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A Study of Physiological Changes by The Types of Paralysis Model in Activity Daily of Living (마비모델 유형별 일상생활활동 수행 시 생리적 변화 연구)

  • Sim, Kyoung-Bo;Kim, Dong-Hyun;Kim, Hee-Jung;Moon, Jung-In;Kim, Hyoung-Min
    • The Journal of Korean society of community based occupational therapy
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    • v.1 no.2
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    • pp.21-30
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    • 2011
  • The previous studies were prevalent a study of treatment like a environmental modification or compensative approach and intervention which used in today to paralyzed patients. These interventions were related with occupational therapy widely. The purpose of this study is to provide a basic datum for environmental modification, compensative approach, and intervention observing physiological changes which is shown in early paralyze patients. The subjects were 40 students who were 20 female and 20 male in a college. The students were devided into hemiplegic and paraplegic model. The model was designed using a experimental cloths. A instrument to measure body composition was a precision instrument. The results of the study were as follow: First, there was no different homogeneity between activity daily of living of hemiplegic and paraplegic model. Second, there was a significant different body water and basal metabolic rate between before and after activity daily of living of hemiplegic model. Third, there was a significant different body water and basal metabolic rate between before and after activity daily of living of paraplegic model. Forth, there were no significant different physiological change between after activity daily of living of hemiplegic model and paraplegic model. We observed early changes of body composition using a hemiplegic and paraplegic model. We could know it was reduced body water rate and basal metabolic rate in regardless of type of paralysis. Therefore, it is important to know these physiological changes of paralyzed patients and improve body water and basal metabolic rate of the patients.

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Job Analysis for Role Identification of General Hospice Palliative Nurse (호스피스 완화 간호사 역할규명을 위한 직무분석)

  • Kim, Boon-Han;Choe, Sang-Ok;Chung, Bok-Yae;Yoo, Yang-Sook;Kim, Hyun-Sook;Kang, Kyung-Ah;Yu, Su-Jeong;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.13 no.1
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    • pp.13-23
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    • 2010
  • Purpose: This study was to identify the role of general hospice palliative nurse through job analysis (duties, task, and task elements). Methods: The sample consisted of 136 nurses or professors who were performing duties related to hospice care areas in Korea. A survey method was used, and the questionnaire included frequencies, criticality, and difficulties of task elements in job description by the DACUM method. Descriptive statistics were performed by using SPSS WIN 17.0. Results: The job description of general hospice palliative nurse was identified 8 duties, 36 tasks, and 137 task elements. As for the 8 duties, the average scores of frequency, criticality, and difficulty were 2.94, 3.66, and 2.80, respectively. The role of ‘pain assessment’ was the most important task element among frequency and criticality. The lowest score at the frequency and criticality were ‘manage public finance’ and ‘collect datum through diagnostic test & lab', respectively. Furthermore, the role of 'identify spiritual needs of patients and family' was the most difficult task, whereas the role of 'manage documents and information' was the least. Conclusion: In this study, we could recognize the reality of general hospice palliative nurse's performances. For general hospice palliative nurse, therefore, concrete practice guide lines of psychosocial and spiritual care, communication skills, and bereavement care with qualifying system are critically needed.

Changes of Clay Mineral Assemblages in the Northern Part of the Aleutian Basin in the Bering Sea during the Last Glacial Period (마지막 빙하기 동안 베링해 알류샨 분지 북부 지역의 점토광물 조성 변화)

  • Kim, Sung-Han;Cho, Hyen-Goo;Khim, Boo-Keun
    • Journal of the Mineralogical Society of Korea
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    • v.24 no.1
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    • pp.19-29
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    • 2011
  • Clay mineral assemblages of core PC25A collected from the northern part of the Aleutian Basin in the Bering Sea were examined in order to investigate changes in sediment provenances and transport pathways. Ages of core PC25A were determined by both Last Appearance Datum of radiolaria (L. nipponica sakaii; $48.6{\pm}2\; ka$) and age control points obtained by the correlations of $a^{\ast},\; b^{\ast}$, and laminated sediment layers with the adjacent core PC23A, whose ages are well constrained. The corebottom age of core PC25A was calculated to be about 57,600 yr ago and core-top might be missing during coring execution. Average contents of smectite, illite, kaolinite, and chlorite during the last glacial period are 11% (5~24%), 47% (36~58%), 13% (9~19%), and 29% (21~40%), respectively. Clay mineral assemblages of the last glacial period are characterized by higher illite and lower smectite contents than those of core MC24 representing the modern values. Illite-rich clay sediments during the warm Early Holocene were transported from the northern part of Alaska continent (Province 1) through the ice-melt waters. During the deglacial period (B${\phi}$lling-All${\phi}$rod) of MIS 2, clay-sized particles seemed to be also transported by ice-melt waters mainly from Province 2 and Province 3 located farther south than Province 1. Higher smectite content during the Last Glacial Maximum is attributed to increased amounts of clay particles from the adjacent Alaska Peninsula (Province 4). From the early to the middle MIS 3, illite and smectite contents decreased, whereas chlorite content increased. With the low sea level standing during MIS 3 the supply of clay sediments from Province 2 and Province 3 was most likely intensified. Changes in clay mineral assemblages of core PC25A located in the northern part of the Aleutian Basin in the Bering Sea are closely related to the change of surface current system caused by sea level variation during the last glacial period.

Study on the Evaluation CO2 Emission-Absorption of Concrete in the View of Carbonation (콘크리트의 탄산화 관점에서 CO2 배출량-흡수량 평가에 관한 연구)

  • Lee, Sang-Hyun;Lee, Sung-Bok;Lee, Han-Seung
    • Journal of the Korea Concrete Institute
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    • v.21 no.1
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    • pp.85-92
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    • 2009
  • A concrete is considered unfriendly-environmental material because it uses cement which emits much $CO_2$ during producing process. However, a concrete absorbs $CO_2$ through carbonation process during service life. In this paper how much concrete absorbs $CO_2$ through carbonation was calculated using 1) concentration of carbonatable substances in concrete, 2) carbonated volume of concrete, 3) molecular weight of $CO_2$ based on references and the method was proposed. $CO_2$ emission from producing $1m^3$ concrete was calculated based on $CO_2$ emission datum of materials used in concrete. From using these methods that calculate $CO_2$ emission and absorption of concrete, assessment of $CO_2$ emission-absorption against a real apartment was conducted by subtracting absorption $CO_2$ according to service life from $CO_2$ emission in the process of making concrete. As a result, a ratio of absorption over emission of $CO_2$ through concrete carbonation according to service life 40, 60, 80 years was assessed about 3.65, 4.47, 5.18%. An objective of this study is to propose how to calculate emission - absorption of $CO_2$ from producing and using concrete. Although the result value, emission - absorption of $CO_2$, is 5.18% very low when the service life of an apartment is 80years, the value can be improved by reducing emission from using blended cement such as blast furnace slag or increasing replacement ratio of cement and increasing carbonated volume of concrete from expanding service life of a building. This study may be useful when $CO_2$ emission - absorption of concrete is evaluated in the further study.

A Study on the Care Needs of Family-Caregivers to the Patients with Stroke (뇌졸중환자 가족의 간호요구)

  • Kim Mi-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.175-192
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    • 1997
  • The purpose of this study was to identify the care needs of family-caregivers to the patients with stroke. Subjects were 115 family-caregivers caring for the patients while they were in-patients or out-patients with stroke in two general hospitals and one oriental medicine hospital located in Seoul and Kwang-Ju. The instrument used for this study was made by the researcher on the basis of results of literature review and interviews with family-caregivers, composed of 35 items. Internal validity by calculation of cronbach's alpha with data of respondents was 0.91, which was regarded as high. The Data were analyzed by SAS program, with percentage, mean, t-test, and ANOVA. Factor structures of care needs of family-caregivers were elicited by factor analysis(PCA, Varimax rotation). Datum collection had been from July 1 to August 14, 1997. The results of this study were as follows : 1. The mean score of the sum of the care needs of family-caregivers was 3.96 and the highest-mean item was 'need for immediate care(M=4.77)', and the lowest-mean item was 'need for chaplian's visit (M=2.82)'. 2. Care needs of the family-caregivers were : Need to be informed of the disease, treatment and care ; need of education and assistance related to physical functional level ; need of social support and consultation ; need of management of nursing problem related to immobility ; need of appreciation ; need of the way to communicate with patients ; need of immediate care and help. The highest mean factor was the 'need for immediate care and help(M=4.74)', and the lowest mean factor was the 'need of appreciation(M=3.58)'. 3. The variables influencing the degree of care needs perceived by family-caregivers to the patients with stroke were as follows : There were significant differences between need to be informed of the disease, treatment and care and general characteristic factors, which were family caregiver's sex (p=.0178), caring period(p=.0223) and patient's suffering period(p=.0244). There were significant differences between need of education and assistance related to physical functional level and general characteristic factors, which were patient's paralysis(p=.0177), patient's ADL dependency(p=.0032). There were significant differences between need of social support and consultation and general characteristic factors, which were family caregiver's sex(p=.0055), occupation(p=.0159), religion(p=.0093) and patient's sex(p=.0134). There was significant difference in the degree of need of management of nursing problem related to immobility, according to the patient's ADL dependency(p=.0493). There were significant differences between need of appreciation and general characteristic factors, which were family caregiver's age(p=.0107), sex(p=.0133), and patient's age(p=.0338). There were significant differences between need of the way to communicate with patient and general characteristic factors, which were patient's paralysis(p=.0002) and aphasia(p=.0001). There were significant differences between need of immediate care and help and general characteristic factors, which were family caregiver's caring period(p=.0162) and patient's suffering period(p=.0116). 4. The mean score of patient's ADL dependency was 3. 38 and the highest-mean item was 'ascending and descending stairs(M=4.12)', and the lowest-mean item was 'drinking(M=2.60)'. There was no significant difference in the degrees of care needs related to the patient's ADL dependency. 5. The highest information source of family-caregivers was from the doctors about the disease, treatment and care(26.1%). The second highest one was from mass media(20.8%), and the third one was from the nurses. The above findings may be used as the basic data to seek more efficient way of elevating nursing practice and quality for family-caregivers to the patients with stroke.

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A Study on the Effects of the Behavior Problems for the Demented Elderly upon the Stress among Family members (치매 노인의 문제행동이 가족스트레스에 미치는 영향)

  • 마정수;김초강
    • Korean Journal of Health Education and Promotion
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    • v.12 no.1
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    • pp.83-110
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    • 1995
  • The purpose of this study was to investigate the status of the problematic behavior for the demented elderly and the stress among family members, and the effects of the problematic behavior upon the stress in order to offer the basic data for the adult and the elderly health education about dementia. For this purpose, 70 families who were resident in Seoul and Inchon were surveyed by quetionnaires. This was carried out from 26 July, 1994 to 11 September, 1994. Datum was analysed by using SPSS\PC+ including percentage, mean, t - test, ANOVA, Pearson correlation. So, the results of this study were as follows: 1. In view of socia-demographic characteristics, female were 82.9%, and of the female daughters-in-law of the demented elderly were 44.9%. 40th years old were 32.9% and 88.6% wase married. The christian were 34.8%, those who graduated university 47.1%, and those who had a job 32.9%. 2. Of the demented elderly, female were 74.3%, 80 years old were 37.1%, and their average age was seventy-seven point one years old. 66.2% of the elderly has been lived alone and the christian were 27.5%. In addition, those who graduated elementary school were 66.5%. 3. Of the behavior problem for the demented elderly, Activities of the Daily Living(ADL) was the most severe problem. The 2nd was cognitive function problem, the 3th, change of personality, the 4th, emotional disturbance, and the last, misconduct behavior. 4. For the status of behavior problems, females were more severe than male, and 80th years elderly ware the most severe groups. The longer disease period was, the severe problematic behaviors were, and in 4-6 years of the disease period the status was the highest(p<0.05). Those who diagnosed the disease had more severe problems(p<0.001). 5. The orders of the stress among family members caring for the demented elderly in this study were as follows : 1. The deficiency of supporting network 2. Decrease of elderly's cognitive activities 3. Assistance of BADL(Basic Activities of Daily Living) 6. Elderly's abnormal behavior 5. Assistance of IADL(Instrumental Activities of Daily Living), 6. As for the status of the stress among family members, female respondants were higher than male. On the ages, 20th years' stress score were the highest. Daughters-in-law were stressed more than other family members. The longer the time of caring per day was, the highest the status of the stress(p<0.05), 7. Those who caring for female elderly and more than 80 years had more stressed. When the elderly was received the diagnosis, the family members were more stressed. On the disease period, 1-2 years was the highest and after 2 years the status of the stress was decreased and more than 6 years was the lowest(p<0.05). 8. Behavior problems of the demented elderly were closely associated to the stress for family members. Of the problems, change of personality was the most related factor(r = 0.6552). The factors of Basic Activities of the Daily Living(BADL) was most correlated on assistance of Basic Activities of Daily Living (BADL), emotional disturbance the assistance of IADL(Instrumental Activities of Daily Living). Change of personality was most related to the stress of the decrease of cognitive activities and elderly's abnormal behavior. The deficiency of supporting network was most related to misconduct behavior.

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A Study of material analysis and its experimentation of metamorphosis and its utilities in Copper Alloy plates for contemporary metal craft (현대금속공예용 동합금판의 재료분석과 형질변환 실험 및 응용에 관한 연구)

  • Lim, Ock-Soo
    • Archives of design research
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    • v.17 no.4
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    • pp.241-250
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    • 2004
  • In this research, the copper alloy plates C2200, C5210, C7701, C8113 were selected to make datum and to identify further usage of metal craft experimentation. For its experimentation, the general welding and TIG welding methods were researched; for 2nd experimentation, the Reticulation and Electroforming skill's differences in color and temperature were researched. With these methods 3 different kinds of works are introduced for sample studies. For this research, Dr. Lee, Dong-Woo who works in Poongsan Metal Co, supported 4 kinds of copper alloy metals. Which are Commercial bronze (Cu-Zn), Deoxidiged Copper(Cu-Sn-P), Nickel Silver (Cu-Ni-Zn), and White Bronze (Cu-Ni); they were applied partly and wholly by the method of Laminatin, Reticulation, Fusing, and Electroforming skills. In case of C2200, the brass, the A. C. TIG welding method is better under 2mm slight plate; the D.C. TIG welding is better upper 2mm plate; and 250~300$^{\circ}C$ is recommended for remain heat treatment. In case of C5210, not having Hydrogen in high temperature return period, doesn't need Oxygen in high temperature and hardening in comparative high temperature neither, it is good for welding. It contains Sn 2-9% ad P 0.03-0.4% generally; and in accordance with the growth rate of Sn contain amount, the harden temperature boundary become broad. In case of cold moment after welding, they are recommended that higher speed TIG welding, smaller melting site and less than 200$^{\circ}C$ for pre-heating temperature. In case of C7701, the 10-20% Ni, 15-30% Zn are widely used.. If it is upper 30% Zn, it become (${\alpha}+{\beta}$) system and adhesive power rate become lower, and the productivity become lower in low temperature but the productivity become higher in high temperature. Nickel Silver's resistance of electricity is well; and the heatproof and incorrodibility is good, too. Lastly, in case of C8113, good at persistence in salty and grind; high in strength of high temperature. In case of white brass, contain 10-30% Nickel and hardened in high temperature and become single phrase. For these reason, the crystallization particles easily become large, if the resistance become higher small amount of Pb, P, S separation rate become higher.

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CT Simulation Technique for Craniospinal Irradiation in Supine Position (전산화단층촬영모의치료장치를 이용한 배와위 두개척수 방사선치료 계획)

  • Lee, Suk;Kim, Yong-Bae;Kwon, Soo-Il;Chu, Sung-Sil;Suh, Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.165-171
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    • 2002
  • Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.

A research on Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) (Restoration and Medico-Historic Investigation) (향약구급방(鄕藥救急方)에 대(對)한 고증(考證))

  • Sheen, Yeong-Il
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.71-83
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    • 1996
  • Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) is our own, medical work written about the middle of the time of Korea Dynasty. I restored and researched this book because it needed to be illuminated about its medico-historic value and then I came to some conclusions as follows. 1. Hyang-Yack-Ku-Keup-Bang was published in Dae-jang-do-kam(大藏都監) of Kanghaw island(江華島) about the middle of Korea Dynasty. Choi Ja-ha(崔自河) republished it on original publication ground in Euiheung(義興) of Kyungsang-Province(慶尙道) in July, Taejong's(太宗) 17th year of Chosen Dynasty (A.D.1417) and this book was published again in Chungcheng Province(忠淸道) in Sejong's(世宗) 9th year(A.D.1427). The book published in Taejong's days was in the possession of books department of Kung-nae-cheng(宮內廳) in Japan and was the oldest medical book of existing ones. 2. Bang-Jung-Hyang-Yack-Mock-Cho-Bu(方中鄕藥目草部) of this book was originally intended to be adjusted in each division with the title of Bang-Jung-Hyang-Yack-Mock(方中鄕藥目). But Herb part(草部) only followed editing progress of Jeung-Lew-Bon-Cho(證類本草), the rest is not divided into each part and is together arranged at the below of Herb part with the title of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. The Korean inscriptions on some drugstuffs in this book are different between Native Name(鄕名) of three volumes of provisions and general-spoken(俗云) of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. In this, it is estimated that the publishing time and editor of tile volume of provisions and Bang-Jung-Hyang-Yack-Mock-Cho-Bu are different. I think Choi Ja-ha compiled this behind three volumes of provisions when he published. 3. This book picked some prescriptions which consisted of obtainable drugs with ease in Korea in the books of Chell-Keum-Yo-Bang(千金要方), Oi-Dae-Bi-Yo(外臺秘要), Tae-Peong-Sung-Hye-Bang(太平聖惠方), Ju-Hu-Bang(?後方), Kyung-Hum-Yang- Bang(經驗良方) Bo-Je-Bon-Sa-Bang(普濟本事方) Bi-Ye-Baik-Yo-Bang(備預百要方) and so on and got together our own prescriptions. On the whole Bi-Ye-Baik-Yo-Bang was a chief referrence book, On this, other books referred to and corrected. 4. In provisions quoted from Hyang-Yack-Jip-Sung-Bang(鄕藥集成方), there are seven provisions; leg-paralysis part, coughing part, headache part, obstetrics part, etc. don't show in this book. This is why Choi Ja-ha published only certain texts on Dae-jang-do-kam edition his own posession. So we can think the existing edition has a little misses compared with original edition. 5. This book recorded only names of drugstuffs in animal drug department like fowls, crab, goldbug, earthworm, etc. and didn't tell us ways of taking those. This is effect of Buddhist culture on medicine. This is efforts to practice 'Don't murder';one of Five Prohibition of Buddhism. 6. Beacause this book was published at the time, when our originative medicine would be set forth. This followed the Chinese ways in Theory, Treatment, Prescription and used 'Hyang Yack' in Medication out of theory of Korean medicine, which was a transitional form. So this is all important material which tell us aspects of development of 'Hyang Yack' the middle of Korea Dynasty.and this is also the beginning of originative, medical works like Dong-Eui-Bo-Kam(東醫寶鑑), Dong-Eui-Su-Bo-Won(東醫壽世保元). 7. There are few contents based on 'Byen-Jeung-Lon-Chi(辨證論治)'in this book. So we can see this book is not for doctors who study medical thoughts but for general public who suffer from diseases resulted from war. Because this book was written for a first-aid treatmeant, this is an index of medical service for the people those days. And this is also an useful datum for first-aid medicine or military medicine in these modern days. 8. Nowadays, parts of learned world of Korean medicine disregard essential theories and want to explain Korean medicine only by the theories or the methods of Western medicine. Moreover they don't adopt Chinese and Japanese theorys & thoughts about Oriental medicine in our own style and just view in there level. What was worse, there is a growing tendency for them to indulge in a trimming policy of scholarship and to take others' ideas. I think these trends to ignore our own medical thoughts involving growth of 'Hyang Yack' in the middle of Korea Dynasty, Dong-Eui-Bo-Kam and Dong-Eui-Su-Se-Bo-Won. So we, as researchers of Korean medicine, must get out of this tendency, and take over brilliant tradition and try to develop originative Korean medicine.

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3-D Conformal Radiotherapy for CNS Using CT Simulation (입체조준장치를 이용한 중추신경계의 방사선 입체조형치료 계획)

  • 추성실;조광환;이창걸
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.90-98
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    • 2003
  • Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

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