• Title/Summary/Keyword: Hospital Management

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Effects of Self Care Program on Hypertensive Control in Hypertensive Patient (고혈압환자에게 적용한 자가관리프로그램 중재 효과)

  • Kim, Ok-Ran
    • Research in Community and Public Health Nursing
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    • v.14 no.4
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    • pp.568-578
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    • 2003
  • This study was conducted to estimate the effects of self-care program on knowledge and symptoms related hypertension self-care and physiological index in essential hypertensive patients aged between 35-74 year. The subjects for the experiment group and the control group of this study were 70 men and women selected through random sampling from adults at Sangju Red Cross Hospital in Gyeongsanbuk-do, and the experiment was carried out during the period from the 15th of September to the 30th of April in 2002. This study measured systolic and diastolic blood pressure (SBP, DBP, the mean value of the two measures) and total cholesterol (TC) and surveyed the subjects' diet and life style in relation to hypertension using a self-report questionnaire. In order to study the significance of the effects of self-care program, the author carried out t-test, paired t-test, ANCOVA, chi-square analysis and effectiveness index (EI) analysis. Results of the study are as follows: The experiment group got higher mean scores than the control group in the degree of low sodium intake and the degree of high calcium and high potassium intake, and the difference was statistically significant(P<0.05). The effectiveness index of the self-care program in smoking was 0.797 at the 1st posttest and 0.601 at the 2nd posttest, and in physical activities 0.600 at the 1st posttest and 0.849 at the 2nd posttest. The rate of regular antihypertensive drugs intake of the experimental group was higher than that of the control group. and the effectiveness index of the self-care program was 0.715. The mean score of the systolic blood pressure of the experimental group was lower than that of the control group, and the difference was statistically significant(P<0.05). In conclusion, these findings support usefulness of self-care programs in reducing systolic blood pressure and in promoting self-care related to diet and life style for treating and preventing hypertension.

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A Study in an Effective Programs for Emergency Care Delivery System (응급의료 전달체계의 충실 방안)

  • Kwon Sook Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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Effects for kangaroo care: systematic review & meta analysis (캥거루 케어가 미숙아와 어머니에게 미치는 효과 : 체계적 문헌고찰 및 메타분석)

  • Lim, Junghee;Kim, Gaeun;Shin, Yeonghee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.599-610
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    • 2016
  • This paper reports the results of a systematic review (SR) and meta-analysis research to compare the effect of Kangaroo care, targeting mothers and premature infants. A randomized clinical trial study was performed until February 2015. The domestic literature contained the non-randomized clinical trial research without restriction according to the level of the study design. A search of the Ovid-Medline, CINAHL, PubMed and KoreaMed, the National Library of KOREA, the National Assembly Library, NDSL, KISS and RISS. Through the KMbase we searched and combined the main term ((kangaroo OR KC OR skin-to-skin) AND (care OR contact)) AND (infant OR preterm OR Low Birth Weight OR LBW), ((kangaroo OR kangaroo OR kangaroo) AND (care OR nursing care OR management OR skin contact)) was made; these were all combined with a keywords search through the selection process. They were excluded in the final 25 studies (n=3051). A methodology checklist for randomized controlled trials (RCTs) designed by SIGN (Scottish Intercollegiate Guidelines Network) was utilized to assess the risk of bias. The overall risk of bias was regarded as low. In 16 studies that were evaluated as a grade of "++", 9 studies were evaluated as a grade of "+". As a result of meta-analysis, kangaroo care regarding the effects of premature mortality, severe infection/sepsis had an insignificant effect. Hyperthermia incidence, growth and development (height and weight), mother-infant attachment, hypothermia incidence, length of hospital days, breast feeding rate, sleeping, anxiety, confidence, and gratification of mothering role were considered significant. In satisfaction of the role performance, depression and stress presented contradictory research results for individual studies showing overall significant difference. This study has some limitations due to the few RCTs comparing kangaroo care in the country. Therefore, further RCTs comparing kangaroo care should be conducted.

The Relation between Obesity and Glomerular Filtration Rate in Children and Adolescents (소아 및 청소년에서 비만과 사구체여과율과의 관계)

  • Jung, Youngsu;Kim, Dongwoon;Lim, Inseok
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1219-1224
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    • 2005
  • Purpose : The prevalence of obesity in children and adolescents has been rising rapidly in Korea because of changes of diet and lifestyle. As with adults, obesity in children and adolescents can cause diabetes mellitus, hyperlipidemia, cardiovascular diseases and renal diseases. The aim of the present study is to examine the relation of obesity, glomerular filtration rate(GFR) and serum cystatin C concentration in children and adolescents. Methods : Data of 115 children and adolescents aged between 6 years and 20 years without clinical evidence of renal diseases were included in the study. From May 2004 to December 2004, blood samples were collected from children and adolescents who were seen at the Department of Pediatrics at Chungang University Yongsan Hospital. Obesity degrees and body mass indices(BMI) were measured, and GFRs were estimated from Schwartz's formula. Serum cystatin C was measured by particle enhanced nephelometric immunoassay using Behring Nephelometer II. Results : GFRs were significantly different between the obese group(BMI >95 percentile, $145.79{\pm}23.10mL/min$) and the non-obese group(BMI <95 percentile, $134.61{\pm}26.19mL/min$) divided by BMI (P=0.031). GFRs were not significantly different between the obese group(obesity degree >120 percent, $144.29{\pm}23.08mL/min$) and the non-obese group(obesity degree <120 percent, $134.54{\pm}26.57mL/min$) divided by obesity degree(P=0.051), but were significantly different between severe obese group (obesity degree >150 percent, $155.55{\pm}20.40mL/min$) and the non-obese group(P=0.004). GFRs were correlated positively with BMI($r^2=0.037$, P=0.039), but were not correlated significantly with obesity degree($r^2=0.030$, P=0.066). Serum cystatin C concentrations were not significantly different between the obese group and the non-obese group, divided by BMI as well as by obesity degree(P>0.05). Conclusion : Obesity may lead to an alteration of renal hemodynamics such as hyperfiltration, appropriate control and management for obesity is necessary.

Complications and Perinatal Factors According to the Birth Weight Groups in the Infants of Diabetic Mothers (당뇨병 산모아에서 출생 체중군에 따른 합병증 및 주산기 인자)

  • Son, Kyung-Ran;Back, Hee-Jo;Cho, Chang-Yee;Choi, Young-Youn;Song, Tae-Bok;Park, Chun-Hak
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.447-453
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    • 2003
  • Purpose : This study was performed to compare complications and perinatal factors according to the birth weight groups in the infants of diabetic mothers(IDM). Methods : Three hundred and one singleton diabetic mothers and their babies of more than 30 weeks' gestational age admitted in the department of Pediatrics, Chonnam University Hospital from January 1996 to March 2002 were enrolled. Complications and perinatal factors were compared between large for gestational age(LGA) and appropriated for gestational age(AGA) infants. Results : Hypomagnesemia was observed in 37.5%, jaundice in 21.3%, hypoglycemia in 11.1%, hypocalcemia in 7.0%, and birth injury in 19.6%. Congenital anomaly was noted in 24.9% with cardiovascular anomaly most commonly. In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, Cesarean section rate, maternal height, weight before pregnancy, weight gain during pregnancy, and the incidence of unawareness of gestational DM were significant compared with the AGA group. Conclusion : In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, maternal height, weight before pregnancy and weight gain during pregnancy were larger, and the incidence of unawareness of gestational DM was higher compared with the AGA group. These results suggest that careful examination and management are needed to detect the high risk, pregnant DM mothers with possible LGA babies.

A Study on the Factors that Determine the Initial Success of Start-Up (스타트업의 초기 성공을 결정하는 요인에 관한 연구)

  • Lee, Hyun Ho;Yun, Hwangbo;Gong, Chang-Hoon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.12 no.1
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    • pp.1-13
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    • 2017
  • The purpose of this study is to find out which factors determine the success of start-up in the initial market and what are the most important determinants. For the empirical analysis, the questionnaire related to the analysis of success factors for start-up success was designed according to the quantitative analysis (AHP technique). First, we selected 8 representative success factors for successful start-up in the initial market. In order to determine the degree of priority among these factors, we surveyed 12 entrepreneurs who are interested in entrepreneurship, universities, research institutes, and public officials. As a result of the empirical analysis, 51% of the funds in the tier 1 were ranked as the top priority to determine success factors. Followed by research and development (32.5%), management (8.7%) and marketing (7.8%). In particular, when each of the four items is calculated as 100 according to the result of the tier 1, and the tier 2 is converted, the foreign investment is analyzed as 43.7%. It was followed by 15.14% of R & D facilities, 14.07% of ideas, 8.7% of managerial ability, 7.29% of domestic investment, 5.85% of buyer feedback, 3.3% of development strategy and 1.95% of marketing strategy. Among the eight success factors, overseas investment items showed the closest preference to half, and it was the most important variable that determines the success or failure of market entry. The implication of this study is that many start-ups in Korea expect to receive investment and support from overseas accelerators. This means that overseas investment itself has been recognized as a start-up that makes services and products that can be used in the global market. A high preference for attracting foreign investment is due to the fact that the amount of investment is larger than that of Korea and that it can flexibly cope with the pressure on the performance compared to domestic investors. In this study, it was meaningful that we could confirm this fact through questionnaires of start-up experts. In future research, we need to find a viable alternative through studying how to provide start-up to foreign direct investment at the national level.

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Viral Patterns and Clincal Analysis of Acute Respiratory Tract Infections of Children in Korea(September, 1998~August, 2002) (바이러스에 의한 소아 급성 하기도 감염의 유행 및 임상양상(1998년 9월~2002년 8월))

  • Lee, Su-Jin;Park, Eun-Young;Oh, Phil-Soo;Lee, Kon-Hee;Kim, Kwang-Nam;Lee, Kyu-Man
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.102-113
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    • 2003
  • Purpose : Acute respiratory tract infections are the most common illnesses in children. The great majority of these infections involving lower respiratory tracts infections(LRTI) are caused by respiratory viruses such as respiratory syncytial virus(RSV), parainfluenza virus (PIV), influenza virus(INF), adenovirus(ADV), etc. Our purpose of this study was to examine the seasonal occurrence, clinical and laboratory features of each viral infections. Methods : Nasopharyngeal aspirates(NPA) were collected from 913 hospitalized children on the first day of admission. They were all admitted to Hangang Sacred Heart hospital and diagnosed as LRTIs. The study period was from September 1998 to August 2002. Specimens were inoculated onto HEp-2 cell, LLC-MK2 cell and MDCK cell. Viruses were detected by immunofluorescent method performed at day 10 postinoculation. Respiratory viruses were detected in 251(27%) cases. Medical records of 208 cases diagnosed as acute LRTIs were all taken reviewed and analyzed. Results : The identified pathogens were RSV 122 cases(58%), PIV 30 cases(14%), INFA 20 cases(10%), INFB 21 cases(11%) and ADV 15 cases(7%) during the study period. Outbreaks of RSV infections occurred every year but mostly on December, 1998 and November, 1999. LRTIs by PIV and ADV occurred during all seasons of the year. INFA was isolated moslty on March, 1999 and January, 2000. INFB infections occurred largely on April, 2002. The clinical diagnoses were bronchiolitis 88 cases(43%), pneumonia 87 cases(42%), croup 19 cases(9%) and tracheobronchitis 14 cases(6%). Common symptoms and signs were cough, rhinorrhea, sputum and fever. WBC counts in peripheral blood showed normal findings in 123 cases(59%). Each viral infections also showed some differences in auscultatory findings and chest X-ray findings. Conclusion : We learned that viruses are one of the major and important etiologic agents of acute LRTIs of children in Korea. However, we still need to find out more about its characteristic clinical features and continue studying on their seasonal occurrence to focus on their management and also prevention.

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Efficacy of Dextranomer/Hyaluronic Acid Copolymer ($Deflux^{(R)}$) Injection for Vesicoureteral Reflux in Children (방광요관역류 환아에서 내시경적 요관 점막하 Dextranomer/hyaluronic acid copolymer ($Deflux^{(R)}$) 주사요법의 효과에 대한 연구)

  • Hong, Suk-Jin;Hwng, Hyun-Hee;Hong, Eun-Hui;Cho, Min-Hyun;Chung, Sung-Kwang
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.229-234
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    • 2009
  • Purpose : The aim of this study was evaluating the efficacy of endoscopic $Deflux^{(R)}$ submucosal injection in children with primary vesicoureteral reflux (VUR). Methods : Retrospective analysis of medical record was conducted on 38 children (59 ureters) who underwent endoscopic $Deflux^{(R)}$ injection due to primary VUR. Data were collected from March 2000 to February 2006. Mean infused amount of $Deflux^{(R)}$ was 0.77 cc. After $Deflux^{(R)}$ injection, patients were reassessed by voiding cystourethrogram (VCUG) 6 months later. Results : The success rate of endoscopic $Deflux^{(R)}$ submucosal injection 6 months later by VCUG was 100% for grade 1 VUR, 87.5% for grade 2, 60% for grade 3, 26.6% for grade 4, 16.6% for grade 5, respectively and there was negatively significant correlation between success rate and grade of VUR (P<.01). Degree of improvement of VUR by endoscopic $Deflux^{(R)}$ submucosal injection was not related to age at diagnosis, time to operation, existence of voiding dysfunction or constipation and infused amount of $Deflux^{(R)}$. However, group with anticholinergics medication had significantly lower success rate than non-medication group (P<0.047). Conclusion : Endoscopic $Deflux^{(R)}$ submucosal injection is effective therapy in patient with primary VUR, especially low grade VUR. It can be not only a useful substitute for prophylaxis with antibiotics, but also an effective management prior to ureteroneocystostomy in children with primary VUR.

Clinical Evaluation of Nephrotic Syndrome Manifesting in the First Year of Life (1세 이하의 소아에서 발병한 신증후군의 임상적 고찰)

  • Cho, Sung-Hee;Lee, Joo-Hoon;Cho, Young-Mi;Park, Young-Seo;Cheong, Hae-Il
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.161-169
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    • 2009
  • Purpose : This study was performed to report the diagnosis and treatment of nephrotic syndrome manifesting in the first year of life. Methods : We retrospectively reviewed the clinical data with chart review in 7 patients who were diagnosed as nephrotic syndrome manifesting in the first year of life from 1996 to 2007. Results : Three patients had congenital nephrotic syndrome, the other 4 patients had infantile nephrotic syndrome. Their ages ranged from birth to 11 months and male to female ratio was 1 to 6. Renal biopsies were done in 6 patients. One patient had Finnish type congenital nephrotic syndrome, 2 patients had diffuse mesangial sclerosis, 2 patients had focal segmental glomerulosclerosis and 1 patient had minimal change disease. Genetic analyses of NPHS2, PLCE1, and WT1 were done in 4 patients and 2 of them had WT1 mutation. Among 3 patients with congenital nephrotic syndrome, 1 patient was diagnosed as congenital nephrotic syndrome of Finnish type and the other 2 patients were diagnosed as Denys-Drash syndrome. All of the patients with congenital nephrotic syndrome died due to sepsis. Among 4 patients with infantile nephrotic syndrome, 2 patients died and 1 had remission, another patient progressed to end stage renal disease. Conclusion : Most of nephrotic syndrome manifesting in the first year was hereditary renal disease. Patients with nephrotic syndrome manifesting in the 3 month of life had poorer prognosis and needed more aggressive management including early dialysis and renal transplantation might be considered compared with infantile nephrotic syndrome. Further genotype-phenotype correlation studies are needed.

The Effect of School Dental Service on Dental Health Knowledge, Beheaviors and Dental Health Status Among Elementary School Students (학교 구장보건실 운영이 초등학생들의 구강보건지식, 행태 및 건강상태에 미치는 영향)

  • Lee, Tae-Yong;Yun, Go-Eun;Kim, Kwang-Hwan
    • The Journal of Korean Society for School & Community Health Education
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    • v.10 no.1
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    • pp.87-104
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    • 2009
  • Objective: In this study, the dental health care knowledge, dental health behaviors and dental health status of elementary school students were compared and analyzed in the cases of their schools having dental health care center or not one. Methods: The target groups were 167 students of A school (experimental group) where pit-and-fissure sealants, fluoride mouthrinsing, and fluoride gel application were carried out with all grades of students by school dental health care center and 158 students of B school (control group) where fluoride mouthrinsing, for all grades students and pit-and-fissure sealants for the first grade students are carried out but have no the school dental health care center. Results: This study was carried out through the answer sheets and recordings of dental inspection. The findings of this study are as follows: 1. The dental health care knowledge was compared and the results showed that on average 14.2$\pm$2.1 in experimental group and 14.0$\pm$1.9 in the control group were no significantly different (p>0.05). 2. The dental health behaviors were compared and the results showed that the experimental group was significantly different(p<0.05) in terms of the number of times of dental brushing a day, the method of tooth brushing, the time of tooth brushing, the experience of tooth brushing with fluorine, the kinds of snacks and tooth brushing in school after lunch. But there was no significant difference(p>0.05) in the time of tooth brushing and the tooth brushing after eating snacks. 3. The DMF rate was compared and the results showed the significantly difference between the average experimental group and 53.8$\pm$5.0 in the control group(p<0.05). 4. The DMFT index was compared and the results showed the significantly difference between the average 0.6$\pm$2 in the experimental group and 1.4$\pm$1.6 in the control group(p<0.05). 5. The DMFI rate was compared and the results showed the significantly difference between the average 4.2$\pm$8.3 in the experimental group and 9.5$\pm$11.0 in the control group. (p<0.05). 6. The DT rate were compared and the results showed the significantly difference between the average 10.2$\pm$29.5 in the experimental group and 32.4$\pm$44.0 in the control group(p<0.05). 7. The FT rate were compared and the results showed the significantly difference between the average 88.5$\pm$31.0 in the experimental group and 67.5$\pm$44.0 in the control group(p<0.05). Conclusions: Based on the results, above there was no significant difference in dental health care knowledge between both the experimental and the control group. But we discovered that the experimental group is better than the other one in dental health care behaviors and dental health status. Therefore, we could conclude that the school dental health care center efficiently carried out the dental care and treatment. As school dental health care centers did not work out efficiently in terms of their educating on the dental health acre knowledge, the related programs to be developed and supported.

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