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Development of a Critical Pathway for Patients with Coronary Artery Bypass Graft (관상동맥 우회술 환자를 위한 Critical Pathway개발)

  • 김기연
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.117-131
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    • 1998
  • The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft (CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study. a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June. 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes. the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items : tests, nutrition, medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13. 9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found that among the total of 571 items. there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day, which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day, but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test. the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the “stairs climbing” item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

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A Case Study on High and Low Performance Areas for Family Planning (가족계획 우수.부진지역 사례연구)

  • 홍성열;김태일
    • Korea journal of population studies
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    • v.4 no.1
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    • pp.105-130
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    • 1981
  • This study was conducted to compare the characteristics of high performane areas for family planning with that of low performance areas and to find factors which strongly affected contraceptive practice behavior. For the study, eight areas were selected from 274 rural family planning canvassing areas of Korean Population Policy and Program Evaluation Study, which was an action study operated in all areas of Cheju Island from July 1, 1976 until December 31,1979. As a first step of the action study, Cheju Island was devided up 318 family planning canvasser areas Each area was consisted of 200 households in rural district and 300 households in urhan one Duriog the period of project, each canvassing area had been managed by a female family planning canvasser, selected by director of health center considering several individual conditions needed for family planning activities Basic activities of canvassers were to counsell all the eligihie couples in own charged area about family planning methods and also to distribute contraceptives such as condoms and oral pills. In case couples desire to accept sterilization including vasectomy and tubal-ligation, the canvassers played a linking role connecting potential client with family planning field workers. Canvassng areas shows significant differentce in performance for family planning, nevertheless they are supposed to have almost the same conditions regarding family planning distribution channel. Because the purpose of the Cheju project was to eliminate all the problems that existed in governmental distribution system, that is to remove geographic, economic, cognitive and administrative barriers Accumulated performances of family planning methods accepted by residents in each area were calculated by eligible women aged 14-49. And then canvassing areas were ranked according to performance score. Consequently, 4 areas in extremely high and low family planning performance areas were selected respectively. Major results were obtained by comparing characteristics of high performance area with that of low performance areas, which are as follows: 1. The mean number of living children was about the same both in high and low performance areas for family planning. But respondents' mean age (38.5) in high performance areas was higher than that (37.0) in low performance areas 2. Respondents' perception in the expectant educational level of others' children in high performance areas was higher than that in low performance areas, although respondents educational level, monthly expenditure and ratio of children in high school and above was not different. 3. Ratio of ownerships of TV and newspaper in high performance areas was highen than that in low performance areas 4. The duration of canvasser' charge in high performance areas was longer than that of low performance areas, showing the fact that canvassers didn't move cut in high performance areas 5. In high performance areas, canvassers' houses were relatively located in the center part of the village. And so villagers resided in near distances from the anvasser's house 6. 4H clubs' activities in high performance areas were more active than those in low performance areas Therefore it was assumed that cohesiveness of community in high performance areas were stronger than that in low areas. 7. Canvassers' family planning practice rate was higher than that in low performance areas, and also canvassers' human relationship was more sociable than that of canvassers in low performance areas. 8. Fourteen variables which showed relatively high significance level in $X^2$ and F test were selected as independent variables for stepwise regression analysis. According to the results of regression analysis. five of 14 variables-distributors education level ($R^2$=.4439), duration of distributor's charge ($R^2$=.6166), 4H club activities ($R^2$=.6697), canvasser's contraceptive practice ($R^2$=.7377) and location of distributions house ($R^2$=.8010) explained 80.1 percent of total variance.

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Purification of Oat ${\beta}-Glucan$ by ${\alpha}-Amlyase$ Treatment and Characterization of Its Physicochemical Properties (귀리 ${\beta}-glucan$${\alpha}-amlyase$를 이용한 정제와 이화학적 특성)

  • Park, Hee-Joeng;Kang, Tae-Su;Lee, Hee-Bong;Kim, Kwang-Yup;Jang, Keum-Il;Noh, Young-Hee;Jeong, Heon-Sang
    • Korean Journal of Food Science and Technology
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    • v.37 no.5
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    • pp.776-782
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    • 2005
  • The effects of purification using ${\alpha}-amlyase$ (Termamyl 120L) on physicochemical properties of ${\beta}-glucan$ from oat bran were studied. Four fractions were selected as fraction A ($55^{\circ}C$, 15%, pH 6), fraction B ($45^{\circ}C$, 15%, pH 6), fraction C ($50^{\circ}C$, 0%, pH 7), and fraction D ($50^{\circ}C$, 10%, pH 5) from the result of physiological test, and three consecutive subfractions were obtained by repeated ${\alpha}-amlyase$ treatments on the each fractions. The contents of ${\beta}-glucan$, protein, and ash after purification were in 81.4-88.2%, 4.1-6.3% and 2.6-6.2%, respectively. The apparent viscosities of purified ${\beta}-glucan$ aqueous solutions were similar to those of hydroxy methyl cellulose. Glucose was a major monosaccharide of ${\beta}-glucan$ extracts, and xylose and arabinose were also detected as minor constituents on TLC. The average molecular weight ranged $2.0{\times}10^6-5.1{\times}10^6$ and was decreased after purification. From the result of the differential scanning calorimetry, the melting point ranged $130-140^{\circ}C$ with purification step and thermal transition enthalpy was increased. The ratio of ${\beta}-(1{\rightarrow}3)\;to\;{\beta}-(1{\rightarrow}4) $ linkages were 1:2.22-1:2.52, and increased up to 1:5.50 after purification.

Development of an Adaptive Capacity Indicator to Climate Change in the Agricultural Water Sector (농업용수의 기후변화 적응능력 지표 개발 - 가뭄에 대한 적응을 중심으로 -)

  • Yoo, Ga-Young;Kim, Jin-Teak;Kim, Jung-Eun
    • Journal of Environmental Policy
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    • v.7 no.4
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    • pp.35-55
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    • 2008
  • Assessing vulnerability to climate change is the first step to take when setting up appropriate adaptation strategies. Adaptive capacity to climate change is the important factor comprising vulnerability. An adaptive capacity index in agricultural water management system was developed considering agricultural water supply and demand for rice production in Jeolla-do, Korea. The agricultural water supply was assumed to be equal to the amount of water stored in the major agricultural reservoirs, while data on the agricultural water demand was obtained from the dynamic simulation results by Korea Agriculture Corporation(KAC). The spatial unit for analysis was conducted at the county(Si, Gun, Gu) level and temporal scale was based on every month from 1991-2003. Adaptive capacity for drought stress index(ACDS index) was calculated as the percentage of data points where the irrigated water supply was greater than the crop water demand. The ACDS index was compared with SWSCI(Standard Water Storage Capacity Index) and the relationship showed high degree of fit($R^2$=0.84) using the exponential function, indicating that the developed ACDS index is useful for evaluating the status of the balance between agricultural water supply and demand, especially for the small sized agricultural reservoirs. This study provided the methodological basis for developing climate change vulnerability index in agricultural water system which is projected to be more frequently exposed to drought condition in the future due to climate change. Further research should be extended to the study on the water demand of the crops other than rice and to the projection of the change in ACDS index in the future.

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Tendency of 'a Cartoon Image' Appearing in Korean Modern Fine Arts - Ocusing on 'Atomouse' of Lee Dong-gi - (한국 현대 미술에 나타나는 '만화 이미지'의 경향성 -이동기의 <아토마우스>를 중심으로-)

  • Jeon, Young Je
    • Cartoon and Animation Studies
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    • s.36
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    • pp.669-702
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    • 2014
  • Today, in Korean modern fine arts, 'cartoon images' are utilized for their roles of the 'personas' of the artists, and as the 'texts' for the artistic discourses, while they play a role as a bridgehead between the public and art. In this study, we made a study, focusing on 'Atomouse' of Lee Dong-gi, in order to examine how the borrowing of the 'cartoon images' was made in the Korean modern fine arts, and what its period context is. 'Atomouse' of Lee Dong-gi is the first cartoon character that appeared in Korean modern fine arts, and it has acquired a symbolism of a subculture being acknowledged as art. In this study, we tried to find out what period contexts the changes of 'Atomouse' have, focusing on the private exhibitions of Lee Dong-gi, such as 'Smoking' Exhibition (2006), 'Bubble' Exhibition (2008), 'Double Vision' Exhibition (2008), 'The Garden of Uncertainty' Exhibition (2012) and 'Do Not Look Back with Angry Face' Exhibition (2013). Atomouse was born in the era of 'lack of pop' a change was attempted of it in the era of 'excess of pop' and its proceeding ended along with the 'settlement of the neo-pop'. From Atomouse started from the unconsciousness of the artist, we can find the 'identity' of the Republic of Korea, which was being influenced by the 'American and Japanese' culture, as well as the symbolism of a subculture being acknowledged as art, while it emerged as an icon to represent the Korean pop art of the time. Then, as the agony and self-examination of the artist was contained in it, its use was changed into the role as a persona and it was utilized as a tool to connect the and figurative worlds. In the end, the artist put an end to the proceeding of the 'Atomouse' at the boundaries of a persona and an alter ego, removing the creation with his own hands. In the process in which Lee Dong-gi created and changed 'Atomouse', the start-up and growth of the pop art are included in the history of the Korean modern fine arts, apart from a study of an artist. 'Atomouse' was not only painted on the walls of the subway stations in the form of public art, but it tried to closely communicate with the public through the collaboration with diverse media. It made the best use of the 'marketability' which a 'cartoon character' had at first, so that pure art was made a step closer to the public. So 'Atomouse' of Lee Dong-gi not only raised a subculture into the realm of high art, but lowered the door sill to high art. Through the study we could confirm what position 'Atomouse' of Lee Dong-gi, which started absurdly between parody and Hommage, takes in Korean modern art of today.

Autopoietic Machinery and the Emergence of Third-Order Cybernetics (자기생산 기계 시스템과 3차 사이버네틱스의 등장)

  • Lee, Sungbum
    • Cross-Cultural Studies
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    • v.52
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    • pp.277-312
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    • 2018
  • First-order cybernetics during the 1940s and 1950s aimed for control of an observed system, while second-order cybernetics during the mid-1970s aspired to address the mechanism of an observing system. The former pursues an objective, subjectless, approach to a system, whereas the latter prefers a subjective, personal approach to a system. Second-order observation must be noted since a human observer is a living system that has its unique cognition. Maturana and Varela place the autopoiesis of this biological system at the core of second-order cybernetics. They contend that an autpoietic system maintains, transforms and produces itself. Technoscientific recreation of biological autopoiesis opens up to a new step in cybernetics: what I describe as third-order cybernetics. The formation of technoscientific autopoiesis overlaps with the Fourth Industrial Revolution or what Erik Brynjolfsson and Andrew McAfee call the Second Machine Age. It leads to a radical shift from human centrism to posthumanity whereby humanity is mechanized, and machinery is biologized. In two versions of the novel Demon Seed, American novelist Dean Koontz explores the significance of technoscientific autopoiesis. The 1973 version dramatizes two kinds of observers: the technophobic human observer and the technology-friendly machine observer Proteus. As the story concludes, the former dominates the latter with the result that an anthropocentric position still works. The 1997 version, however, reveals the victory of the techno-friendly narrator Proteus over the anthropocentric narrator. Losing his narrational position, the technophobic human narrator of the story disappears. In the 1997 version, Proteus becomes the subject of desire in luring divorcee Susan. He longs to flaunt his male egomaniac. His achievement of male identity is a sign of technological autopoiesis characteristic of third-order cybernetics. To display self-producing capabilities integral to the autonomy of machinery, Koontz's novel demonstrates that Proteus manipulates Susan's egg to produce a human-machine mixture. Koontz's demon child, problematically enough, implicates the future of eugenics in an era of technological autopoiesis. Proteus creates a crossbreed of humanity and machinery to engineer a perfect body and mind. He fixes incurable or intractable diseases through genetic modifications. Proteus transfers a vast amount of digital information to his offspring's brain, which enables the demon child to achieve state-of-the-art intelligence. His technological editing of human genes and consciousness leads to digital standardization through unanimous spread of the best qualities of humanity. He gathers distinguished human genes and mental status much like collecting luxury brands. Accordingly, Proteus's child-making project ultimately moves towards technologically-controlled eugenics. Pointedly, it disturbs the classical ideal of liberal humanism celebrating a human being as the master of his or her nature.

The Usage of the Vulgate Bible in the European Catholicism: from the Council of Trent until the Second Council of Vatican (유럽 천주교의 불가타 성경 사용 양상: 트렌토 공의회 이후부터 2차 바티칸 공의회 이전까지)

  • CHO, Hyeon Beom
    • The Critical Review of Religion and Culture
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    • no.32
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    • pp.257-287
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    • 2017
  • It seems to be quite an ambitious endeavor to trace back the translation history of Catholic Vulgate Bible from Latin language to Asian languages since 16th century. I try to bring out the translation(translative) procedure of Latin Bible to the Chinese Version, which is eventually come up (and the latter)to the Korean Version. It has been supported and funded by the National Research Foundation of Korea. This task has a three-year plan. For the first step(operation), I examined and searched the European situation of the Vulgate Bible in the Catholic Church, i.e. the ritual use of Vulgate Bible in the Mass and the religious retreat. The liturgical texts, to begin with, were analysed to disclose how the Vulgate Bible was reflected in them. The Lectionary and the Evangeliary were the typical ones. The structure or the formation system of the Lectionaries for Mass was based on the liturgical year cycle. From this point, the Vulgate Bible was rooted in the religious life of European Catholics after the Council of Trent which had proclaimed the Vulgate to be authentic source of the Revelation, therefore, to be respected as the only authoritative Bible. How did the Catholic Church use the Vulgate Bible out of the context and the boundary (sphere) of liturgy? The Meditation guide books for the purpose of instructing the religious retreat was published and (diffused) circulated among the priests, the religious persons and even the laymen. In those books also were included (found) the citation, the interpretation and the commentaries of the Vulgate Bible. The most of the devotees in Europe read the biblical phrases out of the meditation guide books. There are still remained the unsolved problems of how to understand (for understanding) the actual aspect of the Vulgate Bible in the European Catholic Church. All the Biblical verses were translated into French and included in the meditation guide books published in France. What did the Holy See think the French translation of the Vulgate Bible? Unfortunately, there were not found the Vatican Decrees about the European translation of the Vulgate Bible. The relationship between the Vulgate Bible and the Meditation guide (Those) will be much important for the study of Chinese translation of it. The search for the Decrees and the researches on it and the European and the non-European translations of the Vulgate Bible will be a continuous task for me as well as the other researchers on these subjects in the future.

Automatic Fracture Detection in CT Scan Images of Rocks Using Modified Faster R-CNN Deep-Learning Algorithm with Rotated Bounding Box (회전 경계박스 기능의 변형 FASTER R-CNN 딥러닝 알고리즘을 이용한 암석 CT 영상 내 자동 균열 탐지)

  • Pham, Chuyen;Zhuang, Li;Yeom, Sun;Shin, Hyu-Soung
    • Tunnel and Underground Space
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    • v.31 no.5
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    • pp.374-384
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    • 2021
  • In this study, we propose a new approach for automatic fracture detection in CT scan images of rock specimens. This approach is built on top of two-stage object detection deep learning algorithm called Faster R-CNN with a major modification of using rotated bounding box. The use of rotated bounding box plays a key role in the future work to overcome several inherent difficulties of fracture segmentation relating to the heterogeneity of uninterested background (i.e., minerals) and the variation in size and shape of fracture. Comparing to the commonly used bounding box (i.e., axis-align bounding box), rotated bounding box shows a greater adaptability to fit with the elongated shape of fracture, such that minimizing the ratio of background within the bounding box. Besides, an additional benefit of rotated bounding box is that it can provide relative information on the orientation and length of fracture without the further segmentation and measurement step. To validate the applicability of the proposed approach, we train and test our approach with a number of CT image sets of fractured granite specimens with highly heterogeneous background and other rocks such as sandstone and shale. The result demonstrates that our approach can lead to the encouraging results on fracture detection with the mean average precision (mAP) up to 0.89 and also outperform the conventional approach in terms of background-to-object ratio within the bounding box.

Development of the Teaching-Learning Process Plan for Process-Based Assessment in Home Economics of Middle School: Focusing on the Life Design Unit (과정 중심 평가를 위한 중학교 가정과 교수·학습과정안 개발: 생애설계 단원을 중심으로)

  • Ko, Eun Mi;Heo, Young Sun;Chae, Jung Hyun
    • Journal of Korean Home Economics Education Association
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    • v.33 no.1
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    • pp.101-127
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    • 2021
  • The purpose of this study is to design and develop a teaching-learning process plan for process-based assessment, focusing on the unit related to life design in middle school home economics(HE: Home Economics part of 「Technology and Home Economics」), to propose a feedback plan after implementing it, and to evaluate the plan through participatory observation and interviews. The student reflection journals, teacher's class journals, participatory observation journals, interviews, and performance tasks, were collected and analyzed to provide foundational date to be utilized for feedback to students, and class improvement. The research results are as follows: First, the developed teaching-learning process plan consists of a total of 8 sessions, i.e. 2 sessions for each of the four learning themes, under the practical question of "What should I do to live the life I want?" The portfolio was composed of five evaluation topics and for evaluation, oral presentation, observational evaluation, self-assessment, and peer evaluation were considered. Second, during the class, feedback from teachers, feedback from fellow students, feedback through results, and a plan to record them were provided. Third, from the analysis of collected data including observation journals and interviews, it was apparent that the students recognized the necessity of process-based assessment after the class, and students acknowledged that through the process-based evaluation in which they are evaluated on the efforts they made and provided with feedbacks, they participated more in class, and it lead them to experience a sense of growth and a feeling that they took a step forward into their future. Teachers suggested that the class through feedback was suitable for the unit and the capacity of the class, but the difficulty they experienced in giving feedback was presented as a disadvantage. For the process-based assessment, follow-up research is needed on various ways to provide feedback on-line and off-line through changes in the perception of assessment.

A Study on Intelligent Skin Image Identification From Social media big data

  • Kim, Hyung-Hoon;Cho, Jeong-Ran
    • Journal of the Korea Society of Computer and Information
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    • v.27 no.9
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    • pp.191-203
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    • 2022
  • In this paper, we developed a system that intelligently identifies skin image data from big data collected from social media Instagram and extracts standardized skin sample data for skin condition diagnosis and management. The system proposed in this paper consists of big data collection and analysis stage, skin image analysis stage, training data preparation stage, artificial neural network training stage, and skin image identification stage. In the big data collection and analysis stage, big data is collected from Instagram and image information for skin condition diagnosis and management is stored as an analysis result. In the skin image analysis stage, the evaluation and analysis results of the skin image are obtained using a traditional image processing technique. In the training data preparation stage, the training data were prepared by extracting the skin sample data from the skin image analysis result. And in the artificial neural network training stage, an artificial neural network AnnSampleSkin that intelligently predicts the skin image type using this training data was built up, and the model was completed through training. In the skin image identification step, skin samples are extracted from images collected from social media, and the image type prediction results of the trained artificial neural network AnnSampleSkin are integrated to intelligently identify the final skin image type. The skin image identification method proposed in this paper shows explain high skin image identification accuracy of about 92% or more, and can provide standardized skin sample image big data. The extracted skin sample set is expected to be used as standardized skin image data that is very efficient and useful for diagnosing and managing skin conditions.