• Title/Summary/Keyword: Managing system

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A Study of community diagnosis activity by Community Health Nurse Working in Health Centers (보건소 보건간호사의 지역사회 진단활동에 관한 조사연구)

  • Cho Won-Jung;Kim Young-Ran
    • Journal of Korean Public Health Nursing
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    • v.6 no.1
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    • pp.32-45
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    • 1992
  • An important role of community health nurses in health centers is to solve community health problems found through data collection methodology which has been used to identify the health needs of the community, diagnose the health problems and to plan health programs suitable for the health problems. Also community health nurses must be prepared to know the community health needs and to participate in the planning process. Since 1956 when the health center law was established, community health nurses have really implemented only the services which the government has asked them to do. This has kept them busy enough. But these days as society is in rapid change, community health nurses should have the flexibility to deal with the social change and demands that are unique to their community each which has different health needs and demands. So community health nurses need to identify what community health problems exist in their particular communities. The purposes of this study were as follows. 1) To explore the suitability of the health programs which the government has asked the community health nurses to do for their own communities and if these programs are not suitable, to explore the reasons why. 2) To explore the degree to which the community health nurses have the ability to identify health problems in their own communities and activate the community diagnostic process. 3) To identify the degree that the community health nurses have the ability to implement plans related to community diagnosis. 4) To find out how much data related to community health problems, the community health nurses have and how they are utilizing it. 5) To measure the community health nurses self-confidence concerning diagnostic activities for community health. The study subjects were 454 Community Health Nurses working in Health Centers in Seoul, Korea. The period of data collection was 6 days(Nov. 9th 1991-Nov. 15th 1991). A questionnaire used for data collection was composed of three different items; general characteristics, community health diagnostic activities and self-confidence in performing diagnostic activities. The results of the study are as follows. First, over one third of the respondents replied that the government required activities for their communities are not appropriate. Of these activities the most frequent reply $(51.2\%)$ indicated that many of the activities in the community were inappropriate to the actual situation. Further, $25\%$ of the replies indicated that many activities were only administratively oriented and as such not appropriate. Second, $49.8\%$ of the respondents replied that they had done general assessments and had a general idea of the health problems of their community. Effective solutions to health problems could be found with an increase in health personnel and management ability according to $41.5\%$ of the respondents. Third, to the question as to whether they had ever independently implemented a plan towards solving community diagnosed problems, $52\%$ of nurses replied 'never', $40\%$ 'occasionally' but only $7.5\%$ replied that they did it frequently. Actually there was very little done even in the basic work of collecting the necessary data. Fourth, when asked how much of basic information they had collected that might be used in community diagnosis activity, of 26 items in 5 areas, there was hardly one for which complete data had been collected. Fifteen percent did have data on the geographical aspects of their area, housing distribution and types of housing, while $17.8\%$ knew the frequency with which the health center was used. Concerning community resources, even with a list of community resources, only $12.3\%$ had data on any of these resources, and this data was incomplete. Further, information about social work institutions, and facilities was also incomplete, only $14.2\%$ of the respondents had any data and even it was incomplete; that is, in general, the nurses did not have this information. Fifth, concerning the confidence of the community health nurse in their ability to carry out community diagnoses activities, $60\%$ replied that they were very or at least nominally confident, indicating that although they were not doing community diagnostic activities they felt they could do so, as they were carrying out home visits and program planning as part of their official duties. The following recommendations are made based on the results of this study. First; since the community health nurses have a high perception of the need for community diagnostic activities and. high confidence in their ability to carry out this activity and high percentage of respondents replied that with a little training they could do this even better it is recommended that community diagnostic activity training be included in the continuing education program for community health nurses. Second, in order for the Community Health Nurses to successfully solve the health problems of their respective community they reported to a need to increase the number of health personnel, improve the facilities and the system of managing their work. Considering this, it is recommended that ways be sought to remedy these deficits.

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Perspective of breaking stagnation of soybean yield under monsoon climate

  • Shiraiwa, Tatsuhiko
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.8-9
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    • 2017
  • Soybean yield has been low and unstable in Japan and other areas in East Asia, despite long history of cultivation. This is contrasting with consistent increase of yield in North and South America. This presentation tries to describe perspective of breaking stagnation of soybean yield in East Asia, considering the factors of the different yields between regions. Large amount of rainfall with occasional dry-spell in the summer is a nature of monsoon climate and as frequently stated excess water is the factor of low and unstable soybean yield. For example, there exists a great deal of field-to-field variation in yield of 'Tanbaguro' soybean, which is reputed for high market value and thus cultivated intensively and this results in low average yield. According to our field survey, a major portion of yield variation occurs in early growth period. Soybean production on drained paddy fields is also vulnerable to drought stress after flowering. An analysis at the above study site demonstrated a substantial field-to-field variation of canopy transpiration activity in the mid-summer, but the variation of pod-set was not as large as that of early growth. As frequently mentioned by the contest winners of good practice farming, avoidance of excess water problem in the early growth period is of greatest importance. A series of technological development took place in Japan in crop management for stable crop establishment and growth, that includes seed-bed preparation with ridge and/or chisel ploughing, adjustment of seed moisture content, seed treatment with mancozeb+metalaxyl and the water table control system, FOEAS. A unique success is seen in the tidal swamp area in South Sumatra with the Saturated Soil Culture (SSC), which is for managing acidity problem of pyrite soils. In 2016, an average yield of $2.4tha^{-1}$ was recorded for a 450 ha area with SSC (Ghulamahdi 2017, personal communication). This is a sort of raised bed culture and thus the moisture condition is kept markedly stable during growth period. For genetic control, too, many attempts are on-going for better emergence and plant growth after emergence under excess water. There seems to exist two aspects of excess water resistance, one related to phytophthora resistance and the other with better growth under excess water. The improvement for the latter is particularly challenging and genomic approach is expected to be effectively utilized. The crop model simulation would estimate/evaluate the impact of environmental and genetic factors. But comprehensive crop models for soybean are mainly for cultivations on upland fields and crop response to excess water is not fully accounted for. A soybean model for production on drained paddy fields under monsoon climate is demanded to coordinate technological development under changing climate. We recently recognized that the yield potential of recent US cultivars is greater than that of Japanese cultivars and this also may be responsible for different yield trends. Cultivar comparisons proved that higher yields are associated with greater biomass production specifically during early seed filling, in which high and well sustained activity of leaf gas exchange is related. In fact, the leaf stomatal conductance is considered to have been improved during last a couple of decades in the USA through selections for high yield in several crop species. It is suspected that priority to product quality of soybean as food crop, especially large seed size in Japan, did not allow efficient improvement of productivity. We also recently found a substantial variation of yielding performance under an environment of Indonesia among divergent cultivars from tropical and temperate regions through in a part biomass productivity. Gas exchange activity again seems to be involved. Unlike in North America where transpiration adjustment is considered necessary to avoid terminal drought, under the monsoon climate with wet summer plants with higher activity of gas exchange than current level might be advantageous. In order to explore higher or better-adjusted canopy function, the methodological development is demanded for canopy-level evaluation of transpiration activity. The stagnation of soybean yield would be broken through controlling variable water environment and breeding efforts to improve the quality-oriented cultivars for stable and high yield.

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Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling (환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서)

  • Park, Jung-Ho;Joe, Hyon;Park, Hyeoun-Ae;Han, Hye-Rah
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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Survey of the Status of Conutry-of-origin Lables and Hygine on the Meat Markets of 4 Regions in Korea (4개 권역 축산물 판매업소의 원산지 표시실태 및 위생상태 표본조사)

  • Nam, Bo-Ra;Nam, Jung-Oak;Park, Jung-Min;Lee, Ra-Mi;Gu, Hyo-Jung;Kim, Myung-Hee;Chang, Un-Jae;Suh, Hyung-Joo;Kim, Jin-Man
    • Food Science of Animal Resources
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    • v.27 no.1
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    • pp.122-126
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    • 2007
  • Expenditure on meat and meat products has been increased in Korea due to the increase of income and the change of diet. From raising farm animals to eating the meat, various hazardous elements can make their ways into the meat and meat products. Recently the issues on food safety and hygiene are drawing a lot of attention, and the current system for managing the safety of foods is still needed to be improved. This survey was aimed to monitor the current situation of country-of-origin labels and hygiene for the meat markets at 4 regions Korea. The survey was performed by collecting samples from whole- sale and retail stores in the nation, which were selling beef. The markets were divided into groups as to territory and the size of the market (Large size, Medium size, and Small size). In terms of size distribution, small butcher shops occupied the highest percentage. On the itemized suitability test of unpacked and packed beef, all the market of 4 regions showed good agreements. However, such labels indicating the methods of cooking and storage were not properly posted on the products. Especially for Ho-nam region, corrections are needed. The results of monitoring sanitation conditions for the butcher shops at 4 regions in Korea showed relatively low suitability. Especially, there were serious lack of knowledge about wearing the sanitation clothing, caps, and shoes. The problem with food safety is so complicated that producer, consumer, food manufacturer, the press, the government, and scholar should solve altogether. It is necessary to educate farmers, food handlers, consumers, etc. and provide them with an accurate information and knowledge.

Effect of Toothbrushing Facilities on PHP index and Oral Health-related Behaviors in Elementary schools (양치시설 여부에 따른 초등학생의 구강환경관리능력 및 구강건강관리 행태 변화)

  • Hwang, Yoon-Suk;Kim, Kwang-Soo;Jung, Jae-Yeon;Yoo, Young-Jae;Kim, Soo-Hwa;Lim, Mi-Hee
    • The Journal of Korean Society for School & Community Health Education
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    • v.14 no.3
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    • pp.27-40
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    • 2013
  • Objectives: This study was conducted at a request for cooperation through an analysis of the effect of toothbrushing facilities at a public health center in Seongdong-gu. Also, with the aim of furnishing basic data to the proposal of a program for improving the ability of school aged children in managing oral cavities and developing a correct toothbrushing habit, the study conducted an investigation of how toothbrushing facilities affect change in the oral environment management ability and behavior of oral health care. Methods: From among elementary schools located in Seongdong-gu, Seoul the study selected A Elementary School where toothbrushing facilities were established and have been operated since 2008, B Elementary School in an adjacent region within the jurisdiction of Seongdong-gu where the demographic environment was similar among schools where toothbrushing facilities were newly established in 2012, and C Elementary School without toothbrushing facilities. Then the study was aimed at first grade students of the schools and an investigation was carried out from April to December 2012. Through a dental checkup, the study evaluated the teeth and periodontal health conditions, and a test of the oral environment management ability was undertaken three times. Regarding change of oral health care behavior, the study carried out a self-recording survey. Results: 1. Concerning decayed and filled tooth(dft) and decayed and filled surface (dfs), A Elementary School where toothbrushing facilities have been established and operated from the past showed a relatively lower decayed, missing, and filled teeth index than B Elementary School where toothbrushing facilities were established in 2012 or C Elementary School without toothbrushing facilities; however, there was no significant difference (p>0.05). For CPI, there was no significant difference by school; however, in looking into the difference between boy students and girl students, Code (0) was discovered higher in boy students whereas Code (1) was shown higher in girl students. 2. In the PHP index test in accordance with the existence of toothbrushing facilities before the installation of toothbrushing facilities, for A Elementary School where toothbrushing facilities have been established and operated from the past, the school recorded 4.28 points whereas B Elementary School where the facilities were established in 2012 recorded 3.51 points. Meanwhile C Elementary School without the facilities posted 4.30 points. Therefore there was a statistically significant difference according to the existence of toothbrushing facilities (p<0.05). 3. In a comparison of teeth health care behavior according to the existence of toothbrushing facilities, the number of answers that the respondent did not brush their teeth after lunch over the past one week was higher in B Elementary School and C Elementary School where there were no toothbrushing facilities. Regarding the average number of brushing after lunch for one week, it was discovered higher in A Elementary School (p<0.01). 4. In change of teeth health care behavior before and after the establishment of toothbrushing facilities, the case of answering that the respondents did not brush their teeth after lunch for one week increased more after establishment than before establishment. Also the average number of teeth brushings after lunch for one week decreased further after the establishment of toothbrushing facilities; however, it did not show a significant difference (p>0.05). One of the reasons that they do not brush their teeth, "the lack of a place", decreased significantly after establishment than before establishment (p<0.05), whereas the answer, "because their friends do not brush their tooth" increased greatly after establishment than before establishment; however, there was no significant difference (p>0.05). 5. In the comparison of the degree of knowledge about dental health according to the existence of toothbrushing facilities, the degree of knowledge about dental health was shown significantly higher in A Elementary School with toothbrushing facilities than in B Elementary School and C Elementary School where there were no toothbrushing facilities (p<0.01). Conclusions: Given the above results, it is difficult to attract change in behavior only with an environmental improvement; therefore, it is deemed necessary to develop an educational program that will help children to make a habit of oral health care not only through a school but also through a related policy and financial support of government organizations as well as the construction of the basis of a systematic and consistent cooperative system with relevant organizations.

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Clinical Study of Acute and Chronic Pain by the Application of Magnetic Resonance Analyser $I_{TM}$ (자기공명분석기를 이용한 통증관리)

  • Park, Wook;Jin, Hee-Cheol;Cho, Myun-Hyun;Yoon, Suk-Jun;Lee, Jin-Seung;Lee, Jeong-Seok;Choi, Surk-Hwan;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.192-198
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    • 1993
  • In 1984, a magnetic resonance spectrometer(magnetic resonance analyser, MRA $I_{TM}$) was developed by Sigrid Lipsett and Ronald J. Weinstock in the USA, Biomedical applications of the spectrometer have been examined by Dr. Hoang Van Duc(pathologist, USC), and Nakamura, et al(Japan). From their theoretical views, the biophysical functions of this machine are to analyse and synthesize a healthy tissue and organ resonance pattern, and to detect and correct an abnormal tissue and organ resonance pattern. All of the above functions are based on Quantum physics. The healthy tissue and organ resonance patterns are predetermined as standard magnetic resonance patterns by digitizing values based on peak resonance emissions(response levels or high pitched echo-sounds amplified via human body). In clinical practice, a counter or neutralizing resonance pattern calculated by the spectrometer can correct a phase-shifted resonance pattern(response levels or low pitched echo-sounds) of a diseased tissue and organ. By administering the counter resonance pattern into the site of pain and trigger point, it is possible to readjust the phase-shifted resonance pattern and then to alleviate pain through regulation of the neurotransmitter function of the nervous system. For assessing clinical effectiveness of pain relief with MRA $I_{TM}$ this study was designed to estimate pain intensity by the patient's subjective verbal rating scale(VRS such as graded to no pain, mild, moderate and severe) before application of it, to evaluate an amount of pain relief as applied the spectrometer by the patients subjective pain relief scale(visual analogue scale, VAS, 0~100%), and then to observe a continuation of pain relief following its application for managing acute and chronic pain in the 102 patients during an 8 months period beginning March, 1993. An application time of the spectrometer ranged from 15 to 30 minutes daily in each patient at or near the site of pain and trigger point when the patient wanted to be treated. The subjects consisted of 54 males and 48 females, with the age distribution between 23~40 years in 29 cases, 41~60 years in 48 cases and 61~76 years in 25 cases respectively(Table 1). The kinds of diagnosis and the main site of pain, the duration of pain before the application, and the frequency of it's application were recorded on the Table 2, 3 and 4. A distinction between acute and chronic pain was defined according to both of the pain intervals lasting within and over 3 months. The results of application of the spectrometer were noted as follows; In 51 cases of acute pain before the application, the pain intensities were rated mild in 10 cases, moderate in 15 cases and severe in 26 cases. The amounts of pain relief were noted as between 30~50% in 9 cases, 51~70% in 13 cases and 71~95% in 29 cases. The continuation of pain relief appeared between 6~24 hours in two cases, 2~5 days in 10 cases, 6~14 days in 4 cases, 15 days in one case, and completely relived of pain in 34 cases(Table 5~7). In 51 cases of chronic pain before the application, the pain intensities were rated mild in 12 cases, moderate in l8 cases and severe in 21 cases. The amounts of pain relief were noted as between 0~50% in 10 cases, 51~70% in 27 cases and 71~90% in 14 cases. The continuation of pain relief appeared to have no effect in two cases. The level of effective duration was between 6~12 hours in two cases, 2~5 days in 11 cases, 6~14 days in 14 cases, 15~60 days in 9 cases and in 13 cases the patient was completely relieved of pain(Table 5~7). There were no complications in the patients except a mild reddening and tingling sensation of skin while applying the spectrometer. Total amounts of pain relief in all of the subjects were accounted as poor and fair in 19(18.6%) cases, good in 40(39.2%) cases and excellent in 43(42.2%) cases. The clinical effectiveness of MRA $I_{TM}$ showed variable distributions from no improvements to complete relief of pain by the patient's assessment. In conclusion, we suggest that MRA $I_{TM}$ may be successful in immediate and continued pain relief but still requires several treatments for continued relief and may be gradually effective in pain relief while being applied repeatedly.

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Appling Nursing Theory to Clinical Practice of Home Health Care (가정간호실무에 적용가능한 이론적틀)

  • Woo, Seon-Hye
    • Journal of Home Health Care Nursing
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    • v.11 no.1
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    • pp.5-13
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    • 2004
  • The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

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Clinical Observational study of Pulmonary Tuberculosis for admitted patients at a National Tuberculosis Hospital - Comparison with the previous results in 1995 - (일개 국립결핵병원에 입원치료를 받은 폐결핵환자의 임상양태에 관한 연구 - 1995년과 2002년 비교연구 -)

  • Park, Seung-Kyu;Lee, In-Hee;Kim, Byoung-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.392-398
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    • 2005
  • Background : The last national tuberculosis survey was carried out in 1995. In 2000, the KTBS(Korean Tuberculosis Surveillance System) replaced a previous national survey. However, the KTBS does not show some of the important epidemiological indexes such as the prevalence of positive tuberculosis or the drug resistance rate. The aim of this study was to compare the clinical features of pulmonary tuberculosis patients admitted to a national tuberculosis hospital in 1995 and 2002. From this study, the authors expect to estimate the trend of the clinical features of tuberculosis in Korea even though it can not represent the Korean tuberculosis situation as a whole. Method : A cross sectional analysis of the clinical features for 331 pulmonary tuberculosis in-patients admitted to the National Masan Tuberculosis Hospital as of Dec. 2002, was carried out and these results were compared with those reported in 1995. Results : In comparison with the data reported in 1995, the mean age was increased by 3.6 years ($44.1{\pm}14.6$ vs $47.7{\pm}16.4$, p<0.01). The number of past tuberculosis history and used anti-tuberculous drugs prior to admission decreased from $2.0{\pm}1.7$ and $6.1{\pm}2.3$ to $1.7{\pm}1.8$ and $4.6{\pm}3.6$(p<0.05, p<0.001), respectively. While the resistance rate for anti-tuberculous drugs was similar (81.0% vs 77.6%), the initial resistance rate(10.5% vs 21.4%) and initial MDR rate(2.4% vs 16.5%) increased significantly(p=0.012, p=0.001, respectively). In 1995, the public health communities were in charge of approximately 65% of newly diagnosed tuberculosis cases, but this reduced to 40.5% in 2002(p<0.001). Conclusion : The existing national TB program (NTP) needs to be revised and strengthened in order to cope with the unfavorably changing situation of the domestic TB problem because the number of TB patients has not decreased and the initial resistance rate has increased greatly. Furthermore, the public and private sectors should cooperate each other to control the TB problem effectively because the private sector is now managing more than half of the TB patients.

A Study on Family Stress and Coping of the Parents of Child who has a Cleft Lip or / and Cleft Palate (구순 및 구개열 환아 부모의 가족 스트레스와 대처에 관한 연구)

  • Roh Nan Lee;Tak Young, Ran
    • Child Health Nursing Research
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    • v.2 no.2
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    • pp.45-57
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    • 1996
  • A serious disease in a family influences the entire family member given the fact that the members closely interact with each other. Especially in terms of pediatric nursing, study on family gains importance as the need to care of families whose children with developmental disabilities and chronic disease This study was done based on The Resiliency Model of Family Adjustment and Adaptation(McCubbin, 1991) is intended to examine the stress of parents whose children suffer from cleft lip or /and cleft palate. It also helps them to cope with the stress and analyze the relationship between the stress and coping This study used Family Inventory of Life Events and Changes (FILE) and Coping Health Inventory for Parents(CHIP) for measuring family stress and coping. The two instruments are revised to fit the social and cultural environment of Korean culture. Data collection was done from April 18, 1996 to May 18, 1996 at 8 University medical centers located in Seoul. Those who answered questionnaires were 84 parents whose children have cleft lip or /and cleft palate. SPSS PC+ was used to analyze the data collotted. Programs used for data analysis were t-test, ANOVA, Pearson correlation coefficient. The study is summarized as follows .1. The average score of family stress is 10.46(percentage of the full score 24.90) and 'finance and business strains'(3.25), and 'intrafamily strains'(2.65) ranked the highest. The average score of family's coping is 1.93, which is close to the answer of' moderately helpful' and they are measured to put their utmost efforts to' intergration and cooperation of family and optimistic definition on the situation'. 2. There is no significant statistical correlation between the family stress and coping. 3. Mothers show more stress than fathers in the parts of 'illness and family care strains' and 'losses'(t〓-2.34, t〓-2.32, p<.05). 4. Fathers show more willingness to cope with the stress than mothers do in the parts of' seeking social support','self-esteem','emotional comfort' 5. Mothers are more stress than fathers in the parts of family stress and its coping with it by usual traits(t〓-2.78, p<.05). Parents with religion are measured to cope more willingly than those who are not 6. Income of a family shows positive correlationship with family coping (r〓.28, p<.05). The study shows that gender difference is significant variable in studying on family stress and coping. Mothers get more stress than fathers, which has much to do with the fact that they are in charge of raising children and keeping houseworks. Accordingly, managing family crisis and its survival can be induced by giving support for the mothers, studying fathers including the rest of the family members and giving nursing care and arbitration ; religious background is also considered to be one of the important factors in family stress , judging from the relationship between family income and family's coping, caring given to suffering children is needed on societal levels. The above considerations bring up the need to have a longitudinal study of children with congenital anomaly including cleft lip or /and cleft palate and their families about family stress and coping. Resiliency programs on family system and their effectiveness and the relationship between the enlarged families with social and cultural values reflecting Korean tradition are also needed to be studied.

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Knowledge Management Strategy of a Franchise Business : The Case of a Paris Baguette Bakery (프랜차이즈 기업의 지식경영 전략 : 파리바게뜨 사례를 중심으로)

  • Cho, Joon-Sang;Kim, Bo-Yong
    • Journal of Distribution Science
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    • v.10 no.6
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    • pp.39-53
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    • 2012
  • It is widely known that knowledge management plays a facilitating role that contributes to upgrading organizational performance. Knowledge management systems (KMS), especially, support the knowledge management process including the sharing, creating, and using of knowledge within a company, and maximize the value of knowledge resources within an organization. Despite this widely held belief, there are few studies that describe how companies actually develop, share, and practice their knowledge. Companies in the domestic small franchise sector, which are in the early stages in terms of knowledge management, need to improve their KMS to manage their franchisees effectively. From this perspective, this study uses a qualitative approach to explore the actual process of knowledge management implementation. This article presents a case study of PB (Paris Baguette) company, which is the first to build a KMS in the franchise industry. The study was able to confirm the following facts through the analysis of target companies. First, the chief executive's support is a critical success factor and this support can increase the participation of organization members. Second, it is important to build a process and culture that actively creates and leverages information in knowledge management activities. The organizational learning culture should be one where the creation, learning, and sharing of new knowledge is developed continuously. Third, a horizontal network organization is needed in order to make relationships within the organization more close-knit. Fourth, in order to connect the diverse processes such as knowledge acquisition, storage, and utilization of knowledge management activities, information technology (IT) capabilities are essential. Indeed, IT can be a powerful tool for improving the quality of work and maximizing the spread and use of knowledge. However, during the construction of an intranet based KMS, research is required to ensure that the most efficient system is implemented. Finally, proper evaluation and compensation are important success factors. In order to develop knowledge workers, an appropriate program of promotion and compensation should be established. Also, building members' confidence in the benefits of knowledge management should be an ongoing activity. The company developed its original KMS to achieve a flexible and proactive organization, and a new KMS to improve organizational and personal capabilities. The PB case shows that there are differences between participants perceptions and actual performance in managing knowledge; that knowledge management is not a matter of formality but a paradigm that assures the sharing of knowledge; and that IT boosts communication skills, thus creating a mutual relationship to enhance the flow of knowledge and information between people. Knowledge management for building organizational capabilities can be successful when considering its focus and ways to increase its acceptance. This study suggests guidelines for major factors that corporate executives of domestic franchises should consider to improve knowledge management and the higher operating activities that can be used.

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