• Journal of Korean Academy of Nursing Administration
• /
• v.7 no.2
• /
• pp.265-284
• /
• 2001

The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

• Journal of the Korean association of regional geographers
• /
• v.6 no.3
• /
• pp.101-115
• /
• 2000

This study aims to make a research on the secondary school education of geography and the system of teacher training in Belgium, focused on the case of Francophone Community. What has been made clear by this research can be summed up as follows. The first two years of the secondary school offer two hours of 'environment education', per week, which can be categorized into the learning of living geography, in that at this stage students learn how to observe the geographic phenomena in their daily life and pigeonhole them. The two years of the second stage of the secondary school offer one hour of 'world geography' which actually is focused on the district of Europe and Russia. The two years of the third stage of the secondary school offer an advanced course of geography which aims to teach systematically the physical geography and the human geography. A remarkable change in geographic education in Belgium is that in the wake of the Revision Act of the secondary school education, textbooks were replaced by other teaching manuals adapted to the regional condition by the teachers. This may result in a wide gap of achievements in geography according to the conditions of educational establishments. Another notable change is that the stress of geographic education tends to be placed on the ability of acquiring practical geographic knowledge rather than the geographic information itself. And it is also another marked tendency that most learning activities in geography class are conducted on the basis of student-centered and the method of investigation. Teachers of the lower secondary schools in Belgium are trained in the School of Education as multi-major teachers, such as a teacher for biology-chemistry-geography or a teacher for history-sociology-geography. Teachers of the higher secondary school education are trained in the Department of Teacher Education in universities as solo-major teachers in that they are required to know more deeply to teach an advanced course of geography in the higher secondary schools. To improve the teacher education many folds of policies are adopted. One is that many in-service teachers are officially put into services of guiding and teaching teacher training. Another is that faculty members in charge of teacher training course are trying to level up the qualifications of teachers by rigorous disciplining.

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.67-72
• /
• 2011

Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.

• Journal of Nutrition and Health
• /
• v.41 no.8
• /
• pp.851-859
• /
• 2008

To promote the adoption of healthier eating patterns, this study was aimed to develop and evaluate alternative front of pack nutrition signposting concepts. Based on previous research, we developed two signposting concepts, Multiple Traffic Light (MTL) and Multiple Traffic Light with % Daily Value (MTL-%DV). The signposts featured three key nutrients, total sugar, saturated fat, and sodium. Actual food packaging with no front of pack signposting (NoSP) was included in the evaluation to act as a benchmark against which to compare the performance of the different signposting options. Using an interviewer administered method, we assessed the degree of understanding and time to interpret on a total of 534 subjects (194 elementary, 108 middle, and 103 high schoolers, 128 adults). In the individual product evaluations, MTL (87.0%) obtained the highest level of correct responses, followed by MTL-%DV (83.1%) and NoSP (52.2%). Except for signposting concepts, age, gender and living area were not associated with the degree of correct responses in multivariate analyses. When used to compare products with different colors of nutrient contents, correct responses were more than 90% for MTL-%DV (91.5%) and MTL (90.3%). The middle and high schoolers revealed the lower likelihood of correct response compared to the other two groups. In case of comparing products with same colors of nutrient contents, the proportion of correct responses was the highest in NoSP (90%), followed by MTL%DV (77.4%) and MTL (48.5%). In terms of time to interpret, MTL-%DV and MTL performed better than NoSP in the individual product evaluation and the comparison of two products with different colors of nutrient contents. NoSP performed the best in the comparison of two products with same colors of nutrient contents. A majority of the participants preferred MTL-%DV (78%) most and thought it the most useful in helping them make healthier food choices. Based on these findings, MTL-%DV was considered to most closely meet the objectives of the initiatives.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.34 no.5
• /
• pp.644-651
• /
• 2005

Dietary supplement mainly made of herb and fiber was examined whether it could reduce body weight and fat, modify blood lipid concentrations and bowel habits in 30 collegians without intentional diet restriction or lifestyle change for 5 weeks. Free-living subjects were required to take diet pills 2 times daily 30 minutes before meals. Before the study began, 24 hr recall diet record and the questionnaires had been collected. Anthropometric measurements (height, weight, waist and hip circumferences, triceps and abdomen skinfold thickness, and body fat) were performed and blood samples were withdrawn before and after the study. Blood lipid fractions analyzed were total cholesterol (TC), triglyceride (TG), HDL-cholesterol and LDL-cholesterol. After the trial, body weight, body mass index, and percent ideal body weight of the subjects were reduced to mean of 0.5 kg, 0.2 and $0.9\%$, respectively (p<0.05). Percent body fat, triceps and abdomen skinfold thickness, and waist and hip circumferences were all reduced significantly except for $\%$ abdominal fat, but $\%$ body muscle mass increased from $36.5\%$ to $37.4\%$ (p=0.000). TC and TG were remarkably diminished (p<0.01) and LDL-cholesterol tended to decrease, but no change was observed in HDL-cholesterol. Bowel movements were also increased (p<0.01). In conclusion, this specific herb and fiber-rich dietary supplement reduced body weight and body fat indices, improved anthropometric indices, modified blood lipid fractions and bowel movement desirably. The study suggest that herb and fiber-rich dietary supplement might help control body weight, body fat loss and adult diseases positively.

• Journal of Korean Academy of Nursing
• /
• v.23 no.3
• /
• pp.467-486
• /
• 1993

Today, more chronically ill and handicapped people are being cared for at home by a family member caregiver. The task of caring for a family momber may mean that the caregiver has less time and money and more work which may result in increased fatigue and symptoms of illness. This study was done to examine the well-being of family caregivers. Fifty three family caregivers were interviewed. Concepts were measured using existing tools and included : Burden(25 item 5 point scale), Social sup-port (21 item 7 point scale), Health status defined by a symptom checklist(48 item S point scale), and Well -being defined by a quality of life scale (14 item 7 point scale) and caregiving activities. Data collection was done by interview and Q-sort. Social support and well - being were positively correlated as were symptoms and burden. Symptoms and burden were negatively correlated with social support and well-being. Items on the quality of life scale had a mean score range from 3.09 to 4.96. Quality of life related to income was lowest (3.09) but the desire to use more money for the patient was rated 2.90 on the burden scale where the item means ranged from 0.73 to 3.55. The high mean of 3.55 was for obligation to give care and the low 0.73 was (or not feeling that this was helping the patient. Mean scores for symptoms ranged from 0.26 to 2.15 with the 2.15 being for “worry about all the things that have to be done.” Over half of the patients were dependent for help with some activities of daily living. The caregivers reported doing an average of 3.40 out of five patient care activities including bathing (77.4%), shampooing (67.9%), and washing face and hands (49.1％), and 3.74 out of seven home maintenance activities including laundry (98.1％), cooking (83.0%), and arranging bed-ding(75.5%). The caregivers reported their spouse as one of the main sources of social support, including in times of loneliness and anger The mean score for loneliness as burden was 2.15 and ranked fourth and 31 (58.5％) of the sample reported being lonely recently and not being satisfied with the support received. Similarly anger caused by the patient was given a mean score of 2.13, and anger was reported to have been present recently by 38 (71.7%) of the sample and satis-faction with the support given was low. Having someone to help deal with anger ranked twelfth out of 21 items on the social support scale and had a mean score of 3.98 (range 3.49 to 5.98). Spouses were reported as a major source of social support but the fact that 50% of the caregivers were caring for a spouse, may account for the quality of this source of social support having been affected. These caregivers faced the same problems as others at the same stage of life. but because of the situation, there was a strain on their resources, particularly financial and social. In conclusion it was found that burden is correlated negatively to quality of life and positively to symptoms, but in this sample, symptoms and bur-den were scored relatively low. Does this indicate that the caregivers accept caregiving as part of their destiny and accept the quality of their lives with burden and symptoms just being a part of caregiving\ulcorner Does the correlation between the bur-den and symptoms indicate they are a measure of the same phenomenon or that the sample was of a more mobile, less burdened group of caregivers\ulcorner Quality of life was the one variable that was significant in explaining the varience on burden. Further study is needed to validate the conclusions found in this study but they indicate a need for nurses to ap-proach these caregivers with a plan tailored to each individual situation and to give consideration to interventions directed at improving quality of life and expanding social support networks for those caring for spouses.

• Journal of Aquaculture
• /
• v.18 no.2
• /
• pp.122-129
• /
• 2005

Ammonia is the major limiting factor in intensive aquaculture production systems. Therefore, quantification of ammonia excretion is important for the water quality management in aquaculture systems. Ammonia excretion is known to be affected by many factors such as body weight and dietary protein level (DPL). In this study, experiments were carried out to investigate the effects of body weight and DPLs on the rates of ammonia excretion of Nile tilapia Oreochromis niloticus. Three sizes of fishes (mean initial weight; 4.8 g,42.7 g and 176.8 g) were fed each of two dietary protein levels (30.5% and 35.5%). Daily feeding levels for the three fish sizes of 4.8 g, 42.7 g and 176.8 g were 6%, 3%, and 1.5% body weight per day, respectively. Each group of fish was stocked in a 17.1-L aquarium and all treatments were triplicated. Following feeding, the weight-specific ammonia excretion rate of O. niloticus increased, peaked at 4 to 8 h, and returned to pre-feeding levels within 24 h. Total ammonia nitrogen (TAN) excretion.ate per unit weight decreased with the increase of fish weight for each diet (P<0.05). The TAN excretion rate increased with increasing dietary protein content for each fish size (P<0.05). TAN excretion rates (Y) for each diet with different fish weights were described by the following equations: low DPL diet (30.5%): $Y\;(mg\;kg^{-1}\;d^{-1})=955.69-147.12\;lnX\;(r^2=0.95)$, high DPL diet (35.5%): $Y\;(mg\;kg^{-1}\;d^{-1})=1362.41-209.79\;lnX\;(r^2=0.99)$. Where: X=body weight (g wet wt.). The TAN excretion rates ranged 28.5%-37.1% of the total nitrogen ingested for the low DPL diet (30.5%) and 37.4-38.5% for the high DPL diet (35.5%). Total nitrogen losses of fish fed the high DPL diet $(35.5%;\;0.26\sim0.91g\;kg^{-1}\;d^{-1})$ were higher than those fed the low DPL diet $(30.5%;\;0.22\sim0.68g\;kg^{-1}\;d^{-1})$. The losses decreased per kg of fish as fish size increased. Results will provide valuable information fer water quality management and culture of Nile tilapia in recirculating aquaculture systems.

• Journal of Korean Home Economics Education Association
• /
• v.24 no.2
• /
• pp.135-154
• /
• 2012

The purpose of this study was to investigate the trends of HE exam questions through analyzing the examination items for secondary Home Economics(HE) teaching certification from 2002 to 2011. The results of the study were as follows: First, regarding the analysis on pedagogy of HE course, it accounted for 30.9% of the total questions, and recently, it increased to 35%. Regarding the ratio of questions by each evaluation element, 'practice of teaching and learning methods for HE course'(33.2%) had the highest ratio, and 'essence of the education of HE'(3.2%) had the lowest ratio. Second, regarding the analysis on eating habits, it amounted to 17.5% of the total questions, and recently reached 15%. With regard to the ratio of each evaluation element, 'cooking theory and practice'(26.1%) had the highest ratio, and 'culture of eating habits'(3.7%) had the lowest ratio. Third, regarding the analysis on clothing habits, it accounted 15% of the total questions, and recently reached 12.5%. With regard to the ratio of each evaluation element, 'clothing management'(25.1%) and 'production of clothing and living necessaries'(25.1%) had the highest ratio, and 'selection of clothing and self-expression'(3.0%) had the lowest ratio. Fourth, regarding the analysis on housing life, it accounted for 11% of the total questions, and recently reaches 12.5%. With regard to each evaluation element, 'the understanding of housing life culture'(22.5%) had the highest ratio, and 'the understanding of housing interior design'(10.7%) had the lowest ratio. Fifth, regarding the analysis on daily life as a consumer, it accounted for 12.4%, and recently reaches 12.5%. With regard to the ratio of each evaluation element 'management of domestic resources'(34%) had the highest ratio, and 'planning of entire life and domestic welfare'(0%) had the zero ratio. Sixth, regarding the analysis on family life, it accounted for 13.3% of the total questions, and recently reaches 12.5%. With regard to the ratio of each evaluation element, 'the understanding of family and the changes in family'(23.8%) had the highest ratio, and 'marriage and the development of family'(2%) had the lowest ratio.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.12 no.12
• /
• pp.5684-5691
• /
• 2011

The purpose of this study is to examine effects of constraint-induced movement therapy(CIMT) and/or cognitive-perceptual training(CPT) on the change of hand function in cerebrovascular accident(CVA) patients and to evaluate the change in the amount and quality of use of the affected upper extremity in performing daily living tasks. The subjects of study were 10 patients who had been under rehabilitation for more than three months after CVA onset. They were all determined as mild cognition impairment according to NCSE or MVPT test. For CIMT group, to restrict the movement of the unaffected hand the subjects had been worn modified resting arm-splint in daytime for 4 weeks. For CIMT+CPT group, the subjects were performed CPT with CIMT and control group had been under conventional occupational therapy for the same period. CIMT+CPT group showed significant improvement in simulated feeding, lifting large light objects, and lifting large heavy objects of Jebsen-Taylor Hand Function Test. CIMT group also showed significant improvement compared with control group. The mean changes of the amount of use(AOU) of the affected arm had a statistically significant difference among groups (p<.05). While CIMT+CPT group had the biggest change in the quality of movement(QOM) of upper extremity of the affected side, CTL group showed the smallest change. Both CIMT and CIMT+CPT groups had statistically significant difference in the change in the quality of movement in upper extremity of affected side with CTL group(p<.05), but there was not significant difference between CIMT group and CIMT+CPT group. CIMT performed to the patients of stroke, with mild impairment in cognitive perceptual abilities showed the improvement in hand movement and AOU and QOM of upper extremity in the affected side and the combination of CIMT with CPT showed synergic effects.

• Korean Journal of Heritage: History & Science
• /
• v.54 no.4
• /
• pp.36-59
• /
• 2021

This study infers the origin and production period of the , which is in the Onyang folk museum, through analysis and interpretation of the Haeju Palgyeong and exploration of the landscapes and traditions contained in the painting. The first collection of landscapes to Haeju was identified as Haeju Palgyeong by Ku Sa-meng (1531-1604). Yoo Man-ju, writing in 1782, referred to it as Go-palgyeong in 『Heumyeong』 while Haeju Palgyeong was defined as Geum-palgyeong (今八景), which is the Haeju Palgyeong in the earliest period confirmed by literature. is 'Boating on the Nam river (南江泛舟)', 'Lotus viewing at Buyongdang (芙蓉賞蓮)', 'Foot washing at Gwangseokcheon (廣石濯足)', 'Seokbyul at Haeunkyo (泣川送客)', 'Fishing at Haeunjeong (東亭釣魚)' and 'Sea view at Namsan( 南山望海)', and the final two contain a picture that contains 'Viewing the moon at Yeonghaeru (瀛海玩月)' and 'Writing contest and Archery at Baeklimjeong (栢林觀德)' The Suyang Chaemi(首陽採薇), Shingwang-jeoljeol (神光霽雪), and Jiseong falls (池城瀑布) of Gopalgyeong, which were excluded from Haeju Palgyeong, are all landscapes unfolding as a grand site of Suyangsan Mountain. is a result of the reorganization of Seunggyeong centered on Eupchi (邑治), away from the Suyangsan area. It has emerged as a seunggyeong of Haeju. The elaborateness of trying to contain the detailed prizes representing Haeju, such as the specialty sake of Haeju, is revealed. Most of the landscapes depicted in are historic and outstanding spots in Haemok, but the scenes of life related to daily life are properly arranged. In addition, Foot washing (濯足), Fishing(釣魚), Doing laundry (漂母), Lotus viewing (賞蓮), Sending guests (送客), Drinking (飮酒), sea viewing (望海), Moon viewing (玩月), Archery (射藝), Poetry (詩作), Drinking tea (飮茶), and Dancing (歌舞) are of various styles. Compared with the Gopalgyeongs, Haeju Palgyeong did not take into account the distribution of landscapes in the four seasons, and the small-sized view was also broken. When considering the time of the construction of Haeunjeong and the deterioration of Yeonghhoeru, it is believed that was produced in the early- to mid-18th century. is considered to be a painting that contributed to strengthening the sense of intimacy with the local people and promoting the pride of Haeju by showing the representative scenery of Haeju, such as scenic spots and customs, away from the ideal utopia.