• 제목/요약/키워드: Collection 6

검색결과 2,661건 처리시간 0.073초

폐 농양및 농흉 치료에서 Pig-tail 도관 배액술의 효과 (The effect of Percutaneous pig-tail catheter drainage in the management of lung abscess and empyema)

  • 김연수;김성민;김진호;이경상;양석철;윤호주;신동호;박성수;이정희;최요원;전석철;김영태
    • Tuberculosis and Respiratory Diseases
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    • 제43권4호
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    • pp.571-578
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    • 1996
  • 배 경 : 폐 농양은 괴사된 폐실질에 농이 고이는 질환으로 1940년대 이전까지는 폐 농양은 체외 배액술에 의한 방법이 치료 원칙이었으나 피 이후 파양한 항생제의 발달로 대부분의 폐 농양에서는 항생제와 체위적 배농술을 포함한 내과적 치료법이 매우 효과적으로 이용되어 왔고 내과적 치료에 실패한 경우에 한해서 폐엽 절제를 포함한 외과적 치료 방법이 적용되어 왔다. 농흉은 흉막강내에 농이 고이는 질환으로 흉수 그람 염색상 양성이어야 하고 약제의 효과적인 침투가 어려우므로 내과적인 치료만으로 치유를 기대할 수 없고 흉관삽관 등 수술적인 조작이 필요하다. 하지만 최근 환자의 전신상태가 불량하거나 외과적 폐절제술이 용이하지 않는 경우에 국소 마취로 직경이 작은 카테타를 사용하여 경피적으로 배농시켜 치료하는 방법을 시행하고 있다. 이에 본 연구에서는 한양대학병원에 내원한 폐 농양 10례와 농흉 23례의 환자를 대상으로 pig-tail 도관 배액술을 시행하였기에 이에 대한 치료 효과를 보고하는 바이다. 대상 및 방법 : 1990년 1월 1일부터 1996년 5월 20일까지 한양대학병원에서 입원 치료한 환자중에서 pig-tail 도관을 이용하여 치료한 폐 농양 환자 10례와 농흉 환자 23례를 대상으로 하였고 각 환자들은 도관 배액술 전에 단순 흉부 X-선사진과 흉부 전산화 단층촬영을 하였고 형광 투시 또는 초음파 유도하에서 천자를 시행하였다. 천자후 카테타는 배액이 잘 되는 위치에서 피부에 고정되어었고 매일 배액량을 관찰한 후 3-4일 간격으로 단순 흉부 X-선사진을 검사하여 폐 농양의 크기나 농흉의 크기가 줄고 임상적 호전이 있으면서 배농량이 하루 5ml이하일때 도관을 제거하였다. 결 과 : 원인균은 폐 농양에서는 Staphylococcus aureus aureus 1례, Klebsiella pneumoniae 1례였으며 농흉에서는 결핵균이 14례로 가장 많았고 2례에서는 Streptococcus pneumoniae 였고 나머지에서는 균의 성장을 관찰할 수 없었다. 카테타의 삽입기간은 폐농양에서는 1-2주 사이가 7례(70%)였으며 농흉에서도 1-2주 사이가 14례(60.8%)로 가장 많았다. 경피적 배농은 29례(87.8%)에서 성공적이었으며 그 중 20례(60.6%)에서는 그 크기가 빠르게 감소되었다. 결 론 : 폐 농양과 농흉에서 pig-tail도관을 통한 배농은 항생제 요법과 보조 요법에 반응하지 않는 경우와 외과적인 수술의 어려움이 있는 환자들에서 비교적 안전하게 선택할 수 있는 효과적인 치료 방법으로 생각된다.

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한국의 2005-2009년도 영아사망률 중에서 출생체중, 임신나이 별 구분에 따른 신생아 사망률의 비율 관찰 (Analysis of Infant Mortality Rate in Korea Concerning According to Birth Weight and Gestational Age from 2005 to 2009)

  • 조미진;고진희;정성훈;최용성;한원호;장지영;배종우
    • Neonatal Medicine
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    • 제18권2호
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    • pp.182-188
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    • 2011
  • 목적: 한국에서 최근 신생아사망률(NMR), 영아사망률(IMR)는 주산기, 신생아, 소아과 의료의 발전으로 현저한 개선을 이루었다. 본 연구는 한국에서 최근 5년간 IMR 중에서 NMR가 차지하는 비율을 알아보아, NMR의 개선이 IMR의 감소에 미친 영향을 알아보고자 한다. 방법: 한국 통계청의 출생 자료 및 신생아 및 영아에 관련된 통계와 보고서의 자료를 기초로 하였다. 2005-2009년 간 한국에서 영아사망 중에서 신생아 사망이 차지하는 비율의 변화와 출생 시의 출생체중와 임신나이에 따른 분포별 사망이 영아사망에 차지하는 비율을 조사하였다. 결과: 2005-2009년 간 한국의 총 출생 수는 감소하였으나, 미숙아 수, 저체중출생아(LBWI) 수, 극수제체중출생아(VLBWI) 수는 증가하였다. 연도별 신생아 및 영아 사망 수, NMR, IMR는 감소하였다. 전체 영아사망 중에서 신생아사망이 차지하는 비율은 2005년 57.1%, 2009년 56.3%로 전체적으로 반 이상을 차지하였다. 신생아사망 중에서는 후기 신생아사망 보다는 조기 신생아사망의 비율이 높았다. 연도별로 출생 시 정상체중아, LBWI, VLBWI, 미숙아 사망 수는 감소추세 이었다. 전체 영아사망 중에서 출생 시 정상체중아에서 사망과 출생 시 LBWI 사망의 비는 2005년 42.1:57.9, 2009년 44.2:55.8, 전체 영아사망 중에서 출생 시 만삭아에서 사망과 미숙아 사망의 비는 2005년 42.9:57.1, 2009년 44.6:55.4로 LBWI, 미숙아의 사망이 높았다. 5년간 평균 수치의 출생체중별, 임신나이별 신생아 사망 비율도 관찰하였다. 결론: 한국에서 저출산 시대에 총 출생 수는 감소하고 있지만, 미숙아 LBWI의 빈도는 증가 추세이다. 한국에서 전반적인 연도별 전체 신생아 및 영아사망 수의 감소와 NMR, IMR의 개선과 IMR에서 NMR이 차지하는 비율의 감소 추세 등이 고무적이지만, 아직도 IMR에서 NMR의 비율은 반 정도를 차지하고 있다. 향후 한국에서 IMR의 보다 좋은 개선을 위하여 NMR의 지속적인 감소가 필요할 것으로 사료되며, 이를 위해서 미숙아 LBWI, 이중에서도 고위험 신생아인 VLBWI와 임신나이 32주 미만의 미숙아의 예후를 더욱 향상해야 할 것이다. 본 자료를 향후 신생아 관리의 기초로 활용되기를 기대한다.

폐엽종실(廢棄種實)의 식량자원화(貪糧資源化)에 관(關)하여 -제(第) 1 보(報) : 포도씨의 화학적(化學的) 조성(組成)- (Studies on the Development of Food Resources from Waste Seeds -I. Chemical Composition of Grape Seed-)

  • 윤형식;권중호;황주호;최재춘;신대휴
    • 한국식품과학회지
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    • 제14권3호
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    • pp.250-256
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    • 1982
  • 미이용(未利用) 폐엽종자(廢葉種字)를 식량자원(貪糧資源)에 이용(利用)하기 위(爲)한 기초자료(基礎資料)를 얻기 위(爲)하여 포도씨의 지방질(脂肪質) 성분(成分)과 단백질(蛋白質) 성분(成分)을 검토(檢討)한 결과(結果)는 다음과 같다. 1. 포도씨의 일반성분중(一般成分中) 조지방(粗脂肪)은 25.1%, 조단백질(粗蛋白質)은 12.0%였다. 2. 포도씨 기름에는 중성지방질(中性脂肪質)이 95.46%이나 복합지방질(複合脂肪質)은 약(約) 4.5%에 불과하였으며, 중성지방질(中性脂肪質)의 성분(成分)으로써는 91.89%가 트리-글리세리드였고, 스테롤에스터, 스테롤, 디-글리세리드 및 유리 지방산은 각각(各各) 3.24% 2.87%, 1.20% 및 0.80%였다. 3. 지방산(脂肪酸) 조성(組成)은 총지방산(總脂肪酸)과 중성지방질(中性脂肪質)에서 리놀레산$(69.72{\sim}71.72%)$과 올레산$(18.09{\sim}19.46%)$이 주지방산(主脂肪酸)이었고, 총지방질(總脂肪質)과 인지질(燐脂質)은 올레산$(20.20{\sim}35.27%)$과 팔미트산$(26.80{\sim}39.98%)$의 함량(含量)이 비교적(比較的) 높았으며, 중성지방질(中性脂肪質)에서 분별(分別)한 트리-글리세리드의 지방산(脂肪酸) 조성(組成)은 올레산이 43.08%로 가장 늪은 함량(含量)이었다. 4. 염(鹽)$(0.1\;M\;MgSO_4)$ 용해성(溶解性) 단백질(蛋白質) 의 추출율(抽出率)은 약(約) 31%, 아미노산(酸) 조성(組成)은 글루탐산이 가장 높은 함량(含量)이었고 다음이 아르기린, 아스파르트산의 순(順)이었다. 5. 포도씨 단백질(蛋白質)의 전기영동(電氣泳動) 결과(結果) 3개의 밴드를 나타내었고, 분획(分劃)된 주단백질(主蛋白孫)의 수득율(收得率)은 약(約) 82%였으며, 아미노산(酸) 조성(組成)은 글루탐산, 아스파르트산 및 아르기린의 순(順)으로 높은 함량(含量)이었다. 6. 염용해성(鹽溶解性) 단백질(蛋白質)에서 분획(分劃)된 주단백질(主蛋白孫)의 분자량(分子量)은 약(約) 81,000이었다.

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ICNP를 적용한 학교간호현상 및 특성과 초.중.고등학교의 학교간호현상 비교 (Comparison of School Nursing Phenomena at Elementary, Middle and High Schools by Applying ICNP)

  • 김영임;왕명자;양순옥;현혜진;박은옥
    • 한국학교보건학회지
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    • 제17권1호
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    • pp.1-12
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    • 2004
  • Purpose : this study purposed to investigate school nursing phenomena in Korea by applying ICNP, the international standard nursing classification system developed by ICN, and to compare school nursing phenomena at elementary, middle and high schools. Method : The subjects of this study are 110 nursing teachers from 82 elementary schools, 16 middle schools, and 12 high schools. In the survey, subjects were asked to score the degree to which phenomena and characteristics of Korean school nursing, identified in previous research, on a 5 point scale. Questionnaires were distributed and recovered by mail and email. The period of data collection was 6 months from July to December 2003. The general characteristics of schools and nursing teachers were represented with frequencies and percentages, the phenomena and characteristics of school nursing with the mean score of the questions, and the phenomena school nursing by school grade with ANOVA and Duncan's posterior analysis. Results : 1) As for the characteristics of schools according to school nursing phenomena related to human behavior, the mean score of questions on inadequate stress management was highest at 3.24 points followed by the score on inadequate weight control (3.23), inadequate eating habits (3.22), the risk of spine disorders (2.68), inadequate emergency management (2.62), inadequate response to sex -related problems (2.19), and smoking and drug use (1.85). 2) As for the characteristics of schools according to school nursing phenomena related to human function, the mean score of questions on oral health management was highest at 3.11 points followed by the score on the risk of digestive system disorder (2.87), improper eyesight management (2.81), the risk of respiratory system disorders (2.75), lack of sexual identity (2.52), and inadequate contagious disease control (2.12). 3) As for the mean score according to school nursing phenomena related to environment, the score of the risk of accidents in classroom was highest as 2.68 points followed by the score of the risk of accidents around the school (2.65), maladjustment to school (2.62), the risk of accidents outside the classroom (2.43), inadequate learning environment (1.83), the risk of exposure to socially and physically harmful environment factors (1.82), and inadequate waste disposal (1.77). 4) This study tested the mean scores of questions corresponding to each school nursing phenomenon in order to see if there is a difference in the school nursing phenomenon among elementary, middle and high schools, and performed Duncan's posterior comparison for school nursing phenomena. A significant difference was found at p<.1. According to the results, school nursing phenomena found to be significantly different among elementary, middle and high schools was smoking and drug use (p<.05), which appeared more problematic in high school than in elementary school. phenomena such as inadequate eating habits, inadequate weight control, inadequate response to sex-related problems and inadequate waste disposal were also found to be statistically different at p<.1; however, according to the result of Duncan's posterior comparison, no difference was found among groups in improper eating habits and improper response to sex-related problems, and a significant difference was found between middle and high schools in inadequate weight control and inadequate waste disposal. Conclusion: Based on the results of this study, it is necessary to plan school health projects focused on the characteristic school nursing phenomena that had high scores and to develop and execute school healthe projects in accordance with the characteristics of elementary, middle and high schools. Considering that the scores of school nursing phenomena related to human behavior are high, it is necessary to introduce school health promotion projects in a systematic way.

본태성 고혈압 환자의 자가간호증진을 위한 자기조절 프로그램 효과 -Orem이론과 Bandura이론의 합성과 검증- (An Effect of the Self-Regulation Program for Hypertensives -Synthesis & testing of Orem and Bandura's theory-)

  • 박영임;홍여신
    • 지역사회간호학회지
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    • 제5권2호
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    • pp.109-129
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    • 1994
  • Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

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실험대학 과제도서실 운영에 관한 조사연구 (A Research Survey on the Reserved Book System of Pilot Universities in Korea)

  • 최달현
    • 한국도서관정보학회지
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    • 제5권
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    • pp.119-168
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    • 1978
  • This is a survey of the reserved book system in the pilot universities in Korea. We have surveyed only 22 university libraries among 29 pilot schools as of 1977, because of the differences in the library users, library organization, library facilities, and library materials between universities and colleges. In 1972, the Korean Ministry of Education developed a reformation plan for their higher education based on the teaching method of curriculum-oriented faculty instead of that of the faculty-oriented curriculum. The former puts emphasis on the cultivation of a student's thinking, creativity, and judgement through self-teaching to do a given assignment. The reserved book system in a college or university library is one of the most important methods necessary to accomplish the above educational aim. The survey used a questionnaire with 50 question on 28 items concerning the various aspects of the reserved book system in 22 pilot universities. the survey result discovered many problems needing correction. The following list describes the measures needed to correct the problems found in the pilot universities. 1. The management of a centralized reserved book system is much more effective and economical than the decentralized reserved book system when a university is located on the same campus. 2. In the university library, an independent reserved book department requires to gain the desired educational aims as compared with the reserved book room controlled by any other department in the library. 3. The reserved book system should not be adopted by all the departments at once but enlarged gradually, for it needs the understanding and support of faculty members and the university itself. 4. As competence is essential to the effective operation of the reserved book room, the university library should not place an unqualified person in charge of the reserved book department. 5. The librarian in charge of the reserved book department is required to do more professional works such as analysis of users, collection and analysis of syllabuses, maintenance of faculty member cooperation, establishment of measures to acquire unavailable materials, and drawing up an effective management plan. However, he is spending most of his time in clerical works, that is, non-professional works. 6. Three to five titles of each reserved book are considered reasonable and required materials should be shelved in proportion to the number of students, that is, one copy per eight or ten students if the materials are allowed to lend for two hours at a time. For the supplementary materials, the library needs to place two or three copies per subject. 7. Professors must select reserved books with care so that they can be used year after year. 8. Few universities are asking professors the number of class students and the date when the reserved material will no longer be needed on reserve. 9. The library should gather all the lists of reserved books from every professor at least three to five months before the courses open, because it takes a long time to obtain foreign materials. 10. It is desirable that the reserved book department should collect the lists and prepare the materials with promptness and consistency. 11. Instead of block buying, it is desirable to purchase reserved books at the time the library gets the reserved book list from the professors. The library should also inform faculty members whether it obtained each reserved book or not before the course open. 12. The library should make a copy of materials if a professor requires to reserve an out-of-print book or partial contents of a book, journal, and thesis. 13. An independent budger for reserved books from the budget for general materials is desired. 14. The shelf arrangement of reserved books by courses or professors under the same department is much more preferable than a classified arrangement. 15. While most of the universities adopted the open shelves system for all the reserved books, it is more effective and economical to take a compromise system, that is, closed shelves for requires materials and open shelves for supplementary materials. 18. Circulation of reserved books needs a different system between required materials and supplementary materials: two or three hours and/or overnight loan for the former and two and/or three days loan for the latter. 17. A reserved book room should be open a long time after class so that students can have sufficient time to use the room. 18. The library must take daily and monthly statistic as well as statistics on every aspect of the reserved book system in order that the library ma decide on policy and management of the reserved book room in collaboration with the university. Furthermore, regular reports on the use of the reserved book room should be made to the president and the executive council by the library to acquire their understanding and cooperation for the reserved book system. 19. Cooperation of faculty members is indispensable to the effective management of the reserved book department and it is desirable to make a committee which will fix various decisions about the system. Whenever the director of the library make his decision, he must consult with his staff in order to involve them earnestly in the operation of the system.

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들깻잎과 생산환경의 미생물 분포 (Distribution of Microorganisms in Perilla Leaf and Cultivation Area)

  • 김세리;이지영;이서현;고현석;윤요한;권세혁;류경열;윤혜정;김원일;윤종철;김두호;정덕화
    • 한국식품과학회지
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    • 제43권2호
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    • pp.243-248
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    • 2011
  • 본 연구는 국내 일일 평균 섭취량이 많은 들깻잎을 대상으로 미생물 안전성을 평가하고 미생물에 대한 오염도를 조사하였고, 검출빈도가 높은 S. aureus와 B. cereus의 오염원을 조사하였다. 들깻잎의 미생물 오염도 조사 결과 일반세균수 수준은 4.82 log CFU/g이었다. 대장균군의 오염수준은 0.83-5.33 log CFU/g으로 농가 간 차이가 크게 나타났으며 50% 농가의 들깻잎에서 4.00 log CFU/g 이상 검출되었다. 또한 병원성미생물 분석결과, E. coli는 3%(4/114)의 들깻잎에서 1.00 log CFU/g 이하로 검출되었으며 S. aureus의 경우 검출빈도는 7.9%(9/114)였고 1.6%(2/114)의 들깻잎에서 S. aureus가 2.00 log CFU/g 이상으로 다소 높게 검출되었다. B. cereus는 0-3.81 logCFU/g 수준이었고 검출빈도는 46.5%(53/114)였으며 2곳의 농가에서 3.00 log CFU/g 이상으로 높게 검출되었다. 한편 E. coli O157:H7, Salmonella spp, 그리고 L. monocytogenes는 모두 검출되지 않았다. 또한 들깻잎 생산환경(토양, 수질, 작업자 및 포장대 등)에서 위생지표세균과 S. aureus와 B. cereus를 조사한 결과 일반세균수와 대장균군이 대부분의 시료에서 3.00 log $CFU/100cm^2$ 이상 검출되었고 일부 손, 수확용기 및 포장대에서 대장균군이 4.00 log $CFU/100cm^2$, hand 이상으로 높게 검출되었다. S. aureus는 관개용수, 포장대, 포장비닐, 작업자의 손과 복장에서 검출되었고 검출 수준은 0.33-1.31 log $CFU/100cm^2$이었다. B. cereus의 경우는 다양한 시료에서 빈번하게 검출되었고 특히 앞서 위생지표세균결과에서 오염도가 높았던 수확용기와 포장대에서 최고 5.50 log $CFU/100cm^2$까지 검출되었으며 수확 전 들깻잎보다 수확 후 들깻잎에서 B. cereus 수준이 증가되는 경향을 보였다. 이상의 결과를 통하여 들깻잎의 유해미생물 오염은 생산단계부터 발생되고 있으므로 이러한 유해미생물의 오염을 사전에 관리하는 GAP제도를 도입해야 할 것이다.

종합병원(綜合病院)의 간호행위양상(看護行爲樣相)에 따른 간호원가(看護原價) 산정(算定)에 관(關)한 연구(硏究) (A Study on Accounting for Nursing Cost by Korean Diagnosis Related Groups (K - DRGs))

  • 오효숙
    • 한국보건간호학회지
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    • 제3권2호
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    • pp.5-46
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    • 1989
  • The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

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구조적 공백과 협업필터링을 이용한 추천시스템 (Recommender Systems using Structural Hole and Collaborative Filtering)

  • 김민건;김경재
    • 지능정보연구
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    • 제20권4호
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    • pp.107-120
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    • 2014
  • 본 연구에서는 사회연결망분석기법 중 하나인 구조적 공백 분석 결과를 이용하여 추천과정에 사용자의 정성적이고 감성적인 정보를 반영할 수 있는 협업필터링 기반의 추천시스템을 제안한다. 협업필터링은 추천기술 중 가장 많이 활용되고 있지만 전통적으로 확장성과 희박성 등의 문제점뿐 만 아니라 사용자-상품 매트릭스의 선호도만을 이용하여 추천을 함으로써 사용자의 정성적이고 감성적인 정보를 추천과정에 반영하지 못한다는 한계점이 있다. 본 연구에서 제안하는 추천시스템은 사회연결망분석에서 중심성 분석과 함께 연결망 내의 주요개체를 탐지할 수 있는 구조적 공백 분석을 이용하여 연결망 내의 대표 사용자들을 추출한 후 이들을 중심으로 군집을 형성한 후 각 군집색인 협업필터링을 수행하는 과정을 통해 전통적인 협업필터링에서 반영하지 못했던 정성적, 감성적 정보를 반영한다. 한편, 군집색인 협업필터링을 수행함으로써 추천의 효율성을 높일 수 있는 장점도 있다. 본 연구에서는 실제 사용자들의 상품에 대한 선호도 평가점수와 사용자들의 사회연결망 정보를 수집하여 실험을 수행하고 전통적인 협업필터링과 다양한 형태의 협업필터링과의 추천성과 비교를 통하여 제안하는 시스템의 유용성을 확인한다. 비교모형으로는 전통적인 협업필터링, 임의 군집색인 기반 협업필터링, k평균 군집색인 기반 협업필터링을 이용한 추천시스템이며, 실험 결과, 제안한 모형이 다른 비교모형에 비해 추천성과의 정확도가 가장 우수하였다. 추천성과의 차이에 대한 통계적 유의성 검정 결과, 제안 모형은 전통적인 협업필터링 기반의 추천시스템과는 통계적으로 유의한 성과 차이가 없었으나, 다른 두 모형에 대해서는 통계적으로 유의한 성과의 차이가 있는 것으로 나타났다.

중고등학생의 에이즈 예방교육(豫防敎育)을 통한 에이즈 지식(知識)과 성의식(性意識) 변화(變化)에 관(關)한 연구(硏究) (A Study on the Change of AIDS Knowledge and Sexual Behavior among Middle and High School Students through AIDS Prevention Education)

  • 권관우;이경무;김정순
    • 한국학교보건학회지
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    • 제12권1호
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    • pp.109-129
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    • 1999
  • AIDS is worldwide problem. It has threatens societies and is potentially a big problem among youth. UNAIDS has warned that collective global responses are necessary; with half of the newly infected being children and young people in 1998, educating youth below age 24 is essential. Because of both their unexpected, strong sexual activities and an easjer tendency to change their behavior than adults, UNAIDS emphasizes the importance of prevention education for youth. In Korea, 4 cases of HIV infection have officially been reported among high school students. Considering the potential seriousness of HIV infection among youth, the Korean AntiAIDS Federation (KAAF) began an education programme for Korean youth (middle & high school pupils) as one intervention method in 1993. The purpose of this study is to evaluate the impact of the education programs performed and to develop a better programme. The intervention method used in this study was mainly a lecture in a big or small auditorium or through broadcasting systems using audio-visual teaching aids. The period of this survey was from Nov. 10 to Dec. 26. in 1998. The subjects surveyed were 792 pupils who were sampled from 12 different middle and high schools in Seoul by a two-stage cluster sampling. Self-recording the structured questionnaire was used for data collection. Data were analyzed by using a paired t-test to compare the knowledge difference before and after the interrention method. A chi-square test to compare the consciousness difference between pre-post-education results was used, and an ANOVA was ased to compare the knowledge difference among the selected groups. Major results of this study are summarized as follows: (1) AIDS knowledge significantly changed after AIDS prevention education. (2) The direct lecture in a big or small auditorium is more effective than an indirect lecture through a broadcasting system or through audio-visual teaching aids. (3) Those who had not seen obscene materials (e.g. pornography films, magazines etc.) acguired much more knowledge than others after AIDS prevention education. (4) Those who had no girlfriend/or boyfriend acquired much more knowledge than the others after AIDS prevention education. (5) As to the attitudes toward chastity, more girls than boys and students who had not seen obscene materials rather than those who already had were liable to support the state ment: "all should remain chase" and their consciousness on "being chaste" changed much more than that of others after intervention. (6) As to the individual evaluation of lectures, 23.1% shows "very good", 44.1% "good", 26.9% "normar" '-' thus, the positive evaluation was to 94.2%. The negative response was 5.8%. (7) As to the desire for AIDS education sponsored by KAAF in the future, more than 90.5% showed a positive reaction. (8) As to the educators in future education methods, pupils wanted lecturers from outside their schood. (9) Students from vocational high schools have seen obscene materials much more than other groups and the percentage of those who had a girlfriend/or boyfriend was higher than that of the others as wello. (10) 90% of those who watched obscene materials responded that they experienced these materials while at middle school and 100% before reaching the second grade of high school. (11) The number of boys who have experienced obscene materials is twice as many as that of girls. (12) The percentage of boys who have a girlfriend is much higher than the percentage of girls who have a boyfriend. (13) Among those who have friends of the opposite sex, 11.1% say that they hare had sexual contact and 20.8% hare experienced kissing and caressing.

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