• Title/Summary/Keyword: Improvement Methods

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Efficacy of the Antibiotics Chosen by ATS Guideline in the Treatment of Korean Patients with Community-acquired Pneumonia Admitted to a Tertiary Hospital (3차 병원에 입원한 한국 지역사회획득 폐렴 환자에서 미국흉부학회 추천 항생제의 유용성)

  • Oh, Sung-Yong;Park, Sang-Joon;Kang, Kyeong-Woo;Koh, Young-Min;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Choi, Dong-Chull;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.460-470
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    • 1999
  • Background : In 1993, American Thoracic Society (ATS) recommended a guideline for the initial management of adults with community-acquired pneumonia(CAP). However, etiologic organisms and medical system in Korea seem to be different from those in Western countries. Retrospective analysis was done to evaluate the efficacy of antibiotics chosen by ATS guideline in the treatment of Korean patients with CAP admitted to a tertiary university medical center. Methods : Hospitalized patients with CAP at Samsung Medical Center from April 1997 through March 1998 were retrospectively reviewed. Patients who fulfilled all of the following criteria were included in this study : (1) fever ${\geq}38^{\circ}C$ (2) purulent sputum (3) pulmonary infiltrates on chest X-ray. Patients were classified as : 1) ATS group ; patients whose initial antibiotics were chosen by ATS guideline 2) Non-ATS overuse group ; additional antibiotics administered more than those of ATS guideline, and 3) Non-ATS underuse group ; initial antibiotics were insufficient to ATS guideline. Response of empirical antibiotics and etiologic organisms of 3 groups were identified. Results : Sixty-four patients were enrolled. Thirty-six patients were classified into ATS group, 10 patients Non-ATS overuse group, and 18 patients Non-ATS underuse group. Thirty-three patients of 36 ATS group, 9 patients of 10 Non-ATS overuse group, and 14 patients of 18 Non-ATS underuse group showed improvement by initial empirical antibiotics. There was no statistical difference in antibiotic response between 3 groups (p>0.05). S. pneumoniae (12.5%), K. pneumoniae (9.4%), and P. aeruginosa (4.7%), Mycoplasma (3.1%) were the most commonly isolated organisms. In 18 patients with severe CAP, P. aeruginosa was isolated only in 1 patient and Legionella organism not isolated. Conclusion : Initial empirical antibiotics chosen by ATS guideline were effective in the management of Korean patients with CAP admitted to a tertiary hospital. However, well-designed large-scale prospective study is needed to identify etiologic organisms and choose an adequate initial empirical antibiotics in Korean adults patient with severe CAP.

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Clinical Course of Untreated Sarcoidosis (스테로이드 치료를 받지 않은 유육종증 환자의 임상경과)

  • Koh, Young-Min;Chung, Kyeong-Jae;Park, Sang-Joon;Kang, Kyeong-Woo;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.807-816
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    • 1999
  • Background: Sarcoidosis, uncommon in Korea, has variable clinical course, ranging from benign self-limited recovery to life-long disability regardless of corticosteroid therapy. The purpose of this study is to observe the clinical course of untreated sarcoidosis. Methods: Twenty four patients who were confirmed as sarcoidosis by tissue diagnosis were included. For average 12month follow-up periods, subjective symptoms, radiologic findings, and parameters of pulmonary function test(FVC, $FEV_1$, DLco) were evaluated every 3mooths compared between corticosteroid treated(n=5) and non-treated(n=19) patients. 'Deterioration' was defined if patients met more than one of followings (1) decrement in any parameters of pulmonary function test(2) worsening in the degree of dyspnea(3) increase in radiologic extents, and (4) newly developed extrapulmonary sarcoidosis. 'Stable' was defined as no significant interval changes in every parameters. 'Improvement' was defined as decrement of extension of the radiologic lesions without deterioration. Results: Among 19 untreated sarcoidosis patient, one deteriorated, 14 improved(13 of them showed complete resolution in radiology), and 4 were remained stable. On the other hand, five corticosteroid treated patients, uveitis was developed in one, 2 improved, and 2 remained stable. Conclusion : These findings suggest that patient with sarcoidosis, especially those without serious extrapulmonary disease, has stable clinical course and would not need corticosteroid therapy.

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The Recognition and Utilization of Middle School Technology.Home Economics Teacher's Guidebook (중학교 "기술.가정" 교과 교사용 지도서에 대한 가정 교사의 인식 및 활용)

  • Kang, Eun-Yeong;Shin, Hye-Won
    • Journal of Korean Home Economics Education Association
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    • v.19 no.2
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    • pp.1-12
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    • 2007
  • This study analyzed the recognition and utilization regarding teacher's guidebook for middle school technology-home economics class in the 7th Educational Curriculum. The data were collected via e-mail to teachers teaching home economics in middle schools. These e-mail addresses were acquired from middle school web pages registered on the Educational Board. The 355 data were analyzed using the SPSS program. The results were as follows: First, teachers recognized highly the necessity of teacher's guidebook. However, as the actual guidebook was not adequately helpful, the overall degree of satisfaction was relatively low. Teachers utilizing guidebook had more positive recognition on teacher's guidebook than teachers who did not. And teachers majored in technology education thought teacher's guidebook more helpful compared with teachers majored in home economics education. Second, teachers referenced teacher's guidebook mostly for field practice guidance. Third, teachers who did not utilize teacher's guidebook used other reference materials such as Internet Web sites and audiovisual materials. They were most commonly used for the reason that the contents were ample and easy to access. Fourth, the followings were suggested to improve teacher's guidebook. The provision of learning contents that can be practically used in class, the various samples of teaching-learning method, the specified methods of planning and criteria for performance assessment, the adequate supplementations regarding textbook contents, and the improvement of the outward layout format of the guidebook.

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Needs analysis for development of training program for newly appointed Home Economics teachers - Focusing on the participants of first-grade teachers qualification training - (초임기 가정과 교사 직무연수 프로그램 개발에 대한 요구 분석 - 1급 정교사 가정 자격연수 대상자 중심으로 -)

  • Lee, Hyunjung
    • Journal of Korean Home Economics Education Association
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    • v.30 no.1
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    • pp.15-28
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    • 2018
  • Teachers are not completed by appointment, but gradually made through self-development and training for a long time. In order to improve a sense of responsibility of home economics teachers, and also to suggest the purpose and direction of program through job training, the needs of training subjects should be preferentially understood. Thus, this study aims to provide basic data for establishing the developmental operation measures of training for home economics teachers, by researching the needs for training performed after the qualification training for first-grade teachers, targeting the teachers participating in the qualification training program for first-grade teachers of home economics in 2017. About the half of the research subjects received the home economics training one time or less for last three years. Through the training for first-grade teachers, the technical improvement of lesson instruction was demanded the most. As professional qualifications that should be cultivated through training, the ability to develop teaching methods and teaching/learning materials was the highest. Regarding the theme of training, the development of teaching/learning materials for home economics was desired the most. They wanted the training method including direct participation with high utilization for lesson, sublation of competition-centered evaluation, preference of instructors with field experience, continuous opportunity of home economics training, and communicative training. Regarding the needs for the 2015 revised curriculum, the demand for the training of 'human development and family' area was the highest. Therefore, in order to improve the professionalism of teachers through home economics training, it would be necessary to improve the educational environment such as temporal room for training and administrative support, and also to provide diverse types of training like group training, remote training, and smartphone app training suitable for changes in the generation of teachers. Also, on top of forming communities of home economics teachers, and sharing great contents of training, there should be individually-customized training for practice and sharing lesson cases.

"Healthy Japan 21" - A new Perspective on Health Promotion Policy for Japan in the 21st century - (건강한 일본 21 - 21세기 일본의 건강 증진 정책에 대한 새로운 전망 -)

  • Hasegawa, Toshihiko
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.59-88
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    • 2004
  • ' Healthy Japan 21 ' is a new health policy that has been proposed for the 21st century: it embodies a totally new concept for its viewpoints and methods. To start with, for its goal, the focus is placed on the ' quality of life ' or a life that is tree of diseases, rather than mere prolongation of life. For its doctrine, the emphasis has shifted dramatically from improving the health of the entire population (the traditional approach for health improvement) to ' achieving an ideal health status for each individual. The ultimate aged society that arrives first in Japan is a society in its ultimate form for human being. Why did Japan become westernized, giving up her traditional culture? Why did she go through industrialization, sacrificing her nature? And why does she try so hard to industrialize the developing countries? These efforts are all preparation for the arrival of a ultimate aged society. During the 20th century, we believed in unlimited possibilities and expanded our social frontier. 1n the 21st century, on the other hand, a super-aged society (the ultimate society), a glimpse of which we have witnessed from time to time, will descend on us sooner or later. It is expected to arrive first in Japan. ' Healthy Japan 21 ' is intended to prepare for the arrival of the hitherto unheard of super-aged society by building the physiological basis of people. This policy is social experimentation on an immense social scale, in which questions are posed on the understanding of health, the relationship between individuals and society, the relationship between administration and citizens, the manner by which central and local governments operate, and the new relationship between prevention and therapy. ' Healthy Japan 21 ' may be summarized as an experiment on a huge scale directed to the ultimate form of human society, in which Japan and each of her citizens playa role and set an example for the rest of the world. Even just by considering various approaches newly suggested for this venture, one may be convinced that it is a policy with features suitable for a country that has already achieved the world's highest longevity.

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A Study on Forecasting Accuracy Improvement of Case Based Reasoning Approach Using Fuzzy Relation (퍼지 관계를 활용한 사례기반추론 예측 정확성 향상에 관한 연구)

  • Lee, In-Ho;Shin, Kyung-Shik
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.67-84
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    • 2010
  • In terms of business, forecasting is a work of what is expected to happen in the future to make managerial decisions and plans. Therefore, the accurate forecasting is very important for major managerial decision making and is the basis for making various strategies of business. But it is very difficult to make an unbiased and consistent estimate because of uncertainty and complexity in the future business environment. That is why we should use scientific forecasting model to support business decision making, and make an effort to minimize the model's forecasting error which is difference between observation and estimator. Nevertheless, minimizing the error is not an easy task. Case-based reasoning is a problem solving method that utilizes the past similar case to solve the current problem. To build the successful case-based reasoning models, retrieving the case not only the most similar case but also the most relevant case is very important. To retrieve the similar and relevant case from past cases, the measurement of similarities between cases is an important key factor. Especially, if the cases contain symbolic data, it is more difficult to measure the distances. The purpose of this study is to improve the forecasting accuracy of case-based reasoning approach using fuzzy relation and composition. Especially, two methods are adopted to measure the similarity between cases containing symbolic data. One is to deduct the similarity matrix following binary logic(the judgment of sameness between two symbolic data), the other is to deduct the similarity matrix following fuzzy relation and composition. This study is conducted in the following order; data gathering and preprocessing, model building and analysis, validation analysis, conclusion. First, in the progress of data gathering and preprocessing we collect data set including categorical dependent variables. Also, the data set gathered is cross-section data and independent variables of the data set include several qualitative variables expressed symbolic data. The research data consists of many financial ratios and the corresponding bond ratings of Korean companies. The ratings we employ in this study cover all bonds rated by one of the bond rating agencies in Korea. Our total sample includes 1,816 companies whose commercial papers have been rated in the period 1997~2000. Credit grades are defined as outputs and classified into 5 rating categories(A1, A2, A3, B, C) according to credit levels. Second, in the progress of model building and analysis we deduct the similarity matrix following binary logic and fuzzy composition to measure the similarity between cases containing symbolic data. In this process, the used types of fuzzy composition are max-min, max-product, max-average. And then, the analysis is carried out by case-based reasoning approach with the deducted similarity matrix. Third, in the progress of validation analysis we verify the validation of model through McNemar test based on hit ratio. Finally, we draw a conclusion from the study. As a result, the similarity measuring method using fuzzy relation and composition shows good forecasting performance compared to the similarity measuring method using binary logic for similarity measurement between two symbolic data. But the results of the analysis are not statistically significant in forecasting performance among the types of fuzzy composition. The contributions of this study are as follows. We propose another methodology that fuzzy relation and fuzzy composition could be applied for the similarity measurement between two symbolic data. That is the most important factor to build case-based reasoning model.

Time Resolution Improvement of MRI Temperature Monitoring Using Keyhole Method (Keyhole 방법을 이용한 MR 온도감시영상의 시간해상도 향상기법)

  • Han, Yong-Hee;Kim, Tae-Hyung;Chun, Song-I;Kim, Dong-Hyeuk;Lee, Kwang-Sig;Eun, Choong-Ki;Jun, Jae-Ryang;Mun, Chi-Woong
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.1
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    • pp.31-39
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    • 2009
  • Purpose : This study proposes the keyhole method in order to improve the time resolution of the proton resonance frequency(PRF) MR temperature monitoring technique. The values of Root Mean Square (RMS) error of measured temperature value and Signal-to-Noise Ratio(SNR) obtained from the keyhole and full phase encoded temperature images were compared. Materials and Methods : The PRF method combined with GRE sequence was used to get MR temperature images using a clinical 1.5T MR scanner. It was conducted on the tissue-mimic 2% agarose gel phantom and swine's hock tissue. A MR compatible coaxial slot antenna driven by microwave power generator at 2.45GHz was used to heat the object in the magnetic bore for 5 minutes followed by a sequential acquisition of MR raw data during 10 minutes of cooling period. The acquired raw data were transferred to PC after then the keyhole images were reconstructed by taking the central part of K-space data with 128, 64, 32 and 16 phase encoding lines while the remaining peripheral parts were taken from the 1st reference raw data. The RMS errors were compared with the 256 full encoded self-reference temperature image while the SNR values were compared with the zero filling images. Results : As phase encoding number at the center part on the keyhole temperature images decreased to 128, 64, 32 and 16, the RMS errors of the measured temperature increased to 0.538, 0.712, 0.768 and 0.845$^{\circ}C$, meanwhile SNR values were maintained as the phase encoding number of keyhole part is reduced. Conclusion : This study shows that the keyhole technique is successfully applied to temperature monitoring procedure to increases the temporal resolution by standardizing the matrix size, thus maintained the SNR values. In future, it is expected to implement the MR real time thermal imaging using keyhole method which is able to reduce the scan time with minimal thermal variations.

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A Meta-Analysis of Korean Literatures about Sick Role Behavior of Pulmonary Tuberculosis Patients applied Health Belief Model (건강신념모형을 적용한 폐결핵 환자의 환자역할행태 연구에 대한 메타분석)

  • Kim, Chun-Bae;Jo, Heui-Sug;Rhee, Jung-Ae
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.1-13
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    • 2003
  • Objectives: The purpose of this study is to summarize results from 11 domestic studies about sick role behavior applied health belief model and to assess the effectiveness of components on behavior change by using meta-analysis. Methods: We collected the existing literatures by using major web search of 'pulmonary tuberculosis patients', 'health belief model', and 'sick role behavior' as key words and by reviewing content of journals. Quantitative meta-analysis was performed by SAS program. Results: Among 66 articles, 11 studies were selected for quantitative meta-analysis. The knowledge level about pulmonary tuberculosis had more effect for only sick role behavior as general characterisitcs(d=0.7870). All the components of health belief model produced significant effects on sick role behavior with the magnitude of effect size from 0.31 to 0.73. The largest effects were benefits on actions of sick role behavior. Conclusions: Overall, these investigation provide very substantial empirical evidence supporting health belief model dimensions as important contributors to the explanation and prediction of sick role behavior among the type of health related behavior in pulmonary tuberculosis patients. Strategic intervention including health education, etc. based on health belief model showed clear advantage in improvement of behavioral change.

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A Legal Study on Safety Management System (항공안전관리에 관한 법적 고찰)

  • So, Jae-Seon;Lee, Chang-Kyu
    • The Korean Journal of Air & Space Law and Policy
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    • v.29 no.1
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    • pp.3-32
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    • 2014
  • Safety Management System is the aviation industry policy for while operating the aircraft, to ensure the safety crew, aircraft and passengers. For operating a safe aircraft, in order to establish the international technical standards, the International Civil Aviation Organization has established the Annex 19 of the Convention on International Civil Aviation. As a result, member country was supposed to be in accordance with the policy of the International Civil Aviation Organization, to accept the international standard of domestic air law. The South Korean government announced that it would promote active safety management strategy in primary aviation policy master plan of 2012. And, by integrating and state safety programmes(ssp) and safety management system(sms) for the safe management of Annex 19 is to enforce the policy on aviation safety standards. State safety programmes(ssp) is a system of activities for the aim of strengthening the safety and integrated management of the activities of government. State safety programmes(ssp) is important on the basis of the data of the risk information. Collecting aviation hazard information is necessary for efficient operation of the state safety programmes(ssp) Korean government must implement the strategy required to comply with aviation methods and standards of the International Civil Aviation Organization. Airlines, must strive to safety features for safety culture construction and improvement of safety management is realized. It is necessary to make regulations on the basis of the aviation practice, for aviation safety regulatory requirements, aviation safety should reflect the opinion of the aviation industry.

Differences in Thrombolytic Effects in Accordance with Dosing-regimens of Tissue-type Plasminogen Activator in Experimental Pulmonary Embolism (실험적 폐색전증에서 조직형플라스미노겐활성체의 투여방법에 따른 혈전용해효과의 차이)

  • Chung, Hee-Soon;Kim, Ho-Jung;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.123-134
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    • 1993
  • Background: Tissue-type plasminogen activator is a physiologic activator, which has high affinity for fibrin and is activated by fibrin. Because of these properties, t-PA has the potential to induce effective thrombolysis without producing a systemic lytic state. In practice, however, therapeutically efficacious doses of t-PA has been associated with the development of a systemic lytic state. As experience with t-PA has accumulated, it has suggested that the fibrin selectivity is influenced by the dose and duration of t-PA infusion, and many studies have performed in an attempt to optimize the duration of t-PA regimen. Methods: This study was designed to assess the thrombolytic efficacy of t-PA and the differences of two dosing regimens of t-PA (infusion of 1 mg/kg t-PA over 15 or 180 minutes) in a canine model of pulmonary embolism, induced by injection of radioactive autologous blood clots. By continuously counting over both lung fields with a external gamma counter, we correlated rate and extent of pulmonary thrombolysis with corresponding pulmonary hemodynamics in addition to the gas analyses of arterial and mixed venous blood. Results: 1) While total clot lysis was similar ($36.2{\pm}3.3%$ and $39.6{\pm}2.3%$ respectively, p>0.05) when t-PA was infused over 15 or 180 minutes, the rate of lysis during infusion was markedly increased with the shorter infusion ($81.4{\pm}16.8%/hr$ vs $37.3{\pm}2.4%/hr$, p<0.05). 2) The duration of thrombolysis was $63.3{\pm}22.2$ minutes although t-PA was administered over 15 minutes, and it was only $148.5{\pm}14.0$ minutes in case of the infusion over 180 minutes (p<0.05). 3) The increased rate of thrombolysis with the shorter infusion was accompanied by a faster amelioration of cardiopulmonary impairment from pulmonary embolism (p<0.05). Conclusion: It is concluded that the shorter (15 minutes) infusion of t-PA is superior to the longer (180 minutes) infusion when the dose is equal, in consideration of the faster improvement in cardiopulmonary impairment from pulmonary embolism.

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