• Title/Summary/Keyword: Service injection

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Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center (보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도)

  • Ahn, Kyeong-Sook;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.1-13
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    • 1995
  • Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

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Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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The Evaluation of Usefulness of 99Mo-99mTc Generator Using(n,γ)99Mo Developed by Korea Atomic Energy Research ((n,γ)99Mo를 이용한 99Mo-99mTc발생기의 유용성 평가)

  • Seo, Han Kyung;Kim, Jeong Ho;Shim, Cheol Min;Kim, Byung Cheol;Choi, Do Cheol;Gwon, Yong Ju;Park, Yung Sun;Kim, Dong Yun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.48-52
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    • 2013
  • Purpose: The Molybdenum which is the raw material of $^{99}Mo-^{99m}Tc$ generator is produced from the nuclear reactor. However, output has dwindled as the two nuclear reactors supplying the bulk of radioactive material-one in Chalk River, Ontario and the other in Petten, the Netherlands-have been closed for repairs or maintenance. This resulted in the enhancement of its price. So $^{99}Mo-^{99m}Tc$ generator using$(n,{\gamma})^{99}Mo$ is developed by Korea Atomic Energy Research Institute (KAERI). Medicinal availability of this generator is evaluated in this study. Materials and Methods: The radioactivity of $^{99m}Tc$ eluted in generator 1, 2 and 3 unit developed by KAERI was measured. The quality control test of generator such as appearance test, pH test, LAL test, sterility test, chemical impurity (Al) test and radiochemical purity test were performed. Planar and SPECT/CT image sof SD rat (6 weeks, Female) at 2 hr after injection of $^{99m}Tc-HDP$ (hydroxymethylenediphosphonate) (TechneScan HDP, Malinckrodt Medical, Dutch) and $^{99m}Tc-DPD$ (diphosphono-1, 2-propanedicarboxylicacid) (TECEOS, CIS bio international, France) which were labeled with $^{99m}Tc$ eluted in KAERI and commercial generator (40.5 GBq, Malinckrodt Medical, Dutch) using SPECT/CT camera (Symbia, Siemense, Germany) were obtained respectively. Results: The mean radioactivity of $^{99m}Tc$ elution generator 1unit was 4.18 GBq (113 mCi), generator 2 unit was 4.73 GBq (128 mCi) and generator 3 unit was 3.33 GBq (90 mCi). All quality control tests were within normal limit except pyrogentest. Pyrogen test was positive. Planar and SPECT/CT images of rat injected $^{99m}Tc-HDP$ which was labeled with $^{99m}Tc$ eluted in commercial generator show increased uptake in bone, stomach and bowl. Planar images show increased uptake in liver and bone in case of $^{99m}Tc-DPD$. However, images of rat injected $^{99m}Tc-HDP$ and $^{99m}Tc-DPD$ which were labelled $^{99m}Tc$ eluted in KAERI generator show increased uptake in bone, liver and spleen. Conclusion: If shortcoming is removed such as pyrogen and liver appearance, domestic role as an alternative generator is thought to be able to fill and to secure the national medical service by supplying $^{99m}Tc$ when the supply of $^{99m}Tc$ be comes short.

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Comparison of Effectiveness about Image Quality and Scan Time According to Reconstruction Method in Bone SPECT (영상 재구성 방법에 따른 Bone SPECT 영상의 질과 검사시간에 대한 실효성 비교)

  • Kim, Woo-Hyun;Jung, Woo-Young;Lee, Ju-Young;Ryu, Jae-Kwang
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.9-14
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    • 2009
  • Purpose: Nowadays in the nuclear medicine, many studies and efforts are being made to reduce the scan time, as well as the waiting time to be needed to execute exams after injection of radionuclide medicines. Several methods are being used in clinic, such as developing new radionuclide compounds that enable to be absorbed into target organs more quickly and reducing acquisition scan time by increase the number of Gamma Camera detectors to examine. Each medical equipment manufacturer has improved the imaging process techniques to reduce scan time. In this paper, we tried to analyze the difference of image quality between FBP, 3D OSEM reconstruction methods that commercialized and being clinically applied, and Astonish reconstruction method (A kind of Iterative fast reconstruction method of Philips), also difference of image quality on scan time. Material and Methods: We investigated in 32 patients that examined the Bone SPECT from June to July 2008 at department of nuclear medicine, ASAN Medical Center in Seoul. 40sec/frame and 20sec/frame images were acquired that using Philips‘ PRECEDENCE 16 Gamma Camera and then reconstructed those images by using the Astonish (Philips’ Reconstruction Method), 3D OSEM and FBP methods. The blinded test was performed to the clinical interpreting physicians with all images analyzed by each reconstruction method for qualitative analysis. And we analyzed target to non target ratio by draws lesions as the center of disease for quantitative analysis. At this time, each image was analyzed with same location and size of ROI. Results: In a qualitative analysis, there was no significant difference by acquisition time changes in image quality. In a quantitative analysis, the images reconstructed Astonish method showed good quality due to better sharpness and distinguish sharply between lesions and peripheral lesions. After measuring each mean value and standard deviation value of target to non target ratio with 40 sec/frame and 20sec/frame images, those values are Astonish (40 sec-$13.91{\pm}5.62$ : 20 sec-$13.88{\pm}5.92$), 3D OSEM (40 sec-$10.60{\pm}3.55$ : 20 sec-$10.55{\pm}3.64$), FBP (40 sec-$8.30{\pm}4.44$ : 20 sec-$8.19{\pm}4.20$). We analyzed target to non target ratio from 20 sec and 40 sec images. And we analyzed the result, In Astonish (t=0.16, p=0.872), 3D OSEM (t=0.51, p=0.610), FBP (t=0.73, p=0.469) methods, there was no significant difference statistically by acquisition time change in image quality. But FBP indicates no statistical differences while some images indicate difference between 40 sec/frame and 20 sec/frame images by various factors. Conclusions: In the circumstance, try to find a solution to reduce nuclear medicine scan time, the development of nuclear medicine equipment hardware has decreased while software has marched forward at a relentless. Due to development of computer hardware, the image reconstruction time was reduced and the expanded capacity to restore enables iterative methods that couldn't be performed before due to technical limits. As imaging process technique developed, it reduced scan time and we could observe that image quality keep similar level. While keeping exam quality and reducing scan time can induce the reduction of patient's pain and sensory waiting time, also accessibility of nuclear medicine exam will be improved and it provide better service to patients and clinical physician who order exams. Consequently, those things make the image of department of nuclear medicine be improved. Concurrent Imaging - A new function that setting up each image acquisition parameter and enables to acquire images simultaneously with various parameters to once examine.

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Recent Progress in Air-Conditioning and Refrigeration Research : A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2009 (설비공학 분야의 최근 연구 동향 : 2009년 학회지 논문에 대한 종합적 고찰)

  • Han, Hwa-Taik;Lee, Dae-Young;Kim, Seo Young;Choi, Jong-Min;Baik, Yong-Kyu;Kwon, Young-Chul
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.22 no.7
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    • pp.492-507
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    • 2010
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2009. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) Research trends of thermal and fluid engineering have been surveyed as groups of general thermal and fluid flow, fluid machinery and piping, and new and renewable energy. Various topics were covered in the field of general thermal and fluid flow such as an expander, a capillary tube, the flow of micro-channel water blocks, the friction and anti-wear characteristics of nano oils with mixtures of refrigerant oils, etc. Research issues mainly focused on the design of micro-pumps and fans, the heat resistance reliability of axial smoke exhaust fans, and hood systems in the field of fluid machinery and piping. Studies on ground water sources were executed concerning two well type geothermal heat pumps and multi-heat pumps in the field of new and renewable energy. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics and industrial heat exchangers. Researches on heat transfer characteristics included the heat transfer in thermoelectric cooling systems, refrigerants, evaporators, dryers, desiccant rotors. In the area of industrial heat exchangers, researches on high temperature ceramic heat exchangers, plate heat exchangers, frosting on fins of heat exchangers were performed. (3) In the field of refrigeration, papers were presented on alternative refrigerants, system improvements, and the utilization of various energy sources. Refrigeration systems with alternative refrigerants such as hydrocarbons, mixed refrigerants, and $CO_2$ were studied. Efforts to improve the performance of refrigeration systems were made applying various ideas of suction line heat exchangers, subcooling bypass lines and gas injection systems. Studies on heat pump systems using unutilized energy sources such as river water, underground water, and waste heat were also reported. (4) Research trend in the field of mechanical building facilities has been found to be mainly focused on field applications rather than performance improvements. In the area of cogeneration systems, papers on energy and economic analysis, LCC analysis and cost estimating were reported. Studies on ventilation and heat recovery systems introduced the effect on fire and smoke control, and energy reduction. Papers on district cooling and heating systems dealt with design capacity evaluation, application plan and field application. Also, the maintenance and management of building service equipments were presented for HVAC systems. (5) In the field of architectural environment, various studies were carried to improve indoor air quality and to analyze the heat load characteristics of buildings by energy simulation. These studies helped to understand the physics related to building load characteristics and to improve the quality of architectural environment where human beings reside in.

A Numerical Study for Effective Operation of MSW Incinerator for Waste of High Heating Value by the Addition of Moisture Air (함습공기를 이용한 고발열량 도시폐기물 소각로의 효율적 운전을 위한 수치 해석적 연구)

  • Shin, Mi-Soo;Shin, Na-Ra;Jang, Dong-Soon
    • Journal of Korean Society of Environmental Engineers
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    • v.35 no.2
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    • pp.115-123
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    • 2013
  • Stoker type incinerator is one of the most popular one used as municipal solid waste (MSW) incineration because, in general, it is quite suitable for large capacity and need no preprocessing facility. Nowadays, however, since the combustible portion of incoming MSW increases together with the decrease of the moisture content due to prohibition of directly burying food waste in landfill, the heating value of waste is remarkably increasing in comparison with the early stage of incinerator installation. Consequently, the increased heating value in incinerator operation causes a number of serious problems such as reduction of waste amount to be burned due to the boiler heat capacity together with the significant NO generation in high temperature environment. Therefore, in this study, a series of numerical simulation have been made as parameters of waste amount and the fraction of moisture in air stream in order to investigate optimal operating condition for the resolution of the problems associated with the high heating value of waste mentioned above. In specific, a detailed turbulent reaction flow field calculation with NO model was made for the full scale incinerator of D city. To this end, the injection method of moisturized air as oxidizer was intensively reviewed by the addition of moisture water amount from 10% and 20%. The calculation result, in general, showed that the reduction of maximum flame temperature appears consistently due to the combined effects of the increased specific heat of combustion air and vaporization heat by the addition of water moisture. As a consequence, the generation of NOx concentration was substantially reduced. Further, for the case of 20% moisture amount stream, the afterburner region is quite appropriate in temperature range for the operation of SNCR. This suggests the SNCR facility can be considered for reoperation. which is not in service at all due to the increased heating value of MSW.

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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