• Title/Summary/Keyword: care management

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Outcomes and Management of Fetal Infants with Birth Weight Below 500 g at a Tertiary Center (출생체중 500 g 미만의 태아영아 치료성적 및 치료의 실제)

  • Chang, Yun Sil;Kim, Yu Jin;Koo, Soo Hyun;Lee, Jang Hoon;Hwang, Jong Hee;Choi, Chang Won;Shim, Jae Won;Kim, Sung Shin;Ko, Sun Young;Lee, Eun Kyung;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.939-945
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    • 2005
  • Purpose : The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. Methods : We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center(SMC), or transferred to neonatal intensive care unit(NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. Results : Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8(15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4(44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was $23^{+3}$ among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age($24^{+2}{\pm}1^{+3}$ vs. $25^{+4}{\pm}2^{+3}$) and birth weight($424{\pm}17$ vs. $453{\pm}19$)(P<0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3(75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. Conclusion : Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.

E-Commerce in the Historical Approach to Usage and Practice of International Trade ("무역상무(貿易商務)에의 역사적(歷史的) 어프로치와 무역취인(貿易取引)의 전자화(電子化)")

  • Tsubaki, Koji
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.19
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    • pp.224-242
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    • 2003
  • The author believes that the main task of study in international trade usage and practice is the management of transactional risks involved in international sale of goods. They are foreign exchange risks, transportation risks, credit risk, risk of miscommunication, etc. In most cases, these risks are more serious and enormous than those involved in domestic sales. Historically, the merchant adventurers organized the voyage abroad, secured trade finance, and went around the ocean with their own or consigned cargo until around the $mid-19^{th}$ century. They did business faceto-face at the trade fair or the open port where they maintained the local offices, so-called "Trading House"(商館). Thererfore, the transactional risks might have been one-sided either with the seller or the buyer. The bottomry seemed a typical arrangement for risk sharing among the interested parties to the adventure. In this way, such organizational arrangements coped with or bore the transactional risks. With the advent of ocean liner services and wireless communication across the national border in the $19^{th}$ century, the business of merchant adventurers developed toward the clear division of labor; sales by mercantile agents, and ocean transportation by the steam ship companies. The international banking helped the process to be accelerated. Then, bills of lading backed up by the statute made it possible to conduct documentary sales with a foreign partner in different country. Thus, FOB terms including ocean freight and CIF terms emerged gradually as standard trade terms in which transactional risks were allocated through negotiation between the seller and the buyer located in different countries. Both of them did not have to go abroad with their cargo. Instead, documentation in compliance with the terms of the contract(plus an L/C in some cases) must by 'strictly' fulfilled. In other words, the set of contractual documents must be tendered in advance of the arrival of the goods at port of discharge. Trust or reliance is placed on such contractual paper documents. However, the container transport services introduced as international intermodal transport since the late 1960s frequently caused the earlier arrival of the goods at the destination before the presentation of the set of paper documents, which may take 5 to 10% of the amount of transaction. In addition, the size of the container vessel required the speedy transport documentation before sailing from the port of loading. In these circumstances, computerized processing of transport related documents became essential for inexpensive transaction cost and uninterrupted distribution of the goods. Such computerization does not stop at the phase of transportation but extends to cover the whole process of international trade, transforming the documentary sales into less-paper trade and further into paperless trade, i.e., EDI or E-Commerce. Now we face the other side of the coin, which is data security and paperless transfer of legal rights and obligations. Unfortunately, these issues are not effectively covered by a set of contracts only. Obviously, EDI or E-Commerce is based on the common business process and harmonized system of various data codes as well as the standard message formats. This essential feature of E-Commerce needs effective coordination of different divisions of business and tight control over credit arrangements in addition to the standard contract of sales. In a few word, information does not alway invite "trust". Credit flows from people, or close organizational tie-ups. It is our common understanding that, without well-orchestrated organizational arrangements made by leading companies, E-Commerce does not work well for paperless trade. With such arrangements well in place, participating E-business members do not need to seriously care for credit risk. Finally, it is also clear that E-International Commerce must be linked up with a set of government EDIs such as NACCS, Port EDI, JETRAS, etc, in Japan. Therefore, there is still a long way before us to go for E-Commerce in practice, not on the top of information manager's desk.

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Baby Food Knowledge, Attitudes and Practices of Multi-cultural Families in a Rural Area (일개 농촌지역 다문화가정의 이유식에 대한 지식, 태도 및 실천)

  • Kim, Min-Seo;Kim, Keon-Yeop;Kim, Kyeong-Na;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.500-509
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    • 2017
  • This study was conducted from December 2015 to March 2016 to investigate the knowledge, attitude, and practice of baby foods in rural multi-cultural families. The survey included the general characteristics of households and infants, knowledge, attitude, and practice of baby food. The results indicated that the mean score of baby food knowledge was 3.79, 4.07 for attitudes, and the practice group was 25.0%. In the knowledge of baby food, the groups with a total number of two or more children, high educational background for both the father and mother, Chinese or Japanese nationality, high Korean language ability, and marriage for at least 6 or more years was higher (p<0.05). In the attitude of baby food, the groups with a total number of two or more children, a higher mother's Korean language, and the mother in charge of the baby food were higher (p<0.05). In the case of baby food practice, the groups the baby mother was from Japan and Cambodia, there was no occupation, and the mother was in charge of the baby food were higher (p<0.05). Knowledge and attitude according to the practice of baby food showed a higher knowledge (p <0.001) and attitude in the weaning practiced group than unpracticed. To produce baby food for infants in multi-cultural families, it is important to improve the Korean language ability of infant mothers who are in charge of baby food, and it is necessary to provide correct information related to infant formula utilizing the supporters of the neighboring mothers. In addition, it is necessary to provide customized education and support that is contingent upon the nationality of the native people while remaining mindful of the cultural implications of multi-cultural families.

Impact of fetal diagnosis of congenital heart disease on parents (선천성 심질환의 산전 진단이 보호자의 임신 유지 결정에 미치는 영향)

  • Choi, Eun Young;Lee, Chang Hoon;Yoon, Myung Ja;Han, Eun Sook;Hong, Joon Suk;Jung, Yun Sook;Choi, Jung Yun
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1073-1078
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    • 2006
  • Purpose : This study was performed to assess how a fetal diagnosis of congenital heart disease affects parents, as regards pregnancy management and care of infants after birth. Methods : Database search to find out abnormal fetal echocardiography performed at Seoul National University Children's Hospital from July 1988 to June 2003 revealed 370 examinations. After excluding both arrhythmias without structural cardiac disease and multiple pregnancies, 299 pregnancies remained and this data formed the basis of this analysis. We retrospectively reviewed the medical records with special attention to pregnancy outcomes and also tried to find out factors influencing parental decisions on whether to continue or terminate pregnancy. Results : In this study, the mean gestation age at diagnosis was $28{\pm}6.0weeks$. The mean age of mothers was $30{\pm}3.9$ years old. Younger gestational ages at diagnosis(P=0.000), more severe grades of fetal heart disease(P=0.002) and younger mothers(P=0.014) correlated with terminations of pregnanies. But the grades of fetal status, the grades of associated anomaly, whether in-vitro-fertilization was carried out or not and numbers of previous children were not significant. Conclusion : This study found that the earlier gestational ages at diagnosis, younger maternal age and higher grades of fetal heart disease tended to lead parent to select abortions. Fetal echocardiographies were performed too late. Moreover Koreans have a biased view that malformation is a something incurable and a tragedy not only to oneself, but also to a family. So parents select terminations of pregnancy, even in curable cases. This is very unethical.

Promotional Strategies of Local Drugstores

  • Kim, Seung-Mi;Lee, Sang-Yoon;Kim, Pan-Jin;Kim, Nam-Myun;Youn, Myoung-Kil
    • The Journal of Industrial Distribution & Business
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    • v.1 no.1
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    • pp.5-12
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    • 2010
  • The retail business of drugstore was introduced to Korea for the first time 10 years ago. Since Olive Young introduced a retail store in the name of drugstore in 1999 for the first time in Korea, new distribution channel combining drugstore, cosmetic products and dairy products, etc has been made. At initial stage, the new distribution channel grew up slowly because of low specialty and economic stagnation. However, the three big distribution channels, that is to say, Olive Young (CJ), Watsons (GS) and W Store (Kolon Well Care), etc, were established to produce new distribution system following large-scaled discount stores as well as convenience stores. The purpose of the study is to investigate ways making Korean style drugstore be new retail business in addition to traditional markets, department stores, E-Mart and other general super markets and to examine problems preventing the drugstore from being promoted and to find out solutions. The speciality retailers that is called a category killer attacking department stores as well as marts is expanding market quickly. New consumption trend that gives priority to wellbeing is being expanded in accordance with high level of standards of living life: The drugstore is thought to be new alternative of distribution because it keeps special products. Young ladies who are main customers of drugstores respond to the trend sensitively to have more buying power that is thought to be promising. And, consumers' desire has become concrete and special. This is because consumers want not only convenient shopping but also special shopping system that is current trend. These days, so called Multi-shop and Total shop and other special shops have been recently opened. Special multi-shop has been concentrated on fashion product and miscellaneous goods so far: Health total wellbeing shop shall be popular in accordance with wellbeing trends. Drugstores can play an important role. Drugstores were opened for the first time ten years ago. In particular, Olive Young succeeded in going into the black after making efforts for a long time by many persons. Drugstores could succeed in the business owing to many persons in the past as well as customers who liked drugstores. However, drugstores once lost ways and recorded poor business results. The three drugstores, that is to say, Olive Young, Watsons making efforts to go into the black and W-Store pursuing traditional drugstore shall compete each other and make effort to satisfy customers' desire. In that way, the three drugstores can be assured of present business as well as future business. The consumers' demand trend has become special at sub-division so that drugstores that can satisfy the demand can succeed in the business. Large businesses may be more interested in the 4th generation retail business to produce good income and to have bright future. Drugstore business and market are likely to expand and develop owing to large business' participation in drugstore business. Drugstores expanded shop at Seoul and Gyeonggi-do until middle of 2000. Drugstore business at station sphere in Seoul and Gyeonggi-do that have high ratio of temporary population has low customer loyalty to have limitation on continuous growth. Since 2009, drugstores have opened new shops at local towns: From the year of 2010, drugstores need to establish multiple shop strategy by accelerating business speed and to allow customers to drop in the shop anywhere in the nation and to enter consumers' life deeply, so that they can strengthen business base definitely. Drugstores need to have price competitiveness to have multiple shop opening strategy and to satisfy consumers and to supply high quality services that is future subject to solve. And, Olive Young and Watsons that are Korean style drugstore need to keep system in order and to strengthen substance as Korean style drugstore and to expand marketing, so that they can get business outcome within 5 years that was done 10 years before and they become the 4th generation retail business. The study had difficulties at collecting material from the three drugstore because of poor cooperation. And, the author had great difficulty at collecting statistical material that was made in disorder. Further effort is needed considering such problems.

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Antioxidant activity of extracts from soybean and small black bean (대두와 쥐눈이콩 추출물의 항산화 활성에 관한 연구)

  • Hong, Ju-Yeon;Shin, Seung-Ryeul;Kong, Hyun-Joo;Choi, Eun-Mi;Woo, Sang-Chul;Lee, Myoung-Hee;Yang, Kyung-Mi
    • Food Science and Preservation
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    • v.21 no.3
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    • pp.404-411
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    • 2014
  • This study was carries out to analyzed the antioxidant activities of extracts extrated from soybean and small black bean for the development of functional materials. Yields of hot-water and ethanol extracts were higher in the soybean than small black bea, and yields of hot-water extracts were higher than ethanol extracts. Total phenol contents were 26.22 mg/g in the ethanol extracts from small black bean, and were higher than those in the soybean extracts. Total flavonoid contents were 30.52 mg/g of hot-water extracts from small black bean. The EDA values were increased by the increase of extract concentrations and were high in the hot-water and ethanol extracts from bean and small black bean The EDA values was high in the extracts of small black bean from low concentrations. The SOD-like activity of hot-water and ethanol extracts from small black bean was higher than those of soybean extracts. The SOD-like activity was 73%, 62% of the hot-water and ethanol extracts from small black bean in 10 ml/mL extract concentration, respectably. The nitrite scavenging ability was high extracts from soybean was 47.60% in pH 1.2, Those of hot-water extracts were higher than in ethanol extracts in 10 ml/mL extract concentration. The xanthine oxidase inhibitory activities were increased by the increase of extract concentrations and were high in ethanol extracts from small black bean of low concentration. The xanthine oxidase inhibitory activities was hot-water extracts from soybean were higher than 5 ml/mL extract concentration than those of other extracts. The inhibitory activities of tyrosinase were increased by increase of extract concentrations and were high each other 42.05%, 45.67% of hot-water and ethanol extracts from small black bean in 10 ml/mL extract concentration. Reducing power was increased by increase of extract concentrations in extracts of small black bean, and were high more than double in hot-water and ethanol from small black bean than extracts of soybean.

Task Analysis of Paramedics of Korea Based on DACUM Method (DACUM 기법에 의한 1급 응급구조사의 직무분석)

  • Bae, Ki-Sook;Koh, Bong-Yeun;Lee, Jung-Eun;Lee, In-Mo;Choi, Keun-Myoung;Kim, Soo-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.5-23
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    • 2011
  • Objective : This study grasps specific task on paramedics who plays a great role in the emergency scene, thereby eliciting definition of job called paramedics and analyzing occupation by DACUM method. Thus, the aim is to suggest working-level guidelines on the task of paramedics. Methods : It targeted paramedics who are working at hospitals, fire stations, and industries in Seoul and Gyeonggi area from Oct. 11, 2010 to Nov. 30. A total of 608 copies of questionnaire were analyzed by DACUM method. A research tool on occupational analysis consisted of 8 pieces for duty, 43 pieces for task, and 149 pieces for task elements. In order to survey performance frequency, importance, and difficulty by element, each task was developed by this research team, and each task was analyzed and finally elicited through workshop of DACUM method. Results : The occupational definition of paramedics, which was defined through this DACUM, was elicited as 'professional job of performing emergency medical care on the scene, during transferring, or within medical institution in order to maintain life and prevent wound deterioration, targeting a person who is put in emergency situation.' Task element, whose performance frequency was indicated to be the highest, was in order of checking mental status($2.76{\pm}0.497$), checking vital signs($2.70{\pm}0.578$), and airway/c-spine immobilization($2.69{\pm}.546$). Especially, defibrillation stood at $2.23{\pm}.655$ points. Task element, whose performance frequency was low, was in order of caring sexual abuse victims($1.32{\pm}0.563$), performing cricothyrotomy($1.36{\pm}0.618$), and caring cardiac arrest victims($1.40{\pm}0.636$). Importance of task was in order of airway/c-spine immobilization ($2.88{\pm}0.338$), maintenance of respiration($2.88{\pm}0.351$), caring cardiac arrest victims($2.87{\pm}0.349$), and performing CPR($2.87{\pm}0.361$). Task element, whose importance is low, was indicated to be in order of enema($2.29{\pm}0.736$), urinary catheterization($2.35{\pm}0.664$), and nasogastric intubation($2.35{\pm}0.667$). Task element, whose difficulty was shown to be the highest, was indicated to be in order of caring cardiac arrest victims during pregnancy ($2.60{\pm}0.559$), caring cardiovascular injury($2.59{\pm}0.546$), and labor management($2.53{\pm}0.533$). Conclusion : Based on the results of this study, the job performance work table(Dacom chart) of paramedics is suggested to be used, thereby being applied to development in education and curriculum of paramedics. It is necessary to evaluate usefulness of the job performance work table by estimating effect of education for paramedics based on the job performance work table of paramedics.

Reduction Effect of Aromatherapy on Stress and Insomnia (아로마요법의 스트레스 및 수면장애 감소효과)

  • Park, Sang-Ock;Kim, Seok-Beom;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.17-26
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    • 2002
  • Reducing the level of stress and insomnia by aromatherapy is proposed as a method of self-care and health promotion in the future. Of the people who received aromatherapy from July, 1999 to February, 2000 at the Complementary and Alternative Medicine Center at the Gyeongu City Health Center, 48 people agreed to participate in a questionnaire survey, presented before and after their aromatherapy, and the data were analyzed. When the people received aromatherapy at the Complementary and Alternative Medicine Center, they inhaled the aroma from a vaporizer and when at home, they inhaled from a tissue, gauze or washbowl. Two sessions per week (2 hrs./session) were provided at the Center in the total 1-month duration of the therapy. The oil made from a blend of clarysage, geranium, rose at a ratio of 3:2:1 was used for relieving stress, and the oil made from a blend of clarysage, lavender, and lemon at 2:2:1 ratio was used for relieving insomnia. The scores of stress of 92.5 17.5 points before aromatherapy significantly reduced to $87.4{\pm}4.2$ points after therapy(p<0.01), and the scores of insomnia of $2.5{\pm}1.2$ points before aromatherapy significantly reduced to $1.0{\pm}1.1$ points after therapy(p<0.01). The reduction in stress and insomnia from aromatherapy was more significant in those who were experiencing high levels of stress and insomnia. Therefore, stress and its related insomnia can be effectively relieved with proper application of aromatherapy. With benefits such as little side-effects, convenient and simple education, low cost, and the do-it-yourself feature. aromatherapy can be expanded into a self-management program for promoting health of the community people.

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Necrotizing Enterocolitis - A Survey by the Korean Association of Pediatric Surgeons - (괴사성 장염 - 대한소아외과학회회원 대상 전국조사 -)

  • Lee, Suk-Koo;Kim, D.Y.;Kim, S.G.;Kim, W.K.;Kim, I.K.;Kim, S.Y.;Kim, S.C.;Kim, J.E.;Kim, J.C.;Park, K.W.;Park, W.H.;Seo, J.M.;Song, Y.T.;Oh, S.M.;Oh, J.T.;Lee, N.H.;Lee, D.S.;Lee, S.C.;Jun, Y.S.;Chung, S.Y.;Chung, S.E.;Choi, K.J.;Choi, S.O.;Choi, S.H.;Han, S.J.
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.70-85
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    • 2006
  • A nationwide survey on necrotizing enterocolitis (NEC) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the three-year period from July 2001 to June 2004. Eighty one patients were included in the questionnaire, but only 71 patients were registered from 22 members in 16 hospitals. At the same time survey on focal intestinal perforation (FIP) was undertaken and 17 patients were registered from 11 members in 10 hospitals. Total 19,041 newborns were admitted to neonatal intensive care unit during the study period. Eighty one patients (17.27 %) were underwent surgery among 469 babies who were managed under the impression of NEC. The male to female ratio was 2.1:1. The premature were 60.6 %. The most common site of involvement was ileum. Overall and operation survival of NEC were 72 % and 79 %, respectively. The survival was lower in smaller babies, multiple segments involvement and involvement of both the small and large intestine. But there was no difference in survival according to sex or prematurity. The FIP showed very similarity with NEC in terms of incidence, and the age of diagnosis and operation. But the survival was much better and 100 %. The results showed the clinical characteristics of NEC and the trend of management in NEC in Korea. In the future we hope we can discuss about this topic in prospective manner.

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Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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