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Effect of Mediating Variable on the Relationship between Job Stress and Stress Response among Clinical Dental Hygienists (임상치과위생사에서 직무스트레스와 스트레스 반응에 있어 매개요인의 영향)

  • Choi, Ja-Hyeong;Choi, Jun-Seon
    • Journal of dental hygiene science
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    • v.14 no.2
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    • pp.114-122
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    • 2014
  • The purpose of this study was to analyze the effect of mediating variables on the relationship between job stress and stress response. A survey was conducted to 243 clinical dental hygienists from January 15, 2013 to March 20, 2013 and the data were analyzed using t-test, one-way ANOVA, Pearson's correlation analysis, and hierarchical multiple regression analysis. The subjects who worked in poor working environment, had high level of role conflict and overload and aggressive nature showed high stress responsivity (p<0.01). The variable that showed mediation effect on the relationship between job stress and physical discomfort, depression was shown to be personality type (p<0.05). Also, the variable that showed mediation effect on the relationship between job stress and turnover intention was social support (p<0.05). According to the results, personality type and social support were shown to be important parameters when it came to the relationship between job stress and stress response. Therefore, in order to reduce negative outcomes caused by stress, it is suggested to provide an educational opportunity on self-control management while increasing social support from the organizational and structural level. Especially, it is asked to expand the system that provides encouragement and recognition to feel the sense of achievement in the course of their duty execution.

Intensity Modulated Radiation Therapy Commissioning and Quality Assurance: Implementation of AAPM TG119 (세기조절방사선치료(IMRT)의 Commissioning 및 정도관리: AAPM TG119 적용)

  • Ahn, Woo-Sang;Cho, Byung-Chul
    • Progress in Medical Physics
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    • v.22 no.2
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    • pp.99-105
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    • 2011
  • The purpose of this study is to evaluate the accuracy of IMRT in our clinic from based on TG119 procedure and establish action level. Five IMRT test cases were described in TG119: multi-target, head&neck, prostate, and two C-shapes (easy&hard). There were used and delivered to water-equivalent solid phantom for IMRT. Absolute dose for points in target and OAR was measured by using an ion chamber (CC13, IBA). EBT2 film was utilized to compare the measured two-dimensional dose distribution with the calculated one by treatment planning system. All collected data were analyzed using the TG119 specifications to determine the confidence limit. The mean of relative error (%) between measured and calculated value was $1.2{\pm}1.1%$ and $1.2{\pm}0.7%$ for target and OAR, respectively. The resulting confidence limits were 3.4% and 2.6%. In EBT2 film dosimetry, the average percentage of points passing the gamma criteria (3%/3 mm) was $97.7{\pm}0.8%$. Confidence limit values determined by EBT2 film analysis was 3.9%. This study has focused on IMRT commissioning and quality assurance based on TG119 guideline. It is concluded that action level were ${\pm}4%$ and ${\pm}3%$ for target and OAR and 97% for film measurement, respectively. It is expected that TG119-based procedure can be used as reference to evaluate the accuracy of IMRT for each institution.

Evaluation of Difference between Skin Motion and Tumor Motion for Respiration Gated Radiotherapy (호흡조절방사선치료를 위한 피부움직임과 종양움직임 차이 평가)

  • Kwon, Kyung-Tae;Lim, Sang-Wook;Park, Sung-Ho;Kwon, Soo-Il;Shin, Sung-Soo;Lee, Sang-Wook;Ahn, Seung-Do;Kim, Jong-Hoon;Choi, Eun-Kyung
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.14-20
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    • 2008
  • Accounting for tumor motion in treatment planning and delivery is one of the most recent and significant challenges facing radiotherapy. The purpose of this study was to investigate the correlation and clarified the relationship between the motion of an external marker using the Real-Time Position Management (RPM) System and an internal organ motion signal obtained fluoroscope. We enrolled 10 patients with locally advanced lung cancer and liver cancer, retrospectively. The external marker was a plastic box, which is part of the RPM used to track the patient's respiration. We investigated the quantitatively correlation between the motions of an external marker with RPM and internal motion with fluoroscope. The internal fiducial motion is predominant in the caraniocaudal direction, with a range of $1.3{\sim}3.5cm$ with fluoroscopic unit. The external fiducial motion is predominant in the caraniocaudal direction, with a range of $0.43{\sim}2.19cm$ with RPM gating. The two measurements ratio is from 1.31 to 5.56. When the regularization guided standard deviation is from 0.08 to 0.87, mean 0.204 cm, except only for patients #3 separated by a mean 0.13 cm, maximum of 0.23 cm. This result is a good correlation between internal tumor motion imaged by fluoroscopic unit and external marker motion with RPM during expiration within 0.23 cm. We have demonstrated that gating may be best performed but special attention should be paid to gating for patients whose fiducials do not move in synchrony, because targeting on the correct phase difference alone would not guarantee that the entire tumor volume is within the treatment field.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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A Study on a Type of Regeneration Project on Old Industrial Complex (노후산업단지 재생사업 추진 유형에 관한 연구)

  • Kim, Joo-hoon;Byun, Byung-seol
    • Journal of the Economic Geographical Society of Korea
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    • v.21 no.2
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    • pp.192-211
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    • 2018
  • With significant influences of old industrial complex in September 2009, Ministry of Land, Infrastructure and Transport chose the 4 districts for the first pilot project. In December 2014, the second pilot project districts were established. In addition, there were 10 districts in April 2016 and 5 districts in April 2016 as the third pilot project and 5 districts in March 2017 as the fourth pilot project. In order to promote smooth business operation of the recycling business, we introduced the effective area designation and special system as stipulated in Article 39.12-13 of the Industrial Location and Development Act revised in May 2015. The effective area, It is a method that can promote propagation and diffusion of the rehabilitation business through visualization by making effective the promotion of the rehabilitation business and by promoting the business in consideration of the geographical feature of the region and industry group, The setting of the unreasonable effective area is based on the criteria and classification of the plan and the objective promotion method according to the individual characteristics of the aged industrial park because the delay of the rehabilitation business and the possibility of the increase of many problems are presented Be sure to Data Envelopment Analysis (DEA) and the old industrial complex database were constructed and utilized to classify the types of recycling projects. Therefore, in this study, it is necessary to strengthen the competitiveness of aged industrial complex by examining the correlation between the diagnosis of 83 aged industrial complex sites and the rehabilitation projects supported by the Ministry of Land, and the types of business promotion for aged industrial parks. It can be used as a guideline for the feasibility of the project.

The Changes of Respiratory Mechanics by a Bronchodilator Inhalation Under the Variable Level of PEEP in Patients with Acute Respiratory Distress Syndrome (급성호흡곤란증후군에서 기도확장제 투여 전후에 호기말양압 수준의 변화가 호흡역학에 미치는 영향)

  • Hong, Sang-Bum;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.251-259
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    • 2002
  • Background : Reduced lung compliance and increased lung resistance are the primary lung mechanical abnormalities in acute respiratory distress syndrome (ARDS). Although there is little information regarding the mechanisms responsible for the increases in the respiratory resistance of ARDS, bronchodilators have been frequently administered in mechanically ventilated ARDS patients. To determine the effect of a bronchodilator on the respiratory mechanics depending on the level of applied positive end-expiratory pressure (PEEP), the changes in the respiratory mechanics by salbutamol inhalation was measured under the variable PEEP level in patients with ARDS. Materials and Methods : Fifteen mechanically ventilated paralyzed ARDS patients (14 of male, mean age 57 years) were enrolled in this study. The respiratory system compliance, and the maximum and minimum inspiratory resistance were obtained by the end-inspiratory occlusion method during constant flow inflation using the CP-100 pulmonary monitor (Bicore, Irvine, CA, USA). The measurements were performed at randomly applied 8, 10 and 12 cm $H_2O$ PEEP before and 30 mins after administrating salbutamol using a meter-dose-inhaler (100ug${\times}$6). Results : 1) The maximum inspiratory resistance of the lung was higher than the reported normal values due to an increase in the minimal inspiratory resistance & additional resistance. 2) The maximum inspiratory resistance and peak airway pressure were significantly higher at 12cm $H_2O$ of PEEP compared with those at 10cm $H_2O$ of PEEP. 3) Salbutamol induced a significant decrease in the maximum and the minimum inspiratory resistance but no significant change in the additional resistance only was observed at 12cm $H_2O$ of PEEP(from $15.66{\pm}1.99$ to $13.54{\pm}2.41$, from $10.24{\pm}2.98$ to $8.04{\pm}2.34$, and from $5.42{\pm}3.41$ to $5.50{\pm}3.58cm$ $H_2O$/L/sec, respectively). 4)The lung compliance did not change at the applied PEEP and salbutamol inhalation levels. Conclusion : The bronchodilator response would be different depending on the level of applied PEEP despite the increased respiratory resistance in patients with ARDS.

Health-Related Behaviors and Nutrient Intake of Police Officers Based on the Level of Job Stress (일부 지역 경찰공무원의 직무스트레스 정도에 따른 건강관련 형태 및 영양소 섭취량에 관한 연구)

  • Joo, Hye-Eun;Sohn, Cheong-Min
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.4
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    • pp.518-525
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    • 2010
  • The purpose of the study was to examine health-related behaviors and nutrient intake in relation to job stress level of police officers. Total of 166 police officers working in Jeonbuk area participated in the study. The study was conducted from February to March, 2009. Subjects were given self-administered questionnaire on their general health status, dietary and health-related habits. Nutrient intake was assessed by semi-quantitative food frequency questionnaire. Subjects were divided into four groups (very low, low, high, very high) by their job stress level scores. Main concerns of job stress were from 'job demand', 'organizational system' and 'lack of reward'. More than 95% of the subjects were confident of their health status. Health habits, such as drinking, smoking and exercising, were better than that of average Korean men. There were significant differences in dietary habits in relation to job stress level. Lower job stress group showed lower rate of skipping breakfast (p<0.01), more affordable meal time (p<0.05) and better snacking habits (p<0.001). Sweet food preference was higher in lower job stress group (p<0.05). The average calorie intake was $2063\pm532.7$ (88.5% of EER) and there was no significant difference in nutrient intake among job stress levels. However, mean intake of calcium and vitamin $B_2$ was less than 75% of %DRI in higher job stress group. Therefore, further support in nutritional counseling programs to improve dietary behaviors and health habits and to reduce job concerned stress of the police officers will be necessary.

Parents' Satisfaction on Foodservice Quality of Kindergartens in Chungbuk Province (충북지역 유치원 급식품질에 대한 학부모 만족도)

  • Lee, Joo-Young;Lee, Young-Eun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.4
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    • pp.613-623
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    • 2010
  • The purpose of this study was to examine parents' perceptions towards the importance and performance levels of foodservices quality at kindergartens. The questionnaire was developed to measure the thirty-one quality attributes of foodservice operations. A questionnaire survey was conducted to 500 parents and the return rates were 62.4%. The survey period was from July 15 to August 8, 2008. The parents had a high level of perception toward the need for foodservice, earning 4.46 points out of 5 point. Their perceptions of foodservice quality were examined by six dimensions of importance and performance level. While the parents gave 4 points or greater of 5 points to most quality attributes of importance level, they gave 4 points or less out of 5 points to most quality attributes of performance level. As for the importance and performance level of the quality dimensions of foodservice, parents regarded sanitation as the most important dimension. IPA showed that 'ventilation', 'sanitation of tableware' and 'sanitation of dining tables and chairs' were included as 'focus' areas. The overall satisfaction level for foodservice was 3.74 out of 5 points A higher level of satisfaction was shown at self-operated foodservice system of kindergartens. According to multiple regression analysis, 46.3% of the variance in the respondents' overall satisfaction scores was explained by factors such as food, menu and price, facilities, sanitation, atmosphere and foodservice effects.

Quality Characteristics and Antioxidant Activities of Cookies Supplemented with Aronia Powder (아로니아 분말을 첨가한 쿠키의 품질 특성과 항산화 활성)

  • Lee, Jun Ho;Choi, Ji Eun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.7
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    • pp.1071-1076
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    • 2016
  • The feasibility of incorporating aronia powder (AP) as a value-added food ingredient into convenient food products was investigated using cookie as a model system. AP was incorporated into cookies at amounts of 0, 1, 2, 3, and 4% (w/w) based on total weight of wheat flour. The pH level of cookie dough decreased significantly with increasing levels of AP (P<0.05), whereas moisture content and density were not directly affected by levels of AP incorporation. The spread ratio increased significantly upon addition of AP; however, it was not significantly affected by level of AP incorporation. The loss rate of cookies decreased significantly with increasing levels of AP (P<0.05). In terms of color, lightness and yellowness decreased while redness increased significantly (P<0.05) with increasing levels of AP. Use of AP significantly decreased hardness of cookies (P<0.05), but no significant differences were found between control and 1% sample, 1% and 2% sample, 2% and 3% sample, and 3% and 4% sample (P>0.05). 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) radical scavenging activities were significantly elevated by AP addition, and they increased significantly as AP concentration increased in the formulation (P<0.05). Correlation analysis indicated that acceptances of color and chewiness were negatively correlated well with the level of AP incorporation, density and moisture content of cookie dough, and cookie redness, whereas they were positively correlated with pH of cookie dough, loss rate, and hardness (P<0.01 or P<0.05). Finally, consumer acceptance test indicated that the highest levels of AP incorporation (4%) had an adverse effect on general consumer preferences. In contrast, cookies with moderate levels of AP (2%) are recommended based on overall scores to take advantage of the antioxidant properties of AP without sacrificing consumer acceptability.

Antioxidant Activities and Quality Characteristics of Mulberry Concentrate, Freeze-dried Mulberry, and Pomace (건오디, 건오디박, 오디 농축액의 품질특성 및 항산화성)

  • Jeon, Hye Lyun;Hong, Yoon Pyo;Lee, Ji Hyun;Kim, Hyung Don;Kim, Mee Ree
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.10
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    • pp.1402-1408
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    • 2012
  • Mulberry pomace, a by-product obtained from mulberry juice, has not been utilized as food. In this study, antioxidant activities, proximate composition and physiochemical characteristics of mulberry pomace were evaluated and compared with those of mulberry fruit or mulberry concentrate. Mulberry fruit was pressed and filtered. The filtrate and residue were used as mulberry juice and mulberry pomace, respectively. Mulberry juice was evaporated, after which a concentrate ($24.7^{\circ}Brix$) was obtained. Moisture contents of mulberry concentrate, freeze-dried mulberry, and pomace were 68.7%, 6.03%, and 7.32%, respectively. Reducing sugar contents were 45.7% in freeze-dried mulberry, 24.5% in pomace, and 30.9% in mulberry concentrate. The pH and acidity of the three samples ranged from 5.80~5.92 and, 0.035~0.080%, respectively. Carbohydrate and crude ash contents were the highest in mulberry fruit, whereas crude protein, fat, and fiber contents were the highest in pomace. Redness of the Hunter color system was 4.7 in mulberry and 4.3 in pomace. Total phenolic content was the highest in mulberry fruit, whereas total flavonoid content was the highest in pomace. Antioxidant activities (DPPH, hydroxyl, and ABTS radical scavenging activities) were enhanced in the order of mulberry fruit> pomace> mulberry concentrate. Especially, antioxidant activities, such as DPPH and hydroxyl radical scavenging activities, of mulberry pomace were similar with those of mulberry fruit. Based on these results, freeze-dried mulberry pomace may be considered as a functional as well as an additive material for food processing.