• Title/Summary/Keyword: Cooperation control

Search Result 2,744, Processing Time 0.042 seconds

Stressful Life Events, Health Symptoms, Social Support and Coping/in Early Adolescents (스트레스생활사건, 건강문제, 대응, 사회적 지지의 관계 -청소년을 대상으로-)

  • 오가실;한정석
    • Journal of Korean Academy of Nursing
    • /
    • v.20 no.3
    • /
    • pp.414-429
    • /
    • 1990
  • Numerous research reports have substantiated the role of stressful life events in relation to the onset of health changes. The relationship tends to hold across different age groups. Theoretically, adolescence has been considered a developmental crisis period of great stress, impoverished coping skills and high vulnerability to biological, social and psychological demands. The research problem addressed by this study was to examine the relationships between stressful life events and health symptom patterns, and the effect of two variables, coping and social, support, theoretically considered to mediate the relationship between stress and health symptoms in adolescents. The following five hypotheses were tested in this research : 1. Health symptoms are positively related to stressful life events in adolescents, 2. Health symptoms are negatively related to coping in adolescents, 3. Health symptoms are negatively related to social support in adolescents, 4. When coping is controlled, the relationship between health symptoms and stressful life events will decrease, and 5. When social support is controlled, the relationship between health symptoms and stressful life events will increase. The study subjects consisted of 1090 high school students of the metropolitan city of Seoul. The following sampling procedure was used : 1. Of the 169 high schools in nine school administrative districts in the city, a proportional sample of ten schools was selected. 2. One class from each of the freshman and sophomore was randomly selected and all the students who were in the sampled class were used as the study sample. The study was limited to freshman and sophomore adolescents, aged 15 to 18(mean=16.6). Of the 1090 subjects 688(63%) were boys and 402(37%) were girls. An Adolescent Inventory of Stressful Life Events, a Health Symptom Questionnaire and an Adolescent Coping Inventory were adapted for this study. The Norbeck Social Support questionnaire was utilized to collect the data on perceived social support. Five high school teachers in the areas of school health and counselling reviewed the items of each questionnaire for content validity. A pilot study was undertaken to ascertain reliability. Fifty three high school students responded to the questionnaires and gave their opinions on the items. For stressful life events, health symptoms, coping, and social support, the Cronbach's alpha's on the study were .70, .94, .77, and .76, respectively. Research assistants attended all the sampled classes with the school proctor to explain the purpose and procedures of the study to the students. The questionnaires along with a ballpoint pen were distributed to the students who were asked to complete each item. The research assistants left the ballpoint pen with the students as a gift for their cooperation. An average of 50 minutes was required to complete the questionnaires. Using an SPSS, the first, three hypotheses were tested using Gamma, a measure of association for ordinal variables. Partial gamma was used to test the fourth and fifth hypotheses. Patterns of elaboration described by Babbie were selected to interpret the relationship of the three variable analyses. The significance of gamma was determined by Chisquare at a .05 level of significance. There was a positive relationship between health symptoms and stressful life events(Gamma=.35, p=.000). Thus the first hypothesis was supported. Unexpectedly, coping was positively related with health symptoms(Gamma=.13, p=.000). That is, the higher the coping levels, the greater number of health problems. The third hypothesis, the higher the level of social support, the fewer the health symptoms, was not accepted in this adolescent study group. When coping was controlled, under the condition of low coping the association between health symptoms and stressful life events increased significantly to a partial gamma of .39, and under the condition of high coping it was .30. According to the elaboration model, when one partial relationship is the same or greater than the original and the other is smaller, the control variable should be considered to be specifying the conditions. When social support was controlled the relationship between stressful life events and health symptoms increased under the condition of low social support, but with high social support, the relationship decreased. Both partial gamma were statistically significant at .05 level(.43 and .26 relatively). It can be interpreted that stressful life events are strongly and positively related to health symptoms under the condition of low social support, however this relationship can not be expected with high social support. Thus, the last two hypotheses were conditionally sustained. In this study, the relationships between stressful life events and health symptoms, and the specified me diating roles of coping and social support were found to have statistical interaction. This finding supports the theoretical position of this study. It suggests that stressful life events would create high susceptability to biological social and psychological health symptoms and coping and social support buffering the relationship between stressful life events and health symptom. The findings of this study have implications for nursing practice. When adolescents are confronted with non-developmental life events that are perceived as stressful, nurses should recognize the evidence of the stress-buffering effect of coping and social support on health symptoms and utilize the diverse sources of social support that are readily available to adolescents.

  • PDF

Using CR System at the Department of Radiation Oncology PACS Evaluation (방사선 종양학과에서 CR System을 이용한 PACS 유용성 평가)

  • Hong, Seung-Il;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
    • /
    • v.6 no.2
    • /
    • pp.143-149
    • /
    • 2012
  • Today each hospital is trend that change rapidly by up to date, digitization and introducing newest medical treatment equipment. So, we introduce new CR system and supplement film system's shortcoming and PACS, EMR, RTP system's network that is using in hospital harmoniously and accomplish quality improvement of medical treatment and service elevation about business efficiency enlargement and patient Accordingly, we wish to introduce our case that integrate reflex that happen with radiation oncology here upon to PACS using CR system and estimate the availability. We measured that is Gantry, Collimator Star Shot, Light vs. Radiation, HDR QA(Dwell position accuracy) with Medical LINAC(MEVATRON-MX) Then, PACS was implemented on the digital images on the monitor that can be confirmed through the QA. Also, for cooperation with OCS system that is using from present source and impose code that need in treatment in each treatment, did so that Order that connect to network, input to CR may appear, did so that can solve support data mistake (active Pinacle's case supports DICOM3 file from present source but PACS does not support DICOM3 files.) of Pinacle and PACS that is Planning System and look at Planning premier in PACS. All image and data constructed integration to PACS as can refer and conduct premier in Hospital anywhere using CR system. Use Dosimetry IP in Filmless environment and QA's trial such as Light/Radition field size correspondence, gantry rotation axis' accuracy, collimator rotation axis' accuracy, brachy therapy's Dwell position check is available. Business efficiency by decrease and so on of unnecessary human strength consumption was augmented accordingly with session shortening as that integrate premier that is neted with radiation oncology using CR system to PACS. and for the future patient information security is essential.

Radiation Exposure Dose Reduction on Upper Gastrointestinal Series (위장조영검사에서 피폭선량 저감)

  • Lim, Byung-Hak;Chon, Kwon Su
    • Journal of the Korean Society of Radiology
    • /
    • v.11 no.2
    • /
    • pp.109-116
    • /
    • 2017
  • Upper gastrointestinal series is non-invasive examination, and it is useful for patients or elderly patients who have difficulty in endoscopic examination because of absence of any side effects other than temporary constipation or abdominal pain. The entire image of the gastrointestinal tract can be seen and have been widely used in the diagnosis of upper gastrointestinal diseases. However, there is a possibility that radiation dose increases due to improper movement and breath control, when examination is carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. In upper gastrointestinal series to increase understanding of examination, to induce appropriate cooperation during examination, to reduce the number of retakes and shorten examination time, and to reduce dose of the subject, the procedure and precautions of the gastrointestinal test were made as a movie. We investigated the effectiveness of pre-education using the movie to reduce the inspection time, the number of re-shoots, and the reduction of exposure dose by watching the movie during the waiting time before examination. 120 patients that were selected each 20 patients aged from 30s to 80s were evaluated were evaluated for exposure dose, examination time, and the number of retakes before and after the movie training. The radiation dose, the examination time, and the number of retakes were respectively $3171.83{\mu}Gy{\cdot}m^2$ and $2931.73{\mu}Gy{\cdot}m^2$, 8.05 min, and 6.75 min, and 1.68 times and 1.22 times before and after movie training. It can be concluded that the movie training on the gastrointestinal examination influences the reduction of the examination time, the number of retakes and the reduction of the radiation dose.

Heart Rate Variability and Autonomic Activity in Patients Affected with Rett Syndrome (Rett 증후군 환자에서의 자율신경 활성도 및 심박수 변이도 측정)

  • Choi, Deok Young;Chang, Jin Ha;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.10
    • /
    • pp.996-1002
    • /
    • 2003
  • Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.

Ubiquitous Sensor Network Application Strategy of Security Companies (시큐리티업체의 유비쿼터스 센서네트워크(USN) 응용전략)

  • Jang, Ye-Jin;An, Byeong-Su;Ju, Choul-Hyun
    • Korean Security Journal
    • /
    • no.21
    • /
    • pp.75-94
    • /
    • 2009
  • Since mechanical security systems are mostly composed of electronic, information and communication devices, they have effects in the aspects of overall social environment and crime-oriented environment. Also, the importance is increasing for wireless recognition of RFID and tracing function, which will be usefully utilized in controlling the incomings and outgoings of people/vehicles or allowance, surveillance and control. This is resulting from the increase in the care for the elderly according to the overall social environment, namely, the aging society, and the number of women entering, as well as the increase in the number of heinous crimes. The purpose of this study is to examine the theoretical considerations on ubiquitous sensor network and present a direction for securities companies for their development by focusing on the technological and application areas. To present strategies of response to a new environment for security companies, First, a diversification strategy is needed for security companies. The survival of only high level of security companies in accordance with the principle of liberal market competition will bring forth qualitative growth and competitiveness of security market. Second, active promotion by security companies is needed. It is no exaggeration to say that we are living in the modern society in the sea of advertisements and propaganda. The promotional activities that emphasize the areas of activity or importance of security need to be actively carried out using the mass media to change the aware of people regarding security companies, and they need to come up with a plan to simultaneously carry out the promotional activities that emphasize the public aspect of security by well utilizing the recent trend that the activities of security agents are being used as a topic in movies or TV dramas. Third, technically complementary establishment of ubiquitous sensor network and electronic tag is needed. Since they are used in mobile electronic tag services such as U-Home and U-Health Care, they are used throughout our lives by forming electronic tag environment within safe ubiquitous sensor network based on the existing privacy guideline for the support of mobile electronic tag terminal commercialization, reduction in communication and information usage costs, continuous technical development and strengthening of privacy protection, and the system of cooperation of academic-industrial-research needs to be established among the academic world and private research institutes for these parts.

  • PDF

Mechanisms for Anti-wrinkle Activities from Fractions of Black Chokeberries (블랙초크베리 분획물로부터의 주름억제 효과에 대한 작용기전)

  • Choi, Eun-Young;Kim, Eun-Hee;Lee, Jae-Bong;Do, Eun-Ju;Kim, Sang-Jin;Kim, Se-Hyeon;Park, Jeong-Yeol;Lee, Jin-Tae
    • Journal of Life Science
    • /
    • v.26 no.1
    • /
    • pp.34-41
    • /
    • 2016
  • Black chokeberries (scientific name Aronia melanocarpa) have been reported to have major effects due to anti-oxidant, anti-inflammatory, and anti-cancer capabilities. In this study, we investigated the anti- wrinkle effects of A. melanocarpa, including collagenase inhibition effects and their molecular biological mechanisms, such as oxidative stress-induced matrix metalloproteinase (MMP), mitogen-activated protein (MAP) kinase, and activator protein (AP)-1 expression and/or phosphorylation. In collagenase inhibition activity, the ethyl acetate fraction of black chokeberry (AE) was 77.2% at a concentration of 500 μg/ml, which was a significant result compared to that of Epigallocatechin gallate (positive control, 83.9% in 500 μg/ml). In the reactive oxygen species (ROS) assay, the AE produced 78% of ROS in 10 μg/ml and 70% of ROS in 75 μg/ml, which was a much lower percentage than the ROS production of H2O2-induced CCRF S-180II cells. In the MTT assay, cell viability was increased dose-dependently with AE in H2O2-induced cells. In protein expression by western blot assay, the AE suppressed the expression and phosphorylation of MMPs (MMP-1, -3, -9), MAPK (ERK, JNK, and p38), and AP-1 (c-Fos and c-Jun), and expressed the pro-collagen type I in H2O2-induced cells. These results suggest that black chokeberries have anti-wrinkle and collagen-production effects, and they may be used in applications for material development in the functional food and cosmetic industries.

A single case study using Contextual Support Model based music therapy intervention for a terminal pediatric patient (말기질환 아동을 위한 환경적 지지모델(The Contextual Support Model of Music Therapy)에 근거한 음악치료사례연구)

  • Jun, Mi Hye
    • Journal of Music and Human Behavior
    • /
    • v.2 no.2
    • /
    • pp.15-31
    • /
    • 2005
  • Terminal pediatric patient include congenital metabolic abnormalities, chromosome aberrations, congenital anomalies, neuromuscular diseases and other incurable conditions as well as malignant tumors. One third of these diseases are cancers, and two thirds of cancers are lymphadenoma and leukemia. Terminal pediatric patient may feel fear, anger and frustration against treatment process in hospitals, lose control of themselves and stay in helplessness due to restrictions within controlled hospital environment. This study examined the relationship between hospitalized childrens behavior and music using Contextual Support Model of Music Therapya theory stating therapeutic music environments possess three elements of Structure, Autonomy support and Involvement, and increase childrens active engagement. Focused on these three therapeutic elements, this study analyzed music therapy cases of terminally ill children to examine the relationship between childrens behavior and music as environmental supportive medium in the environment. This study is on a single case case subject, a 10-year-old girl with acute lymphocytic leukemia. Nine sessions of music therapy activities were conducted and analyzed using qualitative method. Focusing on three therapeutic elements of Contextual Support Model, analysis of sessions was made on the basis of activities specifically designed for this study. Main music therapy activities included singing while playing musical instruments, singing while listening to music through CD player, making up songs, and searching for song lines. The findings of this study are as follows: a) in terms of Structure, music therapy suggested a direction for effective musical activities for terminally ill children by providing environments where child can sing, play musical instruments and make up songs; b) in terms of Autonomy support, music therapy encouraged childs voluntary participation by giving her chances to make choice while singing or playing musical instruments; c) in terms of Involvement, child could gain positive approval of the therapist and conduct musical activities in cooperation with the therapist. Music therapy serves as supportive medium in the environment, develops spontaneity and self-reliance in emotionally depressed children, and promotes voluntary attitudes in the restricted hospital environment. Based on the positive effects of music therapy, more studies need to be conducted with an approach to more various terminal pediatric patients.

  • PDF

Recent Developments in Space Law (우주법(宇宙法)의 최근동향(最近動向))

  • Choi, June-Sun
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.1
    • /
    • pp.223-243
    • /
    • 1989
  • The practical application of modern space science and technology have resulted in many actual and potential gains of mankind. These successes have conditioned and increased the need for a viable space law regime and the challenge of space has ultimately led to the formation of an international legal regime for space. Space law is no longer a primitive law. It is a modern law. Yet, in its stages of growth, it has not reached the condition of perfection. Therefore, under the existing state of thing, we could carefully say that the space law is one of the most newest fields of jurisprudence despite the fact that no one has so far defined it perfectly. However, if space law can be a true jurisprudential entity, it must be definable. In defining the space law, first of all, the grasp of it's nature iis inevitable. Although space law encompasses many tenets and facets of other legal discriplines, its principal nature is public international law, because space law affects and effects law relating intercourse among nations. Since early 1960s when mankind was first able to flight and stay in outer space, the necessity to control and administrate the space activities of human beings has growingly increased. The leading law-formulating agency to this purpose is the United Nation's ad hoc Committee on Peaceful Uses of Outer Space("COPUOS"). COPUOS gave direction to public international space law by establishing the 1963 Declaration of Legal Principles Governing the Activities of the States in the Exploration and Use of Outer Space("1963 Declaration"). The 1963 Declaration is very foundation of the five international multilateral treaties that were established successively after the 1963 Declaration. The five treaties are as follows: 1) The Treaty on Principles Governing the Activities of States in the Exploration and Use of Outer Space including Moon and other Celestial Bodies, 1967. 2) The Agreement on the Rescue of Astronauts, the Return of Astronauts, and the Return of Objects Launched into Outer Space, 1968. 3) The Convention on International Liability for Damage Caused by Space Objects, 1972. 4) The Convention on Registration of Objects Launched into Outer Space, 1974. 5) The Agreement Governing Activities of States on the Moon and Other Celestial Bodies: Moon Treaty, 1979. The other face of space law is it's commercial aspect. Space is no longer the sole domination of governments. Many private enterprise have already moved directly or indirectly into space activities in the parts such as telecommunications and space manufacturing. Since space law as the public international law has already advanced in accordance with the developments of space science and technology, there left only a few areas untouched in this field of law. Therefore the possibility of rapid growth of space law is expected in the parts of commerical space law, as it is, at this time, in a nascent state. The resources of the space environment are also commercially both valuable and important since the resources include the tangible natural resources to be found on the moon and other celestial bodies. Other space-based resources are solar energy, geostationary and geosynchronous orbital positions, radio frequencies, area possibly suited to human habitations, all areas and materials lending themselves to scientific research and inquiry. Remote sensing, space manufacturing and space transportation services are also another potential areas in which commercial. endeavors of Mankind can be carried out. In this regard, space insurance is also one of the most important devices allowing mankind to proceed with commercial space venture. Thus, knowlege of how space insurance came into existence and what it covers is necessary to understand the legal issues peculiar to space law. As a conclusion the writer emphasized the international cooperation of all nations in space activities of mankind, because space commerce, by its nature, will give rise many legal issues of international scope and concern. Important national and world-community interests would be served over time through the acceptance of new international agreements relating to remote sencing, direct television broadcasting, the use of nuclear power sources in space, the regularization of the activities of space transportation systems. standards respecting contamination and pollution, and a practical boundary between outer space and air space. If space activity regulation does not move beyond the national level, the peaceful exploration of space for all mankind will not be realized. For the efficient regulation on private and governmental space activities, the creation of an international space agency, similar to the International Civil Aviation Organization but modified to meet the needs of space technology, will be required. But prior to creation of an international organization, it will be necessary to establish, at national level, the Office of Air and Space Bureau, which will administrate liscence liscence application process, safety review and sale of launch equipment, and will carry out launch service.

  • PDF

A Comparison of Minilaparotomy and Laparoscopic Sterilization (Minilaparotomy 불임술(不妊術)과 복강경불임술(腹腔鏡不妊術)에 관(關)한 비교연구(比較硏究))

  • Bai, Byoung-Choo
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.4 no.1
    • /
    • pp.17-25
    • /
    • 1977
  • Anderson(1937), Power and Barnes(1941) reported a study concerning a method of tubal sterilization in association with peritoneoscopy or laparoscopy in which they cauterized the tubes. There appears to have been a hiatus of interest in sterilization (cold or hot) associated with laparoscopy until reintroduction by Palmer(1963), Frangenheim(1964) and Steptoe(1967). On the other hand, for interval female sterilization, however, minilaparotomy is relatively new. By Saunder and Munsick(1972), John Lyle(1974), Frank Stubb(1974), Vitoon(1973) and B.C. Bai(1975), their own technique for interval female sterilization requires 2.0 to 2.5cm, incision at the margin of the mons pubis. In Korea, female sterilization by means of minilaparotomy firstly reported by B.C. Bai using Bai's uterine elevator, of his own device, early in 1975. Recently inteval female sterilization by laparoscopy and minilaparotomy are widely accepted throughout the world especially in Asian countries. Minilaparotomy is carried out from 1974, laparoscopic sterilization from 1976, and in this study each of 250 cases of those were analysed and discussed for the comparison at Seoul Red Cross Hospital. (1) In the age distribution, numerous clients were in their age of $31{\sim}35$ in laparoscopy as well as minilaparotomy. Average 33.7 years in L and 33.2 years in M. (M=minilaparotomy, L=laparoscopic sterilization) (2) As regarding living children, women having 3 children represented the greatest number, 113 cases out of 250 in M group and 102 cases out of 250 in L group. Average No. of child are 2.9 in Land 3.1 in M. (3) Concidering the operation day in the menstrml cycle, the greatest number of cases, those who underwent tubal sterilization during the days of $26{\sim}$, next during the $6{\sim}10$ days of the cycle in both group. (4) Concidering the operation time, 188 cases by laparoscopy were performed in $6{\sim}10$ minutes, 33 cases within 5 minutes and 24 cases in $11{\sim}15$ minutes. Maximum 50 minutes, minimum 4 minutes and average 8.3 minutes. The majority of cases (154 cases) by minilaparotomy required $6{\sim}10$ minutes and 67 cases $11{\sim}15$ minutes, 6 cases within 5 minutes. Maximum 30 minutes, minimum 4 minutes and average 10.4, minutes. In both groups, most of the reasons for the extra length were surgical difficulties such as thick abdominal wall, pelvic adhesion, less cooperation of patients in early period of this study. (5) Hospital stay after operation in L group required $3{\sim}4$ hours in 125 cases, $2{\sim}3$ hours in 41 cases, $4{\sim}5$ hours in 32 cases out of 250. Maximum 8 hours, minimum 1 hour and average 3.8 hours. In M group hospital stay required $6{\sim}7$ hours in 100 cases, over 7 hours in 85 cases, $5{\sim}6$ hours in 46 cases and so on. Maximum 14 hours, minimum 2 hours and average 6.5 hours. (6) The time between operation and gas passing in the majority cases of both groups, were $12{\sim}36$ hours. A veragetime 20.3 hours in L and 27.2 in M. (7) Laparoscopic sterilization coincident with induced abortion were carried out in 27 cases, laparoscopy with minilaparotomy to control for mesosalpingeal hemorrhage in 1 case. Minilaparotomy coincident with induced abortion were performed in 65 cases, D and C whit polypectomy, menstrual regulatian, and remaval of IUD in 1 case respectively. (8) In L group, 1 case of mesosalpingeal hemorrhage, 1 case of abdominal wall infection were complicated during operation. In M group, 1 case of uterine perfaration, 1 case of abdominal wall infection, 1 case of hemorrhage from omentum and 1 case of bloody vaginal discharge were complicated. No intensive medical treatment was required for those minor complications in both groups. (9) No failure has been recognized and these two sterilization techniques might be the simple, safe and the most effective method for permanent contraception at present time. There is no significant clinical defference between L and M group in this study.

  • PDF

A Study on Design of Agent based Nursing Records System in Attending System (에이전트기반 개방병원 간호기록시스템 설계에 관한 연구)

  • Kim, Kyoung-Hwan
    • Journal of Intelligence and Information Systems
    • /
    • v.16 no.2
    • /
    • pp.73-94
    • /
    • 2010
  • The attending system is a medical system that allows doctors in clinics to use the extra equipment in hospitals-beds, laboratory, operating room, etc-for their patient's care under a contract between the doctors and hospitals. Therefore, the system is very beneficial in terms of the efficiency of the usage of medical resources. However, it is necessary to develop a strong support system to strengthen its weaknesses and supplement its merits. If doctors use hospital beds under the attending system of hospitals, they would be able to check a patient's condition often and provide them with nursing care services. However, the current attending system lacks delivery and assistance support. Thus, for the successful performance of the attending system, a networking system should be developed to facilitate communication between the doctors and nurses. In particular, the nursing records in the attending system could help doctors monitor the patient's condition and provision of nursing care services. A nursing record is the formal documentation associated with nursing care. It is merely a data repository that helps nurses to track their activities; nursing records thus represent a resource of primary information that can be reused. In order to maximize their usefulness, nursing records have been introduced as part of computerized patient records. However, nursing records are internal data that are not disclosed by hospitals. Moreover, the lack of standardization of the record list makes it difficult to share nursing records. Under the attending system, nurses would want to minimize the amount of effort they have to put in for the maintenance of additional records. Hence, they would try to maintain the current level of nursing records in the form of record lists and record attributes, while doctors would require more detailed and real-time information about their patients in order to monitor their condition. Therefore, this study developed a system for assisting in the maintenance and sharing of the nursing records under the attending system. In contrast to previous research on the functionality of computer-based nursing records, we have emphasized the practical usefulness of nursing records from the viewpoint of the actual implementation of the attending system. We suggested that nurses could design a nursing record dictionary for their convenience, and that doctors and nurses could confirm the definitions that they looked up in the dictionary through negotiations with intelligent agents. Such an agent-based system could facilitate networking among medical institutes. Multi-agent systems are a widely accepted paradigm for the distribution and sharing of computation workloads in the scientific community. Agent-based systems have been developed with differences in functional cooperation, coordination, and negotiation. To increase such communication, a framework for a multi-agent based system is proposed in this study. The agent-based approach is useful for developing a system that promotes trade-offs between transactions involving multiple attributes. A brief summary of our contributions follows. First, we propose an efficient and accurate utility representation and acquisition mechanism based on a preference scale while minimizing user interactions with the agent. Trade-offs between various transaction attributes can also be easily computed. Second, by providing a multi-attribute negotiation framework based on the attribute utility evaluation mechanism, we allow both the doctors in charge and nurses to negotiate over various transaction attributes in the nursing record lists that are defined by the latter. Third, we have designed the architecture of the nursing record management server and a system of agents that provides support to the doctors and nurses with regard to the framework and mechanisms proposed above. A formal protocol has also been developed to create and control the communication required for negotiations. We verified the realization of the system by developing a web-based prototype. The system was implemented using ASP and IIS5.1.