Journal of Korean Academy of Nursing Administration
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v.6
no.1
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pp.135-146
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2000
The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.
Purpose: This study examined the status of food allergy management and importance-performance analysis (IPA) between elementary, and middle and high school employees in school foodservice. Methods: The participants were employees in elementary (n = 171) and middle and high schools (n = 187) in the Jeonbuk area. The demographic characteristics, the status of food allergy management, food allergy education, and the importance and performance status were assessed using a self-administered questionnaire. Results: Approximately 55.0% of employees in elementary and 32.6% in middle and high schools recognized that the foods in menu tables induced allergies. Approximately 93.0% of employees in elementary and 85.0% in middle and high school thought that food allergy management was an important part of school foodservice because of the possibility of health emergencies. Elimination and replacement meals were provided more in middle and high schools than in elementary schools. Food allergy education from nutrition teachers had been given to 62.6% of employees in elementary and 50.3% in middle and high schools. To prevent food allergy accidents, 72.4% of employees in elementary schools and 65.2% in middle and high schools wanted more accurate information on students with food allergies. As a result of IPA, elementary, middle, and high school employees were aware of the importance and performed well: 'Strict control of allergy-inducing foods because of cross-contamination'. On the other hand, they were not aware of the importance and performed them insufficiently: 'Know how to use epinephrine to prepare for emergencies'. Conclusion: Therefore, it is necessary to improve the consciousness of nutrition teachers for the effective application of food allergy education, especially the recognition of allergy-inducing foods and emergency responsive ability.
Journal of the Korean Institute of Traditional Landscape Architecture
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v.33
no.2
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pp.67-77
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2015
The purpose of this paper is to draw historic valuable resources to conserve through the analysis about the preservation status of historic urban environment in Suwon Hwaseong Fortress. As for the conservation of urban environment, it is important to protect the resources showing historical continuity and to manage the resources remaining characteristics of place, the analysis of the preservation status is focused on the perspective of preservation of physical form and land use. This paper makes progress through three phases. First, in order to understand urban environment in Hwaseong Fortress overall, it compares land registration original map in 1911 to current map in 2014 by the four items of topography, water environment, streets and sites. Next, changes of four items in urban environment have been reviewed further by the research of maps, relative literatures, field survey and interview, and are classified according to the criteria of preservation-partially preservation-disappearance. After analysing preservation status, valuable urban historic cultural resources are drawn separately by being preserved continually and by being preserved partially but remaining characteristics of place. As a result, natural factors of topography and waterway and urban factor of streets are remained considerably preserved. And even if these factors are changed, the ground environment features support to understand historic urban context. Second, as preservation of topography, water environment, streets and sites are closely related to each other, integrated conservation frameworks are needed to enhance urban historic landscape. Third, modern historic resources in Hwaseong are remained unchanged and thus it is necessary to understand urban historic environment by the layers of various times besides Joseon Dynasty period. Fourth, historic sites and streets which had been preserved through urban development process are destroyed by recent historic cultural restoration policies, therefore urban historic resources worthy of conservation should be treated prudently.
Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.
Purpose: To evaluate the use of monoclonal antibody (MoAb) as a carrier of the receptor-binding ligand the receptor mediated uptake into liver and subsequent metabolism of $^{111}In-labeled$ galactosylated MoAb-chelator conjugates were investigated and compared with those of $^{111}In$ labeled MoAb. Materials and Methods : T101 MoAb, $IgG_2$ against human lymphocytic leukemic cell, conjugated with cyclic DTPA dianhydride (DTPA) or 2-p-isothiocyanatobenzyl-6-methyl-DTPA (1B4M) was galactosylated with 2-imino-2-methoxyethyl-1-thio-${\beta}$-D-galactose and then radiolabeled with $^{111}In$. Biodistribution and metabolism study was peformed with two $^{111}In-conjugates$ in mice and rats. Results: $^{111}In-labeled$ T101 and its galactosylated conjugates were taken to the liver by the time, mostly within 10 min. However DTPA conjugate was retained longer in the liver than the 1B4M conjugate (55% vs 20% of injected dose at 44 hr). During this time, the radiornetabolite of DTPA conjugate was excreted similarly into urine (24%) and feces (17%). The radiometabolite of 1B4M was excreted primarily into feces (68%) rather than urine (8%). Size exclusion HPLC analysis of the bile and supernatant of liver homogenate showed two peaks the first (35%) with the retention time (Rt) identical to IgG and the second (65%) with Rt similar to free $^{111}In$ at 3 hr post-injection for the 1B4M conjugate, indicating that the metabolite is rapidly excreted through the biliary system. in contrast to DTPA conjugate, the small $^{111}In-DTPA-like$ metabolite was the major radioindium component (90%) in the liver homogenate as early as 3 hour post-injection, but the cumulative radioindium activity in feces was only 17% at 44 hour, indicating that the metabolite from DTPA conjugate does not clear readily through the biliary tract. Conclusion: The galactosylation of the MoAb conjugates resulted in higher hepatocyte uptake and enhanced metabolism, compared to those without galactosylation. Metabolism of the MoAb-conjugates is different between compounds radiolabled with different chelators due to different characteristics of radiometabolites generated in the liver.
Journal of the Korean Institute of Landscape Architecture
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v.39
no.3
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pp.1-9
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2011
The purpose of this study is to propose plans to increase the number of urban parks as a way to help absorb carbon in order to implement the low carbon green city goals of Gangneung. As a study method, park incentive areas and current park areas were set as parameters and the areas of lacking in park space were categorized according to each indicator. The degree of park shortage was classified by overlapping the park shortage areas. Once the areas needing parks were assessed according to priority, target sites were selected on sites where construction would be actually possible. First, results of analysis showed that Songjeong-Dong and Seongdeok-Dong to the east of the target site lacking park space due to old residences and high population density or industrial use areas, were the most severe in the degree of park shortage. It was also shown that areas with high population density and park shortages included the Ponam-Dong, Okcheon-Dong and Hongje-Dong areas. Accordingly, the east side of the target areas and Hongje-Dong were both considered as high-priority areas needing to increase park space and actual possible target sites were selected for the creation of new, small parks in industrial areas by creating parks in school yards, in facility relocation sites and legal reviews. In addition, analysis indicators of park shortages were re-evaluated according to the securing of the park and it was shown that the problems in park shortages were resolved with the proper positioning of parks. In addition, satisfaction in the area of park per person, $3m^2$ was at a higher than a certain level in all areas except Songjeong-Dong, demonstrating that the park areas were evenly distributed. Areas of park shortage were shown in part of Songjeong-Dong and Seongdeok-Dong. This could be resolved by using alternative park resources such as the adjacent Gyeongpo Provincial Park, the beach and Namdaecheon.
Purpose: The examination of nuclear medicine observes the change in accordance with the time elapsed in the same region purposed and there are many examinations to acquire the image during the same term. At this time, the same parameter should be applied. The hepatobiliary scan, lung scan etc, are the acquired examination in the divided time with a regular term. Pre-set time that is applied in continued next image is set in order to acquire the fixed counts. The same scan time should be applied for each image. This study will look for the rational plan and analyze the change of scan time in accordance with the time of the decision of scan time at examination that pre-set time is applied. Methods: The hapatobiliary scan that use the radio pharmaceutical $^{99m}Tc$-mebrofenin is choosed as compensation from Jan. 2009 to Mar. 2009 in the department of nuclear medicine in ASAN MEDICAL CENTER. Scan is started after 5 minutes from when 222 MBq (6 mCi) is injected to patient. We let patient stand up between both detectors, and possibly close to the front of detector. When scan time reach 10%, 25%, 50%, 75% of total scan time, we measured the expected total scan time. After finishing all of scan, we compared the total scan time and the expected total scan time, while image is acquiring. and we observed the change of scan time in accordance with radio activity by using phantom. Results: After starting scan, a difference of when scan time reach 10%, 25%, 50%, 75% of total scan time is that the biggest difference is 5 seconds on 10%. There statistically is difference between 25% (t:2.88, p<0.01) and 50% (t:2.05, p<0.01). Conclusions: When the same the scan time is applied in the examination that acquire the many frame, concluding the same scan time has a important effect on a quantitative analysis. Although method that decide the scan time after finish all of the examinations, there is a few problem to apply practical affairs. This may cause an inaccurate result on the examination that need a quantitative analysis. We think that operator should try to improve it. At least, after reach 50% of total scan time, deciding the total scan time mean that you can minimize error of a quantitative analysis caused by unmatched scan time from a gap of image.
As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.
Lee, Yung Kwun;Lee, Hee Chul;Chun, Jung Mi;Yoon, So Young;Lee, Woo Gill;Shin, Son Moon
Clinical and Experimental Pediatrics
/
v.48
no.7
/
pp.760-765
/
2005
Purpose : We studied the changes in antibiotic sensitivity to the causative organisms of urinary tract infection(UTI), in order to provide useful information on the choice of adequate drugs in the treatment of UTI. Methods : We retrospectively analyzed the major causative organisms and their antibiotic sensitivities in 69 patients diagnosed with UTI in the Department of Pediatrics, Samsung Cheil Hospital from 2002 to 2003. Results : The frequency of UTI was the highest in infants younger than 1 year of age(88.4 percent). The male to female ratio was 3.05 : 1. Escherichia coli was the most frequent organism(78.3 percent), followed by Klebsiella(11.6 percent), Pseudomonas(2.9 percent), Proteus(2.9 percent), Enterobacter, Morganelle, and Enterococcus(1.4 percent) in descending order. Antibiotic sensitivity of gram negative organisms was above 90 percent against imipenem, amikacin, 80 percent against aztreonam, cefepime, ceftriaxone, 50-70 percent against gentamicin, trimethoprime-sulfamethoxazole (TMP/SMX), and 23 percent against ampicillin(23.4 percent). Conclusion : Antibiotict sensitivity of gram negative organisms was high to amikacin and third generation cephalosporins but low to ampicillin, gentamicin and TMP/SMX. The use of ampicillin or TMP/SMX, as the first choice of the empiric and prophylactic treatment for UTI, should be reconsidered and investigated further.
Lee, So Hyang;Park, Soo Yeon;Kim, Jong Sik;Choi, Byung Ki;Park, Hee Chul;Jung, Sang Hoon
The Journal of Korean Society for Radiation Therapy
/
v.27
no.1
/
pp.73-78
/
2015
Purpose : Under the assumption of change to the amplitude based sorting, the study will use four dimensional computed tomography imaging (4DCT) arrayed using the phase based sorting to analyze the respiratory phase difference. Materials and Methods : The study analyzed the 4DCT (4-dimensional computed tomography) images of 10 liver cancer patients that were treated with respiratory gated radiotherapy from 2015 February to March. Using RPM respiratory gating (RPM 1.7.5, Varian, USA) equipment, imaging according to respiratory cycle of phase based sorting was acquired and using a treatment planning system (Pinnacle 9.2, Philips, USA) the acquired imaging according to respiratory cycle was used to measure the abdominal movement value by respiratory cycle. The measuring point was the point where the center point of the Marker Block and the body surface met in the 50% phase image and here the coordinate values Lateral, Vertical, Longitudinal (X, Y, Z) were set as reference points, and on the X, Z plane identical to the reference point, using the identical method the Y axis coordinate value of each 0%, 30%, 40%, 50%, 60%, 80% phase images were acquired to quantitatively measure the variation of distance to the Y axis. The abdominal movement value according to respiration was applied to the theoretical model that the value decreases linearly from maximum inhalation to maximum exhalation to divide the variation of my value to predict as amplitude value by respiratory cycle and conversely the variation in amplitude was recalculated with the phase variation deviation value to analyze. Results : The deviation value between expected value and actual location was the largest in the 30% phase with 0.24 cm, and standard deviation was also the largest in 30% phase with 0.13 cm. The effective value of the deviation value derived from the average of the deviation squared value of each patient appeared as minimum 0.7 cm, maximum 0.18 cm, average 0.12 cm, and standard deviation 0.4 cm. Also by dividing the actual movement distance value with the peak expiration value then converting it into %Phase, the deviation value with actual phase 16.5% in 30% phase, 10.0% and 40% phase, 10.0% and 60% phase, 15.4% and 80% phase, and overall average about 13%, and arraying based on amplitude, phase shift occurred and further it was from peak expiration the chance of deviation occurrence was increasingly measured. Conclusion : Based on the results of the study there were differences between value acquired based on theoretical model and actual value. Therefore in respiratory gated radiotherapy using external surrogates, there needs to be establishment of respiration gated radiation system that avoids the combination of two Sorting methods considering that there will be occurrence of treatment and corresponding clinical differences due to the phase difference that occur due to the Amplitude based Phase Sorting.
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