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A Comparative Study of Two Different Heel Lancet Devices for Blood Collection in Preterm Infants (미숙아에서 채혈을 위한 발뒤꿈치 천자시 두 종류 천자 기구의 비교)

  • Lim, Hyo-Bin;Rhu, Mi-Joo;Jung, Ji-Mi;Jeon, Ga-Won;Sin, Jong-Beom
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.239-244
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    • 2010
  • Purpose: To evaluate two different heel lancet device in terms of pain response and success of the procedure in the preterm infants undergoing heel puncture. Methods: 100 preterm infants undergoing capillary blood gas analysis or capillary bilirubin monitoring underwent heel puncture, were randomly allocated to blood sampling from the heel with either a conventional manual lancet or an automatic incision device. Primary outcome measures included the Premature Infants Pain Profile (PIPP) score, total duration of procedure, number of heel puncture and number of bruise. The pain response was evaluated using PIPP score and the effectiveness was evaluated using three criteria: total duration of blood sampling, number of puncture, bruising of the heel or ankle. Statistical analysis was performed using the SPSS ver. 13.0 program. Difference between the groups were analysed with t test (continuous variables) and the Chi square test or Fisher test (categorical variables). Results: The mean PIPP score was 4.91 for the automatic lancet group compared with 5.84 for the conventional manual lancet group (P=0.0255).The number of pain scores above 7 during blood collection did not differ between two groups (P=0.2167). The procedure took less time to perform in the automatic lancet group (mean, 30.69 seconds) than in the conventional lancet group (mean, 48.92 seconds) (P<0.0001). Conclusion: This study demonstrated that the automatic lancet device causes less pain and a shorter procedure time than the conventional manual lancet in preterm infants undergoing heel puncture. On the basis of these results the automatic lancet device is very useful method for blood collection in preterm infants by heel puncture.

Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

Targeted Therapies and Radiation for the Treatment of Head and Neck Cancer (두경부 암의 표적 지향적 방사선 치료)

  • Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.77-90
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    • 2004
  • Purpose: The purpose of this review Is to provide an update on novel radiation treatments for head and neck cancer Recent Findings: Despite the remarkable advances In chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) Is an appealing target for novel therapies In head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression Is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuxlmab) and tyrosine kinase inhibitors (ZD1839 and 051-774) have been assessed and have been most extensively studied In preclinical models and clinical trials. Additional TKIs In clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted In rapid translation Into the clinic. Results from Initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or In combination with chemotherapy. In this review, we begin with a brief summary of erbB- mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinlcal and clinical data on the role of EGFR antagonists alone or in combination with radiation In the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR biockade and efforts In the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1 ) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2) how to sequence these agents with radiation and/or cytotoxlc compounds, (3) reliable markers for patient selection and verification of effective blockade of signaling in vivo, and (4) mechanisms behind intrinsic or acquired resistance to targeted agents to facilitate rational development of multi-targeted therapy, Other molecuiar-targeted approaches In head and neck cancer were briefly described, Including angloenesis Inhibitors, farnesyl transferase inhibitors, cell cycle regulators, and gene therapy Summary: Novel targeted theraples are highly appealing in advanced head and neck cancer, and the most premising strategy to use them Is a matter of intense Investigation.

Comparative Analysis of Laparoscopy-assisted Gastrectomy versus Open Gastrectomy (복강경 보조 위절제술과 개복 위절제술의 비교 분석)

  • Lim, Jung Taek;Kim, Byung Sik;Jeong, Oh;Kim, Ji Hoon;Yook, Jeong Hwan;Oh, Sung Tae;Park, Kun Choon
    • Journal of Gastric Cancer
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    • v.7 no.1
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    • pp.1-8
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    • 2007
  • Purpose: There has been increased the number of early gastric cancer and laparoscopy-assisted gastrectomy (LAG), due to early detection through mass screening program. We started the LAG in April 2004 and performed 119 cases of gastric cancer in 2005, so we report a surgical outcome compared with that of open gastrectomy (OG). Materials and Methods: 119 patients underwent LAG in 2005, and for open group, 126 patiens of early gastric cancer were selected sequentially from January 2005 to March 2005. We compared clinicopathologic characteristics, postoperative courses and complications between two groups. Results: There was no significant difference between age, a length of hospital stay, distal resection margin and a number of retrived lymph nodes. The operation time was longer in LAG group (239.2 vs 123.3 mins, P<0.001) and a diet progression was faster in LAG group (first flatus: 3.05 vs 3.70 days, SOW: 2.86 vs 3.22 days, liquid diet: 3.87 vs 4.19 days, soft diet: 4.84 vs 5.26 days, P<0.001). But there was no difference statistically in postoperative discharge date (7.73 vs 8.25 days, P=0.229). The additional requirement of analgesic injection was less frequent in LAG group (2.97 vs 4.92 times, P<0.001). The harvested lymph nodes were similar in both groups (23.9 vs 23.1, P=0.563). A complication rate was lower in LAG group (4.9% vs 9.5%), but there was no statistical significance (P=0.179). There was no mortality in both groups and no conversion to open gastrectomy in the LAG group. Conclusion: LAG can be performed safely and accepted in view of curative procedure in treatment of early gastric cancer. But we need the follow up of long-term period to evaluate the survival rate and recurrence, and a prospective randomized controlled study should be done to establish that LAG will be a standard operation for early gastric cancer.

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A Study on the Lifestyle and Coffee Consumption Motivation (라이프스타일과 커피소비동기에 관한 연구)

  • Jung, Ja Young;Kim, Kwang Jin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.3
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    • pp.53-65
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    • 2013
  • In Korea recently the consumption of coffee has been drastically increased and majority of people who are more than $20^{th}$ are drinking more than a cup of coffee every day. Nowadays coffee a kind of essential items in modern urban society. As the popularity of the coffee is increasing, As the coffee consumption is growing, the studies on coffee also have been increased. Many of the studies on coffee were focused on the consumer attitudes, coffee shops and franchise coffee shops, and coffee components or ingredients. As the products of the coffee are becoming diverse, the consumers of coffee also becoming diverse. There was a study showing that coffee has variety of types, and that motivations and attitudes for coffee consumption are different depend on demographic statistics such as age and life styles. On this study main focus was life style and consumer's motivation on coffee consumption. For this study the survey was conducted on the people living in Seoul City and Kyengkido from March 1, 2013 to March 31, 2013. 600 questionnaires were distributed and 480 were collected and 470 were used for analysis of this study. The statistics program used in this study was SPSS. The method used in the analysis wee factors analysis test, reliability test, validity test, t-testy, One-Way ANOVA, and regression analysis. In this study according to the factor analysis, the life styles were classified the following six categories ; wellbeing pursuit, taste pursuit, atmosphere pursuit, dine-out pursuit, instant pursuit, and economic value pursuit. The factors of coffee consumption motivation were 6; wellbeing consumption motivation, changing mood consumption motivation, social consumption motivation, habitual consumption motivation, and emotional consumption motivation. The demographic factors used in this study were age, marital status, occupation, educational background, residence, income, and eating-out expenses. The hypothesis used in this study were two. The first hypo-thesis was whether the coffee consumption was affected by the life styles. The second hypo-thesis was whether there was any statistical differences on the motivation of coffee consumption according to the characteristics of life style. The outcome of this study demonstrated that life styles had partial impact on coffee consumption motivations. According to the characteristics of the life style, except for the habitual consumption motivation, all the other factors showed statistical differences on coffee consumption motivations according the characteristics of life styles.

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The Comparison of Pregnancy Outcomes between Elective Two and Three Cleavage-state Embryos Transfer in Fresh IVF-ET (체외수정술시 난할단계 배아 2개와 3개를 이식했을 때의 임신예후의 비교)

  • Lyu, Sang-Woo;Won, Hyung-Jae;Lee, Woo-Sik;Han, Ji-Eun;Kim, A-Ri;Kim, You-Shin;Seok, Hyun-Ha;Yoon, Tae-Ki
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.1
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    • pp.65-72
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    • 2010
  • Objective: To compare the respective pregnancy outcomes of cycles undergoing elective two cleavage-stage embryos transfer (2ET) and three cleavage-stage embryos transfer (3ET) in fresh in vitro fertilization and embryo transfer (IVF-ET) program. Methods: We conducted a retrospective matched case control study that included 100 women with 2ET and 100 women with 3ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and cycle characteristics. All of transferred embryos in both groups had good qualities. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with 2ET and 3ET groups were not statistically different; implantation rate (41.0% vs. 35.3%), positive pregnancy rate (58.0% vs. 60.0%), clinical PR (55.0% vs. 59.0%), ongoing PR (51.0% vs. 55.0%), respectively. However, the 3ET group showed significantly higher multiple pregnancy and triplet pregnancy rates (30.9% vs. 50.8%, p=0.031; 1.8% vs. 11.9%, p=0.036, respectively). Conclusion: In women with favorable conditions and good quality embryos undergoing IVF, 2ET can get pregnancy outcomes comparable to those of 3ET and reduce multiple pregnancy (especially, triplet pregnancy).

Application Strategies of Eye-tracking Method in Nightscape Evaluation (야간경관 평가에서의 아이트래킹 분석 적용 연구)

  • Kang, Youngeun;Kim, Mintai
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.4
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    • pp.87-97
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    • 2015
  • There's a trend towards vitalization of nightscape planning businesses nationally and locally as well for city image making and activation of regional economy, but there is still no systematic nightscape planning going on for lack of relevant researches and objective evaluations. This study aims to suggest the guideline for nightscape planning by conducting an eye tracking experiment and survey for recognizing the characteristics of a nightscape. Furthermore, the authors intended to verify the eye-tracking method as a tool for landscape evaluation. The research site was restricted in the campus of Virginia Tech, VA, and those were selected by experts' survey among various types of nightscape images. The variables for analyzing the characteristics of nightscape images selected were 'preference', 'safety(fear)' and 'clearness'. 'Fixation duration', 'saccade duration', 'scan path length', and 'pupil size' were selected as the eye movement measurements. The results of this study are as follows: The first outcome found was that there were significant differences among the characteristics(preference, safety and clearness) of a nightscape by MANOVA, and these variables were correlated positively by Pearson's correlation. Secondly, there were differences on fixation duration, saccade duration and scan path depending on the nightscape setting statistically. Also, the eye tracking measurement in an open setting was recorded lower than enclosed settings. In the result of a heat map, we found the meaning of the fixated areas on both viewing without intention and viewing intentionally. It turned out that the fixated areas were consistent with the areas the subjects felt preferred and clarity in all of the nightscape images, which means people usually focus on what they prefer and see clearly in a certain nightscape. Based on this result and previous studies, the authors could make a conclusion that eye tracking method can apply to evaluate nightscape settings in terms of analyzing the whole characteristics and finding specific points for the detailed analysis as well. Therefore, these results can contribute by suggesting nightscape planning, implication of the landscape evaluation, and implication of the eye tracking study.

A Study on Location Selection for Rainwater Circulation System Elements at a City Level - Focusing on the Application of the Environmental and Ecological Plan of a Development - (도시차원의 빗물순환체계 요소별 입지선정에 관한 연구 - 개발예정지역의 환경생태계획 적용방안을 중심으로 -)

  • Kim, Hyo-Min;Kim, Kwi-Gon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.3
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    • pp.1-11
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    • 2012
  • This study focused on establishing a natural rainwater circulation system using rainwater meant for relatively large urban development projects such as a new town development. In particular, when the location selection techniques for individual elements of a natural rainwater circulation system are developed for the integrated rainwater management, changes in hydrological environment will be minimized and the natural water circulation would be restored to realize the low impact development (LID). In that case, not only the excess will be reduced but water space and green areas in a city would also increase to improve the urban sustainability. First of all, there were five elements selected for the location selection of a rainwater circulation system intended for the integrated rainwater management: rainwater collection, infiltration, filtration, retention and movement spaces. After generating these items, the location selection items and criteria were defined for each of the five elements. For a technique to apply the generated evaluation items and criteria, a grid cell analysis was conducted based m the suitability index theory, and thematic maps were overlapped through suitability assessment of each element and graded based on the suitability index. The priority areas were identified for each element. The developed technique was applied to a site where Gim-cheon Innovation City development is planned to review its feasibility and limitations. The combined score of the overlapped map for each element was separated into five levels: very low, low, moderate, high and very high. Finally, it was concluded that creating a rainwater circulation system conceptual map m the current land use plan based on the outcome of the application would be useful in building a water circulation system at the de1ailed space planning stage after environmental and ecological planning. Furthermore, we use the results of this study as a means for environment-friendly urban planning for sustainable urban development.

Social Worker's Experience of NEET Youth Support Project : Focusing on the Vision Plan (청년니트(NEET) 지원 사업에 대한 종합사회복지관 사회복지사의 경험 : 희망플랜 사업을 중심으로)

  • Noh, Hyejin;Lee, Bongjoo;Park, Mihee;Park, Hojun
    • Korean Journal of Social Welfare Studies
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    • v.49 no.2
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    • pp.125-157
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    • 2018
  • In the reality that the seriousness and concern about the youth problem is increasing, this study focuses on the vision plan project supporting the NEET youth in the social welfare field. Therefore, this study analyzed how the social workers recognized the NEET problem before participating in the project, what difficulties they experienced in the process of the project, and how they coped with these difficulties. The results of the study are as follows. Social workers were saddened by the seriousness of the youth problem before their participation, but they recognized that there was no way to solve it and many social workers were not fully aware of the youth or NEET issues. In this context, in the course of running a project with NEET youth, social workers experienced difficulties due to the nature of the NEET youth, difficulty in forming a relationship with NEET youth, and difficulties for young people not to spend time in the program. And social workers also faced difficulties due to the lack of know-how in the project, difficulties in operating the center alone, and difficulty in achieving employment goals. In the process of coping with these difficulties, social workers have actively sought, persuaded and supported the NEET youths to participate in the project, adapted the time, place and method to the youth, and removed the stigmatization element in the project. They also worked closely with local residents, local institutions and municipalities, formed networks, and changed the viewpoint of providing work experience rather than getting young people, but seeing long-term outcome. As a result, social workers have experienced not only individual change but also social welfare organization, field, community and local institutional change. Based on these results, this study suggested that the social welfare practice field should provide various activities in the process of supporting the youth gap year policy. In addition, this study suggests that the social workers play a role in connecting various actors rather than suppliers when working with young people, and that the social welfare field should expand the scope of project to include youth.