Kim, Hyang;Kim, Sun Hui;Byun, Hyung Suck;Choi, Young Youn
Clinical and Experimental Pediatrics
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v.48
no.9
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pp.953-959
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2005
Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.
In this paper, the resource adequacy as well as the optimum fuel mix is obtained by the following procedures. First, the regulation body, the government agency, determine the reliability index as well as the optimum portfolio of the fuel mix during the planning horizon. Here, the resources with the characteristics of public goods such as demand-side management, renewable resources are assigned in advance. Also, the optimum portfolio is determined by reflecting the economics, environmental characteristics, public acceptance, regional supply and demand, etc. Second, the government announces the required amount of each fuel-type new resources during the planning horizon and the market participants bid to the government based on their own estimated fixed cost. Here, the government announces the winners of the each auction by plant type and the guaranteed fixed cost is determined by the marginal auction price by plant type. Third, the energy market is run and the surplus of each plant except their cost (guaranteed fixed cost and operating cost) is withdrew by the regulatory body. Here, to induce the generators to reduce their operating cost some incentives for each generator is given based on their performance. The performance is determined by the mechanism of the performance-based regulation (PBR). Here the free-riding performance should be subtracted to guarantee the transparent competition. Although the suggested mechanism looks like very regulated one, it provides two mechanism of the competition. That is, one is in the resource construction auction and the other is in the energy spot market. Also the advantages of the proposed method are it guarantee the proper resource adequacy as well as the desired fuel mix. However, this mechanism should be sustained during the transient period of the deregulation only. Therefore, generation resource planning procedure and market mechanisms are suggested to minimize possible stranded costs.
A review was undertaken to obtain information on the range of beak-trimming methods available or under development. Beak-trimming of commercial layer replacement pullets is a common yet critical management tool that can affect the performance for the life of the flock. The most obvious advantage of beak-trimming is a reduction in cannibalism although the extent of the reduction in cannibalism depends on the strain, season, and type of housing, flock health and other factors. Beak-trimming also improves feed conversion by reducing food wastage. A further advantage of beak-trimming is a reduction in the chronic stress associated with dominance interactions in the flock. Beak-trimming of birds at 7-10 days is favoured by Industry but research over last 10 years has shown that beak-trimming at day-old causes the least stress on birds and efforts are needed to encourage Industry to adopt the practice of beak-trimming birds at day-old. Proper beak-trimming can result in greatly improved layer performance but improper beak-trimming can ruin an other wise good flock of hens. Re-trimming is practiced in most flocks, although there are some flocks that only need one trimming. Given the continuing welfare scrutiny of using a hot blade to cut the beak, attempts have been made to develop more welfare friendly methods of beak-trimming. Despite the developments in design of hot blade beak-trimmers the process has remained largely unchanged. That is, a red-hot blade cuts and cauterises the beak. The variables in the process are blade temperature, cauterisation time, operator ability, severity of trimming, age of trimming, strain of bird and beak length. This method of beak-trimming is still overwhelmingly favoured in Industry and there appears to be no other alternative procedures that are more effective. Sharp secateurs have been used trim the upper beak of both layers and turkeys. Bleeding from the upper mandible ceases shortly after the operation, and despite the regrowth of the beak a reduction of cannibalism has been reported. Very few differences have been noted between behaviour and production of the hot blade and cold blade cut chickens. This method has not been used on a large scale in Industry. There are anecdotal reports of cannibalism outbreaks in birds with regrown beaks. A robotic beak-trimming machine was developed in France, which permitted simultaneous, automated beak-trimming and vaccination of day-old chicks of up to 4,500 chickens per hour. Use of the machine was not successful because if the chicks were not loaded correctly they could drop off the line, receive excessive beak-trimming or very light trimming. Robotic beak-trimming was not effective if there was a variation in the weight or size of chickens. Capsaicin can cause degeneration of sensory nerves in mammals and decreases the rate of beak regrowth by its action on the sensory nerves. Capsaicin is a cheap, non-toxic substance that can be readily applied at the time of less severe beak-trimming. It suffers the disadvantage of causing an extreme burning sensation in operators who come in contact with the substance during its application to the bird. Methods of applying the substance to minimise the risk to operators of coming in contact with capsaicin need to be explored. A method was reported which cuts the beaks with a laser beam in day-old chickens. No details were provided on the type of laser used, or the severity of beak-trimming, but by 16 weeks the beaks of laser trimmed birds resembled the untrimmed beaks, but without the bill tip. Feather pecking and cannibalism during the laying period were highest among the laser trimmed hens. Currently laser machines are available that are transportable and research to investigate the effectiveness of beak-trimming using ablasive and coagulative lasers used in human medicine should be explored. Liquid nitrogen was used to declaw emu toes but was not effective. There was regrowth of the claws and the time and cost involved in the procedure limit the potential of using this process to beak-trim birds.
As experiential education services are growing, the need for proper management is increasing. Considering that adequate measures are an essential factor for achieving success in managing something, it is important for managers to use a proper system of metrics to measure the performance of experiential education services. However, in spite of this need, little research has been done to develop a valid and reliable set of metrics for assessing the quality of experiential education services. The current study aims to develop a multi-item instrument for assessing the service quality of experiential education. The specific procedure is as follows. First, we generated a pool of possible metrics based on diverse literature on service quality. We elicited possiblemetric items not only from general service quality metrics such as SERVQUAL and SERVPERF but also from educational service quality metrics such as HEdPERF and PESPERF. Second, specialist teachers in the experiential education area screened the initial metrics to boost face validity. Third, we proceeded with multiple rounds of empirical validation of those metrics. Based on this processes, we refined the metrics to determine the final metrics to be used. Fourth, we examined predictive validity by checking the well-established positive relationship between each dimension of metrics and customer satisfaction. In sum, starting with the initial pool of scale items elicited from the previous literature and purifying them empirically through the surveying method, we developed a four-dimensional systemized scale to measure the superiority of experiential education and named it "Experiential Education PERFormance" (EEPERF). Our findings indicate that students (consumers) perceive the superiority of the experiential education (EE) service in the following four dimensions: EE-empathy, EE-reliability, EE-outcome, and EE-landscape. EE-empathy is a judgment in response to the question, "How empathetically does the experiential educational service provider interact with me?" Principal measures are "How well does the service provider understand my needs?," and "How well does the service provider listen to my voice?" Next, EE-reliability is a judgment in response to the question, "How reliably does the experiential educational service provider interact with me?" Major measures are "How reliable is the schedule here?," and "How credible is the service provider?" EE-outcome is a judgmentin response to the question, "What results could I get from this experiential educational service encounter?" Representative measures are "How good is the information that I will acquire form this service encounter?," and "How useful is this service encounter in helping me develop creativity?" Finally, EE-landscape is a judgment about the physical environment. Essential measures are "How convenient is the access to the service encounter?,"and "How well managed are the facilities?" We showed the reliability and validity of the system of metrics. All four dimensions influence customer satisfaction significantly. Practitioners may use the results in planning experiential educational service programs and evaluating each service encounter. The current study isexpected to act as a stepping-stone for future scale improvement. In this case, researchers may use the experience quality paradigm that has recently arisen.
Journal of Korean Society of Environmental Engineers
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v.36
no.12
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pp.803-812
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2014
This study assesses the strategy and performance of Eco-industrial Park (EIP) initiative implemented by Korea Industrial Complex Corporation (KICOX) with the support of Ministry of Trade, Industry and Energy (MOTIE), Korea since 2005 to 2013 and recommends future directions. After the concept of EIP based on industrial symbiosis (IS) is introduced, the background and implementation procedure of the EIP initiative are described. Then, economic and environmental achievement was assessed. During the project periods (2005-2013), 449 industrial symbiosis project were explored, among which 296 projects have been implemented. Among (Of these 296 projects,) them, 244 projects have been completed in which 118 projects have been commercialized which shows 48% commercialization rate of the completed projects. Through these commercialized projects, around 311.1 billion won/year of economic benefits and reduction of waste by-products of 828,113 tons/year, wastewater of 215,517 tons/year, reduction in energy consumption of 250,475 toe/year and GHG emission reduction of 1,107,189 $tCO_2/year$ were achieved. This results confirmed that EIP initiative based on industrial symbiosis can enhance eco-efficiency of industrial parks and harmonize economy and environment. However, there are obstacles like absence of interagency coordination and cooperation, laws and institutional barriers, increased demand for local governments, funding for project investment. Thus, to utilize EIP initiative as a strategic tool for competiveness and environmental management of industrial parks, it needs intergovernmental collaboration and interdisciplinary approach to lower barrier in implementation.
Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.
During more than 20 years of practice, Civil Aviation Law has experienced three times of amendments since it was enacted in 1995. But these revisions are limited to the technical level. The problems and limitations have become increasingly prominent in its implementation. Firstly, the civil aviation law is the result of interests game among several departments and some legal issues was left behind and the regulation was very vague as a result. Secondly, the process of aviation legislation is the process that the country has undergone profound changes and social transformation. The 20 years is long enough for the society to undergo tremendous changes and 1995 version of civil aviation law does not keep pace of development of economy. There was a serious lag between reality and the law. In order to actively promote the development of the aviation industry and overcome implementation issues of the Civil Aviation Law, Civil Aviation Administration of China (CAAC) initiated modification procedure the law and published new draft of Civil Aviation Law in August 2016. The spirit of this modification is to learn and absorb new achievements of domestic and foreign legislation and the International Convention on civil aviation. Furthermore, the purpose of the revision is to provide favorable policy for the development of civil aviation industry and improve aviation safety and supervision, strengthen and protection of consumer rights and interests, to enhance the safety of civil aviation activities, and promote the development of general aviation. This revision concerned to the 78 articles which are revised or deleted and 24 articles added. The highlights of the draft include but not limited to the enhancement of security management, clarification of the main responsibility for production safety. And also it added the provisions related to the construction of effective tracking capability of public air transport enterprises and license system on the transport of dangerous goods. Compared with the existing civil aviation law, the draft has made a great improvements. But there are several deficiencies and limitations in the drafts. These problems need to be supplemented and perfected through further amendments in near future.
Asia-Pacific Space Cooperation Organization (APSCO) is the only intergovernmental space cooperation organization in Asia. Since its establishment to date, eight countries have signed the convention and become member states. South Korea participated actively in the preparatory phase of creating the organization, and one conference organized by AP-MCSTA which is the predecessor of APSCO was held in South Korea. However, after the APSCO Convention was opened for signature in 2005 to date, South Korea does not ratify the Convention and become a member. The rapid development of space commercialization and privatization, as well as the fastest growing commercial space market in Asia, provides opportunities for Asian countries to cooperate with each other in relevant space fields. And to participate in the existing cooperation framework (e.g., the APSCO) by the Asian space countries (e.g., South Korea) could be a proper choice. Even if the essential cooperation in particular space fields is challenging, joint space programs among different Asian countries for dealing with the common events can be initiated at the first steps. Since APSCO has learned the successful legal arrangements from ESA, the legal measures established by its Convention are believed to be qualified to ensure the achievement of benefits of different member states. For example, the regulation of the "fair return" principle confirms that the return of interests from the relevant programs is in proportion to the member's investment in the programs. Moreover, the distinguish of basic and optional activities intends to authorize the freedom of the members to choose programs to participate. And for the voting procedure, the acceptance of the "consensus" by the Council is in favor of protecting the member's interest when making decisions. However, political factors that are potential to block the participation of South Korea in APSCO are difficult to be ignored. A recent event is an announcement of deploying THAAD by South Korea, which causes tension between South Korea and China. The cooperation between these two states in space activities will be influenced. A long-standing barrier is that China acts as a non-member of the main international export control mechanism, i.e., the MTCR. The U.S takes this fact as the main reason to prevent South Korea to cooperate with China in developing space programs. Although the political factors that will block the participation of South Korea in APSCO are not easy to removed shortly, legal measures can be taken to reduce the political influence. More specifically, APSCO is recommended to ensure the achievement of commercial interests of different cooperation programs by regulating precisely the implementation of the "fair return" principle. Furthermore, APSCO is also suggested to contribute to managing the common regional events by sharing satellite data. And it is anticipated that these measures can effectively response the requirements of the rapid development of space commercialization and the increasing common needs of Asia, thereby to provide a platform for the further cooperation. In addition, in order to directly reduce the political influence, two legal measures are necessary to be taken: Firstly, to clarify the rights and responsibilities of the host state (i.e., China) as providing assistance, coordination and services to the management of the Organization to release the worries of the other member states that the host state will control the Organization's activities. And secondly, to illustrate that the cooperation in APSCO is for the non-military purpose (a narrow sense of "peaceful purpose") to reduce the political concerns. Regional cooperation in Asia regarding space affairs is considered to be a general trend in the future, so if the participation of South Korea in APSCO can be finally proved to be feasible, there will be an opportunity to discuss the creation of a comprehensive institutionalized framework for space cooperation in Asia.
Background: Massive hemoptysis is a major clinical and surgical problem related to high motality. Bronchial and nonbronchial systemic arteries are considered to be the main source of hemoptysis. Embolization of these arteries has become an accepted treatment in the management of massive hemoptysis. Herein we evaluate the effect of arterial embolization in immediate control of massive hemoptysis and investigate the clinical and angiographic characteristics and the course of patients with recurrent hemoptysis after initial successful embolization. Method: 21 patients (15 men & women, aged 21 to 74 years) underwent transcatheter arterial embolization for the treatment of life-threatening massive hemoptysis from Jan 1988 to July 1991. Seven patients had inactive residual pulmonary tuberculosis, 5 cases aspergilloma, 4 cases active pulmonary tuberculosis, 3 cases bronchiectasis and 2 case lung cancer. Arteriography was done by percutaneous catheterization via the femoral artery, and at the same time, arterial embolization was done with gelfoam particle. Result: Immediate control of massive hemoptysis was achieved in all 21 cases by arterial embolization. Hemoptysis recurred in nine of 21 patients. Four cases were aspergilloma, two inactive tuberculosis, two lung cancer, and one bronchiectasis. The initial angiographic findings revealed that nonbronchial systemic arterial supply, bronchial-pulmonary arterial shunt, and marked vascularity were more frequently, but statistically insignificant, in recurred patients. The following complications occured: fever, chest pain, cough, voiding difficulty, paralytic ileus, paraplegia, and splenic infarction. The course of the recurred patients was as follows: Three patients were died due to recurred massive hemoptysis. one was aspergilloma and two lung cancer. Surgical resection could be performed successfully in two patient with relatively good lung function, one aspergilloma and the other inactive tuberculosis. In 4 patients with poor lung function, repeated embolization or medical conservative treatment was continued. Conclusion: Arterial embolization as initial treatment of massive hemoptysis is most useful and relatively safe, although this is a palliative procedure and the potentiality for recurrence exists. Repeated embolization in inoperable patient with recurrent bleeding may improve the lengthening of life.
The objective of the study is to explore the relationships between the variables of nursing productivity on the framework of system del in the tertiary university based care hospital in Korea. Productivity is basically defined as the relation-ship between inputs and outputs. Under the proposition that the nursing unit is a system that produces nursing care output using personal and material resources through the nursing intervention and nursing care management. And this major conception of nursing productivity system comproises input, process and output and feed-back. These categorized variables are essential parts to produce desirable and meaningful out-put. While nursing personnel from head nurse to staff nurses cooperate with each other, the head nurse directs her subordinates to achieve the goal of nursing care unit. In this procedure, the head nurse uses the leadership of authority and benevolence. Meantime nursing productivity will be greatly influenced by environment and surrounding organizational structures, and by also the operational objectives, the policy and standards of procedures. For the study of nursing productivity one sample hospital with 15 general nursing care units was selected. Research data were collected for 3 weeks from May 31 to June 20 in 1993. Input variables were measured in terms of both the served and the server. And patient classification scores were measured drily by degree of nursing care needs that indicated patent case-mix. And also nurses' educational period for profession and clinical experience and the score of nurses' personality were measured as producer input variables by the questionnaires. The process varialbes act necessarily on leading input resources and result in desirable nursing outputs. Thus the head nurse's leadership perceived by her followers is defined as process variable. The output variables were defined as length of stay, average nursing care hours per patient a day the score of quality of nursing care, the score of patient satisfaction, the score of nurse's job satis-faction. The nursing unit was the basis of analysis, and various statistical analyses were used : Reliability analysis(Cronbach's alpha) for 5 measurement tools and Pearson-correlation analysis, multiple regression analysis, and canonical correlation analysis for the test of the relationship among the variables. The results were as follows : 1. Significant positive relationship between the score of patient classification and length of stay was found(r=.6095, p.008). 2. Regression coefficient between the score of patient classification and length of stay was significant (β=.6245, p=.0128), and variance explained was 39%. 3. Significant positive relationship between nurses’ educational period and length of stay was found(r=-.4546, p=.044). 5. Regression coefficient between nurses' educational period and the score of quality of nursing care was significant (β=.5600, p=.029), and variance explained was 31.4%. 6. Significant positive relationship between the score of head nurse's leadership of authoritic characteristics and the length of stay was found (r=.5869, p=.011). 7. Significant negative relationship between the score of head nurse's leadership of benevolent characteristics and average nursing care hours was found(r=-.4578, p=.043). 8. Regression coefficient between the score of head nurse's leadership of benevolent characteristics and average nursing care hours was significant(β=-.6912, p=.0043), variance explained was 47.8%. 9. Significant positive relationship between the score of the head nurse's leadership of benevolent characteristics and the score of nurses' job satis-faction was found(r=.4499, p=050). 10. A significant canonical correlation was found between the group of the independent variables consisted of the score of the nurses' personality, the score of the head nurse's leadership of authoritic characteristics and the group of the dependent variables consisted of the length of stay, average nursing care hours(Rc²=.4771, p=.041). Through these results, the assumed relationships between input variables, process variable, output variables were partly supported. In addition it is also considered necessary that-further study on the relationships between nurses' personality and nurses' educational period, between nurses' clinical experience including skill level and output variables in many research samples should be made.
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