• 대한영양사협회학술지
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• 제7권3호
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• pp.217-226
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• 2001

It is important to supply adequate nutrition to critically ill patients, whose gastrointestinal system is properly functioning, through the enteral tube feeding if oral intake is impossible. In this study we investigated the changes in nutritional status with enteral tube feeding according to the volume required. We investigated the volume ordered according to the patient's requirements, volume infused according to the volume ordered in 41 enteral tube feeding patients in intensive care unit from Jannuary to July, 2000. Body weight, serum albumin level, and total lymphocyte count were evaluated to assess nutritional status. The mean fasting period was 5 days before the enteral feeding and patients whose fasting period over 3 days were 51%. The mean enteral tube feeding period was 29 days and method of feeding was nasogastric, bolus feeding 6 times per day. The volume ordered was 69.7% of the patients' recommended calorie and volume infused was 86.6% of their volume prescribed. Accordingly, the volume infused was estimated 61.7% of their volume required. Only 44.6% of their reqiured volume was infused within 3 days after enteral tube feeding was started. It took 16 days in average to meet the patients' recommended calorie; 56% of subjects still did not fully met their requirements by the end point. Among the impeding factors in supplying enteral tube feeding, factors related to the number of feeding were high residual volume in stomach, vomiting, gastrointestinal bleeding, abdominal distension and surgery. Factors related to the acctual infused volume were diarrhea, gastrointestinal bleeding, abdominal distension, airway management and tube reinsertion. Significant correlations were shown between the volume infused and changes in both the patients' weight and serum albumin level. Deviding the subjects into two groups by their infused volume, less than 70% and more than that, we compared the two to come up with a significant difference in their serum albumin level, -0.23 vs 0.21, and their body weight, -4.52 vs 0.12. In enteral tube feeding, the volume delivered in sufficient to the pateints' energy requirement can affect their nutriitional status in critically ill patient; adequate nutritional management plan is essential. It is necessary to make every effort to educate clinical staff and to set up a unified management program to prescribe adequate ammount of energy for the patient's nutritional requirement.

• 대한간호학회지
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• 제44권2호
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• pp.219-227
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• 2014

Purpose: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. Methods: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. Results: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. Conclusion: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.

• 농촌계획
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• 제24권1호
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• pp.11-19
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• 2018

The purpose of this study was to analyze the participant's perception of importance and performance of rural tourism network products that are linked with local resources, and propose the implications on the development direction of such products. The focus is on helping rural tourism network products acquire competencies that will help them evolve their business and differentiate themselves. To reach these objectives, a survey was designed through theoretical research on the motive of rural tourism and on agritourism networks. The survey was carried out on visitors to rural communities that produce rural tourism network products from November, 2015, to January, 2016 using 165 copies of a questionnaire after distributing 175 copies. The first quadrant continue and sustain', an area of high importance and high performance, included trial program components, stress reduction, getting away from daily routines, gaining new experiences, comfort, experiencing rural culture, travel expenses, and making memories with family. The second quadrant 'requires intensive improvement', an area of high importance but low performance, included having diverse trial programs, refreshment, experiencing agriculture, and education of children. Therefore, continuous interest is required for the area of 'maintenance' just as it is for activating educational farms in rural communities and a more fundamental improvement in the operation should be made for the area of 'intensive management'.

• Nutrition Research and Practice
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• 제15권1호
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• pp.38-53
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• 2021

BACKGROUND/OBJECTIVES: Abdominal obesity is associated with metabolic disorders, and, in recent years, its prevalence in Korea has continuously increased. The change of lifestyle, particularly diet, is critical for the reduction of abdominal obesity. This study evaluated the effectiveness of an intervention focused on dietary self-efficacy and behaviors on the improvement of abdominal obesity. SUBJECTS/METHODS: Abdominally obese adults with additional cardiovascular risk factors were recruited through 16 medical facilities in South Korea from the year 2013 to 2014. The participants were randomly divided into 2 groups: an intensive intervention group (IG) that received a multi-component intervention to reduce abdominal obesity, by mainly focusing on dietary attitude and dietary behavior change, and a minimal information intervention group (MG) that received a brief explanation of health status and a simple recommendation for a lifestyle change. The interventions were provided for 6 mon, and health examinations were conducted at baseline, 3-, 6-, and 12-mon follow-ups. A path analysis was conducted to identify the process governing the changes in abdominal obesity. RESULTS: The IG showed an improvement in self-efficacy for eating control and diet quality at 6-mon follow-up. Abdominal obesity improved in both groups. Waist circumference was observed to be decreased through the path of "improved self-efficacy for eating control in food availability-eating restriction-improved dietary quality" in IG. Most changes in follow-ups were not significantly different between two groups. CONCLUSIONS: The intensive program targeting the modification of dietary behavior influenced management of abdominal obesity, and the effect occurred through a step-by-step process of change in attitude and behavior. Generally, improvements were also seen in the MG, which supports the necessity of regular health check-ups and brief consultation. The results can be used for further development and implementation of more successful interventions.

• 보건행정학회지
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• 제20권2호
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• pp.128-143
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• 2010

Objectives : This study aims to estimate the oral antihyperglycemic medications adherence among ambulatory care with adult type 2 diabetes patients and to identify factors affecting the medication adherence in Korea. Methods : This study used the Korean National Health Insurance Database. Study population was 40,082 patients who were 20 years of age or older and first diagnosed with type 2 diabetes (ICD-10: E11) in 2004. The patients were followed up for two years in order to measure adherence with oral antihyperglycemic medications. The level of medication adherence was measured by the medication possession ratio (MPR). Results : The average MPR in the study population was 49.5%. The appropriate adherence rate (MPR$\geq$80%) was 29.4% and showed variation according to the characteristics of individual patients. Multiple logistic regression analysis revealed that the odds of appropriate adherence increased with female (OR:1.21, CI:1.14-1.27), older age, increasing ambulatory care visits, health insurance (OR:1.53, CI:1.33-1.76), decreasing ambulatory care providers, using a specialized general hospital as their main attending medical institution (OR:10.08, CI:8.96-11.33), having co-morbidity, using polytherapy (OR:1.07, CI:1.01-1.13). Conclusions : The medications adherence for patient with type 2 diabetes is low in Korea, and shows variation according to the characteristics of patients. For proper management of diabetes, health care policy is expected to be enacted to improve medications adherence continuously. In particular, more intensive management is needed for patients with low medications adherence. Also, health care policy makers need to develop the program to induce health care utilization by a patient to be more concentrated with the same provider.

• 한국직업건강간호학회지
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• 제28권4호
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• pp.262-270
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• 2019

Purpose: This study aims to provide preliminary data for weight management, and prevention and management of cardiovascular and cerebrovascular diseases. We examined the effect of changes in the weight of workers at a manufacturing company over three years on their metabolic syndrome and metabolic syndrome diagnosis components. Methods: Necessary data were collected from the questionnaire and the results of the Korean National Health Screening of 2015 and 2017, which included 228 workers at a manufacturing company in G region. The collected data were analyzed using the SPSS/WIN 23.0 program. ANCOVA was used to examine the differences in the metabolic syndrome diagnosis components according to weight change. In addition, multiple logistic regression analysis was used to obtain the odds ratios of metabolic syndrome and metabolic syndrome analysis component, based on the weight changes in the normal weight group and the obesity group. Results: Waist measure, systolic blood pressure, and blood pressure were found to have significant effects based on participants' weight change over three years. These factors increased with a larger increase in weight at a statistically significant level. This study analyzed the weight changes of the normal weight group and the obesity group considering the data from the National Health Screening of 2015, and found that the risk of metabolic syndrome increased at a statistically significant level as body weight increased; thus, the obesity group showed a higher risk in this regard. It was also found that waist measure, fasting blood sugar, and high-density low cholesterol increased at a statistically significant level as body weight increased. Conclusion: Health administrators need to recognize the importance of workers' weight management, select an intensive management group based on a time series analysis of weight changes, and develop and implement programs to manage the metabolic syndrome diagnosis components.

• 한국컴퓨터정보학회논문지
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• 제14권9호
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• pp.75-84
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• 2009

본 논문에서는 EPC Network의 응용 기술 분야에서 가장 중요한 기술로 연구되고 주목받고 있는 RFID를 활용하여 특수질병 감염환자를 효율적으로 관리할 수 있는 U-MAS (U-Medical Administrative Services)시스템을 설계하였다. U-MAS시스템은 질병관리본부에서 질병의 유형에 따라 감염환자들을 격리 수용과 치료, 회복, 퇴원, 격리병동 이탈 등을 집중 관리할 수 있도록 효율성을 증대시킬 수 있으며, 수작업과 단순한 컴퓨터 프로그램을 이용하는 현 수준의 질적 향상을 높이기 위해 RFID 태그를 이용하여 환자의 관리를 좀 더 면밀하고, 격리병동을 벗어나게 될 경우 관할 질병관리지역구에서 보다 빠르게 위치추적 등의 대응을 원활히 할 수 있도록 기여하는데 목적이 있다. 먼저, EPC 네트워크의 관련 기술과 모바일 RFID 시스템에 대한 관련 연구를 기술하고, U-MAS 시스템 설계를 제안한다. 제안된 U-MAS 시스템을 활용할 경우 전염성 질병환자에 대한 모니터링과 격리병동에 있는 환자가 무단으로 이탈하였을 때 위치추적에 소요되는 시간을 단축시키는 질병관리업무의 효율성을 개선할 수 있는 기대 효과를 제시하였다.

• 한국환경생태학회지
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• 제25권4호
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• pp.614-620
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• 2011

본 연구는 내장산국립공원 탐방객 281명을 대상으로 설문조사를 실시하여 탐방 후 평가를 통하여 만족도, 만족요인 과 예측모형을 분석하여 실질적인 공원관리의 기초자료를 제공하는데 그 목적이 있다. 만족도 분석결과 내장산사무소는 공공시설부족 및 불만, 이용프로그램부족, 숙박시설 부족 및 불만, 시설이용료부담감, 바가지요금 등, 백암사무소는 시설이용료부담감, 이용프로그램, 상업시설 불만 및 부족, 숙박시설 등에 불만족하였다. 만족요인으로는 '시설관리', '이용자관리' 요인이 내장산사무소(34.3%)와 백암사무소(45.6%)에서 가장 큰 영향을 미쳤으며, 만족도 예측모형에 있어서 내장산사무소는 '탐방로훼손', '상업시설만족도', '쓰레기처리', 백암사무소는 '문화역사자원훼손', '상업시설만족도', '호객행위방지' 등의 순으로 만족도에 영향을 미치는 예측모형이 만들어졌다. 지리적으로 유사한 위치에 있으며 자원과 특성이 비슷하여 큰 차이를 보이지 않았으며 탐방객의 75%가 집중하는 가을단풍기에 시설 및 이용자를 위한 관리기법이 필요한 것으로 나타났다.

• 한국경영과학회지
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• 제17권1호
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• pp.117-117
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• 1992

Pubilc utility industries including the electric utility industry are facing a new stream of privatization com-petition with the private sector and deregulation. The necewssity to solve now and in the future power supply and demand problems has been increasing through the sophisticated generation expansion plan(GEP) approach con-sidering not only KEPCo's supply-side resources but also outside resources such as non-utility generation(NUG) demand-side management (DSM). Under the environmental situation in the current electric utility industry a new approach is needed to acquire multiple resources competitively. This study presents the development of a modified electric generation expansion analysis system(EGEAS) model with avoided cost based on the existing EGEAS model which is a dynamic program to develope an optimal generation expansion plan for the electric utility. We are trying to find optimal GEP in Korea's case using our modified model and observe the difference for the level of reliabilities such as the reserve margin(RM) loss of load probability(LOLP) and expected unserved energy percent(EUEP) between the existing EGEAS model and our model. In addition we are trying to calculate avoided cost for NUG resources which is a criterion to evaluate herem and test possibility of connection calculation of avoided cost with GEP implementation using our modified model. The results of our case study are as follows. First we were able to find that the generation expansion plan and reliability measures were largely influenced by capacity size and loading status of NUG resources, Second we were able to find that avoided cost which are criteria to evaluate NUG resources could be calculated by using our modified EGEAS model with avoided cost. We also note that avoided costs were calculated by our model in connection with generation expansion plans.

• 한국환경복원기술학회지
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• 제9권5호
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• pp.50-59
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• 2006

This study was initiated to investigate soil chemical properties under different soil systems. Data such as soil acidity(pH), electrical conductivity(EC), organic matter content(OMC), and cation exchange capacity(CEC) were analyzed with samples from multi-layer, USGA, and mono-layer systems. N, P, K and micronutrients were also measured. Multi-layer system was built up to 60-cm depth with rootzone layer, intermediate layer and two drainage layers. USGA system 45 centimeters deep was constructed with rootzone layer, intermediate layer and drainage layer. Mono-layer system, however, was made only with a 30-cm rootzone layer. Differences were observed in soil pH, EC, OMC, CEC and micronutrients. Soil pH was acceptable for turfgrass growth a year after establishment, being 5.5 to 6.5 in the study. Differences were greatly observed for EC among soil systems. Values of EC for multi-layer, USGA, and mono-layer systems were 39.79, 31.26 and 103.54 uS/em, respectively. The increase rate was approximately 4 to 8 times greater with mono-layer system than those with other two systems. Therefore, it was necessary to avoid micronutrient deficiency such as Fe, Mn etc. through an effective management program in mono-layer system because of its faster potential feasibility of salt accumulation. The greatest OMC was associated with USGA system, being 0.97% which was 11% over that of the other systems. Slight differences were observed for CEC among them. Mono-layer system produced 1.45 me/100g, 10.3% and 8.9% lower in CEC than those of multi-layer and USGA system, respectively. Micronutrients such as Fe, Zn, and Mn etc. were below the level required for turf growth, regardless of soil systems. It was considered that one year after turf establishment was not enough to build up micronutrients in sand-based soil systems to the normal level for a turf growth. These results demonstrate that intensive management program including grow-in concept fertilization should be integrated into sand-based soil systems, even after a year in establishment. Regular nutrient monitoring by soil analyses is a strong necessity to decide the kinds and amount of fertilizer. Also, strategic management program must be selectively employed according to sports turf soil systems.