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A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning (농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究))

  • Yeh, Min-Hae;Lee, Sung Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.5 no.1
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    • pp.57-95
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    • 1972
  • This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

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Relationship between Physical Health Status and Life style(Health Practices) (건강상태(健康狀態)와 생활양식(生活樣式)(건강습관(健康習慣))과의 관계(關係))

  • Choi, In-Sook;Roh, Pyong-Ui;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.3
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    • pp.111-140
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    • 2002
  • This study was conducted from April 1 through April 30, 2002 in order to figure out the relationship between physical health status and life style and the factors influencing physical health. Subjects were selected from among the residents older than 20 years old by probability scheme of one out of 2000. Three thousand people were interviewed by questionnaires, and 2,742(91.4%) respondents were used for analysis, and the results are as follows: 1. Ridit(Relatives to an identified distribution it) of category one by sex was 0.26 in man, and 0.25 in woman. Ridit of category two was 0.57 in man and 0.53 in woman, those of category three was 0.72 in man and 0.65 in woman. That of category four was 0.86 in man and 0.85 in woman, that of category five was 0.95 in man and 0.97 in woman, and that of category six was 0.98 in man and 0.99 in woman. The ridits and health related categories by sex were r=.954 in man and r=.966 in woman(p<0.01) 2. Ridits of healthy behavior 2-1. The ridit of males who slept for less than 6 hrs was 0.71, that of those who slept for $7{\sim}8$ hrs was 0.24, and that of those who slept for more than 9 hours was 0.96. The ridit of females who slept for less than 6 was 0.80, that of those who slept for $7{\sim}8$ hrs was 0.32, and that of those who slept for more than 9 hrs was 0.97. 2-2. The ridit of male, who ate breakfast everyday was 0.30, that of those who ate one to four breakfast per week was 0.87, and that of those who never ate breakfasts was 0.96. The ridit of females who ate breakfast everyday was 0.32, that of those who ate breakfast one to four times a week was 0.75, and that of those who never ate breakfast was 0.99. 2-3. The ridit of males whose body weights were 10% lower than normal body weight was 0.45, that of those with $5{\sim}9.9%$ less than normal body weight was 0.28, that of those with ${\pm}4.9%$ of normal body weight was 0.12, that of those whose body weights were $5{\sim}9.9%$ heavier than normal was 0.40, that of those whose body weights were $10{\sim}19.9%$ heavier than normal was 0.74, that of those with $20{\sim}29.9%$ heavier than normal body weights was 0.78 and that of those with 30% heavier than normal body weight was 0.87. That of females with 10% less than normal body weight was 0.53, that of those with $5{\sim}99%$ less than normal body weight was 0.32, that of 4.9% those with ${\pm}f$ normal body weight was 0.14, that of those with 5.0 to 9.9% heavier body weights was 0.43, that of those with 10 to 19.9% heavier body weight was 0.65, that of those with $20{\sim}29.9%$ heavier body weight was 0.94 and that of those with more than 30% of normal body weight was 0.94. 2-4. The ridit of males who exercised everyday was 0.11, that of those who exercised three to four times a week was 0.25, that of those exercising once or twice a week was 0.48, and that of those who never exercised was 0.80. The ridit of females exercising everyday was 0.08, that of those exercising three to four times a week was 0.21, that of those exercising one to two times was 0.35 and that of those who never exercised was 0.72. 2-5. The ridit of males who did not drink at all was 0.14, that of those who drank one or two cups of hard liquor(Soju) was 0.39, that of those who drank a half bottle of Soju was 0.56, that of those who darnk a bottle of Soju was 0.73 and that of those who drank two bottles of Soju was 0.96. The ridit of females who did not drink at all was 0.30, that of those who drank one or two cups of Soju was 0.70, that of those who drank a half bottle of Soju was 0.84, that of those who drank a bottle of Soju was 0.97 and that of those who drank more than two bottles of Soju was 0.99. 2-6 The ridit of males who did not smoke was 0.20, that of those who smoked one or two cigarettes was 0.44, that of those who smoked about ten cigarettes was 0.58, and that of those who smoked more than a pack of cigarettes was 0.85. The ridit of females who did not smoke at all was 0.90, that of those who smokes one or two cigarettes was 0.91, that of those who smoked about the cigarettes was 0.93 and that of those who smoked more than a pack of cigarettes was 0.96 3. The ridit of males who had healthy behavior in six categories was 0.43 and the average age of them was 45, that of those who had healthy behavior in five categories was 0.47 and the average age was 45, that of those who had healthy behavior in three categories was 0.50 and the average age was 43, that of those who had heathy behavior in two categories was 0.60 and the average age was 40, that of those who had healthy behavior in one category was 0.68 and the average age was 38, and that of those who did not have healthy behavior at all in six categories was 0.79 and the average age was 41. The ridit of females who had heathy behavior in six categories was 0.38 and the average age was 45, that of those who had healthy behavior in five categories was 0.40 and the average age was 44, that of those who had healthy behavior in four categories was 0.46 and the average age was 43, that of those who had healthy behavior in three categories was 0.52 and the average age was 44, that of those who had healthy behavior in two categories was 0.57 and the average age was 41, that of those who the healthy behavior in one category was 0.62 and the average age was 40, and that those who did not have healthy behavior in six categories was 0.79 and the average age was 43. 4. The health statues of the persons who the healthy behavior were better than those who did not have healthy behavior. If the people have healthy behavior in young age and they have healthy education continuously, they can live healthier lives.

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Effects of Activation Treatments and Culture Condition on In Vitro Development of Caprine In Vivo and In Vitro Oocytes (재래산양의 체내 및 체외유래 난자의 활성화 처리방법 및 배양조건이 단위발생란의 체외발달에 미치는 영향)

  • Park H. S.;Kim T. S.;Lee Y. H.;Jung S. Y.;Lee M. Y.;Jin J. I.;Park J. K.;Lee J. S.;Kim C. H.
    • Reproductive and Developmental Biology
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    • v.28 no.3
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    • pp.181-185
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    • 2004
  • This study was conducted to examine whether activation treatments, source of oocytes and culture conditions affect in vitro developmental ability of caprine oocytes. Mature Korean native goats were pretreated with intravaginal CIDR for 10 days. The goats were then treated with a single intramuscular injection of 1,000 IU PMSG on Day 8 or twice daily injection of a total of 70 mg FSH for 3 days from Day 8 of CIDR insertion for superovulation. All the goats were injected with 10 mg PGF/sub 2a/ on Day 8 and 400 IU hCG on Day 10 of CIDR. Oocytes were surgically collected by oviduct flushing(in vivo maturation) or direct follicle aspiration(in vitro maturation) through mid-ventral incision at 35 h after hCG injection. Fifteen to twenty oocytes were placed in TCM-199 medium containing 25 mM Hepes and hormones under mineral oil at 39℃ in a humudified atmosphere of 5% CO₂ in air for 22 to 24 h. After maturation, the oocytes were activated by electric stimulation or ionomycin + 6-DMAP. The activated oocytes were then cultured in M16, TCM-199 and mSOF media supplemented with proteins at 39℃ for 6 to 7 days. Activation treatments did not affect cleavage of the oocytes. The cleavage rates were 64.1% (41/64) in oocytes activated by electric stimulation and 76.5% (218/285) in oocytes activated by ionomycin + 6-DMAP. The proportion of development to blastocyst was 15.6% (34/218) in oocytes activated by ionomycin + 6-DMAP, but activation by electric stimulation did not support embryos developed beyond morula stage. There were no differences in the cleavage rates of activated oocytes experiencing in vivo (86.8%, 66/76) and in vitro maturation (69.0%, 127/184). However, the development rate to blastocyst stage was significantly (P<0.05) higher for oocytes matured in vivo (50.0%, 33/66) compared to in vitro (0.8%, 1/127). Culture conditions did not affect the cleavage of -activated oocytes. The cleavage rates were 51.6% (49/95) in M16, 64.3% (18/28) in TCM-199 and 81.0% (145/179) in mSOF, respectively. By contrast, the development rate of activated oocytes to stage was greater (P<0.05) for oocytes cultured in mSOF medium (23.4%, 34/145) than in M16 or TCM-199 (0.0%). Our results suggest that source of oocytes and culture conditions are major factors affecting in vitro development of caprine parthenogenetic oocytes.

The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery (계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로-)

  • 이소우
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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The Abolition Type and The Regional Characteristics of The Elementary Schools in Chungbuk Province (忠淸北道의 國民學校 廢校類型과 그 地域的 特性)

  • ;Chae, Son-Ha
    • Journal of the Korean Geographical Society
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    • v.29 no.1
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    • pp.84-104
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    • 1994
  • The migration of population into the city has been on the increase according as Korea has been industrialized repidly since the 1960's. And there is a steady decrease in rural population. Thus lack of the number of the students forced many elementary Schools to be abolished. The aim of this study is to grasp the abolition types and the regional characteristics with the subject region of Chungbuk province. From the viewpoint of the increasing abolition of the elementary schools, I think it is very important to understand how the elementary schools have been abolished so far and predict how the subject region will have been changed in geography. Data for this study are based on Annual Establishment-Abolition Situation of the Schools published by Chungbuk office of Education in 1992, and many Kinds of the statistical reports, and the interview with the related. The results are as follows: 1. By examining the change of the number of the elementary schools and students in Chnugbuk, the numder of the students had also decreased since 1969 and was less than the half in 1990. As the number of the schools began to decrease ten years later than the students began to, the abolition of the elementary schools has started in reality from 1980's. 2. The 72 elementary schools were aboilshed between 1980 and 1992: the principal school is 9.7%, the branch school is 90.3%. The most fifteen schools are abolished in Yongdong-county and Chechon-county, and the least one school is abolished in Chechon-city and Okchon-county, and there is no abolition in Chongju-city and Chungju-city: According to the type of the abolition process, the least seven principal schools are abolished, and the principal school is reorganized as a branch school and twenty eight branch schools are abolished, and the most thirty seven branch schools are abolished. 3. When special change of the abolition is classified into the first perio (1980-1986) and the second period (1987-1992), in the first period the principal and branch schools were abolished and they are 13.9% of total abolition. The abolition out of them by building a dam is 60%. The principal schools in the submerged area though they have many students, were abolished. In the second period sixty two branch schools are abolished and they are 86.1% of total abolition. The most fifteen schools are abolished in Yongdong-county, thirteen in Chechon-county, seven in Tanyang-county, six in Chongwon-county, five in Chungwon-county and Koesan-county. Unlike the first period, the schools were abolished in this period because the number of students was so small. In this period sixty branch schools were abolished. All the students in the abolished schools except six schools transfered to the principal schools. The 58 school authorities help the students attend school by bus or support the expenses for attending school after that. 4. The abolition types of city, county and myon are classified into five types by the number of the abolished schools. The most forty nine abolished schools in type II are 68.1 of the total abolition. The least three abolished ones in type I are 12.5%. Considering the relation between the abolition type ane the number of schools and students, the number of the schools, increased in type I, II, III, V except IV from 1980 and then have decreased by abolition since 1980, while the more students decreased than they did in 1970 and the more the abolished school increases, the less the students decreases. The average students per school decreased in every abolition type and the most students decreased in type IV. 5. Considering the relation between the abolition type and the regional characteristics, most abolished schools were located between 100m and 300m above the sea level and it is 71% of the total abolition. The region without the abolition is high in the ratio of the cultivate land, ratio of rice field, and the part-time farmer, but the region with many abolition is low in the ratio of cultivated land. As for the manufacturing there are the most city, county and myon in the abolition type in Youngdong-county and Chechon-county where the manufacturing ratio of employing is low but Chongju-city without the abolition is a region where the manufacturing ratio is high. Consequently the development of the manufacturing causes the population to emigation out and the decrease of the population leads the transport is difficult of access, the facilities sold after being abolished are not being used in many ways. 7. Take an example of Youndong-county where the most schools were abolished, I have examined the school district and the population characteristics of the abolition. Though there were more villages, households, populations in the region that is higher than low above the sea level, the schools were abolished. Therefore we know that above the sea level had a great effect on the abolition. As a result of the regional analysis of the abolition, many schools were abolished by the artificial buildings such as a dam in the early 1980's but the schools in the late 1980's were abolished ten years later after the students decreased. More schools were abolished in the region where the manufacturing industry didn't develop. And the higher the school position was above the sea level, the sooner the school was abolished. It is also proved that both the beautiful natural scenery and accessibility are the important factor in using the abolished facilities practically.

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Case study of Music & Imagery for Woman with Depression (우울한 내담자를 위한 MI(Music & Imagery) 치료사례)

  • Song, In Ryeong
    • Journal of Music and Human Behavior
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    • v.5 no.1
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    • pp.67-90
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    • 2008
  • This case used MI techniques that give an imagery experience to depressed client's mental resource, and that makes in to verbalism. Also those images are supportive level therapy examples that apply to positive variation. MI is simple word of 'Music and Imagery' with one of psychology cure called GIM(Guided Imagery and Music). It makes client can through to the inner world and search, confront, discern and solve with suitable music. Supportive Level MI is only used from safety level music. Introduction of private session can associate specification feeling, subject, word or image. And those images are guide to positive experience. The First session step of MI program is a prelude that makes concrete goal like first interview. The Second step is a transition that can concretely express about client's story. The third step is induction and music listening. And it helps to associate imagery more easily by used tension relaxation. Also it can search and associate about various imagery from the music. The last step is process that process drawing imagery, talking about personal imagery experience in common with therapist that bring the power by expansion the positive experience. Client A case targets rapport forming(empathy, understanding and support), searching positive recourse(child hood, family), client's emotion and positive support. Music must be used simple tone, repetition melody, steady rhythm and organized by harmony music of what therapist and client's preference. The client used defense mechanism and couldn't control emotion by depression in 1 & 2 sessions. But the result was client A could experience about support and understanding after 3 sessions. After session 4 the client had stable, changed to positive emotion from the negative emotion and found her spontaneous. Therefore, at the session 6, the client recognized that she will have step of positive time at the future. About client B, she established rapport forming(empathy, understanding and support) and searching issues and positive recognition(child hood, family), expression and insight(present, future). The music was comfortable, organizational at the session 1 & 2, but after session 3, its development was getting bigger and the main melody changed variation with high and low of tune. Also it used the classic and romantic music. The client avoids bad personal relations to religious relationship. But at the session 1 & 2, client had supportive experience and empathy because of her favorite, supportive music. After session 3, client B recognized and face to face the present issue. But she had avoidance and face to face of ambivalence. The client B had a experience about emotion change according depression and face to face client's issues After session 4. At the session 5 & 6, client tried to have will power of healthy life and fairly attitude, train mental power and solution attitude in the future. On this wise, MI program had actuality and clients' issues solution more than GIM program. MI can solute the issue by client's based issue without approach to unconsciousness like GIM. Especially it can use variety music and listening time is shorter than GIM and structuralize. Also can express client's emotion very well. So it can use corrective and complement MI program to children, adolescent and adult.

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Clinical Presentation of the Patients with Non-traumatic Chest Pain in Emergency Department (응급의료센터에 내원한 비외상성 흉통환자의 임상 양상)

  • Chung, Jun-Young;Lee, Sam-Beom;Do, Byung-Soo;Park, Jong-Seon;Shin, Dong-Gu;Kim, Young-Jo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.283-295
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    • 1999
  • Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were $1.1{\pm}0.9$ in non-cardiac diseases, $1.4{\pm}1.1$ in cardiac diseases and $1.7{\pm}1.1$ in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

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A New Approach to Automatic Keyword Generation Using Inverse Vector Space Model (키워드 자동 생성에 대한 새로운 접근법: 역 벡터공간모델을 이용한 키워드 할당 방법)

  • Cho, Won-Chin;Rho, Sang-Kyu;Yun, Ji-Young Agnes;Park, Jin-Soo
    • Asia pacific journal of information systems
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    • v.21 no.1
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    • pp.103-122
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    • 2011
  • Recently, numerous documents have been made available electronically. Internet search engines and digital libraries commonly return query results containing hundreds or even thousands of documents. In this situation, it is virtually impossible for users to examine complete documents to determine whether they might be useful for them. For this reason, some on-line documents are accompanied by a list of keywords specified by the authors in an effort to guide the users by facilitating the filtering process. In this way, a set of keywords is often considered a condensed version of the whole document and therefore plays an important role for document retrieval, Web page retrieval, document clustering, summarization, text mining, and so on. Since many academic journals ask the authors to provide a list of five or six keywords on the first page of an article, keywords are most familiar in the context of journal articles. However, many other types of documents could not benefit from the use of keywords, including Web pages, email messages, news reports, magazine articles, and business papers. Although the potential benefit is large, the implementation itself is the obstacle; manually assigning keywords to all documents is a daunting task, or even impractical in that it is extremely tedious and time-consuming requiring a certain level of domain knowledge. Therefore, it is highly desirable to automate the keyword generation process. There are mainly two approaches to achieving this aim: keyword assignment approach and keyword extraction approach. Both approaches use machine learning methods and require, for training purposes, a set of documents with keywords already attached. In the former approach, there is a given set of vocabulary, and the aim is to match them to the texts. In other words, the keywords assignment approach seeks to select the words from a controlled vocabulary that best describes a document. Although this approach is domain dependent and is not easy to transfer and expand, it can generate implicit keywords that do not appear in a document. On the other hand, in the latter approach, the aim is to extract keywords with respect to their relevance in the text without prior vocabulary. In this approach, automatic keyword generation is treated as a classification task, and keywords are commonly extracted based on supervised learning techniques. Thus, keyword extraction algorithms classify candidate keywords in a document into positive or negative examples. Several systems such as Extractor and Kea were developed using keyword extraction approach. Most indicative words in a document are selected as keywords for that document and as a result, keywords extraction is limited to terms that appear in the document. Therefore, keywords extraction cannot generate implicit keywords that are not included in a document. According to the experiment results of Turney, about 64% to 90% of keywords assigned by the authors can be found in the full text of an article. Inversely, it also means that 10% to 36% of the keywords assigned by the authors do not appear in the article, which cannot be generated through keyword extraction algorithms. Our preliminary experiment result also shows that 37% of keywords assigned by the authors are not included in the full text. This is the reason why we have decided to adopt the keyword assignment approach. In this paper, we propose a new approach for automatic keyword assignment namely IVSM(Inverse Vector Space Model). The model is based on a vector space model. which is a conventional information retrieval model that represents documents and queries by vectors in a multidimensional space. IVSM generates an appropriate keyword set for a specific document by measuring the distance between the document and the keyword sets. The keyword assignment process of IVSM is as follows: (1) calculating the vector length of each keyword set based on each keyword weight; (2) preprocessing and parsing a target document that does not have keywords; (3) calculating the vector length of the target document based on the term frequency; (4) measuring the cosine similarity between each keyword set and the target document; and (5) generating keywords that have high similarity scores. Two keyword generation systems were implemented applying IVSM: IVSM system for Web-based community service and stand-alone IVSM system. Firstly, the IVSM system is implemented in a community service for sharing knowledge and opinions on current trends such as fashion, movies, social problems, and health information. The stand-alone IVSM system is dedicated to generating keywords for academic papers, and, indeed, it has been tested through a number of academic papers including those published by the Korean Association of Shipping and Logistics, the Korea Research Academy of Distribution Information, the Korea Logistics Society, the Korea Logistics Research Association, and the Korea Port Economic Association. We measured the performance of IVSM by the number of matches between the IVSM-generated keywords and the author-assigned keywords. According to our experiment, the precisions of IVSM applied to Web-based community service and academic journals were 0.75 and 0.71, respectively. The performance of both systems is much better than that of baseline systems that generate keywords based on simple probability. Also, IVSM shows comparable performance to Extractor that is a representative system of keyword extraction approach developed by Turney. As electronic documents increase, we expect that IVSM proposed in this paper can be applied to many electronic documents in Web-based community and digital library.

A Study on improvement of curriculum in Nursing (간호학 교과과정 개선을 위한 조사 연구)

  • 김애실
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.1-16
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    • 1974
  • This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

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The Effect of Pleural Thickening on the Impairment of Pulmonary Function in Asbestos Exposed Workers (석면취급 근로자에서 늑막비후가 폐기능에 미치는 영향)

  • Kim, Jee-Won;Ahn, Hyeong-Sook;Kim, Kyung-Ah;Lim, Young;Yun, Im-Goung
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.923-933
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    • 1995
  • Background: Pleural abnormality is the the most common respiratory change caused by asbestos dust inhalation and also develop other asbestos related disease after cessation of asbestos exposure. So we conducted epidemiologic study to investigate if the pleural abnormality is associated with pulmonary function change and what factors are influenced on pulmonary function impairment. Methods: Two hundred and twenty two asbestos workers from 9 industries using asbestos in Korea were selected to measure the concentration of sectional asbestos fiber. Ouestionnaire, chest X-ray, PFT were also performed. All the data were analyzed by student t-test and chi-square test using SAS. Regressional analysis was performed to evaluate important factors, for example smoking, exposure concentration, period and the existence of pleural thickening, affecting to the change of pulmonary function. Results: 1) All nine industries except two, airborn asbestos fiber concentration was less than an average permissible concentration. PFT was performed on 222 workers and the percentage of male was 88.3%, their mean age was $41{\pm}9$ years old, and the duration of asbestos exposure was $10.6{\pm}7.8$ yrs. 2) The chest X-ray showed normal(89.19%), pulmonary Tb(inactive)(2.7%), pleral thickening (7.66%), suspected reticulonodular shadow(0.9%). 3) The mean values of height, smoking status, concentration of asbestos fiberwere not different between the subjects with pleural thickening and others, but age, cumulative pack-years, the duration of asbestos exposure were higher in subjects with pleural thickening. 4) All the PFT indices were lower in the subjects with pleural thickening than in the subjects without pleural thickening. 5) Simple regression analysis showed there was a significant correlation between $FEF_{75}$ which is sensitive in small airway obstruction and cumulative smoking pack-years, the duration of asbestos exposure and the concentration of asbestos fiber. 6) Multiple regression analysis showed all the pulmonary function indices were decreased as the increase of cumulative smoking pack-years and especially in the indices those are sensitive in small airway obstruction. Pleural thickening was associated with reduction in FVC, $FEV_1$, PEFR and $FEF_{25}$. Conclusion: The more concentration of asbestos fiber and the more duration of asbestos exposure, the greater reduction in $FEF_{50}$, $FEF_{75}$. Therefore PFT was important in the evaluation of early detection for small airway obstruction. Furthermore pleural thickening without asbesto-related parenchymal lung disease is associated with reduction in pulmonary function.

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