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Study of Patient Teaching in The Clinical Area (간호원의 환자교육 활동에 관한 연구)

  • 강규숙
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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An Analysis of the Specialist's Preference for the Model of Park-Based Mixed-Use Districts in Securing Urban Parks and Green Spaces Via Private Development (민간개발 주도형 도시공원.녹지 확보를 위한 공원복합용도지구 모형에 대한 전문가 선호도 분석)

  • Lee, Jeung-Eun;Cho, Se-Hwan
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.6
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    • pp.1-11
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    • 2011
  • The research was aimed to verify the feasibility of the model of Park-Based Mixed-Use Districts(PBMUD) around urban large park to secure private-based urban parks through the revision of the urban zoning system. The PBMUD is a type of urban zoning district in which park-oriented land use is mixed with the urban land uses of residents, advertising, business, culture, education and research. The PBMUD, delineated from and based on a new paradigm of landscape urbanism, is a new urban strategy to secure urban parks and to cultivate urban regeneration around parks and green spaces to enhance the quality of the urban landscape and to ameliorate urban environmental disasters like climate change. This study performed a questionnaire survey and analysis after a review of literature related to PBMUD. The study looked for specialists in the fields of urban planning and landscape architecture such as officials, researchers and engineers to respond to the questionnaire, which asked about degree of preference. The conclusions of this study were as follows. Firstly, specialists prefer the PBMUD at 79.3% for to 20.7% against ratio, indicating the feasibility of the model of PBMUD. The second, the most preferable reasons for the model, were the possibility of securing park space around urban parks and green spaces that assures access to park and communication with each area. The third, the main reason for non-preference for the model, was a lack of understanding of PBMUD added to the problems of unprofitable laws and regulations related to urban planning and development. These proposed a revision of the related laws and regulations such as the laws for planning and use of national land, laws for architecture etc. The fourth, the most preferred type of PBMUD, was cultural use mixed with park use in every kind of mix of land use. The degree of preference was lower in the order of use of commercial, residential, business, and education(research) when mixed with park use. The number of mixed-use amenities with in the park was found to be an indicator determining preference. The greater the number, the lower was preference frequencies, especially when related to research and business use. The fifth, the preference frequencies of the more than 70% among the respondents to the mixed-use ratio between park use and the others, was in a ratio of 60% park use and 40% other urban use. These research results will help to launch new future research subjects on the revision of zoning regulations in the laws for the planning and uses of national land and architectural law as well as criteria and indicators of subdivision planning as related to a PBMUD model.

Blood Pressure Reactivity during Nasal Continuous Positive Airway Pressure in Obstructive Sleep Apnea Syndrome (폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症)에서 지속적(持續的) 상기도(上氣道) 양압술(陽壓術)이 혈력학적(血力學的) 변화(變化)에 끼치는 영향(影響))

  • Park, Doo-Heum;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.24-33
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    • 2002
  • Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.

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Diagnosis of Obstructive Sleep Apnea Syndrome Using Overnight Oximetry Measurement (혈중산소포화도검사를 이용한 폐쇄성 수면무호흡증의 흡증의 진단)

  • Youn, Tak;Park, Doo-Heum;Choi, Kwang-Ho;Kim, Yong-Sik;Woo, Jong-Inn;Kwon, Jun-Soo;Ha, Kyoo-Seob;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.34-40
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    • 2002
  • Objectives: The gold standard for diagnosing obstructive sleep apnea syndrome (OSAS) is nocturnal polysomnography (NPSG). This is rather expensive and somewhat inconvenient, however, and consequently simpler and cheaper alternatives to NPSG have been proposed. Oximetry is appealing because of its widespread availability and ease of application. In this study, we have evaluated whether oximetry alone can be used to diagnose or screen OSAS. The diagnostic performance of an analysis algorithm using arterial oxygen saturation ($SaO_2$) base on 'dip index', mean of $SaO_2$, and CT90 (the percentage of time spent at $SaO_2$<90%) was compared with that of NPSG. Methods: Fifty-six patients referred for NPSG to the Division of Sleep Studies at Seoul National University Hospital, were randomly selected. For each patient, NPSG with oximetry was carried out. We obtained three variables from the oximetry data such as the dip index most linearly correlated with respiratory disturbance index (RDI) from NPSG, mean $SaO_2$, and CT90 with diagnosis from NPSG. In each case, sensitivity, specificity and positive and negative predictive values of oximetry data were calculated. Results: Thirty-nine patients out of fifty-six patients were diagnosed as OSAS with NPSG. Mean RDI was 17.5, mean $SaO_2$ was 94.9%, and mean CT90 was 5.1%. The dip index [4%-4sec] was most linearly correlated with RDI (r=0.861). With dip index [4%-4sec]${\geq}2$ as diagnostic criteria, we obtained sensitivity of 0.95, specificity of 0.71, positive predictive value of 0.88, and negative predictive value of 0.86. Using mean $SaO_2{\leq}97%$, we obtained sensitivity of 0.95, specificity of 0.41, positive predictive value of 0.79, and negative predictive value of 0.78. Using $CT90{\geq}5%$, we obtained sensitivity of 0.28, specificity of 1.00, positive predictive value of 1.00, and negative predictive value of 0.38. Conclusions: The dip index [4%-4sec] and mean $SaO_2{\leq}97%$ obtained from nocturnal oximetry data are helpful in diagnosis of OSAS. CT90${\leq}$5% can be also used in excluding OSAS.

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Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan (간경화 환자에서의 저산소혈증과 Tc-99m-MAA 주사를 이용한 폐내단락 측정)

  • Lee, Kye-Young;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.504-512
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    • 1994
  • Background: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant cuases of cirrhosis. It is uncertain that the same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia, Method: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. Results: The hypoxemia of $PaO_2$ less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). But there was no patient with significant hypoxemia of $PaO_2$ less than 60 mmHg. $PaO_2$ was significantly decreased in the patients with spider angioma than the pathients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of $11.4{\pm}4.1%$ than normoxemic group of $4.1{\pm}2.0%$ (p<0.05). Conclusions: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to p1ay a major ro1e in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.

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The Evaluations of Phoria and AC/A Ratio by Watching 3D TV at Near (3D TV 근거리 시청에 따른 사위도와 조절성폭주비 평가)

  • Son, Jeong-Sik;Kim, Dong-Su;Kim, Jung-Ho;Kim, Jae-Do;Hamacher, Alaric;Yu, Dong-Sik
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.3
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    • pp.319-324
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    • 2015
  • Purpose: This study was designed to evaluate the changes of phoria and calculated AC/A ratio, and their recovery time points by watching 3D television (3D TV). Methods: 50 subjects (male 30, female 20) of 20s to 40s ages who can watch 3D, were measured phoria using a Howell phoria card at 3 m for distance and 40 cm for near. The phoria was evaluated before watching 3D TV and every 10 minutes from starting of watching 3D TV for 30 minutes, and every 5 minutes after finishing of watching 3D TV for 30 minutes again. Results: For the distance phoria during and after watching 3D TV, it was increased to more exophoria $-0.98{\pm}1.37{\Delta}$ (prism diopters) after 10 minutes from starting of 3D TV watching (p=0.063) and increased to more exophoria $-1.00{\pm}1.28{\Delta}$ after 30 minutes (p=0.024), and started to decrease after finishing of watching 3D TV and recovered to the level of before 3D TV watching ($-0.78{\pm}1.11{\Delta}$) after 20 minutes (p=0.32) with comparing to phoria of before watching 3D TV ($-0.80{\pm}1.12{\Delta}$). For the near phoria, it was also increased to more exophoria $-5.71{\pm}4.45{\Delta}$ after 10 minutes from starting of watching 3D TV (p=0.000) and $-6.58{\pm}4.36{\Delta}$ after 30 minutes (p=0.000), and started to decrease after finishing of watching 3D TV and recovered to the level of before watching 3D TV after 20 minutes ($-4.34{\pm}3.67{\Delta}$) (p=0.32) with comparing to the phoria of before watching 3D TV ($-4.36{\pm}3.66{\Delta}$). AC/A ratio was decreased from $4.92{\pm}1.17{\Delta}/D$ for before 3D TV watching to $4.11{\pm}1.50{\Delta}/D$ for after 30 minutes from starting of watching 3D TV (p=0.000), and increased after the end of watching 3D TV and recovered to the level of before 3D TV watching ($4.93{\pm}1.18{\Delta}/D$) after 25 minutes (p=0.598). Conclusions: During watching 3D TV at near, it showed a tendency of convergence insufficiency by decrease of calculated AC/A ratio as result that exophoria at near was higher increased than exophoria at distance. However, the increased exophoria at both near and distance was recovered to the level of base line after 25 minutes from the end of watching 3D TV. Through this study, it seems to need rational proposals of advice for watching 3D TV.

Lung Uptake of $^{99m}Tc-sestamibi$ during Routine Gated Exercise SPECT Imaging : Comparison with Left Ventricular Ejection Fraction and Severity of Perfusion Defect (일상적인 운동 부하 게이트 심근 관류 SPECT에서 $^{99m}Tc-sestamibi$ 폐섭취 : 좌심실 구혈률과 관류 결손 정도와의 비교)

  • Jeong, Shin-Young;Lee, Jae-Tae;Bae, Jin-Ho;Ahn, Byeong-Cheol;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.83-93
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    • 2003
  • Background: Lung-to-heart uptake ratio (LHR) in $^{201}Tl-chloride$ myocardial perfusion scan is believed to be a reliable marker for left ventricular (LV) dysfunction, but the clinical value of LHR is controversial for $^{99m}Tc-MIBI$ imaging. Furthermore, most of results suggesting lung uptake of $^{99m}Tc-MIBI$ as a potential marker for LV dysfunction used immediate post-stress images, instead of routine images acquired 1 hour after tracer injection. The goal of our study was to investigate whether LHR evaluated with routine gated $^{99m}Tc-MIBI$ imaging can reflect the degree of perfusion defect or left ventricular performance. Subjects and Methods: 241 patients underwent exercise $^{99m}Tc-MIBI$ myocardial SPECT were classified into normal myocardial perfusion (NP, n=135) and abnormal myocardial perfusion (AP, n=106) group according to the presence of perfusion defect. LHR was calculated from anterior projection image taken at 1-hour after injection. Two legions of interest (ROIs) were placed on left lung above LV and on myocardium showing the highest radioactivity. Subjects were classified by left ventricular ejection fraction (LVEF), as Gr-I: >50%, Gr-II: 36-50%, Gr-III: <36% and by summed stress score (SSS), as Gr-A: <4, Gr-B: 4-8, Gr-C: 9-13, Gr-D: >13, LHR was compared among these groups. Results: In NP group(n=135), LHR, were higher in men than women ($men:\;0.311{\pm}0.03,\;women:\;0.296{\pm}0.03,\;p<0.05$). Significant difference, in LHR were found between NP and AP groups both for men and women ($men:\;0.311{\pm}0.03\;vs\;.\;0.331{\pm}0.06,\;women:\;0.296{\pm}0.03\;vs.\;0.321{\pm}0.07.\;p<0.05$). There were weak negative correlation between LHR and LVEF (r=-0.342, p<0.05) and weak positive correlation between LHR and SSS (r=0.478, p<0.05) in men, but not in women (LVEF: r=-0.279, p=0.100, SSS: r=0.276, p=0.103). Increased LHR was defined when for more than mean + 2SD value ($men{\geq}0.38,\;women{\geq}0.37$) of the LHR of the subject with normal perfusion. Increased LHR were observed more frequently in subjects with lower LVEF (Gr-I: 11.1%, Gr-II: 27.0%, Gr-III: 35.4%, p<0.05) and higher SSS(Gr-A: 14.0%, Gr-B: 5.7%, Gr-C: 18.2%, Gr-D: 40.7%, p<0.05). Conclusions: LHRs obtained from routine $^{99m}Tc-MIBI$ gated SPECT images were weakly correlated with LVEF and perfusion defect. Although significant overlaps were observed between normal and abnormal perfusion group, LHRs could be used as an indirect marker of severe perfusion defect or reduced left ventricular function.

Age or Basal Serum FSH Levels; Which One is Better for Prediction of IVF Outcomes in Patients with Decreased Ovarian Reserve? (난소의 기능이 저하된 불임 환자에서 연령 및 기저 혈중 FSH 수치가 체외수정시술의 예후에 미치는 영향에 관한 연구)

  • Yu, Young;Kim, Min-Ji;Cho, Yeon-Jean;Yeon, Myeong-Jin;Ahn, Young-Sun;Cha, Sun-Hwa;Kim, Hye-Ok;Park, Chan-Woo;Kim, Jin-Young;Song, In-Ok;Koong, Mi-Kyoung;Kang, Inn-Soo;Jun, Jong-Young;Yang, Kwang-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.3
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    • pp.189-196
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    • 2007
  • Objectives: The purpose of this study is to investigate the clinical significance of age and basal serum FSH in predicting the outcomes of in vitro fertilization (IVF) in patients with poor-ovarian response. Methods: From January 2000 to December 2004, 85 second IVF cycles of 85 poor-ovarian response patients under the age of 42 with a back-ground of the first IVF cycles at our infertility center and 5 or less oocytes were retrieved and their basal serum FSH levels of 15$\sim$25 mIU/ml were enrolled in this study. Exclusion criteria were patients with a male factor for the etiology of infertility and undergoing genetic diagnosis of embryo such as PGD. Flare-up protocol was used for ovarian stimulation in all cases. Results: When we stratified the study groups by patient's age, the younger age group (age<35, n=35) showed significantly higher implantation rate (19.0% versus 4.0%, p<0.05) and higher ongoing pregnancy rate (100% versus 14.3%, p<0.05) than the older age group (age$\geq$35, n=50). And then, when we stratified the study populations by basal serum FSH level, the lower FSH group (basal serum FSH<20 mIU/ml, n=58) showed significantly higher number of retrieved oocytes (4.6$\pm$0.7 versus 2.2$\pm$0.5, p<0.05) and lower cancellation rate (19.0% versus 55.6%, p<0.05) than higher FSH group (basal serum FSH$\geq$20 mIU/ml, n=27). Conclusions: In conclusion, it was suggested that the patient's age could predict the IVF outcomes in respect to its potency of pregnancy and ongoing pregnancy. Serum basal FSH levels could predict more accurately the ovarian response of cycle, but not clinical outcomes.

The Present State of Domestic Acceptance of Various International Conventions for the Prevention of Marine Pollution (해양오염방지를 위한 각종 국제협약의 국내 수용 현황)

  • Kim, Kwang-Soo
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.12 no.4 s.27
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    • pp.293-300
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    • 2006
  • Domestic laws such as Korea Marine Pollution Prevention Law (KMPPL) which has been mae and amended according to the conclusions and amendments of various international conventions for the prevention a marine pollution such as MARPOL 73/78 were reviewed and compared with the major contents of the relevant international conventions. Alternative measures for legislating new laws or amending existing laws such as KMPPL for the acceptance of major contents of existing international conventions were proposed. Annex VI of MARPOL 73/78 into which the regulations for the prevention of air pollution from ship have been adopted has been recently accepted in KMPPL which should be applied to ships which are the moving sources of air pollution at sea rather tlnn in Korea Air Environment Conservation Law which should be applied to automobiles and industrial installations in land. The major contents of LC 72/95 have been accepted in KMPPL However, a few of substances requiring special care in Annex II of 72LC, a few of items in characteristics and composition for the matter in relation to criteria governing the issue of permits for the dumping of matter at sea in Annex III of 72LC, and a few of items in wastes or other matter that may be considered for dumping in Annex I of 96 Protocol have not been accepted in KMPPL yet. The major contents of OPRC 90 have been accepted in KMPPL. However, oil pollution emergency plans for sea ports and oil handling facilities, and national contingency plan for preparedness and response have not been accepted in KMPPL yet. The waste oil related articles if Basel Convention, which shall regulate and prohibit transboundary movement of hazardous waste, should be accepted in KMPPL in order to prevent the transfer if scrap-purpose tanker ships containing oil/water mixtures and chemicals remained on beard from advanced countries to developing and/or underdeveloped countries. International Convention for the Control if Harmful Anti-Fouling Systems on the Ships should be accepted in KMPPL rather tlnn in Korea Noxious Chemicals Management Law. International Convention for Ship's Ballast Water/Sediment Management should be accepted in KMPPL or by a new law in order to prevent domestic marine ecosystem and costal environment from the invasion of harmful exotic species through the discharge of ship's ballast water.

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A Survey on the Oral Health Conditions according to Dental Health Behaviors of Elderly People in Community (일부 지역사회 노인들의 구강보건행동에 따른 구강건강상태)

  • Kang, Hyeong-Ku;Yoon, Hyun-Suk;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.30 no.3
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    • pp.263-277
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    • 2005
  • Objectives: This study aimed to reveal the oral health conditions based on the dental health behaviors of a community-dwelling elderly. Methods: The subjects included 206 rural dwellers(100 men & 106 women) aged over 65 years old, who received dental health check-ups in the local public health center and its branches attached to 6 respective Myons of Chunchongnamdo Province, during the 2-month period from Jan. 1st to Feb. 28th, 2005. They were examined by dentists and given self-administered questionnaires asking about their dental heaith behaviors and subjective symptoms of gingival bleeding. Results: The oral health conditions based on dental health behavior showed that those who have not taken dental health service a year were found to have significantly greater number of missing teeth(p=0.002), DMFT(p=0.002) and CPITN(p=0.018), and those who have not observed intra-oral conditions a week to have significantly less number of filled teeth(p=0.002) and significantly greater number of missing teeth(p=0.000) and CPITN (p=0.000) than their respective counterparts. In terms of brushing, those who brushed their teeth below "3 times/day" were found to have significantly greater number of decayed teeth(p=0.000), missing teeth(p=0.000), DMFT(p=0.000) and CPITN(p=0.000) than their counterparts. In terms of time spent in brushing, those who spends "below 3 minutes" had significantly greater number of missing teeth(p=0.002) and DMFT(p=0.041), and significantly less number of filled teeth(p=0.036). According to the use of aid tools for cleaning teeth, the group who don't use them had significantly greater number of DMFT(p=0.041) and CPITN(p=0.018) than its counterpart. Classified by smoking habits, smoking groups had significantly greater number of decayed teeth(p=0.035) and CPITN(p=0.001) than non-smoking groups. Multiple regression analysis of the study data revealed that the significant factors influencing number of decayed teeth were number of brushing, sex and intra-oral observation (explanatory power of 14.2%). The significant factors for number of filled teeth were sex, intra-oral observation, use of aid tools, frequency of brushing, subjective health conditions and drinking of sweet beverages(explanatory power of 18.2%), those for number of missing teeth, number of brushing and age(explanatory power of 13.9%) those for DMFT, number of brushing, sex, use of dental service, age(explanatory power: 13.5%), and those for CPITN included smoking habits, use of dental service, use of aid tools (explanatory power: 10.8%). Conclusions: The study results revealed that the dental health behavior of the elderly population is in poor conditions and their consequent intra-oral health conditions are not good. To improve their oral conditions, public campaign and education will be needed to modify unhealthy dental health behaviors.

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