• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.17-23
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• 2003

Purpose : Cholestasis is a major complication in prolonged use of TPN, especially in the neonatal period, but there are few long-term reviews examining the clinical course in premature infants. Thus, in this study, we reviewed premature infants with TPN-associated cholestasis(TPNAC) to determine the incidence, clinical courses and possible risk factors. Methods : Retrospective review of 66 premature infants less than 2,000 gm of birth weight and on TPN for more than two weeks was performed. Cholestasis was defined as a serum direct bilirubin level greater than 2.0 mg/dL. The clinical course of cholestasis was described, and perinatal risk factors were evaluated. Results : TPNAC developed in 21 out of 66 infants(31.8%). The onset was $41.7{\pm}17.4days$ after receiving TPN, and the mean duration was $33.6{\pm}23.4days$. The incidence of TPNAC was significantly correlated with birth weight, and gestational age, and duration of TPN. But, possible etiologic factors, such as incidence of perinatal asphyxia or infection, showed no remarkable differences between infants with TPNAC and those without TPNAC(control). The enteral intake in the third postnatal week was significantly smaller in infants with TPNAC than in the control infants(P=0.033). Conclusion : The enteral intake in the third postnatal week was smaller in the infants with TPNAC than in the control infants. Thus, the incidence of TPNAC may be reduced by increasing the amount of oral intake during TPN in high risk infants.

• Journal of the Korean Society of Food Science and Nutrition
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• v.44 no.12
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• pp.1839-1846
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• 2015

The purpose of this study was to evaluate the effects of cultivar and milling degree of barley on quality characteristics of Makgeolli as well as compare differences between barley Makgeolli and rice Makgeolli. Saessal-bori groups (Ss-4, Ss-12, and Ss-18) showed dry lees contents of 92.3 g, 69.4 g, and 63.8 g, respectively, whereas Huinchalssal-bori groups (Hcs-6, Hcs-14, and Hcs-20) showed contents of 62.3 g, 42.2 g, and 32.2 g. There were significant differences in quality characteristics between milling degrees and cultivars (P<0.05). The moisture, ash, crude protein, and crude fat contents of raw materials decreased with elevated milling degree. Especially, ash content of raw materials had a direct effect on Makgeolli. The pH, total acidity, and amino acidity milling with elevated decreased degree. There were no differences in total sugar or alcohol content in Makgeolli according to milling degree of barley, whereas there were significant differences between cultivars. Barley Makgeolli showed total sugar and alcohol contents of $10.7{\sim}11.8^{\circ}Brix$ and 14.07~15.07%, respectively, which were significantly lower than $12.0{\sim}12.2^{\circ}Brix$ and 17.27~17.77% in rice Makgeolli (P<0.05). Differences in colors of raw barley according to milling degree had effects on chromaticity of Makgeolli; as milling degree increased, L and b values increased. Lactic acid bacteria counts were 7.21, 6.99, and 6.67 log CFU/mL in Ss-4, Ss-12, and Ss-18, respectively, as well as 6.14, 5.39, and 5.65 log CFU/mL in Hcs-6, Hcs-14, and Hcs-20, which suggests significant reductions with increased milling degree (P<0.05). The same trend was observed in yeast as a key quality of Makgeolli. Suspension stability differed depending on milling degree, so it is expected that suspension stability can be improved by adjusting milling degree.

• Journal of Korean Society of Forest Science
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• v.84 no.1
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• pp.10-21
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• 1995

This study was conducted to compare the changes in the forest resources and the process of establishment and characteristics of the Forest Law in five Northeast Asian Countries, who share the Chinese culture as a common background. The effect of Forest Law on forest resources of each countries is also compared. This study shows that the forest management scheme and the modernistic forest law in the five Northeast Countries were influenced by Japan around the early 20th century. The Forest Laws of the five countries were reestablished after the end of World War II, and now the five countries have their own Forest Law. At present, the five countries are depending on the import of foreign timber for timber supply because of the shortage of domestic timber resources. The Forest Laws of the five countries have a lot of similarities reflecting same cultural background, whereas there are differences originated from social and economic discrepancies. Currently R.O.K. is worst in forest resources compared to the other countries. The Forest Law of R.O.K. has too many articles, which has little direct relationship with forest resources management. Therefore it is recommended to consolidate the law system in the field of forest and forestry in R.O.K. including the amendment of Forest Law directing to sustainable forest and maintaining the efficiency of forest resources management.

• Journal of Korean Society of Forest Science
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• v.86 no.3
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• pp.279-287
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• 1997

This study was carried out to identify the analysis of vegetation-environment relationships of the coniferous forests in subalpine districts of Mt. Chiri by two-way indicaton species analysis(TWINSPAN) and CCA. The results are summarized as follows; The subalpine coniferous forest in Mt. Chin was classified Abies koreana community group by the TWINSPAN method. The Abies koreana community group was classified Abies koreana-Pinus densiflora, Abies koreana-Quercus mongolicd and Abies koreana-Picea jezoensis. The Abies koreana-Quercus mongolica community classified into two subcommunities, typical and Pinus koraiensis subcommunity. The Abies koreana-Picea jezoensis community classified into three subcommunities such as typical, Taxus cuspidate and Cornus controversa subcommunity. The subalpine conifers commnities in Mt. Chiri could be classified into six vegetation units, which consisted of three vegetation communities and five subcommunities. The relationship between vegetation community and influencing environmental factors was analyzed by using the CCA ordination method. It was found that altitude, concentrations of $Ca^{++}$ and $Mg^{++}$ in soil were, major environmental variables, which influence the distribution of vegetation community in the first axis, and $Ca^{++}$ and altitude in the second axis. In the relations of communities and environmental factors by CCA, the optimal ecological habitats of Abies koreana-Pinus densiflora community could be located at low elevations, in which $Ca^{++}$ and $Mg^{++}$ are rich. Abies koreana-Quercus mongolica community prefers the sites in mid-elevation zone, in which $Ca^{++}$ and $Mg^{++}$ are medium level in soil. The optimum site for Abies koreana-Pinus koraiensis community and Abies koreana-Taxus cuspidata community could be high elevations in which $Ca^{++}$ and $Mg^{++}$ are poor. Abies koreana-Cornus controversa community is found in the site at low elevations where $Ca^{++}$ and $Mg^{++}$ are medium.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.114-120
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• 2012

Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.1
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• pp.147-211
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• 1995

Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

• Journal of Korean Academy of Nursing
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• v.30 no.3
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• pp.776-790
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• 2000

Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups：33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

• The korean journal of orthodontics
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• v.33 no.4 s.99
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• pp.307-317
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• 2003

Conventional osseointegrated titanium implants have many limitations; large size, limited location for placement of the implant, severity of the surgery, discomfort of initial healing, difficulty of oral hygiene and uncontrollable force direction. Recently titanium miniscrew and miniplate have been used for an alternative to conventional dental implant. But in relation to miniplate, miniscrew has disadvantages in that more potential inflammation, light orthodontic force application and limited orthodontic application. This study was conducted to evaluate the effectiveness of miniplate by observing the reactions of peri-implant tissues to early orthodontic and orthopedic loading of titanium miniplate. In four adult beagle dogs 10 miniplates were inserted into the alveolar bone using 20 osseointegrated titanium screws. 4 miniplates were placed in two dogs(dogA, B) and 6 miniplates in two dogs(dogC, D). In dogA, B miniplates were loaded with 200gm of force immediately after placement for 15 weeks. In dogc, D, miniplates were loaded with 400gm of force immediately after placement for 8 weeks. Miniplates of dogA were removed, dogA was healed for 4 weeks, and the area which was removed of miniscrew was examined. Following an observation period, the miniplates including miniscrews and the surrounding bone of dogB and dogC, D were removed, respectively. Undecalcified section along the long axis of miniscrews were made and the degree of osseointegration was examined under the light microscope. The results were as follows. 1. In the histologic features there was direct contact between bone and miniscrew in all groups except one, dogC control group. The loaded miniscrew demonstrated only a slight increase of the osseous proximaty when compared with unloaded miniscrew 2. There was no significant difference of the osseointegration of Peri-miniscrew surface between dogB and dogC, D. But dogB showed slightly more increased bone apposition than dogC, D 3. The gingiva overlapping the miniplate and miniscrew showed no inflammatory sign in clinical and histological aspects. 4. The impaled hard and soft tissues at the area which was removed of miniscrews showed good healing without inflammatory reaction. 5. The mobility showed slight increase in un-loaded miniplate but that was insignificant. Based on the results of this study, miniplate(C-tube) can be used as a firm osseous orthodontic and orthopedic anchorage unit immediately after insertion.

• Journal of Korean Medical classics
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• v.4
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• pp.101-126
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• 1990

At early Cheong (淸) dynasty, in medical aspect by dependent on practical studying attitude that must found a theory only by an evidence, there had been a tendancy that hoped direct research of sages' mind-eye by escaping the theory of individual classes since Geum-Won (金-元) dynasty. Yoo Chang (喩昌), born in Man-Ryeok (萬曆) 12th year of Myung (明) dynasty (A.D.1583) and dead in Gang-Hee (康熙) 3rd year of Cheong (淸) dynasty (A.D.1664). The results were as follows after studying his practical idea of medicine. 1. Yoo Chang, by recognizing the ${\ll}$Sang-Han-Ro${\gg}$ has lost its true meaning after commented by Wang Hee (王熙), Lim Eog (林億), Seong Moo-I (成無巳), etc. according to Bang Yoo-Jip's (方有執) Chak-Gan-Jung-Jeong (錯簡重訂) theory, he diversified the protocal of ${\ll}$Sang-Han-Ro${\gg}$ 397 method and arranged under Six Meridian part. (六經) 2. The theory of Sam-Gang-Jeong-Rip (三綱鼎立) can be summerized Gye-Ji (桂枝) syndrome which is the case of Wind (風) has injured Wi (衛) stage, Ma-hwang (麻黃) syndrome which is the case of Cold (寒) has injured Yeong (榮) stage, Dae-Cheong-Ryong (大靑龍) syndrome which is the case both of Wind-Cold (風寒) has injured Yeong-Wi (榮衛) stage, and there has been Sam-Gang-Jeong-Rip theory by anterior medical practitioners already but the person who formally used its Sam-Gang-Jeong-Rip term is Yoo Chang. 3. Yoo Chang seized the On Byeng (溫病) by dividing three category and in Byon-Jeung-Si-Chi (辨證施治) he influenced to many aspect of establishment of later Byon-Jeung system On-Byong (溫病의 辨證體系) pertaining to Triple-Warmer by O-Dang (吳瑭) introducing Triple-Wanner Theory. (三焦理論) 4. At Chu-Jo-Ron (秋燥論) of ${\ll}$EUi-Moon-Beop-Ryo${\gg}$, while ${\ll}$Nae-Gyeong${\gg}$ describing if humidity injury Lung, then occur a disorder in it, Yoo Chang recognized that of au tuam when dryness injure Lung there occure a disorder is it so he insisted that at this case, must use Cheong-Joe-Goo-Pye method (淸操救肺法) withherbs, pertaing to Gam-Yoo-Ja-Yoon(甘柔滋潤性) property and he invented Cheong-Joe-Goo-Pye-Tang. (淸操救肺湯) 5. Yoo Chang', so called, Dae-Gi (大氣) indicates Yang-Gi (陽氣) of chest, he insisted that man's creation and every physiological activity depends on maintainence of Dae-Gi, and it integrate Yeong-Gi (榮氣), Wea-Gi (衛氣), Jong-Gi (宗氣), Jang-Boo-Ji-Gi (臟腑之氣), Gyeong-Rak-Ji-Gi. (經絡之氣) 6. Yoo Chang's expression about partical function and character of stomach, not only bolster its theory of historical physician's expression, that is stomach is. foundatness of postnatal period, but also it has corresponding aspect with modern medicine and clinic. 7. Yoo Chang emphasized "if one cure a disease, be must understood the character of disease first and use drugs later" (先議病 後用藥) phrase about of drug usage, and his theory of Geup-Rew-Man-Joo method (急流挽舟) and three therapy of Simple Ascite (單腹腸) are all unique opinion based upon this phrase mentioned above. 8. Yoo Chang's practical idea of medicine greatly influenced to Jang Ro (張璐), Hwang Won-A (黃元御), Oh Eui-Rak (吳儀洛), Joo Yang-Joon (周揚俊), etc. and theory of Sam-Gang-Jeng-Rip (三綱鼎立), Triple Warmer Theory of On Byong (溫疫의 三焦論治), Chu-Jo-Ron (秋燥論), Dae-Gi-Ron (大氣論) etc. became important object to student of Sang-Han (傷寒) and On-Byeng. (溫病) 9. Yoo Chang's Writings has more practical meaning than other physician's, especially, later the idea of Sang-Han (傷寒) and On-Byong (溫病) greatly contributed to development of Sang-Han theory and formation of On-Byong theory.

• The Korean Nurse
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• v.34 no.5
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• pp.52-67
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• 1996

As home care in developing and becoming part of the health care delivery system in Korea, it is necessary to examine the use of nursing diagnoses and related nursing interventions with a view to increasing the standardization of nursing recording. This study was done to examine the nursing diagnosis and related nursing interventions used in home care. Data were collected using a chart review of the nursing notes written for the home care given to 38 patients who had pulmonary diseases or traumatic brain or spinal cord injuries and who had received home care as part of a demonstration home care project in a college of Nursing in Seoul. Early on in the project discussions as to format and use to nursing diagnosis was done and a tool was developed based on Gordon's eleven functional catergories with the addition of categories to cover family and environment. This tool was used in the data collection. Data included nursing diagnosis, etiologies and interventions. Real numbers and percentages were used in the analysis. The results show that the most frequently used diagnoses were in the category of physical function (75.6%), followed by the category of emotional and social function (21.8%). The least frequently used category was the one for family and environment (2.6%). The order of the frequency of recorded nursing interventions was the same, 82.3% for physical function, 16.2% of emotional and social function and 1.5% for family and environment. Under the category of physical functioning the most frequently used nursing diagnoses were related to mobility (62.2%), nutrition (23.6%) and elimination (11.9%). The frequencies of nursing interventions for these three diagnostic categories were 69.8%, 16.0% and 10.8% respectively. For emotional and social functioning, the most frequently used diagnoses were for cognition-perception (37.1%), self-perception (30.6%) and perception of health (23.7%). The ordering of the frequency of nursing interventions varied slightly. The most frequently used interventions were for the category of self-perception (31.7%) followed by cognition-perception (24.1%) and perception of health (22.9%). Looking at individual diagnoses, it was found that within the categroy of physical functioning, the most frequently used diagnosis was "impaired physical mobility" (29.5%) and this diagnosis involved 43.9% of the interventions. This was followed by "ineffective breathing pattern" (19.4%) with 17.7% of interventions, and "alteration in nutrition, less than body requirements" (11.2%) with 8.1% of the interventions. For the emotional social category, noncompliance was the most frequently used nursing diagnosis (18.2%) with 19.2% of the interventions. This was followed by "anxiety" (13.4%) with 13.6% of the interventions and by "knowledge deficit" (13.4%) but with only 5.5% of the interventions. The other diagnoses and interventions did not follow this pattern of frequency. Although there were a large number of diagnostic and intervention events, the number of actual diagnoses and interventions used were relatively small ranging from six interventions for "knowledge deficit" to 40 interventions for "imparied physical mobility". From this it can be concluded that the results of this study could be used as basic data for the development of standardized charts with respect to nursing diagnosis and interventions for clients with pulmonary disease and clients with traumatic brain or spinal cord injuries. Interventions that were direct care activities (1178) were much more frequent that education (430), and assessment and observation (148). There were also few diagnoses or interventions related to the family and the environment. This suggests two areas that need to be developed in home care and that need to be considered in the development of standardized records for use in home care.