Purpose: Surfactants have been used to improve oxygenation for infants with meconium aspiration syndrome (MAS). We evaluated the change of pulmonary indices after surfactant therapy for MAS through a systematic meta-analysis. Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in MEDLINE, EMBASE, and CENTRAL, up to June 2011, and by additional hand searches. Data were extracted regarding pulmonary indices, such as the oxygen index and arterial alveolar oxygen gradient. Meta-analyses were separately conducted for the studies of surfactant lavage therapy and surfactant bolus therapy. The risk of bias was assessed, and clinical as well as statistical heterogeneities were also investigated. Results: Two RCTs for bolus surfactant therapy and two RCTs for surfactant lavage therapy were identified. The oxygenation index results were heterogeneous between the two studies in which bolus surfactant therapy was given, while a/A $PO_2$ showed significantly better results in the treatment group over time after use of surfactant (12 hours: WMD 0.08, 95% CI 0.04-0.12; 24 hours: WMD 0.17, 95% CI 0.06-0.28). For surfactant lavage therapy, both studies consistently suggested an interventional benefit in terms of the pulmonary indices although it did not reach statistical significance. Conclusion: Surfactant therapy appeared to improve oxygenation of infants with MAS. Since a limited number of RCTs are available in the current literature and those studies were also clinically heterogeneous in terms of illness severity and the method of surfactant use, further research is needed to gather evidence to support surfactant therapy in MAS.
Purpose: From August 2017, hospice-palliative care (HPC) will be provided to patients with acquired immunodeficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), and liver cirrhosis in Korea. To contribute to building a non-cancer (NC) hospice-palliative care model, NC specialists were interviewed regarding the goals, details, and provision methods of the model. Methods: Four physicians specializing in HPC of cancer patients formulated a semi-structured interview with questions extracted from literature review of 85 articles on NC HPC. Eleven NC disease specialists were interviewed, and their answers were analyzed according to the qualitative content analysis process. Results: The interviewees said as follows: It is difficult to define end-stage NC patients. HPC for cancer patients and that for NC patients share similar goals and content. However, emphasis should be placed on alleviating other physical symptoms and emotional care rather than pain control. Timing of the care provision should be when patients are diagnosed as "end stage". Special issues should be considered for each NC disease (e.g., use of anti-retroviral drugs for AIDS patients, oxygen supply for COPD patients suffering from dyspnea, liver transplantation for patients with liver cirrhosis) and education should be provided to healthcare professionals. NC patients tend to negatively perceive HPC, and the government's financial assistance is insufficient. Conclusion: It is necessary to define end-stage NC patients through in-depth discussion to minimize issues that will likely accompany the expansion of care recipients. This requires cooperation between medical staff caring for NC patients and HPC givers for cancer patients.
The purpose of the present study is to develop an instrument of mathematical learning motivation and causal attribution for students and to analyze the results of the instrument. Based on the literature review, mathematical learning motivation is the cumulative effects of self-assessment and self-regulation in mathematical learning and achievement experience. Three factors of mathematical learning motivation is identified as self-regulatory efficacy, task difficulty and mathematical anxiety with 17 self-regulatory efficacy items, 9 task difficulty items and 9 mathematical anxiety items. Three factors of causal attribution for success is identified as ability/effort, luck, and other person with 6 ability/effort items, 4 luck items and 3 other person items. Also, four factors of causal attribution for failure is identified as ability, effort, luck, and other person with 3 ability items, 7 effort items, 3 luck items and 4 other person items. The instrument of mathematical learning motivation and causal attribution for success and failure was administered to 919 middle school students from eight different middle middle schools in Seoul, Gyeonggi-Do, Busan, jeolla-Do area. The correlation of three factors of mathematical learning motivation was calculated. As a result, a positive correlation between self-regulatory efficacy and task difficulty was appeared but mathematical anxiety has a negative correlation with self-regulatory efficacy and task difficulty. This study also examined the differences about mathematical learning motivation's sub-factors shown by three groups of mathematics achievement level. Students of higher achievement level showed that the degree of self-regulatory efficacy and task difficulty was higher than that of lower level group. Students of lowest achievement level showed significantly higher mathematical anxiety degree than that of middle and high group. Students that have higher degree of self-regulatory efficacy and task difficulty preference were attributed into ability/effort cause toward success of mathematics achievement. Also, Male students preferred more difficult task and higher degree of self-regulatory efficacy in mathematics learning than female students. On the contrary, Female students showed higher mathematical anxiety level than male students.
There was a great need to consider a core competency-based approach as a new direction of the science education for gifted students according to the value and vision of the 21st century knowledge-based societies. Therefore we developed a core competency model of scientist and examined its validity as a prerequisite for a core competency-based education of science gifted students. In order to this, the survey was conducted after developing questionnaire through the theoretical review of the various resources such as paper, book, and newspaper articles and the qualitative analysis of the behavioral event interview, and then an exploratory factor analysis was performed to validate the factor structure based on the results of the survey. The results revealed that the core competency model with the 5 cluster units of competency and the 15 core competencies was potentially constituted. And the reliability, convergent validity, and discriminant validity of the core competency model were verified through the confirmatory factor analysis. The cognitive cluster consisted of 5 competencies and they were as follows: creative, comprehensive, exploratory, analytical, and conceptual thinking competency. The achievement-orientation cluster consisted of 3 competencies and they were as follows: initiative, preparation & problem solving, and strategic influence competency. The scientific attitude cluster consisted of 3 competencies and they were as follows: flexible thinking & attitude, passion for research, and views about science competency. The personal effectiveness cluster consisted of 2 competencies and they were as follows: diverse experiences and global attitude competency. Finally, the networking cluster consisted of 2 competencies and they were as follows: personal understanding and communication competency. Findings were expected to provide the basic data for developing programs and establishing strategies based on the core competency as well as introducing the core competency model of scientist to science education for gifted students effectively.
Fertilized egg, by successive cell divisions, differentiates into different tissues and organs with various structures and functions. Different cells and tissues contain different proteins, products of selective gene expression. Not all the genes in any genomes are equally active, temporal and spatial gene expression being the general rule. Present paper attempts to review the tanscriptional mechanisms or the initiations of transcription from several angles. In some of the organisms the genes in the process of transcription or the genes in the inactive state can be seen under the light microscope. Some bands of Drosophila polytene chromosomes may exhibit a swollen or puff appearance under certain conditions. A puff, unfolded or decondensed form of chromomere, represents sets of intense transcriptional activity or RNA synthesis. The heterochromatic X chromosome whose genes remain inactive in the female mammals can be visualized as a dark staining structure called Barr body, Configuration of chromatin differs between transcribed and nontranscribed chromatin. Modification to the chromatin facilitates RNA synthesis. The movement of large polymerase molecule along the DNA would probably be facilitated if some modifications of the chromatin configuration is effected. Methylation of cytosines in CG sequences is associated with inactive genes. Methylation can play a role in determination of mammalian cells during embryogenesis. Demethylation is necessary for the gene to be expressed during development A histone modification that is also known to be correlated with transcriptional capacity of chromatin is acetylation of the lysine residues of the core histones. Chromatin containing a high level of histone acetylation is very sensitive to DNase 1. For the transcription to occur TBP must first bind to the TATA box. Another TF, TF IIB, then binds to the promoter-TBP complex, facilitating the access of RNA polymerase to the transcription initiation site. As recently as eight years ago researchers assumed that histones were irrelevant to the regulation of gene expression. Histones combine with the DNA to form nucleosome of the chromatin. Histones are vital participant in gene regulation. Histone and basal factors compete for access to TATA box. When DNA is exposed to basal factors before histones are introduced, the basal factors assemble on TATA boxes preventing the access of histones, allowing transcription to occur, for transcription to begin, activator protein at the upstream activation sequence or enhancer must interact with the tail of histone H4 at TATA box and cause the histone role particle to dissociate from the TATA box leading to partial breakup of the histone core particle and allowing the basal factors to bind to the TATA box. New concept of genomic flux in contrast to the old concept of static genome has been developed based on the powerful new molecular techniques. Genomic changes such as repetitive DNAs and transposable elements, it is assumed but not yet proved, may affect some of the developmental patterns that characterize particular cells, tissues, organs, and organisms. In the last decade or so remarkable achievement have been made in the researches of the structures and functions of TFs and the specific target sequences located in promoters or enhancers where these TFs bind. TFs have independent domains that bind DNA and that activate transcription. DNA binding domain of TFs serves to bring the protein into the right location. There are many types of DNA binding domains. Common types of motifs can be found that are responsible for binding to DNA. The motifs are usually quite short and comprise only a small part of the protein structure. Steroid receptors have domains for hormone binding, DNA binding, and activating transcription. The zinc finger motif comprises a DNA binding domain. Leucine zipper consist of a stretch of amino acids with a leucine residue in every seventh position Two proteins form a dimer because they interact by means of leucine zippers on similar α-helical domain. This positions their DNA binding basic domains for interaction with the two halves of a DNA sequence with dyad symmetry of TGACTCA, ACTGAGT.
This study aims to assess the influence of climate change on the hydrological cycle at a basin level in North Korea. The selected model for this study is MRI-CGCM 3, the one used for the Coupled Model Intercomparison Project Phase 5 (CMIP5). Moreover, this study adopted the Spatial Disaggregation-Quantile Delta Mapping (SDQDM), which is one of the stochastic downscaling techniques, to conduct the bias correction for climate change scenarios. The comparison between the preapplication and postapplication of the SDQDM supported the study's review on the technique's validity. In addition, as this study determined the influence of climate change on the hydrological cycle, it also observed the runoff in North Korea. In predicting such influence, parameters of a runoff model used for the analysis should be optimized. However, North Korea is classified as an ungauged region for its political characteristics, and it was difficult to collect the country's runoff observation data. Hence, the study selected 16 basins with secured high-quality runoff data, and the M-RAT model's optimized parameters were calculated. The study also analyzed the correlation among variables for basin characteristics to consider multicollinearity. Then, based on a phased regression analysis, the study developed an equation to calculate parameters for ungauged basin areas. To verify the equation, the study assumed the Osipcheon River, Namdaecheon Stream, Yongdang Reservoir, and Yonggang Stream as ungauged basin areas and conducted cross-validation. As a result, for all the four basin areas, high efficiency was confirmed with the efficiency coefficients of 0.8 or higher. The study used climate change scenarios and parameters of the estimated runoff model to assess the changes in hydrological cycle processes at a basin level from climate change in the Amnokgang River of North Korea. The results showed that climate change would lead to an increase in precipitation, and the corresponding rise in temperature is predicted to cause elevating evapotranspiration. However, it was found that the storage capacity in the basin decreased. The result of the analysis on flow duration indicated a decrease in flow on the 95th day; an increase in the drought flow during the periods of Future 1 and Future 2; and an increase in both flows for the period of Future 3.
The Internet has become a medium through which people engage in increasingly sophisticated transactions. Businesses and consumers now use the Internet to communicate and engage in commercial transactions creating a virtual worldwide marketplace. They fear that the determination of Internet jurisdiction could be uncertain because electronic commerce is not executed in one particular place. Until now, there are no specific rules in the model laws and conventions dealing with international jurisdiction in electronic commerce. Due to the fact that U.S. companies are at the forefront of Internet technology, litigation regarding electronic commerce in the U.S. is more advanced than anywhere else in the world This paper analysis the basic framework for personal jurisdiction and approach for determining international jurisdiction in electronic commerce cases and explain the differences of several approaches involving interactions over the Internet. According to jurisdiction approach test, the U.S. employs sliding scale, effects and targeting test in electronic commerce. In recent many research views the targeting test as a global standard for determining international electronic commerce jurisdiction. However, there is still no clear indication of conclusive test of jurisdiction determination for electronic commerce. Therefore, it is a changing and process of jurisdiction test in the U.S. cases. In Korea, there is jurisdiction related clause in Private International Law, but it may be asked whether applicable in electronic commerce. Accordingly, analysis of the precedents changing related to electronic commerce jurisdiction of U.s. is full of suggestions in Korean companies, consumers and helps an enactment of code of civil procedure that containing many group's demands.
The purpose of this study is to examine major factors that affect patterns of living arrangements of older Korean noncitizens in the United States using the 1990 8% Public Use Microdata Sample(PUMS). In order to do so, I analyzed the effects of four factors including acculturation(English proficiency and Age at migration), economic circumstances(Personal Income and Supplemental Security Income: SSI receipt), health status(Mobility and Personal care limitation), and the ethnic community. The results show that acculturation and economic circumstances play an important role in determining the patterns of living arrangements among older Korean aliens, whereas the health status and the ethnic community do not show consistent effects. Regardless of marital status, the impact of age at migration is positively associated with solitary living of older Korean noncitizens, though, the effect of English proficiency show the opposite direction in accordance with marital status. That is, among nonmarried elders, those who cannot speak English are more likely to live alone. The case is reverse for married elders. The impact of economic feasibility is also positively associated with independent living arrangements. Those who receive SSI are much more likely to live apart from family, and elders whose annual personal income between $5,001 and $10,000 have the greatest propensity of solitary living-a large proportion of their income source is SSI. Individuals who receive SSI are also qualified to collect Medicaid, food stamps, rent subsidies, and other welfare benefits. In a sense, the economic feasibility provided by welfare benefits is the key determinant of independent living of older Korean noncitizens. Therefore, the recent welfare reform which denies legal aliens welfare benefits such as SSI and food stamps will severly affect the present living arrangements of older Korean aliens, and give economic burden to their family member The findings also show that there are significant differences within the elderly Korean Americans in terms of demographics, income, fertility, health status, and patterns of living arrangements by U.S. citizenship status. In particular, after controlling for age at migration as a proxy for acculturation, there is a statistically significant variation in living arrangements between elderly Korean noncitizens and naturalized citizens. For both theoretical and methodological reasons, future research on minority aging needs to investigate the concept of U.S. citizenship status for its impact on patterns of living arrangements among the minority elderly.
The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.
Journal of the Korean Society for Library and Information Science
/
v.7
/
pp.89-195
/
1980
The advanced developing countries including Korea are assumed to have reached a developmental stage which necessitates them to formulate and implement a plan for a national information network. Most of the governments in the advanced developing countries are well aware of the necessity for such a plan and some of them have actually commenced their studies on the feasibility of a national network of their own hoping to achieve maximum utility of their limited information resources. Two urgent problems facing planners in the design of a national information network are identified. One is lack of an optimum organisational model to enable them to meet their own situations, and the other is lack of a guideline to help designers evaluate the alternative structures and models when they are available. In resolving these two problems, network planners in the advanced developing countries would benefit from the achievement of the objectives of the present study. The major objective is to elicit and describe common information needs, desires and value of the people using information, and other common factors which are responsible for the present information services in the advanced developing countries and which have implications for the basic structure of the national information network. The value of this study is to aid administrators in Korea and those in the other advanced developing countries who are responsible for making national policies and who are now beginning to recognise the need for information services with the planning of economic and social development so as to enable all the groups in the community to have access to the information which are essential for decision making, research work, studies and even for recreational reading. This recognition will hopefully give them a rational basis for formulating right policies on information services. The methodology utlised for collecting the required data in this study falls under the category of observation and largely consists of the two techniques: literature review and postal questionnaire. Background information on the individual advanced developing: countries was gathered from monographic and periodical literature. and country reports presented at the various international conferences were analysed for other relevant data. For most of the data needed for the present study, a questionnaire on 'Library and Information Services as They Are Available in the Selected Countries' was formulated. This questionnaire was designed to be completed without help, by an expert who was well informed of the library and information services in his or her country. The questionnaire was intended to look in details at what information services in the advanced developing countries were doing-whom they were serving, in what way, and how well and establish to what extent they were meeting the nation's information requirements. It was also intended to ascertain the respondents' ideas on possible future developments in information provision in their countries, that is, in the advanced devanced developing countries. The questionnaire was posted to a total of 63 natinal librarians, directors of national information centres and those of other major libraries or information centres in 21 selected countries. Complete usable responses were received from 34 persons in 14 countries. In order to identify common characteristics of the information needs and desires in the advanced developing countries and the present situation of the information services to meet them, and the requirements and constraints peculiar to those countries which bought to be considered in the design of a national information network for advanced developing countries, an individual report on the current status of information activities for each of the fourteen countries chosen for this study, was presented. The procedure used was to arrange the data acquired in the questionnaire responses and other sources, in the form of fifteen country reports to be summarised by cross-section characteristics later.
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