• Title/Summary/Keyword: care management

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Comparison of Single vs Combined Modality Treatment in Locally Advanced Non-Small Cell Lung Cancer (국소 진행된 비소세포 폐암에서 복합요법과 단일요법의 비교)

  • Kim, Ae-Kyoung;Jeong, Seong-Su;Shin, Kyoung-Sang;Park, Sang-Gee;Jo, Hai-Jeong;Lee, Jong-Jin;Seo, Jee-Won;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.502-512
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    • 1995
  • Background: One quarter to one third of patients with NSCLC present with primary tumors that although confined to the thorax are too extensive for surgical resection. Until resently standard treatment for these patients had been thoracic radiation, which produces tumor regression in most patients but few cures and dismal 5-year survival rate. The fact that death for most patients with stage III tumors is caused by distant metastases has promped a reevaluation of combined modality treatment approaches that include systemic chemotherapy. Therefore, we report the results observed in a study to evaluate the effect of multimodality treatment in locally advanced non-small cell lung cancer from 1/91 to 8/93 in CNUH. Method: We grouped the patients according to the treatment modalities and evaluated response rate, median survival and the effect of prognostic variables. Among 67 patients evaluated, twenty seven patients classified with group A, received cisplatin and etoposide containing combination chemotherapy alone, eighteen patients, classified with group B, received chemotherapy and radiotherapy, fifteen patients, group C, received neoadjuvant or adjuvant chemotherapy and surgery with/without radiation therapy, seven patients, group D, received only supportive care. Result: The major response rate for group A and B was 37% and 61% respectively. There was no statistically significant difference in response rate between A and B groups(p=0.97). The analysis of prognostic factors showed that differences of age, sex, pathology, blood type, smoking year, stage and ECOG performance did not related to improvement in survival. Median survival time was 8.6 months for group A, 13.4 months for group B, 19.2 months for group C, and 5.4 months for group D, respectively and there was statistically significant difference(p=0.003), suggesting that multimodality therapy was associated with signigicant improvement in survival. Subset survival analysis showed a significant therapeutic effect for earlier stage and good performance state(p=0.007, 0.009, respectively). A possible survival advantages were observed for major response groups. Conclusion: It was suggested that multimodality therapy for the management of patients who had stage III disease, has yielded good median survival and long survival for seleted patients. But, it is necessory to validate above result with further investigation in large scale and in prospective randomized trials.

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Application of Noninvasive Positive Pressure Ventilation in Patients with Respiratory Failure (호흡부전 환자에서 비침습적 양압환기법의 적용)

  • Seol, Young Mi;Park, Young Eun;Kim, Seo Rin;Lee, Jae Hyung;Lee, Su Jin;Kim, Ki Uk;Cho, Jin Hoon;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew;Kim, Young Dae
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.26-33
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    • 2006
  • Background: Noninvasive positive pressure ventilation(NPPV) has been increasingly used over the past decade in the management of acute or chronic respiratory failure and weaning of mechanical ventilation. We performed this clinical study to evaluate the usefulness of NPPV in patients who developed acute respiratory failure or post-extubation respiratory failure. Methods: We analysed thirty four patients(sixteen males and eighteen females, mean ages 58 years) who applied NPPV(BIPAP S/T, Respironics co., USA) for respiratory failure or weaning difficulty at medical intensive care unit(MICU), emergency room and general ward of a tertiary hospital. We evaluated the underlying causes of respiratory failure, duration of treatment, the degree of adaptation, complication and predictive parameters of successful outcome. Results: The overall success rate of NPPV was seventy-one percent. The duration of NPPV applying time, baseline blood pressure, pulse rate, respiration rate, $PaO_2$, $PaCO_2$, $SaO_2$ were not different between success group and failure group. But, the baseline pH was higher in the success group. Predictors of success were higher baseline pH, patients with underlying disease of COPD, improvement of vital sign and arterial blood gas value after NPPV application. The success rate in patients with post-extubation respiratory failure was eighty percent. There were no serious complication on applying NPPV except minor complications such as facial skin erythema, abdominal distension & dry mouth. Conclusion: NPPV may be effective treatment in patients with acute respiratory failure or post-extubation respiratory failure in selected cases.

The Operation of Home Economics Education Course in Graduate School of Education and the Graduate Students' Perception (서울소재 교육대학원 가정교육전공 교육과정에 대한 운영실태와 교육대학원생의 인식)

  • Lee, Seon-Jung;Shin, Hye-Won
    • Journal of Korean Home Economics Education Association
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    • v.20 no.4
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    • pp.173-186
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    • 2008
  • This study aimed to examine the operation of the Home Economics education courses in the graduate schools of education, and to find out how graduate students perceive them. Data were collected with the use of handbooks issued by 11 graduate schools of education located in Seoul, and through telephone conversations with the administrative staff. To determine how graduate students majoring in Home Economics perceive their Home Economics courses, a survey was conducted among the graduate students in 10 graduate schools of education, and a total of 131 accomplished questionnaires were used for data analysis. The results of the study are as follows. First, all 11 graduate schools aimed to retrain their teachers, enhance their professionalism, and produce home economics education experts. The Home Economics Education courses come in two strands; a teacher's course and a major course. Most of the schools require a total of 30 credits. All Schools lack professors. Only 3 graduate schools have a home Economics Department in the College of Education. All graduate schools are offering a teacher's course based on a teacher's certification system. In a major course, Home Economics education has the largest number of subjects, with Clothing and Textiles and Food and Nutrition being given greater emphasis, and Consumer Economics, Home Economics Management, Child Care, and Family and Housing Studies being given less emphasis. Second, they mostly regard the graduate school of education as producer of experts, followed by producers of teachers and teacher re-trainers. Those who were majoring in Home Economics Education in college, and the teachers, are more interested in teacher re-training, while the non-teachers and those who were not majoring in Home Economics Education are more interested in producing teachers. They are less satisfied with the operation of the graduate school of education. But they are generally satisfied with the Home Economics Education course. Graduate students registered the lowest satisfaction with a major course, especially experimental subjects. For a teacher's course, the graduate students who are not teachers exhibited higher satisfaction, whereas the teachers showed lower satisfaction. But teachers registered more satisfaction with the practical use of major subjects in the educational field, thinking that their major was a big help in their work at a school. As for what has to be improved with regard to the Home Economics Education course, many cited the necessity of securing a good faculty and expanding the major subjects.

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Diagnosis and Improvements Plan Study of CIPP Model-based Vocational Competency Development Training Teacher Qualification Training (Training Course) (CIPP 모형 기반 직업능력개발훈련교사 자격연수(양성과정) 진단 및 개선 방안 연구)

  • Bae, Gwang-Min;Woo, Hye-Jung;Choi, Myung-Ran;Yoon, Gwan-Sik
    • Journal of vocational education research
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    • v.36 no.2
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    • pp.95-121
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    • 2017
  • The vocational competency development training teacher must complete the training course for the training of vocational competency development training instructor and get the qualification of the vocational competency development training teacher from the Ministry of Employment & Labor with the criteria set by the Presidential Decree. Therefore, it can be said that H_university 's educational performance, which is the only vocational competency development training teacher in Korea and that plays a role of mass production in the labor market, has a great influence on vocational competency development training. The purpose of this study is to identify the problems through the analysis of actual condition of vocational competency development training education based on CIPP model, Furthermore, it was aimed to suggest improvement plan of qualification training education. In order to accomplish the purpose of the research, the present situation of the training course for the vocational competency development training teacher training students was grasped. And We conducted a survey to draw out the improvement plan and utilized the results of 173 copies. We conducted interviews by selecting eight subjects for in-depth analysis and Understand the details of the results of the surveys conducted. As a result of the study, positive responses were obtained from the educational objectives and educational resources in the context factors. On the other hand, there were negative opinions about the curriculum reflecting the learner and social needs. In the input factors, positive opinions were derived from the educational objectives and training requirements. However, there were many negative opinions about the achievement of the learner's educational goals. In addition, there were many negative opinions of online contents education. In the process factors, positive evaluation was high in class related part, learner attendance management, and institutional support. However, negative opinions were drawn on the comprehensive evaluation of qualification training period, and the learner's burden due to lack of learning period appeared to be the main reason. In the factor of calculation, Positive opinions were derived from the applicability of the business curriculum for training courses for training teachers who are in charge of education and training in industry occupations. However, there were negative opinions such as learning time, concentration of learning, and communication of instructors. Based on the results of the study, suggestions for improving the operation of vocational competency training teacher qualification training are as follows. First, it is necessary to flexibly manage the training schedule for the weekly training course for vocational competency development training teachers. Second, it is necessary to seek to improve the online education curriculum centered on consumers. Third, it is necessary to seek access to qualification training for local residents. Fourth, pre - education support for qualified applicants is required. Finally, follow-up care of qualified trainees is necessary.

The Present State and Curriculum Implementation Overview of the Nursing-Specialized Vocational High Schools (특성화고등학교 간호과 운영 현황 및 교육과정 운영실태 분석)

  • Yoon, In-Kyung;Jang, Myung-Hee;Lee, Hyun-Young
    • Journal of vocational education research
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    • v.35 no.4
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    • pp.19-46
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    • 2016
  • The purpose of this study is to analyze the curriculum implementation of the Nursing-Specialized Vocational High School by researching on operation, organization and environment of the program of Nursing. This study aims to improve the curriculum of the Nursing-Specialized Vocational High School. This study has analyzed previous existing studies, Link of School info, Educational Statistics and data indicating establishment, operation and curriculum of the department of Nursing which have been collected from web sites of institutions and associations relevant to Nurse Education. The major results of this study are as follows: 1) As of the first semester of the year 2016, out of a total of thirty eight Specialized Vocational High Schools and Meister High Schools in the country, 6.4% of the schools have nursing educational programs. These schools have established the programs under various names, such as Health Nursing, Dental Health Nursing, Nursing, Nursing and Medical Tourism, Accounting in Nursing and Nursing Management, etc. Since 2012, enrollment rates have increased while post-graduation employment rates have decreased, with the average employment rate of Specialized Vocational High School graduates having reached up to 46% by 2015. 2) The Nursing-Specialized Vocational High School aims to create skilled Nurses Assistant such as Nurse Aide and Care giver. The program is successful in providing necessary courses to acquire required certification and proficient field experience but requires revisional changes in order to create a long-term program of sufficient qualification. The official requirement of 780 hours of field practice was completed during the three educational breaks from the first year of high school to the second year, while the curriculum was conducted separately in the field hospitals. 3) An average of two laboratory classrooms were available based on the facility requirement standard of Cities and Provinces Educational Policies. In order to secure proficient instructors of Nursing education, establishment of specific indicated subjects, regional placement, in-service education, research and supervision are essential for establishing excellence and continual improvement.

Validation of initial nutrition screening tool for hospitalized patients (입원 환자용 초기 영양검색도구의 타당도 검증)

  • Kim, Hye-Suk;Lee, Seonheui;Kim, Hyesook;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.52 no.4
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    • pp.332-341
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    • 2019
  • Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

The Physiologic change associated with aging, essential nutrients and their diseases in senior or geriatric dogs (노령견의 생리적 변화에 따른 필요 영양소 및 질병에 관한 연구)

  • Jung, Hyung-hak
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.4
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    • pp.1456-1471
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    • 2018
  • This article discusses the nutritional requirements, reviews senior or geriatric dog nutritional evaluation, and then addresses some common nutrition-related problems in older dogs. The purpose of this study was to investigate the Physiologic change associated with aging, essential nutrients and their diseases in senior or geriatric dog subjects. According to a 2002 market research, 30% to 40% of dogs raisedin the United States are 7 years of age. In Europe the number of dogs considered to be "senior or geriatric" (>7 years of age) increased by approximately 50% between 1983 and 1995. A 2012 e-mail survey of 50,347 respondents revealed that 33.2% of dogs were 6 to 10 years of age and 14.7% were older than 11 years in the United States. The average life expectancy of dogs raised in the home is affected by health care, aging and nutrition.And, the aging process is influenced by breed size, genetics, nutrition, environment, and other factors. Although many pets remain active and youthful well into their teens, most dogs start to slow down and may show signs of aging beginning as early as 5 or 6 years of age. Improvements in the control of various diseases and in the nutrition of dogs have resulted in a gradual increase in the average lifespan of companion dogs. Nutritional goals for aging dogs include supporting health and vitality, preventing the onset or slowing the progression of age-related health disorders, and enhancing the dog's quality of life and, if possible, life expectancy. Aging brings with its physiologicchanges. Some changes are obvious, such as whitening of hair, a general decline in body and coat condition, and failing senses including sight and hearing. Other changes are less obvious, however, and these include alterations in the physiology of the digestive tract, immune system, kidneys, and other organs. Nutritional requirements can change with age. In addition, many diseases common in older dogs may be nutrient-sensitive, meaning that diet can play an important role in the management of the condition.

The Determinants of Consumption Characteristics and Patterns of Elderly Households (고령자 가구의 소비특성 및 소비패턴 결정요인)

  • Kim, Jinhun
    • 한국노년학
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    • v.36 no.3
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    • pp.905-926
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    • 2016
  • Although the concept of the elderly varies depending on scholars and laws, as consumption expenditure is deeply associated with income due to the nature of this study, 55 years old was set as the low limit standard for the elderly according to Prohibition of Discrimination on Age in Employment and Employment Promotion for the Aged Act and the elderly households were limited to single-elderly person household and an elderly couple family household for this study. It is considered consumption characteristics as a significant analysis subject in terms of social welfare because it could be understood as an expressed need which was a reflection of desire. Therefore, the present study aimed to investigate the consumption characteristics of the elderly households by stereotyping the consumption pattern of the elderly households, and find the determining factors for consumption patterns and thus contribute to the establishment of related policies through the expressed needs of the elderly households. K-means of cluster analysis was performed by putting the consumption expenditure of the elderly households to investigate inherent structural type of consumption pattern of the elderly households, which were the investigation subjects. As a result, four groups were stereotyped and named as below: 'health care-centered type', 'saving-centered type', 'livelihood-centered type', and 'food expenses-centered type' Binary Logistic Regression analysis was used to identify the factors that influence the decision of consumption pattern of the elderly households. The result of study showed that the elderly households faced all different needs and problems and thus there is a need for various approach plans to solve this situation. In particular, although the elderly have been viewed as economically poor people so far, the study showed that there were also kind of prepared households through saving. Overall, livelihoodcentered type accounted for the highest portion and, as a factor that influenced this, marital state and household income played an important role. Therefore, it is considered that more active efforts to increase the income of the elderly households are needed. In addition, age, owning of house and subjective health state were found to also have significant influence. Through these results of the study, the elderly's own improvement of awareness on health, presentation of overall standard for health state of the elderly, securement of the elderly's access to cultural life, and financial management coordination for improvement of quality of life, development and dissemination of jobs suitable for the elderly, and dissemination of communal life household, which is a cooperation residential type, were presented as institutional task in the conclusion.

Spatial Distribution of Macrobenthic Communities on the Rocky Intertidal Zone of Specified Islands, Southern Coast of Korea (남해안 특정도서 암반조간대의 대형저서동물 군집의 공간분포)

  • Yang, Sehee;Yang, Hyosik;Lee, Changil;Seo, Chonghyun
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.6
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    • pp.853-865
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    • 2022
  • In this study, from August to October 2019, we conducted a survey of the spatial distribution and dominant species of macrobenthos on the rocky intertidal zones of 38 specified islands distributed along the southern coast of Korea. On the basis of observation made using 50 × 50 cm quadrats, we identified a total of 80 species, among which, Mollusca were the most abundant fauna, with 54 species that accounted for 67.4% of the total, followed by Crustacea with 15 species (18.7%). The recorded numbers of Cnidaria, Porifera, and Echinodermata species ranged from 1 to 6. In terms of the regional patterns of species richness, specified islands in Yeosu were found to be the most species rich, supporting 61 species, whereas islands in Hadong, Namhae, and Chujado were found to have a similar level of species richness, ranging from 42 to 46 species. Islands in Boseong and Goheung were home to the fewest species, with only 29 species being recorded. At the sampling station scale, we noted a considerable difference in faunal richness, ranging from 6 (St. 6) to 33 (St. 20) species. Among the recorded species, Echinolittorina radiata was identified as the dominant species on 15 specified islands, with the next most abundant species being Tetraclita japonica, considered an indicator species of climate change, which was recorded on 11 islands. In terms of frequency, E. radiata, found on 36 islands, was identified as the most frequently occurring species, followed by Reishia clavigera (30 islands), Mytilisepta virgata (29), Nerita japonica (28), Ligia. exotica (27), and Littorina brevicula (26). Of the 80 species identified, 9, 4, and 2 species of Mollusca, Crustacea, and Cnidaria, respectively, are classified as Marine fauna of accepted foreign export, whereas 50 are Red List species, 44 are species of Least Concern, 3 are Data Deficient species, and 1 species was not evaluated. However, during the survey, we found no Near Threatened or Not Applicable species. On the basis of the findings of this survey, it would appear that the abundance and richness of macrobenthic fauna inhabiting the rocky intertidal zones of specified islands along the southern coast of Korea differ according to different habitat conditions, particularly with respect to the duration of exposure and the extent and properties of the substrata. The findings of this study will provide baseline data for future monitoring and management of specified islands in Korea.

Ecological Network on Benthic Diatom in Estuary Environment by Bayesian Belief Network Modelling (베이지안 모델을 이용한 하구수생태계 부착돌말류의 생태 네트워크)

  • Kim, Keonhee;Park, Chaehong;Kim, Seung-hee;Won, Doo-Hee;Lee, Kyung-Lak;Jeon, Jiyoung
    • Korean Journal of Ecology and Environment
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    • v.55 no.1
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    • pp.60-75
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    • 2022
  • The Bayesian algorithm model is a model algorithm that calculates probabilities based on input data and is mainly used for complex disasters, water quality management, the ecological structure between living things or living-non-living factors. In this study, we analyzed the main factors affected Korean Estuary Trophic Diatom Index (KETDI) change based on the Bayesian network analysis using the diatom community and physicochemical factors in the domestic estuarine aquatic ecosystem. For Bayesian analysis, estuarine diatom habitat data and estuarine aquatic diatom health (2008~2019) data were used. Data were classified into habitat, physical, chemical, and biological factors. Each data was input to the Bayesian network model (GeNIE model) and performed estuary aquatic network analysis along with the nationwide and each coast. From 2008 to 2019, a total of 625 taxa of diatoms were identified, consisting of 2 orders, 5 suborders, 18 families, 141 genera, 595 species, 29 varieties, and 1 species. Nitzschia inconspicua had the highest cumulative cell density, followed by Nitzschia palea, Pseudostaurosira elliptica and Achnanthidium minutissimum. As a result of analyzing the ecological network of diatom health assessment in the estuary ecosystem using the Bayesian network model, the biological factor was the most sensitive factor influencing the health assessment score was. In contrast, the habitat and physicochemical factors had relatively low sensitivity. The most sensitive taxa of diatoms to the assessment of estuarine aquatic health were Nitzschia inconspicua, N. fonticola, Achnanthes convergens, and Pseudostaurosira elliptica. In addition, the ratio of industrial area and cattle shed near the habitat was sensitively linked to the health assessment. The major taxa sensitive to diatom health evaluation differed according to coast. Bayesian network analysis was useful to identify major variables including diatom taxa affecting aquatic health even in complex ecological structures such as estuary ecosystems. In addition, it is possible to identify the restoration target accurately when restoring the consequently damaged estuary aquatic ecosystem.