nursing care standards of various fields are necessary for effective nursing care.

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A Study on Sample Allocation for Stratified Sampling (층화표본에서의 표본 배분에 대한 연구)

  • Lee, Ingue;Park, Mingue
    • The Korean Journal of Applied Statistics
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    • v.28 no.6
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    • pp.1047-1061
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    • 2015
  • Stratified random sampling is a powerful sampling strategy to reduce variance of the estimators by incorporating useful auxiliary information to stratify the population. Sample allocation is the one of the important decisions in selecting a stratified random sample. There are two common methods, the proportional allocation and Neyman allocation if we could assume data collection cost for different observation units equal. Theoretically, Neyman allocation considering the size and standard deviation of each stratum, is known to be more effective than proportional allocation which incorporates only stratum size information. However, if the information on the standard deviation is inaccurate, the performance of Neyman allocation is in doubt. It has been pointed out that Neyman allocation is not suitable for multi-purpose sample survey that requires the estimation of several characteristics. In addition to sampling error, non-response error is another factor to evaluate sampling strategy that affects the statistical precision of the estimator. We propose new sample allocation methods using the available information about stratum response rates at the designing stage to improve stratified random sampling. The proposed methods are efficient when response rates differ considerably among strata. In particular, the method using population sizes and response rates improves the Neyman allocation in multi-purpose sample survey.

Perfusion MR Imaging of the Brain Tumor: Preliminary Report (뇌종야의 관류 자기공명영상: 예비보고)

  • 김홍대;장기현;성수옥;한문희;한만청
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.119-124
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    • 1997
  • Purpose: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. Materials and Methods: We performed perfusion MR imaing preoperatively in the consecutive IS patients with intracranial masses(3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurocytoma, 1 metastasis, 2 abscesses, 1 radionecrosis). The average age of the patients was 42 years (22yr -68yr), composed of 10 males and S females. All MR images were obtained at l.ST imager(Signa, CE Medical Systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media. (contrast media: IScc of gadopentate dimeglumine, about 2ml/sec by hand, starting at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(CE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE SOms, flip angle $90^{\circ}$, FOV $240{\times}240mm,{\;}matrix{\;}128{\times}128$, slice-thick/gap S/2.S). After data collection, the raw data were transferred to CE workstation and rCBV maps were generated from the numerical integration of ${\Delta}R2^{*} on a voxel by voxel basis, with home made software (${\Delta}R2^{*}=-ln (S/SO)/TE). For easy visual interpretation, relative RCB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Cd-enhanced images with focus on the degree and extent of perfusion and contrast enhancement. Results: Two cases of glioblastoma multiforme with rim enhancement on Cd-enhanced Tl weighted image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin. In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion of moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. Conclusion: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade gliomas. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.

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Attitude of Hospital Staff toward Hospice Care - The Program at Wonju Christian Hospital - (일 병원직원들의 호스피스 프로그램에 대한 인식)

  • Choi, Sang-Soon;Hu, Hea-Kung;Park, So-Mi;Kim, Dae-Ran;Kim, Ki-Kyong;Rhoe, Byoung-Seon
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.145-153
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    • 2001
  • Purpose : This study was conducted to describe the attitude of hospital staff toward the hospice program. The purpose of this study was to promote the extension and organization of hospice activities to include hospital staff. Method : This is a descriptive study using a survey method. The subjects for this study were the nurses, physicians, technicians, and support staff at Wonju Christian Hospital. Using a stratified sampling method based on position of staff, the researchers recruited 430 staff members as the sample for this study. Data collection was done through a questionnaire developed by the researchers. The data were analyzed using descriptive statistics and content analysis. Findings : 1)Ninety seven percent (n=417) of the subjects understood the concept of hospice care, and 97.4% (n=419) answered that dying patients should be respected. When considering the hospice team, the subjects of this study indicated that the team should include family members (n=245), physicians (n=77), pastors (n=41), and nurses (n=34), in that order of priority. 2) When asked to indicate priorities for systematic operation of a hospice program, the subjects indicated that the highest priority was "setting up a team for hospice service(31.4%)", followed by "setting up a hospice ward(28.6%)". Sixty seven percent(n=289) recognized the importance of the hospice activities provided by the volunteers, and 85.3%(n=367) intended to use the hospice service of the hospital. The highest merit of hospital-based hospice program is 'acomplishment of mission'. 3) The average score on attitude toward death was 2.84(maximum=4), and the best needful service except hospitalization is 'constructing of support system'. Conclusion : Most of the staff at Wonju Christian Hospital perceive the necessity for systematic hospice activities, and that to achieve this goal, administrative and structural support at the hospital governance level is the first necessity. The results of this study could be useful for any hospital which is in the first stages of setting up and promoting a hospice program.

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Effects of Health Perception, Self-efficacy and Social Support of College Students on the Health Promotion Behaviors (대학생의 건강지각, 자기효능감, 사회적 지지가 건강증진행위에 미치는 영향)

  • Woo, Bok Jin;Lee, Hye Kyung
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.4
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    • pp.1290-1302
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    • 2019
  • This study is a descriptive research with a purpose of examining the effects of health perception, self-efficacy and social support of college students on the health promotion behaviors. The subjects of this study have targeted 196 college students, where the data collection was made from September 10, 2018 to October 5, 2018. As a result of analyzing the differences in health promoting behaviors according to general characteristics of college students, there was a statistically significant difference according to the residence type(F=8.56, p<.001), subjective health status(F=7.23, p=.001), university life satisfaction(F=8.50, p<.001), exercise status(t=6.62, p<.001), and number of breakfasts per week(F=14.13, p<.001). For the correlation between college students' health perception, self-efficacy, social support, and health promotion behaviors, health promotion behavior and health perception(r=44, p<.001), self-efficacy(r=.57, p<.001), and social support(r=.49, p<.001) has shown a significant positive correlation between them. As a result of conducting multiple regression analysis by setting general characteristics, health perception, self-efficacy and social support as independent variables in order to analyze the factors affecting health promotion behaviors of college students, The variables that have significant explanatory power on health promoting behaviors(F=34.921, p<.001) were self-efficacy, social support, number of breakfasts per week(more than 5times), whether or not to exercise, number of breakfasts per week(2 to 4times), rent and lodging for residential type, and for grade, seniors. The explanatory power of these factors on health promotion behaviors was a total of 56.9%. Conclusively, In order to Improving health promotion behavior requires the development and intervention of personalized health promotion programs for each generation that consider self-efficacy and social support and emphasize the importance of proper exercise and proper eating habits.

Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2010 (설비공학 분야의 최근 연구 동향 : 2010년 학회지 논문에 대한 종합적 고찰)

  • Han, Hwa-Taik;Lee, Dae-Young;Kim, Seo-Young;Choi, Jong-Min;Kim, Su-Min;Kwon, Young-Chul;Baik, Yong-Kyu
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.23 no.6
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    • pp.449-469
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    • 2011
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigerating Engineering during 2010. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) Research trends of thermal and fluid engineering have been surveyed as groups of general thermal and fluid flow, fluid machinery, and new and renewable energy. Various topics were presented in the field of general thermal and fluid flow. Research issues mainly focused on the thermal reliability of axial fan and compressor in the field of fluid machinery. Studies on the design of ground source heat pump systems and solar chemical reactors were executed in the field of new and renewable energy. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics and industrial heat exchangers. Researches on heat transfer characteristics included heat transfer in thermoelectric cooling/power generation systems, combined heat and power systems, carbon nano fluid with PVP, channel filled with metal foam and smoke ventilation in a rescue station of a railroad tunnel. Also the studies on flow boiling of R123/oil mixture in a plain tube bundle and R410A charge amount in an air cooled mini-channel condenser were reported. In the area of industrial heat exchangers, researches on plate heat exchanger, shell and tube heat exchanger, enthalpy exchanger, micro channel PCHE were performed. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics and industrial heat exchangers. Researches on heat transfer characteristics included heat transfer in thermoelectric cooling/power generation systems, combined heat and power systems, carbon nano fluid with PVP, channel filled with metal foam and smoke ventilation in a rescue station of a railroad tunnel. Also the studies on flow boiling of R123/oil mixture in a plain tube bundle and R410A charge amount in an air cooled mini-channel condenser were reported. In the area of industrial heat exchangers, researches on plate heat exchanger, shell and tube heat exchanger, enthalpy exchanger, micro channel PCHE were performed. (3) Refrigeration systems with alternative refrigerants such as hydrocarbons, mixed refrigerants, and CO2 were studied. Performance improvement of refrigeration systems are tried applying various ideas of refrigerant subcooling, dual evaporator with hot gas bypass control and feedforward control. The hybrid solar systems combining the solar collection devices with absorption chillers or compression heat pumps are simulated and studied experimentally as well to improve the understanding and the feasibility for actual applications. (4) Research trend in the field of mechanical building facilities has been found to be mainly focused on field applications rather than performance improvements. Various studies on heating and cooling systems, HVAC facilities, indoor air environments and energy resources were carried to improve the maintenance and management of building service equipments. In the field of heating and cooling systems, papers on a transformer cooling system, a combined heat and power, a slab thermal storage and a heat pump were reported. In the field of HVAC facilities, papers on a cooling load, an ondol and a drying were presented. Also, studies on HVAC systems using unutilized indoor air environments and energy resources such as air curtains, bioviolence, cleanrooms, ventilation, district heating, landfill gas were studied. (5) In the field of architectural environment and energy, studies of various purposes were conducted such as indoor environment, building energy, renewable energy and green building. In particular, renewable energy and building energy-related researches have mainly been studied reflecting the global interest. In addition, many researches which related the domestic green building certification of school building were performed to improve the indoor environment of school.

Eco-friendly remediation and reuse for coastal dredged materials using a bioaugmentation technology (생물증강법을 이용한 오염해양준설토의 환경친화적 정화 및 재활용)

  • Kim, In-Soo;Ha, Shin-Young;Koh, Sung-Cheol
    • Korean Journal of Microbiology
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    • v.51 no.4
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    • pp.374-381
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    • 2015
  • Occurrences of coastal dredged materials are ever increasing due to port construction, navigational course maintenance and dredging of polluted coastal sediments. Ocean dumping of the coastal dredged materials has become virtually prohibited as London Treaty will be enacted as of the year 2012. It will be necessary to treat and recycle the dredged materials that may carry organic pollutants and heavy metals in a reasonable and effective process: collection of the dredged materials, liquid and solid separation, and treatment of organic compounds and heavy metals. In this study we have developed a continuous bioreactor system that can treat a mixture of silt and particulate organic matter using a microbial consortium (BM-S-1). The steady-state operation conditions were: pH (7.4-7.5), temperature ($16^{\circ}C$), DO (7.5-7.9), and salt concentration (3.4-3.7%). The treatment efficiencies of SCOD, T-N and T-P of the mixture were 95-96%, 92-99%, and 79-97%. The system was also effective in removal of heavy metals such as Zn, Ni, and Cr. Levels of MLSS during three months operation period were 11,000-19,000 mg/L. Interestingly, there was little sludge generated during this period of operation. The augmented microbial consortium seemed to be quite active in the removal of the organic component (30%) present in the dredged material in association with indigenous bacteria. The dominant phyla in the treatment processes were Proteobacteria and Bacteroidetes while dominant genii were Marinobacterium, Flaviramulus, Formosa, Alteromonadaceae_uc, Flavobacteriaceae_uc. These results will contribute to a development of a successful bioremediation technology for various coastal and river sediments with a high content of organic matter, inorganic nutrients and heavy metals, leading to a successful reuse of the polluted dredged sediments.

An Evaluative Study on Physician's Health Education Activities in Outpatient Medical Care (종합병원 외래환자 진료시 의사의 보건교육활동 평가)

  • 김숙자
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.56-80
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    • 1984
  • The main objectives of the present study is to evaluate Physician's Health Education Activities by means of physician's direct response to the prepared questionnaire and patient's perception to the physician in the course of medical care. For the data collection, the present study was conducted from Aug. 16 to Oct. 7, 1983 for 739 patients and 91 physicians who were attended outpatient clinics of 5 general hospitals in Seoul. The major findings are summarized as follows: 1. Self-evaluation on Physician's Health Education Activities (1) In consideration of health education services for the patient, the data revealed that 9.9% of the sampled physician wanted to strength public health and preventive medicine lecture in the curricula at medical education. On the other hand, only 1.1% expressed that they wanted to make it short. (2) In consideration of the necessity of health education service, it was shown that 95.6% of physicians agreed to take it into consideration. Self expression for the practice of health education was placed on the 3.15 score when 5 point scale used. (3) To evaluate the degree of an explanation about medical care for the patient, Index score with 4 point scale was employed. The Index score for the first time was shown that scale was placed on 3.23 for 'diagnosis', 3.12 for 'progress of the disease', 3.11 for 'discription of procedure' and 3.02 for 'cause of the disease' respectively. In comparison of the physician's explanation about the status of disease for the first and the second visitors to clinic, they evaluated themselves as giving more detailed explanation for the second visitors rather than the first visitors. 2. Physician's Health Education Services evaluated by patients (1) To evaluate physician-patient communication at beginning time for taking history about disease, the Index score with 5 point scale was employed. The data on taking history have shown that the score placed on 3.07 for those patients who visited the first time and 2.53 for second visitors. And the score about listening from the patients was placed on 3.52 and 3.42 respectively. (2) The Index score with 5 point scale, as used before, was also employed to evaluate medical care services for the patient. The data evaluated by the patients was shown that the score placed on 4.21 for patient treatment in general, 4.58 for physician's credibility, and 3.6 for physician's kindness. However, approximately 80% of those who failed to understand physician's explanation was caused by highly sophisticated medical terminology. (3) According to the Index score with 4 point scale, to evaluate physician's explanation, the data was shown that the patient who visited the first time gave 2.51 for 'diagnosis', 2.35 for 'progress', 2.11 for 'cause of the disease' and so on. It is acknowledged on the whole that the patients who visited the second time have more satisfaction in physician's explanation about their disease, than those who visited the first time. 3. Comparison of self-evaluation of Physician's Health Education Activities and patient's perception. (1) There was communication barriers between physicians and patients in expressing some medical terminology. For example physician understood that they explained more than 50% of medical terminology into common words for the patient, but 30% of patient complained medical terminology used by physician. (2) Comparing the index score of health education practice recognized by patients and physicians for both first visit and revisit groups, it was shown that the Index score of health education activities evaluated by physicians themselves were slightly higher than the score evaluated by patients.

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