• 제목/요약/키워드: E2F

검색결과 3,543건 처리시간 0.043초

곤충병원성 선충을 이용한 잔디밤나방, Spodoptera depravata(Butler)(나비목: 밤나방과)의 생물적 방제 (Biological Control of Spodoptera depravata (Butler) (Lepidoptera: Noctuidae) Using Entomopathogenic Nematodes)

  • 강영진;이동운;추호렬;이상명;권태웅;신홍균
    • 한국응용곤충학회지
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    • 제43권1호
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    • pp.61-70
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    • 2004
  • 우리나라산 곤충병원성 선충(Heterorhabditis sp. Gyeongsan, Steinernema carpocapsae GSN1, S. glaseri Dongrae, S. longicaudum Nonsan, S. monticolum Jiri)을 이용한 잔디밤나방(Spodotera depravata)의 환경 친화적 방제 가능성을 알아보기 위하여 실내와 야외에서 실험을 수행하였다. 아울러 잔디의 예고가 곤충병원성 선충의 효과에 미치는 영향과 야외에서 곤충병원성 선충의 처리가 잔디밭에 분포하고 있는 개미와 집게벌레의 밀도 변화에 미치는 영향도 조사하였다. 잔디밤나방 3령충은 곤충병원성 선충에 대하여 처리 5일째 53.3%에서 66.7%의 보정사충율을 나타내었다. S. carpocapsae GSN1과 S. monticolum Jiri의 잔디밤나방 3령충에 대한 반수치사농도 (LC$_{50}$)는 6.9와 3.9마리였다. S. carpocapsae GSN1의 병원성은 잔디밤나방의 령기에 따라 차이가 있어 2령충에서 73.3%로 가장 높았으며, 3령충부터 감소하였다. 예고는 곤충병원성 선충의 병원성에 영향을 미쳤다. 들잔디의 예고가 14mm인 pot에서 4령충의 치사율은 S. carpocapsae GSN1 처리가 40.0%였고, S. monticolum Jiri처리는 33.3%였으며 fenitrothion은 83.3%의 치사율을 나타내었으나 45mm구에서는 모두 낮았다. 곰개미(Formica japonica) 분포지에서 선충처리구의 보정사충율은 fenitrothion 처리구에 비하여 낮았으나, 개미의 감소율은 fenitrothion구에서 56.7%로 높았고, S. carpocapsae GSN1 처리구와 S. monticolum Jiri 처리구에서는 각각 0%, 6.7%로 낮았다. 잔디의 예고는 S. carpocapsae GSN1과 fenitrothion의 효과에 영향을 미쳤다. S. carpocapsae GSN1은 3-4cm 예고구에서는 62.2%의 방제효과를 나타내였으나, 6-8cm와 12-14cm의 예고구에서는 전혀 효과가 없었다. 그러나 fenitrothion 처리구에서는 유의적 차이가 없었다. 못뽑기집게벌레(Forficula scudderi)의 밀도도 fenitrothion 처리구에서만 감소를 보였다. 즉, 3-4cm 예고구에서는 100%의 감소율을 보였고, 6-8cm 구에서는 41.7%, 12-14cm 구에서는 16.1%의 감소율을 나타내었다.

일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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일부 치위생과 재학생의 심신 자각증상에 관한 연구 (A Study of the Psychosomatic Self-Reported Symptom of Dental Hygiene Students)

  • 권순석;문희정
    • 치위생과학회지
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    • 제12권4호
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    • pp.413-421
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    • 2012
  • 본 연구는 치위생과 재학생들이 자각하고 있는 심신건강 문제를 파악하여 재학생들의 건강증진을 위한 프로그램 개발의 기초자료를 제공할 목적으로 경기도 및 강원도 소재일부 치위생과 재학생 432명을 대상으로 설문조사를 하였으며, 다음과 같은 결론을 얻었다. 1. 치위생과 재학생들은 정신적 자각증상(19.37)이 신체적 자각증상(17.53)보다 높게 나타났고, 12개 심신 자각증상의 항목 중에서는 정서불안정(J)이 21.85로 가장 높고, 구강과 항문(D)이 14.59로 가장 낮게 나타났다. 2. 치위생과 재학생들은 연령에서는 '20세 이상'이 '19세 이하'보다, 종교에서는 '있다'가 '없다'보다, 학년에서는 '3 학년'이 '1, 2학년'보다 신체적 정신적 자각증상이 모두 높게 나타났으며, 연령과 학년에서는 통계적으로 유의한 차이가 나타나지 않았으나, 종교에서는 신체적 자각증상(p<.01)과 정신적 자각증상(p<.05), 다자각증상(I) (p<.01), 소화기(C) (p<.01), 공격성(F) (p<.001), 신경질(E) (p<.01), 눈과 피부(B) (p<.05), 정서불안정(J) (p<.05)에서 통계적으로 유의한 차이를 보였다. 3. 생활환경에서는 '나쁘다'가 신체적 정신적 자각증상이 각각 18.11과 19.80으로 가장 높고, '좋다'가 가장 낮았으며, 신체적 자각증상(p<.05), 정신적 자각증상(p<.01), 우울성(K) (p<.001), 생활불규칙성(G) (p<.001), 다자각 증상(I) (p<.01), 허구성(L) (p<.01), 구강과 항문(D) (p<.05), 소화기(C) (p<.05)에서 통계적으로 유의한 차이가 나타났다. 4. 건강검진에서는 '건강검진 센터'가 신체적 정신적 자각증상이 각각 22.26과 20.34로 가장 높았으며, '보건소나 무료 진료소'가 가장 낮았다. 통계적으로는 정신적 자각증상(p<.05), 우울성(K) (p<.01), 다자각증상(I) (p<.05), 정서불안정(J) (p<.05)에서 유의한 차이가 나타났다. 이상의 결과를 종합해 볼 때 치위생과 재학생들의 건강상태를 증진시키고 이를 유지하기 위해서는 건강관리 방법에 관한 다양한 정보제공과 함께 대학의 정규 교육을 통해 건강관리에 대한 관심을 고취시킬 수 있는 프로그램 개발이 필요한 것으로 판단된다.

후계어민 육성을 위한 어촌지역 중등교육과 사회 교육의 연계방안 (A Research on a Joined Project of Social Education and Village Secondary School Education for Raising The Number of Successors to Fishery)

  • 이현우;이경준
    • 수산경영론집
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    • 제19권2호
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    • pp.1-58
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    • 1988
  • The purpose of this study is to investigate the relation between social education and secondary education of seaside and sea village schools for supporting the successors to fishery. Objects of the study were five groups; 321 fishermen, 107 staff members of a Fishery Guidance Center, 1, 001 students, 306 teachers of sea villages, 193 staff members of a Fishery Cooperative Association. The total number of people being object of this study was 1, 876 persons. The questionaire used for this study was made after preliminary counseling with fishermen in sea villages and teachers in seaside schools. The results of this study are as follow ; 1) About the value of Fishery and successors to Fishery There have been more positive responses than negative ones to the question on the value of fishery. The main reason for positive responses lies in the potentiality for development of fishery but the negative responses are because of the heavy work. 56.8% of the respondents expected an increasing number of successor to fishery, but 43.2% of the respondents had a negative foresight on that problem. The negative respondents stated that the fisherman that moved from the sea villages to the urban areas are responsible for the none increasing numbers of successors to fishery. Most of the respondents answered that government support is needed in order to increase the number of successors to fishery. 2) Social education for Fishermen Only 40% of fishermen know the Fishing Village Guidance Center as the main institute for social education. 94.17% of the respondents prefer plural institutes to single ones. 5.9% of the respondents answered with opposit opinions. 40.4% of the respondents answered that technical teachings has not often been practised. The reason why technical teaching does not often come into effect are as follows; lack of technical expertise, insufficient concern of staff members of the Guidance Center or the Cooperation Association. Also fishermen answered that the Fisherman Guidance Center does not often practise technical education. The Fishery Cooperation Association with its social education for fisherman takes the role of education for the economical way and carries out financial assistance. The relationship between the Fishery Cooperative Association and fishermen is presented satisfactory. However, the frequency of education is not satisfactory. Indifferences between staff members of the Fishery Cooperative Association does not carry out fishery education very often. Also loaned money matters were not satisfactory. 3) Secondary education for Fishery This study showed that it is desirable that the practical course of middle schools in islets and seaside villages take education on fishery ; however, a few schools only take the practical course fishery. Most of the fishery high schools want computer education as a new recommendable course. The students of fishery high schools want computer education as a new recommendable course. The students of fishery high schools have problems with scientific terms in the text books for the practical of fishery high schools have problems with scientific terms in the text books for the practical courses. Over 80% of the respondents agreed that the principals of schools in islets and sea side villages should be men having majored in fishery. 4) The connection between social education and secondary education for fishery a. It is desirable that the principal and vice principal of secondary schools in islets and sea side villages are men majored in fishery. b. It is recommendable that fishery courses are taken as practical courses in fishery village schools for it is helpful to relate between the vocation and the district's special character, as well as to built up relation between the middle school education and the fishery high school education. c. The teachers of fishery high schools and the officials of government offices which are related to fishery should work together to realize a program on teaching various kinds of techniques and give other useful informations to fishermen. d. During the vacations the fishery high school could be used for the social education of fishermen. Seminars on fishery technique and cultural aspects could be held. Especially a spiritual education which is needed for the improvement of the society of fishermen could be achieved by a cultural education. e. On the state level a financial support to raise the number of successors to fishery, a national policy for the betterment of the life of fishermen, as well as active publicity activities are necessary. f. A financial support of the government for raising the number of the successors to fishery is needed. For this purpose a fishery education performed on a state level would be desirable.

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부산지역 목회자의 교구간호사업 요구조사 (The Demands on Parish Nursing Services by Pastors in Busan)

  • 손수경;강경자;이지현;이영은;박춘화
    • 지역사회간호학회지
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    • 제13권1호
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    • pp.182-196
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    • 2002
  • The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

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자동차 부품 제조업체와 공급업체 간의 선의와 의사소통이 몰입과 교체의도에 미치는 영향: 구매자의 관점을 중심으로 (The Effect of Benevolence and Communication on Commitment and Switching Intentions : The Automobile Parts Buyer's Perspective)

  • 김홍근;이필수;김민성;이용기
    • 벤처창업연구
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    • 제9권6호
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    • pp.129-144
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    • 2014
  • 본 연구는 자동차 관련 부품 제조업체를 대상으로 하여 사회교환 이론을 바탕으로 선의와 의사소통이 교체의도에 영향을 미칠 것이라는 개념적 틀 안에서 선의, 의사소통, 계산적 몰입, 정서적 몰입, 그리고 교체의도의 관계에 대해 살펴보고자 하였다. 본 연구의 모형은 선의를 상호적 선의와 애타적 선의 2가지 차원으로 구분하여 이러한 요인들이 계산적 몰입, 정서적 몰입, 그리고 교체의도에 어떠한 영향을 미치는 가를 실증적으로 분석하고, 내생변수들 간의 영향관계를 검증하여 연구의 시사점을 도출하였다. 첫째, 상호적 선의는 계산적 몰입과 정서적 몰입에 직접적으로 유의적인 정(+)의 영향을 미치는 것으로 나타났다. 둘째, 상호적 선의가 계산적 몰입과 정서적 몰입에 미치는 상대적 영향력은 차이가 없는 것으로 나타났다. 셋째, 애타적 선의는 계산적 몰입에 통계적으로 유의한 정(+)의 영향을 미치는 것으로 분석되었다. 넷째, 애타적 선의가 계산적 몰입과 정서적 몰입에 미치는 상대적 영향력은 차이가 없는 것으로 나타났다. 다섯째, 의사소통은 정서적 몰입에 직접적으로 정(+)의 영향을 미치는 것으로 분석되었다. 여섯째, 계산적 몰입은 정서적 몰입에 통계적으로 유의한 정(+)의 영향을 미치는 것으로 나타났다. 일곱째, 계산적 몰입은 교체의도에 직접적인 유의한 정(+)의 영향을 미치는 것으로 나타났다. 여덟째, 정서적 몰입은 교체의도에 부(-)의 영향을 미치는 것으로 나타났다. 본 연구는 관계마케팅 이론을 자동차 B to B 시장에 접목시킨 통합적 모형을 제시하여 자동차 부품 제조업체 구매자의 파트너인 공급업체 간의 교체의도를 줄일 수 있는 방안을 제시하였다는 점에서 이론적, 실무적 시사점을 제시하고 있다.

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탁주양조중 Riboflavin의 소장에 관한 연구 (Studies on the Quantitative Changes of Riboflavin during Takju Brewing)

  • 김찬조;최우영
    • Applied Biological Chemistry
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    • 제13권3호
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    • pp.219-222
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    • 1970
  • 탁주 양조에 사용되는 각종 원료중의 Riboflavin을 정량하고 아울러 쌀, 소맥분및 옥수수분을 각각 주원료로 일반 탁주양조법에 따라 담금하여 숙성시까지 그들 술덧중의 Riboflavin의 소장을 측정하여 다음과 같은 결과를 얻었다. 1. 각원료 100g중의 Riboflavin함량 (${\gamma}$)은 쌀 46.9, 소맥분 67.3, 옥수수분 73.9, 누룩 169.0, 소맥분입곡 87.1, 옥수수분입곡 $84.4{\gamma}$이었으며 쌀소맥분 및 옥수수분중의 함량은 증자에 의하여 약 $30{\sim}40%$파괴됨을 보였다. 2. 누룩단용법의 쌀및 소맥분구의 각술덧에서 Riboflavin의 소장은 같은 경향을 보여 3일까지 감소하였다가 이후 다시 증가하며 5일째에 가서 급격히 증가하여 6일째에 약간 감소하는 소장을 보여 결국 양 숙성술덧 100ml중의 Riboflavin함량은 누룩단용법의 쌀구에서 $82{\gamma}$, 소맥분구에서 $72{\gamma}$를 보였으며 누룩및 입곡혼용법의 소맥분및 옥수수분구의 각술및에서는 초기부터 감소하지 않고 기복이 있는 증가의 경향을 보이다가 역시 5일째에 현저히 증가되며 6일째에 다시 감소하여 결국 양 숙성술덧 100ml중에는 소맥분구에서 $88.6{\gamma}$ 옥수수분구에서 $83.6{\gamma}$이었다. 3. 각숙성술덧으로 제성한 탁주 100ml중에는 Riboflavin 이 누룩단용법구들에서 $28.8{\sim}41{\gamma}$, 누룩및 입곡혼용법구들에서 $33.6{\sim}44.5{\gamma}$ .함유됨을 알 수 있었다. 5. 누룩단용법의 쌀구및 소맥분구의 지게미 무수물 100g중에는 Riboflavin이 각각 $47.3{\gamma}$$66.2{\gamma}$함유되었으며 누룩및 입곡혼용법의 소맥분구및 옥수수분구의 것에는 각각 $64.5{\gamma}$$62.9{\gamma}$ 함유되었다.

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흰쥐의 위점막에 Paclitaxel (Taxol)과 방사선조사의 효과 (Effect of the Paclitaxel and Radiation on the Gastric Mucosa of the Rat)

  • 이경자;구혜수
    • Radiation Oncology Journal
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    • 제17권4호
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    • pp.314-320
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    • 1999
  • 목적 : Paclitaxel(Toxol)은 미소관의 집합을 촉진시키고 분해를 방지하는 미소관 억제제로서 이 작용은 세포주기 중 방사선에 예민한 G2fM 시기에 일어나기 때문에 방사선조사와 병용할 경우 방사선감작제 가능성이 있다. Paclitaxel과 방사선조사를 병용하여 흰쥐의 위점막에서 paclitaxe이 방사선의 효과에 미치는 영향을 파악하기 위하여 본 연구를 시행하였다. 대상 및 방법 : 실험군은 paclitaxel 단독군, 방사선조사 단독군 및 paclitaxel과 방사선조사 병용군의 세 군으로 분류하여 paclltaxel 단독군은 paclitaxel (10 mg/kg)을 복강내 1회 주입하였고, 방사조사 단독군은 8 Gy를 전복부에 단일 조사하였으며, paclitaxel과 방사선조사 병용군은 paclitaxel (10 mg/kg)을 복강내 주입 후 24시간에 방사선조사 단독군과 동일한 방법으로 방사선조사하였다. 실험 완료 후 위점막 내 유사분열수, apoptosis와 기타 점막의 변화를 시간별로(6, 24시간, 3일 및 5일) 비교관찰하였다. 결과 : Paclitaxel 주입 후 위점막 내 유사분열은 증가하지 않았고 apoptosis는 6시간에 $5.75\%$였고 3일까지 비슷하게 지속되었다. Paclitaxel 주입 후 경미한 위선의 확장이 24시간에 관찰되었고, 세포의 비정형이 24시간과 3일에 보였으나 5일에는 정상으로 회복되었다. 방사선조사 단독군에서 apoptosis는 6시간에 $6.0\%$로 가장 많았으며 24시간에 $1.25\%$로 감소되었고 5일까지 지속되었다. 위선의 확장과 세포의 비정형은 방사선조사 후 6시간부터 5일까지 계속해서 경미하게 보였다. Paclltaxei과 방사선조사 병용군은 apoptosis가 6, 24시간, 3일 및 5일에 각각 5.5, 4.5, 4.0, $4.0\%$로 방사선조사 단독군에 비하여 24시간부터 많아졌고 3일에는 통계학적으로 유의한 차이가 있었다. 위선의 확장과 세포의 비정형은 Paclitaxel과 방사선조사 병용군에서 방사선조사 단독군에 비하여 증가되지 않았다. 결론 : 흰쥐의 위점막은 paclitaxel 주입 후 24시간에 방사선조사를 시행한 결과 apoptosis를 종말점으로 볼 때 paclitaxel의 첨가효과만을 보여 주었다.

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장티브스에 관한 임상적 관찰 (Clinical review of Typhoid Fever Patients)

  • 최정신
    • 대한간호학회지
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    • 제6권1호
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구 (A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis)

  • 박경숙;정연강
    • 대한간호학회지
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    • 제24권4호
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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