• Title/Summary/Keyword: Treatment support

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Growth Performance, Carcass Characteristics and Plasma Mineral Chemistry as Affected by Dietary Chloride and Chloride Salts Fed to Broiler Chickens Reared under Phase Feeding System

  • Mushtaq, M.M.H.;Pasha, T.N.;Akram, M.;Mushtaq, T.;Parvin, R.;Choi, H.C.;Hwangbo, J.;Kim, J.H.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.6
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    • pp.845-855
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    • 2013
  • Requirements of dietary chloride (dCl) and chloride salts were determined by using $4{\times}2$ factorial arrangement under four phase feeding program. Four levels (0.31, 0.45, 0.59 and 0.73%) and two sources ($NH_4Cl$ and $CaCl_2$) of the dCl were allocated to 1,472 chicks in eight dietary treatments in which each treatment was replicated four times with 46 birds per replicate. The four phase feeding program was comprised of four dietary phases: Prestarter (d 1 to 10), Starter (d 11 to 20), Grower (d 21 to 33) and Finisher (d 34 to 42); and diets were separately prepared for each phase. The cations, anions, pH, dissolved oxygen (DO), temperature, electrical conductivity (EC), total dissolved solids (TDS) and salinity were analyzed in drinking water and were not affected by dietary treatments. BW gain (BWG; $p{\leq}0.009$) and feed:gain (FG; $p{\leq}0.03$) were improved in $CaCl_2$ supplemented diets during d 1 to 10. The maximum response of BWG and FG was observed at 0.38% and 0.42% dCl, respectively, for d 34 to 42. However, the level of dCl for BWG during d 21 to 33 ($p{\leq}0.04$) and d 34 to 42 ($p{\leq}0.009$) was optimized at 0.60% and 0.42%, respectively. The level of dCl for optimized feed intake (FI; $p{\leq}0.006$), FG ($p{\leq}0.007$) and litter moisture (LM; $p{\leq}0.001$) was observed at 0.60%, 0.38% and 0.73%, respectively, for d 1 to 42. Water intake (DWI) was not affected by increasing dCl supplementation (p>0.05); however, the ratio between DWI and FI (DWI:FI) was found highest at 0.73% dCl during d 1 to 10 ($p{\leq}0.05$) and d 21 to 33 ($p{\leq}0.009$). Except for d 34 to 42 ($p{\leq}0.006$), the increasing level of dCl did not result in a significant difference in mortality during any phase. Blood pH and glucose, and breast and thigh weights (percentage of dressed weight) were improved while dressing percentage (DP) and gastrointestinal health were exacerbated with $NH_4Cl$ as compared to $CaCl_2$ supplemented diets ($p{\leq}0.001$). Higher plasma $Na^+$ and $HCO_3{^-}$ and lower $Cl^-$ and $Ca^{{+}{+}}$ were observed in $NH_4Cl$ supplemented diets ($p{\leq}0.001$). Increasing supplementation of dCl increased plasma $Cl^-$ ($p{\leq}0.04$; quadratically) and linearly reduced plasma $K^+$ ($p{\leq}0.001$), $Ca^{{+}{+}}$ ($p{\leq}0.003$), $HCO_3{^-}$ ($p{\leq}0.001$), and $Na^+$ ($p{\leq}0.001$; quadratically). Consequently, higher requirements of dietary chloride are suggested for feed intake; nevertheless, lower levels of dietary chloride are sufficient to support optimal BWG and FG with increasing age. The $NH_4Cl$ supplemented diets ameliorate breast and thigh meat yield along with overall energy balance (glucose).

Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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Effect of Panax ginseng on the Graft-versus-Host Reaction, Production of Leucocyte Migration Inhibitory Factor and Expulsion of Adult Trichinella spiralis in Mice (인삼이 이식편대숙주반응, 대식세포유주저지반응 및 Trichinella spiralis의 expulsion에 미치는 영향)

  • Ha, Tai-You;Lee, Jeong-Ho;Kim, Sang-Hyung
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.1
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    • pp.133-144
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    • 1986
  • This study was undertaken to assess the effect of ginseng administration on T lymphocyte induced local xenogenic graft-versus-host(GVM) reactions which were induced with thymocyte, spleen cell and lymph node cell of ICR mice. Mice received daily 10mg of 70% alcohol ginseng extract oral1y for 100days and control mice remained untreated for the same period of time. The cells from donor mice were injected intradermally into the closely shaven abdominal skin of Sprague-Dawley rats for GVH tests. The thymocyte from control(ginseng-untreated) mice showed a negative local GVH reaction, whereas thymocyte from experimental(ginseng-treated) mice showed a positive reaction with the rate of 17.4%. When spleen cells were injected, the incidence of positive local GVH reaction was 66.7% among ginseng-treated mice, as opposed to incidence of 45.5% of positive local GVH reaction among control mice. The incidence of positive local GVH reaction of the lymph node cells when injected into a recipient was 71.4% among ginseng-treated mice as compared with that of 18.9% among control mice. The relationship between spleen cell inoculum and intensity of the local GVH reaction was assessed in ginseng-untreated mice. The intensity of GVH reaction clearly appears to be dose related. In ginseng-treated mice, a minimum of $1{\times}10^7$ spleen cell was required for production of positive local GVH reaction with almost linear relationship up to an inoculum of $5{\times}10^8$ cells. In control mice, however, a minimum of $1{\times}10^8$ spleen cells was required for positive GVH reaction. These results strongly suggest that the ginseng administration augments significantly the local xenogenic GVH reaction which was used to assess T lymphocyte function and immunocompetence of mice and in addition to this, these results appear to support previous suggestions that the local GVH reaction consitutes a qualitative test of the functional activity of T lymphocytes. These results may be the first to induce local GVH reaction, employing rats as recipient and mice as donor. This study was also desingned to investigate some of the effects of ginseng extract on lymphocyte-macrophage interactions. This was accomplished by in vitro quantification of 1) migratory inhibitory factor(MIF) synthetic capacity of splenic lymphocytes in mice previously primed with ginseng 2) MIF responsiveness of mouse peritoneal macrophages or chicken peripheral leucocytes under the presence of ginseng extract 3) migration ability of chicken peripheral leucocytes by direct stimulation of ginseng extract or ginseng saponin and 4) immunosuppressive effects of immunosuppressants such as cyclophosphamide, cyclosporin A or dexamethasone. Mice divided equally into the ginseng and the saline groups, which received intraperitoneally daily 0.2ml of ginseng absolute alcohol-extract(5mg/ml) and same amount of saline for 15 days, respectively. The cellular immune responsiveness of these mice was assayed 15 days after ginseng pretreatment. Splenic lymphocytes of mice treated with ginseng, when stimulated with sensitized specific-antigen such as sheep red blood cells or toxoplasmin, or with polyclonal activator concanavalin A, produced significantly more MIF than those of control saline group. MIF responsiveness of normal mouse macrophages was significantly augmented when assayed under the presence of ginseng extract (1mg/ml). The migratory ability of normal chicken leucocytes in the absence of MIF was significantly decreased by the stimulation of ginseng extract alone. MIF response was significantly decreased by immunosuppressants and this impaired response was not restored by ginseng pretreatment. This study was additionally performed to evaluate the effect of ginseng on the expulsion of adult Trichinella spiralis in mice. ICR mice were infected experimentally by esophageal incubation of 300 T. spiralis infective muscle larvae prepared by acid-pepsin digestion of infected mice. and received oral administration of 70% alcohol ginseng extract(10mg/mouse/day) for the indicated days plus 4 days before infection. At various times after infection, the number of adult T. spiralis worms in small intestines was determined. Interestingly, ginseng-treatment was accompanied by accelerated expulson of T. spiralis. These results led to the conclusion that Panax ginseng caused some enhancing effect on GVH reaction, macrophage migration inhibition reaction and expulsion of T. spiralis. In addition these results suggested that the mechanisms responsible for this enhancement of ginseng may be chiefly or partially due to nonspecific stimulation of cell-mediated immune response.

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Current Situation on Signing Advance Medical Directives and Actual Life-sustaining Treatment Given at a University Hospital (일개 대학병원의 연명치료 선택 및 사전의료의향서 작성 현황)

  • Yoon, Ho-Min;Choi, Youn-Seon;Hyun, Jong-Jin
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.91-100
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    • 2011
  • Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

Passenger's Right to Compensation in relation to Delayed Flights - From the perspective of EU case law - (운항지연에 따른 승객의 보상청구권 - EU 및 프랑스 판례를 중심으로 -)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.249-277
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    • 2015
  • Regulation (EC) No 261/2004 ("Regulation") is a common rule on compensation and assistance to passengers in the event of denied boarding and of cancellation or long delay of flights. In some recent cases of European nations, passengers sued the air carrier in order to obtain monetary compensation under Article 7(1) of the Regulation. Some courts dismissed the actions on the grounds that, unlike denied boarding or cancellation of the flight, the Regulation provides no compensation in relation to delayed flights. However, Court of Justice of the European Union(CJEU) ruled that Regulation 261/2004 must be interpreted to mean that passengers whose flights are delayed have a right to compensation in cases when the loss of time is equivalent to, or is in excess of three hours - where the passengers eventually reached their final destination three hours or more later than the originally scheduled arrival time. It is true that a strict interpretation of the regulation would suggest that passengers whose flight has merely been delayed are not entitled to compensation. They should only be offered assistance in accordance with the Articles 6 and 9. Nevertheless, the Court recognized the same right to the same compensation for passengers of flights delayed by more than three hours as that explicitly provided for passengers of cancelled flights. On the one hand, the Court bases this ruling on the recitals of the Regulation, in which the legislature links the question of compensation to that of a long delay, while indicating that the Regulations seek to ensure a high level of protection for passengers regardless of whether they are denied boarding or their flight is cancelled or delayed. On the other hand, the Court interprets the relevant provisions of the Regulation in light of the general principle of equal treatment. Furthermore, the Court delivered a ruling that the loss of time inherent in a flight delay, which constitutes an inconvenience within the intention of Regulation No 261/2004 and which cannot be categorized as 'damage occasioned by delay' within the meaning of Article 19 of the Montreal Convention, cannot come within the scope of Article 29 of that convention. Consequently, under this view, the obligation under Regulation No 261/2004 intended to compensate passengers whose flights are subject to a long delay is in line with Article 29 of the Montreal Convention. Although the above interpretation of the Court can be a analogical interpretation, the progressive attitude of the Regulation and the view of Court forward to protect passengers' interest is a leading role in the area of international air passenger transportation. Hopefully, after the model of the positive support in Europe, Korea can establish a concrete rule for protecting passengers' right and interest.

Oral Health and Quality of Life of the Orphans in Dong-gu, Daejeon (대전 동구 보육원생의 구강건강 및 구강건강관련 삶의 질)

  • Koong, Hwa-Soo;Song, Eun-Joo;Hwang, Soo-Jeong
    • Journal of dental hygiene science
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    • v.13 no.3
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    • pp.223-229
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    • 2013
  • The aim of this study was to examine the effectiveness of oral health promotion program in a group of 9~18-year-old children and adolescents living in four orphanages in Dong-gu, Daejeon. The program was based on oral disease prevention program including oral health education, fluoride application and scaling every six months. Oral health status of total 109 orphans was examined by one dentists who were trained in 2010 Korean National Oral Health Survey. Dental caries index, community periodontal index and modified patient hygiene performance index (M-PHP) were checked using dental unit chair. Child oral health impact profile (COHIP) and subjective oral health recognition survey were carried out. Compared with data of 2010 national sample, the mean of decayed, missing and filled teeth showed no difference between the subjects and test values, but the means of decayed teeth, decayed surface, toothbrushing frequency of the subjects showed to become worse with advancing years in spite of oral health promotion program. COHIP, subjective oral health status showed lower than test values, too. In M-PHP and Calculus index, the subjects showed better by periodic oral health education and scaling. We suggest that oral health promotion program for orphans include oral disease treatment program as well as preventive program to improve oral health of orphans efficiently. And, oral health promotion program has to be connected with psychological support for improving quality of life of orphans.

A Study on The Introduction of LID Prior Consultation for Small-Scale Development Projects - Focusing on Cost-Benefit Analysis - (소규모 개발사업의 저영향개발(LID) 사전협의 제도 도입 연구 - 비용편익 분석을 중심으로 -)

  • Ji, Min-Kyu;Sagong, Hee;Joo, Yong-Jun
    • Clean Technology
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    • v.26 no.2
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    • pp.151-157
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    • 2020
  • Rapid urbanization has elevated the risk of urban flooding due to the increase in the impervious surface, causing environmental disasters and environmental pollution problems, such as lowering the groundwater level and increasing water pollution. In Korea, low impact development (LID) techniques have been introduced to minimize these environmental impacts and maintain the water cycle soundness. However, most small-scale development projects are in blind spots because there is no legal basis for rainfall runoff management. Small-scale development projects that increase the surface runoff of rainwater are required to mandate the application of LID facilities in accordance with the polluters' responsibility principle. Therefore, it is necessary to implement a preliminary consultation system for water cycle recovery. This study focuses on the cost-benefit analysis on the application of LID techniques for small-scale development projects. The scale of nationwide small-scale development projects used for cost-benefit analysis were defined as buildings with a land area of more than 1,000 ㎡ or a total floor area of 1,500 ㎡. As a result of analyzing the cost-benefits from the installation of LID facilities, they were found to be much lower than the economic standard value of 1. This might be due to the high cost of facilities compared to the scale of the project. However, considering the overall environmental value of improving the water environment and air quality by the installation of LID facilities and the publicity of reducing the operating cost of sewage treatment facilities, the introduction of a prior consultation for small-scale development projects is inevitable. In the future, institutional and financial support from local governments is required to improve the cost-benefits with the introduction of a prior consultation for small-scale development projects.

Study of Dental Hygienist's Stress Degree and Adaptation Method (치과위생사의 스트레스 정도와 적응 방법에 관한 연구)

  • Gwon, Mi-Young;Jung, Mee-Hee
    • Journal of dental hygiene science
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    • v.4 no.3
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    • pp.133-140
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    • 2004
  • It examines closely the occupation characteristic primary factor which the dentistry hygienic company field which is working to presence at a sickbed is undergoing the degree and from the research which it sees and it grasps the adaptation method against it gropes bitterly with development of the dentistry hygienic company individual to join in, it contributed in dentistry medical treatment service quality improvement and the research which tries to sleep it attempted. Currently the dentistry hygiene which works from Seoul and the condition area subject matter dentist unit, the dentistry hospital and the general hospital dentistry back it did in the object which it will burn. 116 issues which become frequency in question 120 it used SPSS 10.0 and it analyzed. Result of this study is as following. (1) Was expose that stress degree by factor feels about commonness on the whole, and angle prospects and support connection stress at company were the biggest item by item, and appeared as on the other hand relation connection stress with patient is the smallest. (2) Stress that stress degree by each receives in case of there are a lot of other businesses to characteristic businesses except appeared highest. On the other hand, was expose that feel the lowest stress degree an item that other a type of occupation and discord are. (3) 'Do action of that throw goods or closes the door bump' appeared article highest by short term adaptation method about stress, and 'Think and gives up by fate' appeared highest by special skill adaptation method. Short term adaptation method appeared high than special skill adaptation method on the whole but the difference appeared as is very small. (4) Stress degree comparison by general special quality was shown difference that stress by only dental hygiene administration of justice selection motive keeps in mind. (5) All of the result that compare short term, long term adaptation method about stress that feel new dental higienist apple career dental higienist same difference be, but displayed high result in same munhang. (6) Was expose that difference that keep in mind from all arguments in comparison of short term adaptation method by general special quality does not exist, on the other hand, comparison of long-term adaptation method displayed result that religion among only variable keeps in mind statistically.

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Needs Assessment for the Beneficiaries of Home-Based Cancer Patients Management Project (보건소 재가암환자관리사업 대상자의 서비스 요구도 분석)

  • Lee, Ju-Hyung;Park, Jung-Im;Kang, Ji-Hoon;Youm, Jung-Ho;Koh, Dai-Ha;Kwon, Keun-Sang
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.238-250
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    • 2011
  • Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.

Effects of Educational Programs Utilizing Forests on Maladjusted Behavior of Mentally Retarded Students (숲을 활용한 교육이 정신지체학생의 부적응행동에 미치는 영향)

  • Park, Kyoung-Lee;Sim, Woo-Kyung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.38 no.5
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    • pp.64-79
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    • 2010
  • Students with intellectual disabilities typically have great difficulties communicating their needs and wants and may get frustrated, anxious or show signs of aggressive behaviour. They are often unable to understand the concept of relationships with other people as well. This lack of social communication and interaction leads to poor motivation which increases other areas of difficulty in their lives. Therefore, to teach students with intellectual disabilities, it is essential to find special teaching methods to support their positive behavior. This paper proposes that special educational curriculum for students with intellectual impairments utilize natural environments(forests) and materials. The purpose of this study was to investigate the effects of Educational Programs Utilizing Forests on maladjusted behavior of students with mental retardation and to examine the positive effects of such planning practices. The subjects were middle school students who attended a special school for mentally-retarded students. They were divided into two separate groups- an experimental group and a control group. All subjects received the pre and post test using the same method. This program was applied to the formal educational process of middle school from March 1st to October 30th, 2009. In this experiment the results indicate that the effect of using a natural environment(forest) and the materials within a formal educational curriculum was positive as a type of horticultural therapy and that it supports positive behavior strategies in students with intellectual impairments. The usage of various natural materials including plants and flowers within the natural environments provide students with increased opportunities to participate. Teaching methods including natural materials help teachers engage with their students more easily during routine activities as their interest is already stimulated. This project will help students with intellectual impairments to build skills which enable effective participation and increase independence throughout their lives. This should be embedded into both routine and planned activities of the classroom Also, it offers a needed interior plan for the treatment space through an analysis of psychological factors of how the environment affects students.