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Effect of Exercise on Antioxidant Enzyme Activities of Skeletal Muscle and Liver in STZ-diabetic Rats (STZ-당뇨쥐에서 운동부하가 골격근 및 간의 항산화효소 활성도에 미치는 영향)

  • Seok, Kwang-Ho;Lee, Suck-Kang
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.21-30
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    • 2000
  • Background: The purpose of the present study was to investigate the effect of exercise on the activities of antioxidant enzymes, super oxide dismutase(SOD), glutathione peroxidase(GPX) and catalase(CAT) of skeletal muscle(gastrocnemius) and liver in streptozotocin(STZ) induced diabetic rats. The malondialdehyde(MDA) concentration was also measured as an index of lipid poroxidation of tho tissues by exercise-induced oxidative stresses in diabetic rats. Material and Methods: Male Sprague-Dawley rats were randomly divided into control and STZ-induced diabetic rats. The STZ in citrate buffer solution was injected twice at S days intervals intraperitoneally(50, 70 mg/kg respectively). On the 28th day after the first STZ injection, the diabetic animals were randomly divided into pre- and post-exercise groups, The exercise was introduced to the rats of post-exercise group by treadmill running until exhaution with moderate intensity ($V_{O2max}$: 50-70%) of exercise. The duration of average running time was 2 hours and 19 minutes. Results: The blood glucose concentration was increased(p<0.001) and plasma insulin concentration was decreased(p<0.001) in the diabetic rats. The glycogen concentration in the muscle and liver was decreased by exhaustive exercise in the diabetic rats(p<0.001), In the skeletal muscle, the activities of GPX was increased(p<0.05) and the activities of SOD and CAT were not changed in the diabetic rats compare to those of the control rats. The activities of GPX was not changed by exercise but the activities of SOD(p<0.01) and CAT(p<0.01) were decreased by exercise in the diabetic rats, The concentration of MDA was not changed by exercise in diabetic rats, and the values of pre-exercise and post-exercise diabetic rats were not different from the value those of control rats, In the liver, the activities of SOD was decreased(p<0.01), and the activities of GPX and CAT were not changed in diabetic rats compared to the values of control rats, The activities of SOD, GPX and CAT were not changed by exercise in diabetic rats but the activity of SOD seemed to decrease slightly, The MDA concentration was increased in the diabetic rats compared to the values of control rats(p<0.001), but there was no change of MDA concentration by exercise in diabetic rats, Conclusions: In summary, exhaustive physical exercise did not seem to impose oxidative stress on the skeletal muscle because of due to oxygen free radicals, regardless of the decrease in SOD and CAT in the diabetic rats, In liver tissue, the tissue damage by oxidative stress was observed in diabetic rats but the additional tissue damage by exhaustive physical exercise was not observed.

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The Bronchial Biopsies and Steroid Response in Unexplained Chronic Non-Productive Cough (원인을 알 수 없는 만성 기침의 기관지 생검소견과 경구 스테로이드의 효과)

  • Lee, Sang-Yeub;Jeong, Hye-Cheol;Kim, Kyung-Kyu;Kim, Je-Hyeong;Kwan, Young-Hwan;Lee, Sung-Yong;Lee, So-Ra;Cho, Hyun-Deuk;Lee, Sin-Hyung;Shim, Jae-Jeong;Cho, Jae-Yun;Kim, Han-Gyum;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.372-385
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    • 1999
  • Background: The purpose of this study was to examine the causes and pathologic process of chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph by investigating clinicopathologic findings. Method: We studied 25 adults with chronic non-productive cough over a 3-week period with a normal chest radiograph and pulmonary function tests without any other symptoms. Clinical assessment, cough score, chest and sinus radiograph, pulmonary function tests, methacholine challenge, allergic skin prick test, and bronchoscopy for bronchial biopsies were performed. Subjects were then treated with prednesolone 20 to 30 mg/day for 1 to 2 weeks. Results: The experimental group was divided into two subgroups-those infiltrated with eosinophils, and those infiltrated with lymphocytes depending on eosinophil and lymphocyte counts, both of which were respectively higher than those of the control group. Eosinophils infiltrated group had mean numbers of eosinophil of 89.8 $cells/mm^3$ while control group's mean was 0.4 $cells/mm^2$(p=0.005). Lymphocyte infiltrated group was 4 patients whose mean was 84.3 $cells/mm^2$ with 28.4 $cells/mm^2$ of control group(P=0.026). In addition, the mean thickness of the basement membrane of experimental group was $14.20{\pm}5.20{\mu}m$ in contrast of control group whose mean was $3.50{\pm}1.37{\mu}m$(P=0.001). With the methacholine challenge test, 7 of the 21 eosinophil infiltrated subjects were diagnosed with cough variant asthma ; the other 14 with eosinophilic bronchitis. Three subjects with eosinophilic bronchitis were atopic positive (21.4%) with the skin prick test In the lymphocyte dominant group, all four subjects were diagnosed with lymphocytic bronchitis. Cough score was improved after steroid treatment in 22 of 25 subjects in the experimental group (88.0%). Conclusion: These results suggest chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph was associated with airway inflammation by eosinophil and lymphocyte infiltration. The causes for chronic non-productive cough were eosinophilic bronchitis, cough variant asthma, and lymphocytic bronchitis(written in frequency). They further suggest that therapeutic treatment with steroids can provide effective symptomatic relief.

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The Usefulness of Pressure-regulated Volume Control(PRVC) Mode in Mechanically Ventilated Patients with Unstable Respiratory Mechanics (기계 호흡 중 불안정한 호흡역학을 보인 환자에서 압력조절용적조정양식(Pressure-regulated Volume Control Mode)의 효용)

  • Sohn, Jang-Won;Koh, Youn-Suck;Lim, Chae-Man;Shim, Tae-Sun;Lee, Jong-Deog;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1318-1325
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    • 1997
  • Background : Since the late 1960s, mechanical ventilation has been accomplished primarily using volume controlled ventilation(VCV). While VCV allows a set tidal volume to be guaranteed, VCV could bring about excessive airway pressures that may be lead to barotrauma in the patients with acute lung injury. With the increment of knowledge related to ventilator-induced lung injury, pressure controlled ventilation(PCV) has been frequently applied to these patients. But, PCV has a disadvantage of variable tidal volume delivery as pulmonary impedance changes. Since the concept of combining the positive attributes of VCV and PCV(dual control ventilation, DCV) was described firstly in 1992, a few DCV modes were introduced. Pressure-regulated volume control(PRVC) mode, a kind of DCV, is pressure-limited, time-cycled ventilation that uses tidal volume as a feedback control for continuously adjusting the pressure limit However, no clinical studies were published on the efficacy of PRVC until now. 'This investigation studied the efficacy of PRVC in the patients with unstable respiratory mechanics. Methods : The subjects were 8 mechanically ventilated patients(M : F=6 : 2, $56{\pm}26$ years) who showed unstable respiratory mechanics, which was defined by the coefficients of variation of peak inspiratory pressure for 15 minutes greater than 10% under VCV, or the coefficients of variation of tidal volume greater than 10% under PCV. The study was consisited of 3 modes application with VCV, PCV and PRVC for 15 minutes by random order. To obtain same tidal volume, inspiratory pressure setting was adjusted in PCV. Respiratory parameters were measured by pulmonary monitor(CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). Results : 1) Mean tidal volumes($V_T$) in each mode were not different(VCV, $431{\pm}102ml$ ; PCV, $417{\pm}99ml$ ; PRVC, $414{\pm}97ml$) 2) The coefficient of variation(CV) of $V_T$ were $5.2{\pm}3.9%$ in VCV, $15.2{\pm}7.5%$ in PCV and $19.3{\pm}10.0%$ in PRVC. The CV of $V_T$ in PCV and PRVC were significantly greater than that in VCV(p<0.01). 3) Mean peak inspiratory pressure(PIP) in VCV($31.0{\pm}6.9cm$ $H_2O$) was higher than PIP in PCV($26.0{\pm}6.5cm$ $H_2O$) or PRVC($27.0{\pm}6.4cm$ $H_2O$)(p<0.05). 4) The CV of PIP were $13.9{\pm}3.7%$ in VCV, $4.9{\pm}2.6%$ in PVC and $12.2{\pm}7.0%$ in PRVC. The CV of PIP in VCV and PRVC were greater than that in PCV(p<0.01). Conclusions : Because of wide fluctuations of VT and PIP, PRVC mode did not seem to have advantages compared to VCV or PCV in the patients with unstable respiratory mechanics.

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SANET-CC : Zone IP Allocation Protocol for Offshore Networks (SANET-CC : 해상 네트워크를 위한 구역 IP 할당 프로토콜)

  • Bae, Kyoung Yul;Cho, Moon Ki
    • Journal of Intelligence and Information Systems
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    • v.26 no.4
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    • pp.87-109
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    • 2020
  • Currently, thanks to the major stride made in developing wired and wireless communication technology, a variety of IT services are available on land. This trend is leading to an increasing demand for IT services to vessels on the water as well. And it is expected that the request for various IT services such as two-way digital data transmission, Web, APP, etc. is on the rise to the extent that they are available on land. However, while a high-speed information communication network is easily accessible on land because it is based upon a fixed infrastructure like an AP and a base station, it is not the case on the water. As a result, a radio communication network-based voice communication service is usually used at sea. To solve this problem, an additional frequency for digital data exchange was allocated, and a ship ad-hoc network (SANET) was proposed that can be utilized by using this frequency. Instead of satellite communication that costs a lot in installation and usage, SANET was developed to provide various IT services to ships based on IP in the sea. Connectivity between land base stations and ships is important in the SANET. To have this connection, a ship must be a member of the network with its IP address assigned. This paper proposes a SANET-CC protocol that allows ships to be assigned their own IP address. SANET-CC propagates several non-overlapping IP addresses through the entire network from land base stations to ships in the form of the tree. Ships allocate their own IP addresses through the exchange of simple requests and response messages with land base stations or M-ships that can allocate IP addresses. Therefore, SANET-CC can eliminate the IP collision prevention (Duplicate Address Detection) process and the process of network separation or integration caused by the movement of the ship. Various simulations were performed to verify the applicability of this protocol to SANET. The outcome of such simulations shows us the following. First, using SANET-CC, about 91% of the ships in the network were able to receive IP addresses under any circumstances. It is 6% higher than the existing studies. And it suggests that if variables are adjusted to each port's environment, it may show further improved results. Second, this work shows us that it takes all vessels an average of 10 seconds to receive IP addresses regardless of conditions. It represents a 50% decrease in time compared to the average of 20 seconds in the previous study. Also Besides, taking it into account that when existing studies were on 50 to 200 vessels, this study on 100 to 400 vessels, the efficiency can be much higher. Third, existing studies have not been able to derive optimal values according to variables. This is because it does not have a consistent pattern depending on the variable. This means that optimal variables values cannot be set for each port under diverse environments. This paper, however, shows us that the result values from the variables exhibit a consistent pattern. This is significant in that it can be applied to each port by adjusting the variable values. It was also confirmed that regardless of the number of ships, the IP allocation ratio was the most efficient at about 96 percent if the waiting time after the IP request was 75ms, and that the tree structure could maintain a stable network configuration when the number of IPs was over 30000. Fourth, this study can be used to design a network for supporting intelligent maritime control systems and services offshore, instead of satellite communication. And if LTE-M is set up, it is possible to use it for various intelligent services.

A Study on the Compositional Characteristics of Water Systems and Landscapes in Traditional Chinese Seowons (중국 전통서원의 수체계와 수경관의 구성적 특성)

  • MA, Shuxiao;RHO, Jaehyun
    • Korean Journal of Heritage: History & Science
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    • v.55 no.3
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    • pp.74-100
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    • 2022
  • The purpose of this study was to investigate the characteristics of Chinese seowons and to obtain data based on the characteristics of waterscapes unique to Korean seowons. The conclusion of this study from the results of investigation and analysis of the location, water system, and design characteristics of 10 representative traditional seowons in China including Yuelu Seowon(嶽麓書院) conducted based on literature research and field observation is as follows. The water system of Chinese seowons is dualized into an inner and an outer water system, and in general, two and a maximum of three water bodies are superimposed on the outside. The locations of seowons are classified into five types: Four double-sided round water type sites, three converted face water type sites, one three-sided round water type site, a four-sided round water type, and a waterproofing type(依山傍水型). Therefore, compared to the typical Korean seowon facing water in the front and a mountain in the back(背山面水型), the Chinese seowons showed a highly hydrophilic property. The water shapes of the external water system were meandering(46.0%), mooring(36.0%), and broad and irregular(9.0%). In addition, water conception(水態) were streams(31.8%), rivers(27.3%), springs(13.6%), falls(9.1%), lakes(4.5%) and ponds(4.5%), in that order. As for waterscapes of the water system inside the seowon, there were seven in Akrok Seowon and four in Mansong Seowon, indicating a comparatively higher number of waterscapes. Since the 27 detailed waterscapes in 10 seowons that were the subject of the study were classified into six types including ponds and half-moon ponds, they appeared to be more diverse than the Korean seowon. It is noteworthy that in the interior waterscape of the traditional Chinese seowon, the ritualistic order, where at least one half-moon pond or square pond(方池) was arranged, is well displayed. In particular, the half-moon pond(伴池), which is difficult to find in Korean seowon, was found to be a representative waterscape element, accounting for 42.8%. If the square pond of Nanxi Seowon based on Zhu Xi's poem 「Gwanseoyugam(觀書有感)」 is also treated as a square-shaped half-moon pond, the proportion of half-moon ponds in the waterscape will be as high as 50%. The pond shapes consisted of 28% square, 24% each for free curve and round shape, 20% for semi-moon shape, and 3.8% for mountain stream type. This seems to differ greatly from the square-shaped Korean seowon. On the other hand, there were a total of 10 types of structures related to the waterscape inside the Chinese seowon: 11(26.8%) pavilion and bridge sites, five gate room sites(牌坊: 16.5%), four gate and tower sites(樓, 1.4%), two Jae sites(齋, 6.2%), and one site each(3.1%) of Heon(軒), Sa(祠), Dae(臺), and Gak(閣). In particular, the pavilions inside seowon were classified into three types: landscape pavilion(景觀亭 27.2%), tombstone pavilion(碑亭, 18.2%), and banquet pavilion(宴集亭, 54.5%). In general, it was confirmed that the half-moon pond with a pedestal bridge, and the pavilion were the major components with a high degree of connection that dominate the waterscape inside the Chinese seowon.

A Study on the Divinity of 'the Supreme God and Celestial Worthy of the Ninth Heaven Who Spreads the Sound of the Thunder Corresponding to Primordial Origin': Focusing on the Relationship between the Divine Qualities of Being 'the Celestial Worthy of Universal Transformation' and 'the Lord God of Great Creation in the Ninth Heaven' (구천응원뇌성보화천존상제 신격 연구 - '보화천존'과 '구천대원조화주신'의 관계를 중심으로 -)

  • Park, Yong-cheol
    • Journal of the Daesoon Academy of Sciences
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    • v.29
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    • pp.71-100
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    • 2017
  • This study focuses on examining 'the Supreme God and Celestial Worthy of the Ninth Heaven Who Spreads the Sound of the Thunder Corresponding to Primordial Origin', which Daesoon Jinrihoe believes in as the highest divinity. The name of this divinity was first found in Chinese Daoist scriptures. This study starts by considering the global propagation of virtue and then research connected to this topic. There are two alternative names for this divinity in relation to his human avatar, Kang Jeungsan, the subject of faith in Daesoon Jinrihoe. One is 'the Lord God of Great Creation in the Ninth Heaven' meaning the divinity before assuming a human avatar, and the other is 'the Celestial Worthy of Universal Transformation' the same divinity after he discarded his human avatar and returned to his celestial post. To understand how the belief system of Daesoon Jinrihoe differs from that of Daoism, it is necessary to study the divinity's change from being 'the Lord God of Great Creation in the Ninth Heaven' to becoming 'the Celestial Worthy of Universal Transformation'. If this distinction is not made clear, it brings about confusing arguments concerning the term 'Supreme God (Sangje)' as used in Daoism and Daesoon Jinrihoe. In order to offer a specific explanation, this study suggests three possible directions. The first hypothesis is that although these two names, 'the Celestial Worthy of the Ninth Heaven Who Spreads the Sound of the Thunder Corresponding to Primordial Origin' from Daoism and 'the Supreme God of the Ninth Heaven Who Spreads the Sound of the Thunder Corresponding to Primordial Origin' from Daesoon Jinrihoe, are similar, they actually have nothing to do with one another. The second hypothesis is that they are in fact the same divinity. Lastly, the third hypothesis is that they are closely connected, however, the former (the Celestial Worthy of the Ninth Heaven Who Spreads the Sound of the Thunder Corresponding to Primordial Origin) is a position needed to fulfill the mission of Jeungsan, whereas the latter (the Supreme God of the Ninth Heaven Who Spreads the Sound of the Thunder Corresponding to Primordial Origin) is a name received after the human avatar passes and the deity returns to the Noebu, 'the department of lightning'. These hypotheses face certain problems such as arbitrary mixing, the need for the theoretical clarity, and argumental weakness. Therefore, by leaving some unresolved questions, this study encourages future follow-up studies.

Studies on the Mechanical Properties of Weathered Granitic Soil -On the Elements of Shear Strength and Hardness- (화강암질풍화토(花崗岩質風化土)의 역학적(力學的) 성질(性質)에 관(關)한 연구(硏究) -전단강도(剪斷强度)의 영향요소(影響要素)와 견밀도(堅密度)에 대(對)하여-)

  • Cho, Hi Doo
    • Journal of Korean Society of Forest Science
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    • v.66 no.1
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    • pp.16-36
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    • 1984
  • It is very important in forestry to study the shear strength of weathered granitic soil, because the soil covers 66% of our country, and because the majority of land slides have been occured in the soil. In general, the causes of land slide can be classified both the external and internal factors. The external factors are known as vegetations, geography and climate, but internal factors are known as engineering properties originated from parent rocks and weathering. Soil engineering properties are controlled by the skeleton structure, texture, consistency, cohesion, permeability, water content, mineral components, porosity and density etc. of soils. And the effects of these internal factors on sliding down summarize as resistance, shear strength, against silding of soil mass. Shear strength basically depends upon effective stress, kinds of soils, density (void ratio), water content, the structure and arrangement of soil particles, among the properties. But these elements of shear strength work not all alone, but together. The purpose of this thesis is to clarify the characteristics of shear strength and the related elements, such as water content ($w_o$), void ratio($e_o$), dry density (${\gamma}_d$) and specific gravity ($G_s$), and the interrelationship among related elements in order to decide the dominant element chiefly influencing on shear strength in natural/undisturbed state of weathered granitic soil, in addition to the characteristics of soil hardness of weathered granitic soil and root distribution of Pinus rigida Mill and Pinus rigida ${\times}$ taeda planted in erosion-controlled lands. For the characteristics of shear strength of weathered granitic soil and the related elements of shear strength, three sites were selected from Kwangju district. The outlines of sampling sites in the district were: average specific gravity, 2.63 ~ 2.79; average natural water content, 24.3 ~ 28.3%; average dry density, $1.31{\sim}1.43g/cm^3$, average void ratio, 0.93 ~ 1.001 ; cohesion, $ 0.2{\sim}0.75kg/cm^2$ ; angle of internal friction, $29^{\circ}{\sim}45^{\circ}$ ; soil texture, SL. The shear strength of the soil in different sites was measured by a direct shear apparatus (type B; shear box size, $62.5{\times}20mm$; ${\sigma}$, $1.434kg/cm^2$; speed, 1/100mm/min.). For the related element analyses, water content was moderated through a series of drainage experiments with 4 levels of drainage period, specific gravity was measured by KS F 308, analysis of particle size distribution, by KS F 2302 and soil samples were dried at $110{\pm}5^{\circ}C$ for more than 12 hours in dry oven. Soil hardness represents physical properties, such as particle size distribution, porosity, bulk density and water content of soil, and test of the hardness by soil hardness tester is the simplest approach and totally indicative method to grasp the mechanical properties of soil. It is important to understand the mechanical properties of soil as well as the chemical in order to realize the fundamental phenomena in the growth and the distribution of tree roots. The writer intended to study the correlation between the soil hardness and the distribution of tree roots of Pinus rigida Mill. planted in 1966 and Pinus rigida ${\times}$ taeda in 199 to 1960 in the denuded forest lands with and after several erosion control works. The soil texture of the sites investigated was SL originated from weathered granitic soil. The former is situated at Py$\ddot{o}$ngchangri, Ky$\ddot{o}$m-my$\ddot{o}$n, Kogs$\ddot{o}$ng-gun, Ch$\ddot{o}$llanam-do (3.63 ha; slope, $17^{\circ}{\sim}41^{\circ}$ soil depth, thin or medium; humidity, dry or optimum; height, 5.66/3.73 ~ 7.63 m; D.B.H., 9.7/8.00 ~ 12.00 cm) and the Latter at changun-long Kwangju-shi (3.50 ha; slope, $12^{\circ}{\sim}23^{\circ}$; soil depth, thin; humidity, dry; height, 10.47/7.3 ~ 12.79 m; D.B.H., 16.94/14.3 ~ 19.4 cm).The sampling areas were 24quadrats ($10m{\times}10m$) in the former area and 12 in the latter expanding from summit to foot. Each sampling trees for hardness test and investigation of root distribution were selected by purposive selection and soil profiles of these trees were made at the downward distance of 50 cm from the trees, at each quadrat. Soil layers of the profile were separated by the distance of 10 cm from the surface (layer I, II, ... ...). Soil hardness was measured with Yamanaka soil hardness tester and indicated as indicated soil hardness at the different soil layers. The distribution of tree root number per unit area in different soil depth was investigated, and the relationship between the soil hardness and the number of tree roots was discussed. The results obtained from the experiments are summarized as follows. 1. Analyses of simple relationship between shear strength and elements of shear strength, water content ($w_o$), void ratio ($e_o$), dry density (${\gamma}_d$) and specific gravity ($G_s$). 1) Negative correlation coefficients were recognized between shear strength and water content. and shear strength and void ratio. 2) Positive correlation coefficients were recognized between shear strength and dry density. 3) The correlation coefficients between shear strength and specific gravity were not significant. 2. Analyses of partial and multiple correlation coefficients between shear strength and the related elements: 1) From the analyses of the partial correlation coefficients among water content ($x_1$), void ratio ($x_2$), and dry density ($x_3$), the direct effect of the water content on shear strength was the highest, and effect on shear strength was in order of void ratio and dry density. Similar trend was recognized from the results of multiple correlation coefficient analyses. 2) Multiple linear regression equations derived from two independent variables, water content ($x_1$ and dry density ($x_2$) were found to be ineffective in estimating shear strength ($\hat{Y}$). However, the simple linear regression equations with an independent variable, water content (x) were highly efficient to estimate shear strength ($\hat{Y}$) with relatively high fitness. 3. A relationship between soil hardness and the distribution of root number: 1) The soil hardness increased proportionally to the soil depth. Negative correlation coefficients were recognized between indicated soil hardness and the number of tree roots in both plantations. 2) The majority of tree roots of Pinus rigida Mill and Pinus rigida ${\times}$ taeda planted in erosion-controlled lands distributed at 20 cm deep from the surface. 3) Simple linear regression equations were derived from indicated hardness (x) and the number of tree roots (Y) to estimate root numbers in both plantations.

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An Analysis of Determinants of Health Knowledge, Attitude and Practice of Housewives in Korea (한국부인의 보건지식, 태도 및 실천에 영향을 미치는 제요인분석)

  • 남철현
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.3-50
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    • 1984
  • The levels of health knowledge, attitude and practice of housewives considerably effect to the health of households, communities and the nation. This study was designed to grasp the levels of health knowledge, attitude and practice of houswives and analyse the various factors effecting to health in order to provide health education services as well as materials for effective formulation and implementation of health policy to improve the health of the nation. This study has been conducted through interviews by trained surveyers for 4,281 housewives selected from 4,500 households throughout the country for 40 days during July 11-August 20, 1983. The results of survey were analysed by stepwise multiple regression and path analysis are summarized as follows; 1. Based on the measurement instrument applied to this study, the levels of health knowledge, attitude and practice of housewives were extremely low with 54.5 points out of 100 points in full. Higher level with 72 points and above was approximately 21 percent and lower level with 39 points and below was approx. 24 percent. The middle level was approx. 55 percent. In order to implement health programs successively, health education should be more strengthened and to improve the level of health knowledge, attitude and practice (KAP) of the nation, political consideration as a part of spiritual reformation must be concentrated on health. 2. The level of health knowledge indicated the highest points with 57.3 the level of attitude was the second with 55.0 points and the practice level was the lowest with 50.0 point. Therefore, planning and implementation of health education program must be based on the persuasion and motivation that health knowledge turn into practice. 3. Housewives who had higher level of health knowledge, showed their practice level was relatively lower and those who had middle or low level of it practice level was the reverse. 4. Correlations among health knowledge, attitude and practice (KAP) were generally higher and statistically significant at 0.1 percent level. Correlation between total health KAP level and health knowledge was the highest with r=.8092. 5. Health KAP levels showed significant differences according to the age, number of children, marital status, self-assessed health status and concern on health of the housewives interviewed (p<0.001) 6. Health KAP levels also showed significant differences according to the education level, economic status, employment before marriage and grown-up area of the housewives interviewed. (p<0.001) 7. Heath KAP levels showed significant differences according to health insurance benificiary and the existence of patients in the family. (p<0.001). 8. Health KAP levels showed significant differences according to distance to government organizations, schools, distance to health facilities, telephone possession rate, television possession rate, newspaper reading rate and activities of Ban meeting and Women's club. (p<0.001) 9. Health KAP levels showed significant differences according to electric mass communication media such as television, radio and village broadcasting etc. and printed media such as newspaper, magazine and booklets etc., IEC variables such as individual consultation and husband-wife communication, however, there was no significance with group training. 10. Health KAP of the housewives showed close correlation with personal characteristics variables, i.e., education level (r=.5302), age (r=-.3694) grown-up area (r=.3357) and employment before marriage. In general, correlation of health knowledge level was higher than the levels of attitude or practice. In case of health concern and health insurance, correlation of practice level was higher than health knowledge level. 11. Health KAP levels showed higher correlation with community environmental characteristics, Ban meeting and activity of Women's club, however, no correlation with New-village movement. 12. Among IEC variables, husband-wife communication showed the highest correlation with health KAP levels and printed media, electric mas communication media and health consultation in order. Therefore, encouragement of husband-wife communication and development of training program for men should be included in health education program. 13. Mass media such as electric mass com. and printed media were effective for knowledge transmission and husband-wife communication and individual consultation were effective for health practice. Group training was significant for knowledge transmission, however, but not significant for attitude formation or turning to health practice. To improve health KAP levels, health knowledge should be transmitted via mass media and health consultation with health professionals and field health workers should be strengthened. 14. Correlation of health KAP levels showed that knowledge level was generally higher than that of practice and recognized that knowledge was not linked with attitude or practice. 15. The twenty-five variables effecting health KAP levels of housewives had 41 per cent explanation variances among which education level had great contribution (β=.2309) and electric mass com. media (β=.1778), husband-wife communication (β=.1482), printed media, grown-up area, and distance to government organizations in order. Variances explained (R²) of health KAP were 31%, 15%, and 30% respectively. 16. Principal variables contributed to health KAP were education level (β=.12320, β=.1465), electric mass comm. media (β=.1762, β=.1839), printed media, (β=.1383, β=.1420) husband-wife communication (β=.1004, β=.1067), grown-up area and distance to government organizations, in order. Since education level contributes greatly to health KAP of the housewives, health education including curriculum development in primary, middle and high schools must be emphasized and health science must be selected as one of the basic liberal arts subject in universities. 17. Variences explained of IEC variables to health KAP were 19% in total, 14% in knowledge, 9% in attitude, and 10% in health practice. Contributions of IEC variables to health KAP levels were printed media (β=.3882), electric mass comm media (β=.3165), husb-band wife com. (β=.2095,) and consultation on health (β=.0841) in order, however, group training showed negative effect (β=-.0402). National fund must be invested for the development of Health Program through mass media such as TV and radio etc. and for printed materials such as newspaper, magazines, phamplet etc. needed for transmission of health knowledge. 18. Variables contributed to health KAP levels through IEC variables with indirect effects were education level (Ind E=0.0410), health concern (Ind E=.0161), newspaper reading rate (Ind E=.0137), TV possession rate and activity of Ban meeting in order, however, health facility showed negative effect (Ind E=-.0232) and other variables showed direct effect but not indirect effect. 19. Among the variables effecting health KAP level, education level showed the highest in total effect (TE=.2693) then IEC (TE=.1972), grown-up city (TE=.1237), newspaper reading rate (TE=.1020), distance to government organization (TE=.095) in order. 20. Variables indicating indirect effects to health KAP levels were; at knowledge level with R²=30%, education level (Ind E=.0344), newspaper reading rate (Ind E=.0112), TV possession rate (Ind E=.0689), activity of Ban meeting (Ind E=.0079) in order and at attitude level with R²=13%, education level (Ind E=. 0338), activity of Ban meeting (Ind E=.0079), and at practice level with R²=29%. education level (Ind E=.0268), health facility (Ind E=.0830) and concern on health (Ind E=.0105). 21. Total effect to health KAP levels and IEC by variable characteristics, personal characteristics variables indicated larger than community characteristics variables. 22. Multiple Correlation Coefficient (MCC) expressed by the Personal Characteristic Variable was .5049 and explained approximately 25% of variances. MCC expressed by total Community environment variable was .4283 and explained approx. 18% of variances. MCC expressed by IEC Variables was .4380 and explained approx. 19% of variances. The most important variable effected to health KAP levels was personal characteristic and then IEC variable, Community Environment variable in order. When the IEC effected with personal characteristic or community characteristic, the MCC or the variances were relatively higher than effecting alone. Therefore it was identified that the IEC was one of the important intermediate variable.

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축산식품중(畜産食品中)의 Cholestrerol에 관(關)한 고찰(考察)

  • Han, Seok-Hyeon
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 1995.11a
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    • pp.1-48
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    • 1995
  • 식생활은 인간 생활의 주체이고 먹는다는 것은 그 수단이다. 그중 중요한 하나의 명제는 인간이 놓여진 여러 환경에서 어떻게 건강을 유지하고 그 개체가 소유하고 있는 능력을 최대치까지 생리적으로 성장 발전시킴과 동시에 최대한 수명을 연장시키기 위한 식물 섭취방법을 마이크로 레벨까지 해명하는데 있다. 인간은 일생동안 엄청난 양의 음식물을 먹는다(70세 수명일 경우 200만 파운드 즉 체중의 1,400배). 그러나 먹기는 먹되 자신의 건강과 장수를 위하여 어떤 음식을 어떻게 선택하여 어떻게 먹어야 하는 문제가 매우 중요하다. 최근 우리나라도 국민 소득이 늘면서 식생활은 서구화 경향으로 기우는 듯하다. 공해를 비롯한 수입식품 등 여러 가지 문제점이 제기됨에 따라 자연식과 건강식을 주장하는 소리가 높이 일고 있다. 그중에는 축산 식품이 콜레스테롤 함량이 다른 식품에 비하여 높게 함유하고 있다는 것으로 심혈관질환의 주범인양 무차별 강조하는 나머지 육식공포 내지는 계란 등의 혐오감 마저 불러 일으키는 경향까지 있는 듯하다. 따라서 본논고에서는 축산식품중의 콜레스테롤 함량수준이 과연 성인병의 주범인지 아니면 다른 지방산과 관련해서 올바르게 평가하고 그 문제점과 대책을 개관해 보고 요약하면 다음과 같다. 1. 사람은 유사이래 본능적으로 주변의 식물이나 동물의 고기를 먹고 성장하여 자손을 증식시키고 어느 사이에 늙으면 죽음을 맞이 하는 싸이클을 반복하면서 기나긴 세월동안 진화를 하여 오늘날의 인간으로서의 자태를 이루었다. 유인원과 같은 인류의 선조들은 수렵을 통해 육식을 많이 하였을 것이므로 인간은 원래 육식동물이 아닐까? 구석기시대의 유물을 보면 많은 뼈가 출토되고 “얄타미라”나 “라스코” 동굴벽화가 선명하게 묘사되고 있다. 2. 우리나라 선조 승구족의 일파가 백두산을 비롯한 만주 송화강 유역에 유입되면서 수렵과 목축을 주요 식품획득의 수단으로 식품문화권을 형성하면서 남하하여 한반도 민족의 조상인 맥족(貊族)으로 맥적(貊炙)이라고 하는 요리(오늘날의 불고기)를 먹었다는 기록이 있다. 3. 인간의 수명을 1900년대로 거슬러 올라가서 뉴질랜드가 세계최장수국(호주는 2위)로서 평균수명은 남자 58세, 여자 69세인 반면 일본과 한국은 당시 남자 36세, 여자 37세이던 것이 일본은 1989년에 이르러 세계 최장수국으로 등장했으나 1990년 당시 뉴질랜드${\cdot}$호주 등은 목축 및 밀(小麥) 생산국가였기 때문이라는 것과 일본은 오늘날 합리적인 식생활 국가라는 것을 간과해서는 안된다. 4. 우리나라 10대 사망원인중 (1994년도) 뇌혈관질환이 1위, 교통사고 2위, 암이 3위 순위로서 연령별로는 10~30대의 불의의 사고(교통사고), 40~60대는 암, 70대 이상은 뇌혈관질환이 가장 많다. 구미${\cdot}$일 7개국 정상국가들은 심질환 사망이 가장 높다. 5. 식생활의 변화에 있어서 우리나라는 주식으로 섭취해 왔던 곡류는 70년 대비 94년에는 0.7배 감소된 반면 육류 5배, 계란 2.4배, 우유는 무려 29.3배 증가되었다. 식생활 패턴이 서구화 경향으로 바뀌는 것 같다. 6. 71년도 우리나라의 지질섭취량은 국민 1인당 1일 평균 13.1g에 섭취에너지의 5.7%수준이었으나 92년도에는 34.5g으로서 총에너지 섭취량의 16.6%에 달하고 총섭취 지방질중 동물성 섭취 비율은 47%를 차지 한다. 국민 평균 혈청콜레스테롤 농도는 80년에 비해 88년에는 11%가 증가되었고 80년에 210mg/dl 이상 되는 콜레스테롤 혈증인 사람의 비율이 5%에서 88년에는 23%로 크게 증가했다. 7. 세계 정상국가들의 단백질 즉 축산식품의 섭취는 우리나라보다 적게는 2배, 많게는 6~7배 더 섭취하고 90년도 우리나라의 지질섭취량은 일본의 1/3수준에 불과하다. 8. 콜레스테롤은 인체를 비롯한 모든 동물체에 필수적으로 분포하고 있는 것으로 체내 존재하고 있는 총량은 90~150g, 이중 혈청콜레스테롤은 4%(6g)를 차지하고 있음에도 불구하고 이 아주 적은 콜레스테롤에 일희일비(一喜一悲) 논쟁은 60~70년 끄러오고 있다. 9. 콜레스테롤의 생체내 기능으로서는 (1) 세포벽의 지지물질 (2) 신경세포 보호막물질 (3) 담즙산의 합성 (4) 비타민 D의 합성 (5) 임신시에 반듯이 필요한 분자 (6) 기타 여러 가지 기능을 수행하는 것으로 필수적인 물질이다. 10. 우리가 식이를 통해서 섭취 콜레스테롤을 550mg정도를 섭취한다고 하더라도 이 정도의 양은 배설 소모되는 양과 거의 맞먹는 양이다. 피부와 땀샘에서 소실되는 양만도 100~300mg에 달하기 때문에 미국농무성에서 섭취량을 300mg로 제한하는 것은 무의미하다. 11. 콜레스테롤 운반체로서의 지단백질은 그 밀도가 낮은 것으로부터 킬로미크론(chylomicron), 초저밀도 지단백질(VLDL), 저밀도 지단백질(LDL) 및 고밀도 지단백질(HDL)으로 나누는데 LDL은 혈청콜레스테롤 중 약 70%, HDL은 약20%를 함유한다. 12. 혈중 콜레스테롤 수준에 영향을 미치는 요인을 열거하여 보면 다음과 같다. 1) 음식을 통해서 섭취되는 콜레스테롤 중 단지 10~40%정도가 흡수되고, 체내에서 합성되는 콜레스테롤이 증가할수록 식이콜레스테롤은 실제 혈청콜레스테롤 수준에 거의 영향을 미치지 않으므로 식이중함량에 대하여 공포를 느끼고 기피할 필요가 없다. 2) 고도불포화지방산, 단가불포화지방산, 포화지방산의 비 즉 P/M/S의 비가 균형되도록 권장한다. 3) 동맥경화를 비롯한 성인병의 원인이 되는 혈전증에는 EPA의 양을 높여줌으로서 성인병을 예방할 수 있다. 4) 오메가6지방산 아라키도닉산과 오메가3지방산인 EPA로 유도되는 에이코사에노이드 또는 프로스타노이드는 오메가6와 3지방산을 전구체로 하여 생합성되는 중요한 생리활성 물질이다. 5) 사람은 일반적으로 20세에서 60세까지 나이를 먹어감에 따라 혈중 콜레스테롤 수준이 증가하고 60세 이후부터는 일정한 수준을 유지하며 심장보호성 HDL-콜레스테롤은 감소하는 반면에 죽상경화성 LDL콜레스테롤은 증가한다. 6) 높은 HDL콜레스테롤 수준이 심장병 발생 위험요인을 감소시키는 기능을 갖고 있기 때문에 좋은 HDL이라 부르고, LDL은 나쁜 콜레스테롤이라 부르기도 하는데, 이것은 유전적 요인보다도 환경적 요인이 보다 큰 영향을 미친다. 7) 이것은 생활 형태와 영양섭취상태를 포함해서 개인적 생활패턴에 영향을 받는다. 8) 많은 실험에서 혈중 콜레스테롤 상승은 노년의 가령(加齡)에 적응하기 위한 자연적 또는 생리적인 세포의 생화학적이고 대사적인 기능을 위해 필수적일 수 있다는 것을 간과해서는 안될 것이다. 이 점으로 미루어 노년의 여성들을 위한 콜레스테롤 농도를 200mg/dl이 가장 알맞은 양이 아닌 듯하다. 9) 스트레스는 두가지 모양으로 유발되는데 해로은 스트레스(negative), 이로운 스트레스(positive)로서 긴장완화는 혈중 콜레스테롤 농도를 10% 떨어진다. 10) 자주 운동을 하는 사람들은 혈중 HDL콜레스테롤치가 운동을 하지 않는 사람보다 높다. 육체적인 운동의 정도와 혈중 HDL콜레스테롤 농도와는 정비례한다. 11) 흡연은 지방을 흡착시키므로 혈전증의 원이이 되며 혈관속의 HDL농도를 감소시킨다. 12) 에너지의 과잉섭취에 의한 체중 증가느 일반적으로 지단백질대사에 영향을 미치고, 간에서는 콜레스테롤 과잉 생산과 더불어 VLDL콜레스테롤의 LDL콜레스테롤 혈증을 나타냄으로 운동과 더불어 비만이 되지 않도록 하여야 한다. 13. 콜레스테롤 함량에 대한 조절기술 1) 식품의 우열을 평가할 때 단순히 동물성 또는 식물성 식품으로 분류해서 총괄적으로 논한다는 것은 지양되어야 한다. 이것은 그 식품에 함유하고 있는 지방산의 종류에 따라서 다르기 때문이다. 2) 인체의 원할한 기능 유지를 위해서는 P /M /S비율 뿐만 아니라 섭취 지방질의 오메가6 /오메가3계 지방산의 비율이 모두 적절한 범위에 있어야 하며 한두가지 지방산만이 과량일 때는 또 다른 불균형을 일으킬 수 있다는 점을 알아야 한다. 3) 닭고기는 오메가6지방산 함량을 높이기 위하여 사료중에 등푸른 생선이나 어분이나 어유를 첨가하여 닭고기는 첨가수준에 따라 증가됨을 알 수 있다. 4) 오늘날 계란내의 지방산 조성을 변화시켜 난황내의 오메가 3계열 지방산 함량을 증가시킨 계란의 개발이 활발해졌다. 14. 계란 콜레스테롤에 대한 소비자들의 부정적 인식을 불식시키고자 계란의 클레스테롤 함량을 낮추는 과제가 등장하면서 그 기술개발이 여러모로 시도되고 있으나 아직 실용 단계에 이르지 못했다. 15. 계란의 콜레스테롤 문제에 대한 대책으로서 난황의 크기를 감소시키는 방법에 대한 연구도 필요하다. 16. 계란 중 콜레스테롤 함량 분석치는 표현 방식에 따라서 소비자들을 혼란시킬 가능성이 있다. 또한 과거에는 비색법으로 분석했으나 오늘날은 효소법으로 분석하면 분석치에 상당한 차이가 있다. 17. 소비자의 요구를 만족시키고 버터 소비를 촉진시키기 위해 콜레스테롤을 감소시키는 물리적${\cdot}$생물학적 방식이 제안되어 있으나 현장적용이 가능한 것은 아직 없다. 18. 우리나라에서 이미 시판되고 있는 DHA우유가 선보였고 무콜레스테롤 버터의 경우 트란스(trans)형 지방산에 관해서는 논란의 여지가 많을 것이다. 끝으로 국가 목표의 하나는 복지사회 건설에 있고 복지국가 실현에는 국민 기본 욕망의 하나인 식생활 합리화가 선행되어야 한다. 소득이 늘고 국가가 발전해감에 따라 영양식${\cdot}$건강식 및 기호식을 추구하게 됨을 매우 당연한 추세라 하겠다. 우리의 식생활이 날로 향상되어 지난날의 당질 위주에서 점차 축산물쪽으로 질적 개선이 이루어진다는 것은 고무적임에 틀림없다. 이 축산물을 통한 풍요로운 식의 문화를 창출하면서 건강과 장수 그리고 후손에 이르기까지 번영하고 국가 경쟁력 강화에 심혈을 기우려야 할 때이다.

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A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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