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The Effect of Repeated Education using a Computerized Scoring System for the Proper Use of Inhalation Medicine (흡입제의 올바른 흡입방법 교육 시 전산화 평가프로그램을 이용한 반복교육의 효과)

  • Yu, Sung Ken;Park, Sung Im;Park, So Young;Park, Jung Kyu;Kim, Sung Eun;Kim, Jung Youp;Shin, Kyeong Cheol;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.6
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    • pp.491-496
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    • 2007
  • Background: The best way of delivering drugs for the treatment of asthma and chronic obstructive pulmonary disease (COPD) is via the inhaled route of administration. However, many patients use inhaler devices incorrectly. To augment the proper use of inhalation medicine and to improve knowledge of the disease and compliance, we have developed a "Computerized Respiratory Service Program" and applied the use of this program to educate patients. Methods: Prospectively, this study was performed in 164 patients with asthma or COPD prescribed with inhaled medication. When inhalation medication was first prescribed, education using a drug model was conducted two times and thereafter every month. In addition, education using a drug model was conducted and the ability of the patient to use inhalation medicine properly was evaluated. Results: A total of 164 patients participated in the sessions more than two times and received education. Fifty-seven patients participated in three sesions. After the patients received education one time, the ability of these patients to use an inhaler had an average score of 20.6. After the patients received education two times, the average score was 21.9. After the patients received education three times, the average score was 22.3, a further increase. The compliance of using the inhaler was 70.1% at the second session and increased to 81.8% at the third session. Conclusion: Feedback education using the "Computerized Respiratory Service Program" will increase the ability of the patient to use an inhaler and consistent education can maintain patient compliance with inhaler use.

A Solution for Congestion and Performance Enhancement using Dynamic Packet Bursting in Mobile Ad Hoc Networks (모바일 애드 혹 네트워크에서 패킷 버스팅을 이용한 혼잡 해결 및 성능향상 기법)

  • Kim, Young-Duk;Yang, Yeon-Mo;Lee, Dong-Ha
    • Journal of KIISE:Information Networking
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    • v.35 no.5
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    • pp.409-414
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    • 2008
  • In mobile ad hoc networks, most of on demand routing protocols such as DSR and AODV do not deal with traffic load during the route discovery procedure. To solve the congestion and achieve load balancing, many protocols have been proposed. However, the existing load balancing schemes has only considered avoiding the congested route in the route discovery procedure or finding an alternative route path during a communication session. To mitigate this problem, we have proposed a new scheme which considers the packet bursting mechanism in congested nodes. The proposed packet bursting scheme, which is originally introduced in IEEE 802.11e QoS specification, is to transmit multiple packets right after channel acquisition. Thus, congested nodes can forward buffered packets promptly and minimize bottleneck situation. Each node begins to transmit packets in normal mode whenever its congested status is dissolved. We also propose two threshold values to define exact overloaded status adaptively; one is interface queue length and the other is buffer occupancy time. Through an experimental simulation study, we have compared and contrasted our protocol with normal on demand routing protocols and showed that the proposed scheme is more efficient and effective especially when network traffic is heavily loaded.

The Effectiveness and Side Effects of Conscious Sedation using Chloral hydrate, Hydroxyzine, and Nitrous oxide (Chloral hydrate, hydroxyzine 및 N2O/O2 의식하 진정의 효과와 부작용)

  • Kim, Gyeongmin;Lee, Jaesik;Kim, Hyunjung;Nam, Soonhyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.2
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    • pp.109-119
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    • 2020
  • This retrospective study assessed the effectiveness and side effects of conscious sedation using chloral hydrate, hydroxyzine, and N2O/O2 in the sedation of 149 pediatric patients over 188 sedation sessions, and to identify associated variables. The effectiveness of the sedation was evaluated using the Houpt scale, and was considered effective for scale categories of excellent or good. Effectiveness and side effects were assessed every 15 minutes. The effectiveness decreased and side effects increased over time. The effectiveness of sedation during 60 minutes was 57.4%, and one or more side effects occurred in 18.1% of sessions. Effectiveness of sedation increased with body mass index (BMI). When patients were sedated at the beginning of the procedure, the effectiveness was greater. Side effects increased with patient age. When sedation was divided into two sessions, the number of sedation did not affect the effectiveness or side effects. It can be suggested that sedation should be performed over two separate sessions, as a single prolonged session may lead to reduced effectiveness and increased side effects. To maximize effectiveness and minimize side effects, several variables such as BMI, whether to sedate at the beginning of the procedure and age should be considered thoroughly before sedation.

Effect of rTMS on Motor Sequence Learning and Brain Activation : A Preliminary Study (반복적 경두부 자기자극이 운동학습과 뇌 운동영역 활성화에 미치는 영향 : 예비연구)

  • Park, Ji-Won;Kim, Jong-Man;Kim, Yun-Hee
    • Physical Therapy Korea
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    • v.10 no.3
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    • pp.17-27
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    • 2003
  • Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability beyond the duration of the rTMS trains themselves. Depending on rTMS parameters, a lasting inhibition or facilitation of cortical excitability can be induced. Therefore, rTMS of high or low frequency over motor cortex may change certain aspects of motor learning performance and cortical activation. This study investigated the effect of high and low frequency subthreshold rTMS applied to the motor cortex on motor learning of sequential finger movements and brain activation using functional MRI (fMRI). Three healthy right-handed subjects (mean age 23.3) were enrolled. All subjects were trained with sequences of seven-digit rapid sequential finger movements, 30 minutes per day for 5 consecutive days using their left hand. 10 Hz (high frequency) and 1 Hz (low frequency) trains of rTMS with 80% of resting motor threshold and sham stimulation were applied for each subject during the period of motor learning. rTMS was delivered on the scalp over the right primary motor cortex using a figure-eight shaped coil and a Rapid(R) stimulator with two Booster Modules (Magstim Co. Ltd, UK). Functional MRI (fMRI) was performed on a 3T ISOL Forte scanner before and after training in all subjects (35 slices per one brain volume TR/TE = 3000/30 ms, Flip angle $60^{\circ}$, FOV 220 mm, $64{\times}64$ matrix, slice thickness 4 mm). Response time (RT) and target scores (TS) of sequential finger movements were monitored during the training period and fMRl scanning. All subjects showed decreased RT and increased TS which reflecting learning effects over the training session. The subject who received high frequency rTMS showed better performance in TS and RT than those of the subjects with low frequency or sham stimulation of rTMS. In fMRI, the subject who received high frequency rTMS showed increased activation of primary motor cortex, premotor, and medial cerebellar areas after the motor sequence learning after the training, but the subject with low frequency rTMS showed decreased activation in above areas. High frequency subthreshold rTMS on the motor cortex may facilitate the excitability of motor cortex and improve the performance of motor sequence learning in normal subject.

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Effects of Sensory Integration Therapy on Sensory. Motor Development and Adaptive Behavior of Cerebral Palsy Children (감각통합치료가 뇌성마비 아동의 감각.운동발달 및 적응행동에 미치는 영향)

  • Kwon, Hye-Jeoung
    • Journal of Korean Physical Therapy Science
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    • v.8 no.2
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    • pp.977-987
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    • 2001
  • The purpose of this study was to examine the effects of sensory integration therapy (SIT) on sensory' motor development and adaptive behavior of cerebral palsy children. The design of this study was quasi experiments with a non-equivalent pre- and post-test control design. Subjects of the study were arbitrarily chosen based on predetermined selection criteria among the cerebral palsy children who were treated as out-patients at two rehabilitation hospitals one in Seoul, and the other in Kyunggi-do. The study was conducted between early April and late July in 2000. Fifteen children were in the experimental group and eleven in the control group. The allocation was done based on ease of experimental treatment. A five-step SIT program was devised from a combination of SIT programs suggested by Ayres(1985) and Finks(1989), and an author-designed SIT program for cerebral palsy children. The experimental group was subjected to 20 to 30 minutes of SIT per session. two sessions a week for ten -week period. The effects of SIT were measured with respect to 9 sub-areas that can be administered to cerebral palsy children out of a total of 17 sub-areas in the Southern California Sensory Integration Test (SCSIT) developed by Ayres (1980). In addition. the scale developed by Russell (1993) for Gross Motor Function Measure (GMFM). and Perception Motor Development Test developed by 中司利一 et al.(1987) were also applied. Adaptive behavior was analyzed using guidelines in two unpublished documents - School-Age Checklist for Occupational Therapy by the Wakefield Occupational Therapy Associates, and the OTA-Watertown Clinical Assessment by the Watertown Occupational Therapy Associates-, and an author-developed Adaptive Behavior Checklist. Collected data were statistically analyzed by SPSS PC for chi square test, Mann-Whitney test, Wilcoxon signed rank test, and paired t-test. The results were as follows: 1. In sensory development, the experimental group exhibited a score increase compared to the control group, but the difference was not statistically significant, Although the experimental group showed improvements in all. 9 sub-areas compared to the control group, only right-left discrimination exhibited statistically significant change. 2. In gross motor development, the experimental group showed improvements in score compared to the control group, but it was not statistically significant. In fine motor development, the experimental group exhibited statistically significant improvements compared to the control group. In sub-area analysis, figure synthesis showed positive change. 3. In adaptive behavior development, post-experimental adaptive behavior scores were higher compared to pre-experimental scores with statistical significance. Furthermore, sub-areas emotional behavior, perception behavior, gross-fine motor function, oral-respiration function, motor behavior, motor planning, and adaptive response exhibited higher scores after SIT. In conclusion SIT was found to be partially effective in sensory and fine motor development, effective in all adaptive behavior areas, and not effective in gross motor development. Thus, this study has shown that SIT is an effective intervention for sensory development, fine motor development, and adaptive behavior for cerebral palsy children. But, for the effectiveness of SIT on gross motor development, further studies employing longer-time experiments are recommended.

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The Problems for Application of Nursing Process in Clinical Experience of Nursing Students (임상실습에서 학생들이 경험하는 간호과정 적용문제)

  • Yang Young-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.58-71
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    • 1999
  • Nursing process is an essential part for nursing practice. Nursing faculty members must focus on the clinical application for students and try to identify the possible problems that students might face in the fields. The purpose of this study is to examine the actual condition of nursing process education in curricula and to investigate the response of students in clinical experience of nursing process. From 462 students in the 6 associate programs(ADN) and the 6 baccalaureate programs (BSN) data was collected by questionnaire. The results were as followed. 1. Seven programs (58.3%) opened the nursing process in mainly sophomore (BSN) or freshman(ADN). If not opened, the nursing process was taught at the major subjects(espcially fundamental nursing or adult nursing). 2. All Students responded they we supposed to use nursing process in preparing the case report. The majority(94.6%) used NANDA lists for nursing diagnosis and 55.7% of subjects consulted the Korean terms by KNA when translating. The tutors for nursing process in clinical settings were the professor in charge of the subject (68.6) or clinical instructors (48.1%) , assistants(34%). 3. The problems in clinical application that students experienced consisted of 17 items and the mean was 2.27. The biggest problem was 'the lack of the model for RN of applying the nursing process in clinical settings'(2.97). Next the big problem was 'the lack of the competency for implementing the established nursing plans'(2.69). All items were significantly different according to the level of educational programs(ADN or BSN). ADN students had more problems in applying the each step of nursing process and BSN students perceived the NANDA as a guidance of nursing diagnosis and the inconsistency of advices from several instructors or practicum to be mere problematic. 4. The mean of merits after application of nursing process was relatively fair (2.82). The best merit was 'they can identify nursing problems more exactly'(3.07). The second high merit was 'they can study the rational of nursing action' (3.03). BSN than ADN and the subjects of second year than of one year in clinical experience perceived the use of nursing process to be better. Based on this results we need to enforce the application of nursing diagnosis in the class. The use of sample cases can be the efficient method. Students can identify the possible health problems for patient from the cases in imaginary world and discuss them each other. Also we can use the discussion session after practice every other day or as needed. All this is on the good interaction between tutor and student. We must consider to have enough time for student to seize the essence of the nursing process.

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Entity Authentication Scheme for Secure WEB of Things Applications (안전한 WEB of Things 응용을 위한 개체 인증 기술)

  • Park, Jiye;Kang, Namhi
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38B no.5
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    • pp.394-400
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    • 2013
  • WoT (Web of Things) was proposed to realize intelligent thing to thing communications using WEB standard technology. It is difficult to adapt security protocols suited for existing Internet communications into WoT directly because WoT includes LLN(Low-power, Lossy Network) and resource constrained sensor devices. Recently, IETF standard group propose to use DTLS protocol for supporting security services in WoT environments. However, DTLS protocol is not an efficient solution for supporting end to end security in WoT since it introduces complex handshaking procedures and high communication overheads. We, therefore, divide WoT environment into two areas- one is DTLS enabled area and the other is an area using lightweight security scheme in order to improve them. Then we propose a mutual authentication scheme and a session key distribution scheme for the second area. The proposed system utilizes a smart device as a mobile gateway and WoT proxy. In the proposed authentication scheme, we modify the ISO 9798 standard to reduce both communication overhead and computing time of cryptographic primitives. In addition, our scheme is able to defend against replay attacks, spoofing attacks, select plaintext/ciphertext attacks, and DoS attacks, etc.

A Secure Micro-Payment Protocol based on Credit Card in Wireless Internet (무선인터넷에서 신용카드기반의 안전한 소액 지불 프로토콜)

  • Kim Seok mai;Kim Jang Hwan;Lee Chung sei
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.29 no.12C
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    • pp.1692-1706
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    • 2004
  • Recently, there are rapid development of information and communication and rapid growth of e-business users. Therefore we try to solve security problem on the internet environment which charges from wire internet to wireless internet or wire/wireless internet. Since the wireless mobile environment is limited, researches such as small size, end-to-end and privacy security are performed by many people. Wireless e-business adopts credit card WPP protocol and AIP protocol proposed by ASPeCT. WAP, one of the protocol used by WPP has weakness of leaking out information from WG which conned wire and wireless communication. certification chain based AIP protocol requires a lot of computation time and user IDs are known to others. We propose a Micro-Payment protocol based on credit card. Our protocol use the encryption techniques of the public key with ID to ensure the secret of transaction in the step of session key generation. IDs are generated using ECC based Weil Paring. We also use the certification with hidden electronic sign to transmit the payment result. The proposed protocol solves the privacy protection and Non-repudiation p개blem. We solve not only the safety and efficiency problem but also independent of specific wireless platform. The protocol requires the certification organization attent the certification process of payment. Therefore, other domain provide also receive an efficient and safe service.

Hygiene and Safety Management On/Offline Blended Education Case - Centered on the Eunpyeong-gu Children's Service Center - (위생·안전관리 온·오프라인 블렌디드 교육 사례 - 은평구 어린이급식소 중심으로 -)

  • Kim, Jieun;Kim, Hyeri;Kang, Soonjin;Jung, ByeolYi;Hwang, Hailee;Choi, Yejin;Hwang, Hayan;Kang, Jiwon;Ju, Eunseo;Hwang, Hyeyeong;Byun, Jinyoung;Choi, Jieun;Park, Yujin;Park, Jihyun;Han, Jihoon;Nam, Daewoo;Hong, Wansoo
    • Journal of the FoodService Safety
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    • v.2 no.2
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    • pp.111-115
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    • 2021
  • The purpose of this study is to evaluate the effectiveness of online and offline blended education for hygiene and safety management of children's foodservice operations in Eunpyeong-gu. For the teachers of the children's foodservice operations, two online sessions and one offline session were conducted with different educational themes each time. In terms of satisfaction with the education, the online program 'Mission Possible' scored 4.8 points and the collective education of teachers and staff scored 4.6 points, indicating that the training composition and communication with the person in charge were high. In other field opinions, it was found that online and offline education according to the situation was very helpful in the overall management of the children's foodservice operations. With fewer face-to-face opportunities, there were difficulties in on-site support and management. To supplement this, various programs were applied to help children's foodservice operations provide healthy and safe meals and snacks.

Effects of Aquatic Exercise on Upper Extremity Function and Postural Control During Reaching in Children With Cerebral Palsy

  • Yongjin Jeon;Hye-Seon Jeon;Chunghwi Yi;Ohyun Kwon;Heonseock Cynn;Duckwon Oh
    • Physical Therapy Korea
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    • v.30 no.2
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    • pp.128-135
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    • 2023
  • Background: Despite the fact that aquatic exercise is one of the most popular alternative treatment methods for children with cerebral palsy (CP), there are few research regarding its effectiveness. Objects: The purpose of this study was to examine the effects of aquatic exercise on upper extremity function and postural control during reaching in children with CP. Methods: Ten participants (eight males and two females; 4-10 years; Gross Motor Function Classification System levels II-IV) with spastic diplegia were recruited to this study. The aquatic exercise program consisted of four modified movements that were selected from the Halliwick 10-point program to enhance upper extremity and trunk movements. The participants attended treatment two times a week for 6 weeks, averaging 35 minutes each session. The Box and Block Test (BBT), transferring pennies in the Bruininks-Oseretsky Test (BOT), and pediatric reaching test (PRT) scores were used as clinical measures. Three-dimensional motion analysis system was used to collect and analyze kinematic data. Differences in BBT and BOT values among pre-treatment, post-treatment, and retention (after 3 weeks) were analyzed using a Friedman test. In addition, the PRT scores and variables (movement time, hand velocity, straightness ratio, and number of movement units) from the three-dimensional motion analysis were tested using a Wilcoxon signed-rank test. The significance level was established at p < 0.05. When the results appeared to be statistically significant, a post-hoc test for multiple comparisons was performed with the Wilcoxon signed-rank test. Results: All clinical measures, which included BBT, transferring pennies of BOT, and PRT, were significantly increased between pre-intervention and post-intervention scores and between pre-intervention and retention scores after treatment (p = 0.001). Three-dimensional motion analysis mostly were significantly improved after treatment (p = 0.001). Conclusion: Aquatic exercise may help to improve body function, activity, and participation in children with varying types of physical disabilities.