• Title/Summary/Keyword: QUALITY SYSTEM

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The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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Growth and characterization ofZnIn$_2S_4$ single crystal thin film using hot wall epitaxy method (Hot Wall Epitaxy(HWE)에 의한 ZnIn$_2S_4$ 단결정 박막 성장과 특성)

  • 최승평;홍광준
    • Journal of the Korean Crystal Growth and Crystal Technology
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    • v.11 no.4
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    • pp.138-147
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    • 2001
  • The stochiometric mixtures mixture of evaporating materials for the $ZnIn_{2}S_{4}$ single crystal thin film was prepared from horizontal furnace. To obtain the $ZnIn_{2}S_{4}$ single crystal thin film, $ZnIn_{2}S_{4}$ mixed crystal was deposited on throughly etched semi-insulting GaAs(100) in the Hot Wall Epitaxy(HWE) system. The sourceand substrate temperature were $610^{\circ}C$ and $450^{\circ}C$, respectively and the growth rate of the $ZnIn_{2}S_{4}$ single crystal thin film was about 0.5$\mu\textrm{m}$/hr. The crystalline structure of $ZnIn_{2}S_{4}$ single crystal thin film was investigated by photoluminescence and double crystal X-ray diffraction (DCXD) measurement. The carrier density and mobility of $ZnIn_{2}S_{4}$ single crystal thin film measured from Hal effect by van der Pauw method are $8.51{\times}10^{17}{\textrm}{cm}^{-3}$, 291$\textrm{cm}^2$/V.s at $293^{\circ}$K, respectively. From the photocurrent spectrum by illumination of perpendicular light on the c-axis of the $ZnIn_{2}S_{4}$ single crystal thin film, we have found that the values of spin orbit splitting $\Delta$So and the crystal filed splitting DCr were 0.0148eV and 0.1678 eV at $10^{\circ}$K, respectively. From the photoluminescence measurement of $ZnIn_{2}S_{4}$ single crystal thin film, we observed free excition($E_{X}$) typically observed only in high quality crystal and neutral donor bound exicton ($D^{\circ}$, X) having very strong peak intensity. The full width at half maximum and binding energy of neutral donor bound excition were 9meV and 26meV, respectively. The activation energy of impurity measured by Haynes rule was 130meV.

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Compare the Clinical Tissue Dose Distributions to the Derived from the Energy Spectrum of 15 MV X Rays Linear Accelerator by Using the Transmitted Dose of Lead Filter (연(鉛)필터의 투과선량을 이용한 15 MV X선의 에너지스펙트럼 결정과 조직선량 비교)

  • Choi, Tae-Jin;Kim, Jin-Hee;Kim, Ok-Bae
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.80-88
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    • 2008
  • Recent radiotherapy dose planning system (RTPS) generally adapted the kernel beam using the convolution method for computation of tissue dose. To get a depth and profile dose in a given depth concerened a given photon beam, the energy spectrum was reconstructed from the attenuation dose of transmission of filter through iterative numerical analysis. The experiments were performed with 15 MV X rays (Oncor, Siemens) and ionization chamber (0.125 cc, PTW) for measurements of filter transmitted dose. The energy spectrum of 15MV X-rays was determined from attenuated dose of lead filter transmission from 0.51 cm to 8.04 cm with energy interval 0.25 MeV. In the results, the peak flux revealed at 3.75 MeV and mean energy of 15 MV X rays was 4.639 MeV in this experiments. The results of transmitted dose of lead filter showed within 0.6% in average but maximum 2.5% discrepancy in a 5 cm thickness of lead filter. Since the tissue dose is highly depend on the its energy, the lateral dose are delivered from the lateral spread of energy fluence through flattening filter shape as tangent 0.075 and 0.125 which showed 4.211 MeV and 3.906 MeV. In this experiments, analyzed the energy spectrum has applied to obtain the percent depth dose of RTPS (XiO, Version 4.3.1, CMS). The generated percent depth dose from $6{\times}6cm^2$ of field to $30{\times}30cm^2$ showed very close to that of experimental measurement within 1 % discrepancy in average. The computed dose profile were within 1% discrepancy to measurement in field size $10{\times}10cm$, however, the large field sizes were obtained within 2% uncertainty. The resulting algorithm produced x-ray spectrum that match both quality and quantity with small discrepancy in this experiments.

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Antioxidant Activities and Quality Characteristics of Mulberry Concentrate, Freeze-dried Mulberry, and Pomace (건오디, 건오디박, 오디 농축액의 품질특성 및 항산화성)

  • Jeon, Hye Lyun;Hong, Yoon Pyo;Lee, Ji Hyun;Kim, Hyung Don;Kim, Mee Ree
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.10
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    • pp.1402-1408
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    • 2012
  • Mulberry pomace, a by-product obtained from mulberry juice, has not been utilized as food. In this study, antioxidant activities, proximate composition and physiochemical characteristics of mulberry pomace were evaluated and compared with those of mulberry fruit or mulberry concentrate. Mulberry fruit was pressed and filtered. The filtrate and residue were used as mulberry juice and mulberry pomace, respectively. Mulberry juice was evaporated, after which a concentrate ($24.7^{\circ}Brix$) was obtained. Moisture contents of mulberry concentrate, freeze-dried mulberry, and pomace were 68.7%, 6.03%, and 7.32%, respectively. Reducing sugar contents were 45.7% in freeze-dried mulberry, 24.5% in pomace, and 30.9% in mulberry concentrate. The pH and acidity of the three samples ranged from 5.80~5.92 and, 0.035~0.080%, respectively. Carbohydrate and crude ash contents were the highest in mulberry fruit, whereas crude protein, fat, and fiber contents were the highest in pomace. Redness of the Hunter color system was 4.7 in mulberry and 4.3 in pomace. Total phenolic content was the highest in mulberry fruit, whereas total flavonoid content was the highest in pomace. Antioxidant activities (DPPH, hydroxyl, and ABTS radical scavenging activities) were enhanced in the order of mulberry fruit> pomace> mulberry concentrate. Especially, antioxidant activities, such as DPPH and hydroxyl radical scavenging activities, of mulberry pomace were similar with those of mulberry fruit. Based on these results, freeze-dried mulberry pomace may be considered as a functional as well as an additive material for food processing.

S-wave Velocity and Attenuation Structure from Multichannel Seismic surface waves: Geotechnical Characteristics of NakDong Delta Soil (다중채널 표면파 자료를 이용하여 구한 S파 속도와 감쇠지수 구조: 낙동강 하구의 연약 지반 특성)

  • Jung, Hee-Ok
    • Journal of the Korean earth science society
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    • v.25 no.8
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    • pp.774-783
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    • 2004
  • The S wave velocity and Q$s^{-1}$ structure of the uppermost part of the soil in Nakdong Delta area have been obtained to determine the characteristics of the forementioned soil. The phase and attenuation coefficients of multichannel seismic records were inverted to obtain the S wave velocity and Q$s^{-1}$ structure of the soil. The inversion results have been compared with the borehole measurements of the area. The seismic signal of the nearest geophone from a seismic source was used as the source signal to obtain the attenuation coefficients. Amplitude ratios of the signal at each geophone to the source signal wave plotted as a function of distance for the frequency range between 10 Hz and 45 Hz. The slope of a linear regression line which fits amplitude ratio-distance relationship best for a given frequency was used as the attenuation coefficients for the frequency. The dispersion curve of Rayleigh waves and the attenuation coefficients were inverted to obtain the S-wave velocity and Q$s^{-1}$, respectively, in the uppermost 8 meter of soil layer. The borehole measurements of the area show that are two distinct layers; the upper 4 meter of silty-sand and the lower 4 meter of silty-clay. The inversion results indicate that the shear wave velocity of the upper layer is 80 m/sec and 40m/sec in the lower silty-clay layer. The spacial resolution of the shear wave velocity structure is very good down to a depth of 8 meter. The Q$s^{-1}$ in the upper silty-sand layer is 0.02 and increase to 0.03 in the lower silty-sand layer. The spacial resolution of quality factor is relatively good down to a depth of 5 meter, but very poor below the depth. In this study, the S-wave velocity is higher in the silty-clay and the Q$s^{-1}$ is smaller silty-sand than in the silty-clay. However, much more data should be analyzed and accumulated before making any generalization on the shear wave velocity and Q$s^{-1}$ of the sediments.

Growth Characteristics of Cucumber Scion and Pumpkin Rootstock under Different Levels of Light Intensity and Plug Cell Size under an Artificial Lighting Condition (인공광형 폐쇄형 육묘시스템 내 광량 및 플러그 트레이 규격에 따른 오이 접수 및 호박대목의 생육특성)

  • Jang, Yoonah;Lee, Hye Jin;Choi, Chang Sun;Um, Yeongcheol;Lee, Sang Gyu
    • Journal of Bio-Environment Control
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    • v.23 no.4
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    • pp.383-390
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    • 2014
  • This study was conducted to investigate the growth characteristics of cucumber scion and pumpkin rootstock under different levels of light intensity (photosynthetic photon flux, PPF) and plug cell size in a closed transplant production system with artificial lighting. Cucumber scion and pumpkin rootstock seedlings were grown under the combinations of three levels of PPF (PPF 165, 248, and $313{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$) and five types of plug tray (50, 72, 105, 128, and 200 cells in the tray) for nine days. The shoot dry weight and relative growth rate increased with increasing PPF and plug cell size. As PPF increased, cucumber scion and pumpkin rootstock seedlings had higher dry matter, lower specific leaf area, and lower hypocotyl length. The first true leaf of cucumber scion and pumpkin rootstock unfolded at eight and seven days after sowing, respectively, except the treatment using 200-cell plug tray. The unfolding of first true leaf of seedlings grown in 200-cell plug tray was delayed by one day. Accordingly, it was considered that the use of small cell size such as 200-cell plug tray would require more time for the production of scion and rootstock. Based on the results, we suggest that cucumber scion and pumpkin rootstock be grown in 105-cell to 128-cell plug tray for eight days and 72-cell to 105-cell plug tray for seven days, respectively, when using splice grafting method with root-removed rootstock. Additionally, higher PPF is suggested to improve the growth and quality of scion and rootstock.

A Study on Practices and Improvement Factors of Financial Disclosures in early stages of IFRS Adoption - An Integrative Approach of Korean Cases: Embracing Views of Reporting Entities and Users of Financial Statements (IFRS 공시 실태 개선방안에 대한 소고 - 보고기업, 정보이용자 요인을 고려한 통합적 접근 -)

  • Kim, Hee-Suk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.2
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    • pp.113-127
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    • 2012
  • From the end of 1st quarter of 2012, Korean mandatory firms had started releasing financial reports conforming to the K-IFRS(Korean adopted International Financial Reporting Standards). Major characteristics of IFRS, such as 'principles based' features, consolidated reporting, 'fair value' measurement, increased pressure for non-financial disclosures have resulted in brief and various disclosure practices regarding the main body of each statements and vast amount of note description requirements. Meanwhile, a host of previous studies on IFRS disclosures have incorporated regulatory and/or 'compete information' perspectives, mainly focusing on suggesting further enforcement of strengthened requirements and providing guidelines for specific treatments. Thus, as an extension of prior findings and suggestions this study had explored to conduct an integrative approach embracing views of the reporting entities and the users of financial information. In spite of all the state-driven efforts for faithful representation and comparability of corporate financial reports, an overhaul of disclosure practices of fiscal year 2010 and 2011 had revealed numerous cases of insufficiency and discordance in terms of mandatory norms and market expectations. As to the causes of such shortcomings, this study identified several factors from the corporate side and the users of the information; some inherent aspects of IFRS, industry/corporate-specific context, expenditures related to internalizing IFRS system, reduced time frame for presentation. lack of clarity and details to meet the quality of information - understandability, comparability etc. - commonly requested by the user group. In order to improve current disclosure practices, dual approach had been suggested; Firstly, to encourage and facilitate implementation, (1) further segmentation and differentiation of mandates among companies, (2) redefining the scope and depth of note descriptions, (3) diversification and coordination of reporting periods, (4) providing support for equipping disclosure systems and granting incentives for best practices had been discussed. Secondly, as for the hard measures, (5) regularizing active involvement of corporate and user group delegations in the establishment and amendment process of K-IFRS (6) enforcing detailed and standardized disclosure on reporting entities had been recommended.

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Evaluation of 3DVH Software for the Patient Dose Analysis in TomoTherapy (토모테라피 환자 치료 선량 분석을 위한 3DVH 프로그램 평가)

  • Song, Ju-Young;Kim, Yong-Hyeob;Jeong, Jae-Uk;Yoon, Mee Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Nam, Taek-Keun
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.201-207
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    • 2015
  • The new function of 3DVH software for dose calculation inside the patient undergoing TomoTherapy treatment by applying the measured data obtained by ArcCHECK was recently released. In this study, the dosimetric accuracy of 3DVH for the TomoTherapy DQA process was evaluated by the comparison of measured dose distribution with the dose calculated using 3DVH. The 2D diode detector array MapCHECK phantom was used for the TomoTherapy planning of virtual patient and for the measurement of the compared dose. The average pass rate of gamma evaluation between the measured dose in the MapCHECK phantom and the recalculated dose in 3DVH was $92.6{\pm}3.5%$, and the error was greater than the average pass rate, $99.0{\pm}1.2%$, in the gamma evaluation results with the dose calculated in TomoTherapy planning system. The error was also greater than that in the gamma evaluation results in the RapidArc analysis, which showed the average pass rate of $99.3{\pm}0.9%$. The evaluated accuracy of 3DVH software for TomoTherapy DQA process in this study seemed to have some uncertainty for the clinical use. It is recommended to perform a proper analysis before using the 3DVH software for dose recalculation of the patient in the TomoTherapy DQA process considering the initial application stage in clinical use.

Effects of Modified Installation Methods of Roof Ventilation Devices in the Single-span Plastic Greenhouses on Yield and Fruit Quality of Oriental Melon (단동 비닐하우스의 지붕 환기장치 설치방법 개선이 참외생육 및 과실수량에 미치는 영향)

  • Yeo, Kyung-Hwan;Yu, In-Ho;Choi, Gyeong Lee;Lee, Seong-Chan;Lee, Jae-Han;Park, Kyoungs Sub;Lee, Jung-Sup;Bekhzod, Khoshimkhujaev
    • Journal of Bio-Environment Control
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    • v.25 no.4
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    • pp.334-342
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    • 2016
  • In order to evaluate the modified installation methods of roof ventilation devices, derived from the previous experiment ('investigation into the optimum capacity of roof ventilation devices and their deployment'), the conventional and modified (improved) roof ventilation systems were installed in the single-span plastic greenhouse for growing oriental melons. The roof vents ($60{\varphi}$) and roof fans (maximum air capacity of $38m^3/min$) were installed in the spacing of 15m (FT, modified 'side vent+roof fan' ventilation) and 6m (TT, modified 'side vent+roof vent' ventilation) respectively on the roof of greenhouses for the modified roof ventilation treatments, and 20m (FC, conventional 'side vent+roof fan' ventilation) and 8m (TC, conventional 'side vent+roof vent' ventilation) for the conventional ones. The stem diameter, leaf blade lengh, petiole length, and leaf width were lower in the FT and TT treatments than those in the conventional treatments, FC and TC. Although the fruit weight and total yields were slightly lower in the FT and TT treatments, the marketable fruit ratio (%) were higher, as a result of increased fruiting ratio (%) in these treatments, than those of FC and TC. The marketable yields (kg/10a) in the FT and TT treatments were 8,391 kg/10a and 7,283 kg/10a, which were respectively 661 kg/10a and 487 kg/10a higher than those in the treatments of FC and TC. The modified installation methods of roof fan resulted in production of more female flowers and lower fruit drop ratio (%) compared to conventional meathods. In the treatment of the conventional ventilation with roof vent, the fruit weight, fruit length & width, and flesh thickness were higher than in other treatments, but there were no significant differences in the fruit width and flesh thickness among the treatments.

A Study on the Improvement for Medical Service Using Video Promotion Materials for PET/CT Scans (PET/CT 검사에서 동영상 홍보물을 통한 의료서비스 향상에 관한 연구)

  • Kim, Woo Hyun;Kim, Jung Seon;Ko, Hyun Soo;Sung, Ji Hye;Lee, Jeoung Eun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.30-35
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    • 2013
  • Purpose: One of the current services, providing information to the patients and their guardians by using promotion materials induces positive responses and contributes to the improvement of the hospital reliability. Therefore, the objective of this study is to evaluate the effectiveness of audio visual materials, one of the means of promotion, as a way to give accurate medical information to resolve patient's curiosity about purpose and procedure of their examination and deplete complains about waiting which attributes negative effect to service quality assessment. Materials and Methods: 60 patients(mean age $53.97{\pm}12.24$, male : female = 26 : 34) who had $^{18}F-FDG PET/CT$ scan from July 2012 to August 2012 in Seoul Asan Medical Center were referred to the study. All of the patients having PET/CT scan were asked to watch an informative video material before the injection of radiopharmaceutical ($^{18}F-FDG$) and to fill in a questionnaire. Results: As a result of analyzing the contents of questionnaire, 52% of 60 patients had PET/CT scan for the first time and 72.4% of the patients read the PET/CT guidebook offered from their outpatient department or inpatient wards before their scan. After we searched the level of previous knowledge of the purpose and method of PET/CT scan, the patients answered 25.1% "know well", 34% "not sure", 40.9% "don't know" respectively. And 84.7% of the patients answered that watching the PET/CT guide video before the injection helps understanding what exam they were having and 15.3% of the patients did not. For the question asking ever the patients have experienced using our homepage or smart phone QR code to see the guide video before they visit out PET center, only 3.3% of them answered "yes". Lastly, the patients answered 60.1% "yes", 31.4% "so so" and 8.5% "no" respectively for the question asking whether watching the video makes the patients to fill the waiting time short. Conclusion: It is found that understanding of objective and method of the PET/CT scan and level of satisfaction was improved after the patients watched the guide video whether they had PET/CT scan before and read the PET/CT guidebook or not. Also, watching the video was effective for the reduction of perceptible waiting time. But while displaying the PET/CT guide video is useful for providing information about the scan and shortening the waiting time as one of the medical service, utilization of service was actually very poor because of the passive promotion and indifference of the patients about their examination. Therefore, from now on, it is necessary to construct the healthcare system which can be offered to more patients through the active promotion.

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