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A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward (만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구)

  • 김태연;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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Stress distribution in bone surrounding maxillary molar implants under different crown-to-fixture ratio: A 3D FEM analysis (치관/고정체 비에 따른 상악 구치부 임플란트 주변골의 응력 분포에 대한 3차원 유한요소법적 분석)

  • Park, Jong-Chan;Shin, Sang-Wan;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.479-489
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    • 2008
  • Statement of the problem: Under anatomical limitations on maxillary posterior region, a poor crown-to root ratio acting on dental implants can result in undesirable stress in surrounding bone, which in turn can cause bone defects and eventual failure of implants. Purpose: The purpose is to compare stress distribution due to different crown-root ratio and effect of splinting between natural teeth and implants in maxillary molar area under different loads. Material and methods: Analysis of stress arising supporting bone of the natural teeth and the implant was made with 3-dimensional finite element method. The model simulated naturel teeth was made with 2nd premolar and 1st molar in the maxillary molar region (Model T). The model simulated implants placed on same positions with two parallel implants of Straumann Dental Implant cemented abutment (Model I). Each model was designed in different crown-root ratio (0.7:1, 1:1, 1.25:1) and set cement type gold crown to make it non-splinted or splinted. After that, 300 N force was loaded to each model in five ways (Load 1: middle of occlusal table, Load 2: middle of buccal cusp, Load 3: middle of lingual cusp, Load 4: horizontal load to buccal cusp of anterior abutment only, Load 5: horizontal load to middle of buccal cusp of each abutment), and stress distribution was analyzed. Results and conclusion: On all occasions, stress was concentrated at the cervical region of the implant. Under load 1, 2 and 3, stress was not increased even when crown-root ratio increases, but under load 4 and 5, when crown-root ratio increases, stress also increased. There was difference in stress values between natural teeth and implants when crown-root ratio gradually increases; In case of natural teeth, splinting decreased stress under vertical and horizontal loads. In case of implants, splinting decreased stress under vertical loads 1,2 and 3, but increased maximal stress under loads 2 and 3. Under horizontal loads, splinting decreased stress, however the effect of splinting decreased under load 5 than load 4. Furthermore, the stress was increased, when crown-root ratio is 1.25:1. Clinical implications: This limited finite element study suggests that the stress on supporting bone may be increased under non-axial loads and poor crown-root ratio. Under poor crown-root ratio, excessive stress was generated at the cervical region of the implant, and decreased splinting effect for stress distribution, which can be related to clinical failure.

The Effect of Antioxidants on the Fermented Sardine and Taste Compounds of Product (정어리젓 가공에 있어서의 항산화제 처리 효과 및 제품의 정미성분)

  • LEE Eung-Ho;CHO Soon-Yeong;CHA Yong-Jun;JEON Joong-Kyun;KIM Se-Kwon
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.14 no.4
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    • pp.201-211
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    • 1981
  • For the effective utilization of sardine, sardinops melanosticta, one of the major coastal fish in Korea, of which annual catch has been increasing from year to year since 1970, it was processed in form of fermented fish paste. The fish were treated with BHA and Teaox-Ⅱ in concentration of $0.01\%\;and\;0.02\%$ to prevent the oxidation of lipid during fermentation and then salted with $20\%$ table salt and fermented at room temperature of $25\pm3^{\circ}C$. The duration of fermentation necessary for the final product with an acceptable taste was determined by sensory evaluation by means of profile method. From the result of sensory evaluation, one month was found to be suitable as the reasonable duration of fermentation. Both BHA and Tenox-Ⅱ in conceatration of $0.02\%$showed a good preventing effect on the lipid oxidation during fermentation. In case of fermented sardine treated with both antioxidants, lipid oxidation occurred little up to two months, whereas the control showed a remarkable deterioration during one month of fermentation. Most of the nucleotides in sardine was decomposed from adenosing triphosphate to inosine and hypoxanthine during the fermentation of one month. The great portion of free amino acids in the extractives of product was occupied by leucine, glutamic acid, isoleucine, alanine, valine and ysine in turn, and their coatent was $59.4\%$ of the total free amino acids. The amount of essential amino acids was $59.4\%$ of the total free amino acids. The contents of 5'-IMP, betaine, trimethylamine oxide and total creatinine in the extractives of product were $1.9{\mu}mole/g,\;4.9mg\%,\;1.0mg\%\;and\;475mg\%$, respectively. According to the omission test, the main constituents of the characteristic taste of fermented sardine could be assumed as free amino acids and a little amount of 5'-IMP.

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