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A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance - (병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구)

  • Lee, Sook-Ja;Lee, Jin-Kyung;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.5-18
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    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

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Analysis of the Geological Structure of the Hwasan Caldera Using Potential Data (포텐셜 자료해석을 통한 화산칼데라 구조 해석)

  • Park, Gye-Soon;Yoo, Hee-Young;Yang, Jun-Mo;Lee, Heui-Soon;Kwon, Byung-Doo;Eom, Joo-Young;Kim, Dong-O;Park, Chan-Hong
    • Journal of the Korean earth science society
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    • v.29 no.1
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    • pp.1-12
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    • 2008
  • A geophysical mapping was performed for Hwasan caldera which is located in Euisung Sub-basin of the southeastern part of the Korean Peninsula. In order to overcome the limitation of the previous studies, remote sensing technic was used and dense potential data were obtained and analyzed. First, we analyzed geological lineament for target area using geological map, digital elevation model (DEM) data and satellite imagery. The results were greatly consistent with the previous studies, and showed that N-S and NW-SE direction are the most dominant one in target area. Second, based on the lineament analysis, highly dense gravity data were acquired in Euisung Sub-basin and an integrated interpretation considering air-born magnetic data was made to investigate the regional structure of the target area. The results of power spectrum analysis for the acquired potential data revealed that the subsurface of Euisung Sub-basin have two density discontinuities at about 1 km and 3-5 km depth. A 1 km depth discontinuity is thought as the depth of pyroclastic sedimentary rocks or igneous rocks which were intruded at the ring vent of Hwasan caldera, while a 3-5 km depth discontinuity seems to be associated with the depth of the basin basement. In addition, three-dimensional gravity inversion for the total area of Euisung Sub-basin was carried out, and the inversion results indicated two followings; 1) Cretaceous Palgongsan granite and Bulguksa intrusion rocks, which are located in southeastern part and northeastern part of Euisung Sub-basin, show two major low density anomalies, 2) pyroclastic rocks around Hwasan caldera also have lower density when compared with those of neighborhood regions and are extended to 1.5 km depth. However, a poor vertical resolution of potential survey makes it difficult to accurately delineate the detailed structure caldera which has a vertically developed characteristic in general. To overcome this limitation, integrated analysis was carried out using the magnetotelluric data on the corresponding area with potential data and we could obtain more reasonable geologic structure.

Correlations between the Stream Morphological Characteristics and the Hydraulic Geometry Characteristics for the Basin (유역(流域)의 하천형태학적(河川形態學的) 특성(特性)과 수리기하학적(水理幾何學的) 특성(特性)과의 상관성(相關性))

  • Ahn, Sang Jin;Yoon, Yong Nam;Kang, Kwan Won
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.2 no.1
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    • pp.1-17
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    • 1982
  • The stream morphological characteristics of a river basin has a close correlation with the hydrological and hydraulic characteristics of the basin. In this study the correlations of flow duration and Hydraulic geometry with the stream morphological characteristics as well as the correlation between flow duration and hydraulic geometry were analyzed bases on the data for the Geum River basin. The purpose of this study was to provide the necessary informations for water utilization projects at ungauged locations along the river course. First of all, the stream morphological characteristics was analyzed based on the Horton's three laws on the morphology of a stream that is, the law of stream number, the law of average stream length and the law of average stream slope. As is the case for majority of the rivers it was found that the Geum River basin was well developed according to the Horton's laws. High correlations were also found between the basin characteristics and the channel characteristics. The flow duration curves obtained with the daily stream flow data of 10~90% frequency of occurences at the five stage gauging stations in the Geum River could, in general, be expressed as an exponential functional relationship. The concept of proportional stream ordering system was employed to describe continuously the longitudinal variation of the stream morphological characteristics, and the mathematical model was formulated for the discharge-frequency-proportional stream order relationship. With the morphological characteristics as a common parameter the relationships with flow duration, drainage area were established in mathematical expressions, respectively.

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The Effects of the Breast Self-Examination Participant Education program on Breast Self-Examination Compliance and Health Promoting Behaviors in Adult Women (유방 자가 검진 참여 교육 프로그램이 유방 자가 검진 이행과 건강 증진 행위에 미치는 영향)

  • Park, Eun-Hwa;Ryu, Eun-Jung;Choi, Kyung-Sook
    • Asian Oncology Nursing
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    • v.3 no.2
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    • pp.133-144
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    • 2003
  • This study is carrying out a before and after experiment design for the non-equal comparative group to identify the effects of the breast self-examination education on breast self-examination participant education compliance and health promotion in women. The subject of this study was 58 women residing in Chungju. Their age ranged from 20 to 40. These women were not pregnant or did not breast feed, as well as they did not have any breast disease, at the time of survey. They were available for the response to the questionnaires, and understood the purpose of this study. They also agreed to participate in the study, and responded to the 3rd time questionnaires to the end. Thus, brochures and lectures were provided side by side to a group of 19 of those women, and only brochures were provided to another group of 39 of those women. With regard to education, a brochure and a program using a breast model were applied. Then, the frequency of the breast self examination compliance, breast self examination capability and the relations between the breast self examination and activities to promote health were measured, before the education, after 4 weeks of education and after 12 weeks of education. Before education and after 4 weeks of education. I collected the questionnaires myself visiting them, and after 12 weeks of education, the questionnaires were collected by mail. In relation to the study tool, the breast self examination activity was measured by two measuring tools: breast self examination activity frequency and breast self examination compliance capability. As for the frequency, the number of self examination for the period of 3 months, before the questionnaire survey, was measured in the form of self report. In relation to the tool to measure the breast self examination capability, the BSEPRI tool, which was developed by Wood in 1994, was used. Here, as the score was higher, the capability was indicated to be higher. The translated and revised version of Health Promoting Lifestyle Profile II (Walker, Sechrist & Pender. 2002) was used as a tool for health promotion. As the measured score was higher, the health promoting activity was indicated to be higher. The results of this study were as follows: 1. As a result of checking the breast self examination compliance frequency between the experiment group that received the breast self examination participant education and the comparative group that did not receive the education, there was a significant difference in interaction between groups by time, as time passed by. 2. As a result of checking the breast self examination compliance capability between the experiment group and the comparative group, there was a significant difference in interaction between groups by time, as time passed by. 3. As a result of carrying out a repetitive measurement analysis, between the experiment group that received the breast self examination education and the comparative group that did not receive the education, which was carried out to validate the hypothesis that the former would have higher health promoting activities than the latter, there was no significant difference after the breast self examination education was conducted.

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The Usability Analysis of 3D-CRT, IMRT, Tomotherpy Radiation Therapy on Nasopharyngeal Cancer (NPC의 방사선치료시 3D-CRT, IMRT, Tomotherapy의 유용성 분석)

  • Song, Jong-Nam;Kim, Young-Jae;Hong, Seung-Il
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.365-371
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    • 2012
  • The radiation therapy treatment technique is developed from 3D-CRT, IMRT to Tomotherapy. and these three technique was most widely using methods. We find out a comparison normal tissue doses and tumor dose of 3D-CRT, IMRT(Linac Based), and Tomotherapy on Head and Neck Cancer. We achieved radiological image used the Human model phantom (Anthropomorphic Phantom) and it was taken CT simulation (Slice Thickness : 3mm) and GTV was nasopharngeal region and PTV(including set-up margin) was GTV plus 2mm area. and transfer those images to the radiation planning system (3D-CRT - ADAC-Pinnacle3, Tomotherapy - Tomotherapy Hi-Art System). The prescription dose was 7020 cGy and measuring PTV's dose and nomal tissue (parotid gland, oral cavity, spinal cord). The PTV's doses was Tomotherapy, Linac Based - IMRT, 3D-CRT was 6923 cGy, 6901 cGy and 6718 cGy its dose value was meet TCP because its value was up to the 95% based on 7020 cGy, Nomal tissue (parotid gland, oral cavity, spinal cord) was 1966 cGy(Tomotherapy), 2405 cGy(IMRT), 2468 cGy(3D-CRT)[parotid gland], 2991 cGy(Tomotherapy), 3062 cGy(IMRT), 3684 cGy (3D-CRT)[oral cavity], 1768 cGy(Tomotherapy), 2151 cGy(IMRT), 4031 cGy(3D-CRT)[spinal cord] its value did not exceeded NTCP. All the treatment techniques are equated with tumor and nomal tissue doses. The 3D-CRT was worse than other techniques on dose distribution, but it is reasonable in terms of TCP and NTCP baseline Tomotherapy, IMRT -dose distribution was relatively superior- was hard to therapy to claustrophobic patients and patients with respiratory failure. Particularly, in case on Tomotherapy, it take MVCT before treatment so dose measurement will be unnecessary radiation exposure to patients. Conclusion, Tomotherapy was the best treatment technique and 2nd was IMRT, and 3rd 3D-CRT. But applicable differently depending on the the patient's condition even though dose not matter.

Differentiation of True Recurrence from Delayed Radiation Therapy-related Changes in Primary Brain Tumors Using Diffusion-weighted Imaging, Dynamic Susceptibility Contrast Perfusion Imaging, and Susceptibility-weighted Imaging (확산강조영상, 역동적조영관류영상, 자화율강조영상을 이용한 원발성 뇌종양환자에서의 종양재발과 지연성 방사선치료연관변화의 감별)

  • Kim, Dong Hyeon;Choi, Seung Hong;Ryoo, Inseon;Yoon, Tae Jin;Kim, Tae Min;Lee, Se-Hoon;Park, Chul-Kee;Kim, Ji-Hoon;Sohn, Chul-Ho;Park, Sung-Hye;Kim, Il Han
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.120-132
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    • 2014
  • Purpose : To compare dynamic susceptibility contrast imaging, diffusion-weighted imaging, and susceptibility-weighted imaging (SWI) for the differentiation of tumor recurrence and delayed radiation therapy (RT)-related changes in patients treated with RT for primary brain tumors. Materials and Methods: We enrolled 24 patients treated with RT for various primary brain tumors, who showed newly appearing enhancing lesions more than one year after completion of RT on follow-up MRI. The enhancing-lesions were confirmed as recurrences (n=14) or RT-changes (n=10). We calculated the mean values of normalized cerebral blood volume (nCBV), apparent diffusion coefficient (ADC), and proportion of dark signal intensity on SWI (proSWI) for the enhancing-lesions. All the values between the two groups were compared using t-test. A multivariable logistic regression model was used to determine the best predictor of differential diagnosis. The cutoff value of the best predictor obtained from receiver-operating characteristic curve analysis was applied to calculate the sensitivity, specificity, and accuracy for the diagnosis. Results: The mean nCBV value was significantly higher in the recurrence group than in the RT-change group (P=.004), and the mean proSWI was significantly lower in the recurrence group (P<.001). However, no significant difference was observed in the mean ADC values between the two groups. A multivariable logistic regression analysis showed that proSWI was the only independent variable for the differentiation; the sensitivity, specificity, and accuracy were 78.6% (11 of 14), 100% (10 of 10), and 87.5% (21 of 24), respectively. Conclusion: The proSWI was the most promising parameter for the differentiation of newly developed enhancing-lesions more than one year after RT completion in brain tumor patients.

The Effects of Nitric Oxide Inhibitor on Hyperdynamic Circulation in Portal Hypertensive Rats (산화 질소 억제제가 문맥 고혈압 쥐의 혈역학 변화에 미치는 영향)

  • Kim, Pill-Young;Jang, Byeong-Ik;Kim, Tae-Nyeun;Chung, Moon-Kwan
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.181-192
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    • 1999
  • Background: Nitric oxide, a vasodilator synthesized from L-arginine by vascular endothelial cells, accounts for the biological activity of endothelium derived relaxing factor. Previous studies demonstrated that nitric oxide inhibitor, $N^{\omega}$-Nitro-L-Arginine(NNA) diminished the hyperdynamic splanchnic and systemic circulation in portal hypertensive rats The present study was done to determine the role of nitric oxide in the development of hyperdynamic circulations in the prehepatic portal hypertensive rat model produced by partial portal vein ligation. Methods: The portal hypertensive rats were divided into water ingestion group and NNA ingestion group. After partial portal vein ligation, NNA ingestion group and water ingestion group received NNA 1mg/kg/day and plain water through the mouth for 14 days, respectively. Cardiac output, mean arterial pressure, organ blood flow and porto-systemic shunting were measured by radioisotope labeled microsphere methods. Vascular resistances were calculated by standard equation. Results: There were significant decreases in mean arterial pressure, increases in cardiac output and cardiac index, and decreases in total systemic and splanchnic vascular resistance in portal hypertensive rats compared to normal control group (p<0.01). Compared to the water ingestion group, significantly increased mean arterial pressure with decreased cardiac output and cardiac index were developed in the NNA ingestion group. Total systemic and splanchnic vascular resistance were significantly increased in the NNA ingestion group compared to water ingestion group (p<0.05). But, there was no significant difference in portal pressure between the two groups. Conclusion: The hemodynamic results of this study indicate that hyperdynamic circulation in prehepatic portal hypertensive rat mode1 was attenuated by ingestion of NNA. Nitric oxide may play an important role in the development of hyperdynamic circulation with splanchnic vasodilation in chronic portal hypertension.

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The effect of the revolution and forwarding speed of the rotary blade on the tilling power requirement (로우터리 경운(耕耘)날의 회전속도(回轉速度) 및 작업속도(作業速度)가 경운소요동력(耕耘所要動力)에 미치는 영향(影響))

  • Kwon, Soon Goo;Kim, Soung Rai
    • Korean Journal of Agricultural Science
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    • v.11 no.1
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    • pp.160-175
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    • 1984
  • This study was carried out to analyze the effects of the revolution and forwarding speed of the rotary blade and the edge curves which were $30^{\circ}$ and $40^{\circ}$, on the power requirement of rotary tillage. In this study, the revolutions of the rotary blade considered were 204, 243, 285, 360 rpm, and the forwarding speeds of the rotary system considered were 29.40cm/sec, 46.93em/sec. The power requirements of rotary blade were measured by a dynamic strain gage systems at the soil bin which was filled with artificial soil. The results of the study were summarized as follows: 1. The response surface analysis showed that the revolution and forwarding speed of the rotary shaft had an interacting influence on the torque requirement of the rotary blade. The mathematical model developed by the above was repersented as follow. $$T=a_0+a_1V+a_2R +a_3VR+a_4VR^2$$ where, $a_0=constant$ $a_1,\;a_2,\;a_3,\;a_4=coefficients$ V=forwarding speed of the rotary system. (em/sec) R=revolution of the rotary shaft. (rpm) T=tilling torque requirement. (kg-m) 2. When the maximum tilling torque requirement was analyzed, ${\partial}T/{\partial}R$ was decreased with the increasing revolution of rotary shaft, while ${\partial}T/{\partial}V$ was increased, which was minimum at 200~220 rpm. When the forwarding speeds were increased, ${\partial}T/{\partial}R$ was decreased with increasing rate. 3. When the mean tilling torque requirement was analyzed, ${\partial}T/{\partial}V$ was constant at 320~360 rpm and ${\partial}T/{\partial}R$ was decreased with increasing rate along with the increasing revolution of rotary shaft. 4. When the mean tilling torgue requirement per unit volume of soil was analyzed, ${\partial}T/{\partial}V$ was minimum at 270~300 rpm. ${\partial}T/{\partial}R$ for the forwarding speeds of 29.40cm/sec and 46.93cm/sec was same as that for 280~290 rpm. 5. Increasing the edge curves of the rotary blades, the tilling torque requirement was increased. But other studies showed that the smaller the edge curve, the more straw could be wrapped on blades which resulted in increasing torque requirements. Therefore, the edge curve of rotary blade should be considered for the future study.

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A Study on the Performance of Cloud-based VDI Adoption: Comparing between IS administrators and business users (클라우드 기반 VDI 도입 성과에 관한 연구 - 시스템 관리자와 일반 사용자의 비교를 중심으로 -)

  • Kim, Il-Han;Kwon, Sun-Dong
    • Management & Information Systems Review
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    • v.37 no.2
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    • pp.149-167
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    • 2018
  • The purpose of this study is to analyze the performance of Virtual Desktop Infrastructure(VDI) adoption. VDI performance was measured by IS manager (system quality, security, and managerial operation) and business user (usability, access, and user satisfaction). The survey questionnaires were developed for measuring VDI performance. 84 data samples were collected from the companies that had adopted cloud-based VDI. This research model was verified by Smart-PLS and SPSS. The research findings were as follows: First, the companies using VDI experienced actual performance, but they did not attain their expectation. Second, as results of comparing between IS managers and business users, IS administrators had considerably higher performance than business users, which indicates that there were big differences in performance perception among users. Compared with prior research such as technical trend, system construction, and performance improvement, this study has the following implications. First, by comparing the expected performance with the actual performance of the companies that have implemented and operating VDI, it was suggested how a company that wants to adopt VDI can manage the expectation level of VDI and achieve higher actual performance. Second, because the perception of VDI performance differs between business users and system managers, it is meaningful that a fair evaluation of VDI performance requires a balanced consideration of business users and system managers.

Changes in Dormant Phase and Bud Development of 'Fuji' Apple Trees in the Chungju Area of Korea (충주지역에서 '후지' 사과나무의 휴면단계 변화 및 눈 발달)

  • Lee, ByulHaNa;Park, YoSup;Park, Hee-Seung
    • Horticultural Science & Technology
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    • v.33 no.4
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    • pp.501-510
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    • 2015
  • In this study, we investigated the onset and release of endo-dormancy under natural conditions by observing bud break characteristics in 'Fuji' apple trees using water cuttings. Through examinations of bud break rate and days to bud break, we found that the endo-dormancy of 'Fuji' apple tree continues for 70 d from 165 to 255 d after full bloom (DAFB), from late October to early January of the following year. In addition, within 20 d of first bud break, based on a final bud break rate of 60% or more, we able to identify the timing of the changeover from para-dormancy to endo-dormancy, and endo-dormancy to eco-dormancy. Analysis of the chilling requirement during the endo-dormancy period revealed that chilling accumulation up to 255 DAFB to release endo-dormancy amounted to 666 and 517 h based on the CH and Utah models, respectively. Observation of internal changes in the bud during endo-dormancy showed that flower bud differentiation begins from mid-July, and t ime of inflorescence o f the disk f lower is a vailable to f ind. The f lower buds subsequently developed slowly but steadily during endo-dormancy and in the following year in February, the developmental stage of each organ had progressed. Moreover, the flower buds of 'Fuji' apples were mostly healthy during the dormancy period, but some exhibited necrosis of flower primordium, due partial cell damage from the formation of ice crystals rather than a direct effect of the low temperature. Flower buds were formed in both the axillary buds of bourse shoots and terminal buds of spurs, but lower bud differentiation was observed for the terminal buds of spurs at rate of about 65% of total buds, which was directly related to the bud size and shoot diameter.