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A Preliminary Study for Expending of Hospital-Based Home Health Care Coverage - Focused on Car Accident Inpatients Who has the Compensation Insurance - (병원중심 가정간호관리대상 범위 확대를 위한 기초연구(II) - 자동차보험가입 입원환자를 대상으로 -)

  • Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.7 no.1
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    • pp.58-72
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    • 2000
  • This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

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A Study on the School Health Services in the Universities, Colleges and Junior Colleges (우리나라대학의 학교보건관리에 관한 실태조사)

  • 손무인
    • Korean Journal of Health Education and Promotion
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    • v.1 no.1
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    • pp.83-97
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    • 1983
  • The present study is to provide information for the improvement of school health services through research on the current condition of its organization and practice in universities, colleges and junior colleges. The scope of this study is consisted of four components including health organizations/units, school health services, environmental sanitation and health education for the 30 universities, the 20 colleges and the 32 junior colleges in Korea. The major findings are summarized as follows: (1) Among the sampled schools, around 73% of them have the health service organization/unit. When we break down health service organization/unit into the types by the level of school, around 73% of the universities have formal organization called "health center" and 20.0% of them have an informal organization called "health room". For the colleges level, 30.0% of them have the "health center" and 40.0% of them have the "health room". The figure of junior colleges is a quite different from universities and colleges, 56.3% of junior colleges have the "health room" only but the other have no service organization at all. (2) It was found that only 22.0% of 82 schools have the health committee for the school health services. It might be necessary to have a kind of expert committee to establish an annual health service program, budget and health policy in the school. (3) Approximately 29% of those schools having formal health organizations/units appointed directors as a medical persons. 13.4% of the sampled schools are appointed doctors (including the dentists) at health service organization/unit, 9.8% are appointed pharmacist and 65.9% are appointed nurses. Therefore, the data imply that the school health services are depending mainly on nurses. (4) The major activities of school health services are covering primary medical care (84.1%), health counseling (72.0%), physical examination (68.3%), vaccination (58.5%), tuberculosis control (54.9%), parasite control (29.3%) and dental health case(9.8%). Also 69.5% of the schools have the program on the environmental sanitation and the health education program. (5) In regard to health budget taking account of 34 schools, approximately 92% of them have less than 5,000 won per students and only 8.8% of them have more 10,000 won per students. At the average health budget per students is 4089.8 won in universities, 1617.1 won in colleges and 475.0 won in junior colleges. (6) The students enjoy the benifit of medical insurance at 11.0% of 82 schools surveyed. They are all universities. (7) The study found that 56 universities, colleges and junior colleges provide the annual physical examination. Only 21.4% of them have provided it for all students and school employees. (8) 64.3% of the 56 schools surveyed keep a record of the regular physical examinations. Records must be utilized as the basic data for the evaluation of the student's health condition and so the individual student is encouraged to take care of his own health. (9) At the 59 schools which practice health counseling, the main concerns of the counsellees are venereal disease, tuberculosis and psychoneurosis. This shows the need to practice health education in the area of preventive medicine. (10) 69.5% of the 82 universities, colleges and junior colleges surveyed are concerned with supervision of the environmental sanitation in their school, but non-professionals are in charge at 70.1% of them. This indicates negligence in environmental sanitation. (11) 53.7% of the 82 schools responded that they have no special instructive measure for the students' health and 54.9% are found to be negative in the use of a health education method. This reveals a problem. They are not positive to the recognition of their function as the initiative organization for the students' health. (12) The supplementary education for the faculty of the school health services is executed only at 8.5% of all the schools surveyed.

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The Effective Resonance of Caves & Records of a Cave Concert (동굴의 자연음향 효과, 그리고 음악회장 운영사례)

  • Hyun, Haeng-Bok
    • Journal of the Speleological Society of Korea
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    • no.95
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    • pp.35-49
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    • 2009
  • Ever since the beginning of time, caves not only have offered a place to live for humans but they have also been used as cultural spaces. That is, in the event of making some sounds in a location within the cave, the sound that is created is greatly magnified and sounds out as if it is being amplified from a giant megaphone. This, as we well know it, is known as the resonance effect. Here, the cave itself appears to function as a massive wind instrument. Especially in cases like the Altamira Cave (Spain) where cave paintings were found, the point where the cave drawings were found has commonalities in that it is a wide space and that it is usually discovered together with flutes and drums that are made with mammoth bones. We need to focus on this point. We can infer from these facts that the prehistoric people have carried out cultural activities along with their incantation rituals within those caves. In the meantime, amongst the Korean traditional arts, in the case of pansori which is a representative vocal genre, there have been examples where caves were used as practicing locations for those people who are training to perfect their singing. This is known as toguldoggong(土窟獨功) which literally means 'obtaining one's own art by oneself in the earth cave by practicing incessantly'. This process along with pokpodoggong (瀑布獨功) (same as above except that the location is by the waterfall) is the final training stage in order to become a recognized virtuoso on the part of the apprentice. This could be compared to the final annealing and finishing process of producing a metalwork. This has been a long tradition followed by most Korean traditional artists in order to perfect their sound which is harmonious with nature within natural surroundings. By honing in on this point, I have come to think about this matter repeatedly while coaching the university students in vocal singing. In short, I came to the conclusion that "the making of natural sounds will be obtained naturally within natural surroundings like caves!" Consequently, The Society for Studying Cave Sounds was inaugurated on January 1992 along with some of my students. We made use of times like vacations to go around exploring caves all over Jeju and carried out investigations of sounds along with cave exploration on an experimental basis. After 5 years, in September of 1997, we were able to host the first ever cave concert domestically at the Whale Nostril Cave(東岸鯨窟) on Wu-do. After that, we have been hosting the cave concert once every year. We have achieved a record of a total of 14 cave concerts until 2009 of this year. Out of these, 2 were held in Seokhwaeam Cave in Kangwon Province, another two were held in Manjang Cave which is a lava cave, and the remaining 10 were held in the Whale Nostril Cave of Wu-do. Along with that, I have carried out a special recording for the production of a cave music CD in May of 1999. This paper was written and organized by using the main materials that were derived from the experiences of using caves as concert halls in the past. It is hoped that this cave concert will offer a very unique experience to tourists who come to Jeju every year and give them the best possible superior natural sound effect that only Jeju caves can offer.

The Study of the Direction of Development of the Korean Feature Length Animation for Movie Theater : in the Case of 〈 Leafle, A Hen into The Wild 〉 (한국 극장용 장편 애니메이션 산업의 발전 방향에 대한 연구: 〈마당을 나온 암탉〉을 중심으로)

  • Kim, Yoon-A;Mok, Hae-Jung
    • Cartoon and Animation Studies
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    • s.26
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    • pp.109-130
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    • 2012
  • The purpose of this study is to suggest the direction of the development of the feature length animation for movie theater by analyzing of the reasons of the success of . released in 2011 has broken box office records by drawing 2 millions since drew 760 thousands in 1976. This can be one of the success model of the animation for movie theater, considering it has had trouble not only in planning ability and scenario power but also in producing environment where subcontracts are prevalent. This box office hit seems to have been possible through cooperation and division of movie crews and animation crews. Many kinds of materials are reviewed and producer Kim Seonku was interviewed for analysis of the reasons of box office success. Followings are five reasons of success found as the result of analysis and the body of this article is composed of the argument and analysis of each. 1.This animation was planned and produced in the same way of commercial feature films. 2.There was detailed division of work while producing 3. Various kinds of investments were made sequentially, 4. Major film distributor like Lotte and CJ could be motivated 5. There were producers who can mediate between the animation and film field This study suggests the direction both in the aspect of industry and the aspect of training professionals as the result of analysis. In the industrial aspect, transitional cooperation is needed between animation filed and film field which can motivate distributor. Industrial approach like planning, investment, distribution and marketing is absolute for the success of animation for movie theater. Also in the aspect of training professionals, curriculum needs to be improved in the university because the ability and passion of the professionals in the field of animation industry are the most important and education is the most approachable way.

Effects of Simulated Acid Rain on the Chlorophyll Contents in the Needles of Pinus koraiensis and Ligustrum obtusifolium Seedlings (인공산성우(人工酸性雨)가 잣나무 및 쥐똥나무 유묘(幼苗)의 엽내(葉內) 엽록소(葉綠素) 함량(含量)에 미치는 영향(影響))

  • Kim, Chang Ho;Cheong, Yong Moon
    • Journal of Korean Society of Forest Science
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    • v.76 no.1
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    • pp.11-16
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    • 1987
  • With the purpose of pursuing the increase and decrease of chlorophyll a and chlorophyll b caused by application of the simulated acid rain treatment on Pinus koraiensis seedlings and Ligustrum obtusifolium cuttings, the experimental design of randomized block arrangement with three replications was implemented in the experimental field of Yesan National Agricultural Junior College, during the growing season of 1985. Pinus koraiensis seeds stratified in cool and moist condition were sown on pots, and in case of Ligustrum obtusifolium, C1/1 cuttings were potted for experimental use in the early spring. The regime of artificial acid rain, based upon precipitation frequency and density, was simulated from the learning of climatological data averaged from 30 years records. The spray of acid water containing pH values of 4.0 and 2.0 was initiated from the 1st of May and ended on the 31st of August. As control, ground water was also treated at the same time. To analyse the chlorophyll content, those leaves looking representative and unaffected by other harmful agents were sampled on the 18th of September, and UV-visible spectrophotometer was used. With decrease in pH values of acid rain, the content of chlorophyll a and chlorophyll b decreased in both species. The decrease in chlorophyll a could be confirmed through statistical significance, but not in chlorophyll b. And when we discussed the chlorophyll decrease index which was explained in detail in the paper, an attention might be given to similarly decreasing values in both chlorophyll a and chlorophyll b, according as pH levels of acid rain decreased. The ratios of chlorophyll a to chlorophyll b in both species were not affected by different pH leaves of acid rain.

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Pleural Fluid Analysis in Tuberculous Pleurisy Progressing into Severe Pleural Thickening Underwent Pleural Decortication (심한 흉막비후로 진행하여 흉막박피술을 시행받은 결핵성 흉막염 환자들의 흉막액 분석)

  • Chung, Jae Ho;Park, Moo Suk;Kim, Se Kyu;Chang, Joon;Chung, Kyung Young;Kim, Sung Kyu;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.353-360
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    • 2003
  • Background : Although most patients with tuberculous pleurisy respond well to anti-tuberculous drugs, some are known to progress into severe pleural thickening which needs decortication despite adequate anti-tuberculous treatment. Therefore, the purpose of this study was to identify factors associated with the development of severe pleural thickening in patients who finally underwent pleural decortication in tuberculous pleurisy. Patients and Methods : From retrospective medical records review, 121 patients initially diagnosed as tuberculous pleurisy without initial pleural fluid loculation were enrolled between January 1998 and December 2002. They were separated into two groups: 85 patients in group 1 who improved by anti-tuberculous drugs only, and 36 patients in group 2 who had progressed into pleural adhesion and finally underwent pleural decortication despite adequate (more than 6 months) anti-tuberculous treatment. Results : Males were more common in group 2 (M/F=31/5) than in group 1 (M/F=53/32) (p=0.010). Group 2 patients tended to have lower pleural fluid glucose level ($58{\pm}4$ mg/dL) than group 1 ($89{\pm}3$ mg/dL) (p=0.001) and higher pleural fluid adenosine deaminase level ($86{\pm}5$ IU/L) than group 1 ($76{\pm}3$ IU/L), (p=0.038). There were no significant differences in age, symptom duration, pleural fluid amount, or pleural fluid LDH level between groups 1 and 2. Conclusions : There was a relative risk of tuberculous pleurisy progression into severe pleural thickening which needed decortication in the case of male patients, low pleural fluid glucose or high adenosine deaminase level. But further, large-scale, prospective studies should be investigated.

The Clinical Aspects of Wild Plant Poisoning (야생식물 중독의 임상 양상)

  • Ok, Taek-Gun;Park,, Chan-Woo;Cho, Jun-Hwi;Cheon, Seung-Whan;Lee, Seung-Young;Kim,, Sung-Eun;Choi, Ki-Hoon;Bae, Ji-Hoon;Seo, Jeong-Yeul;Ahn, Hee-Cheol;Ahn, Moo-Eob;Cho, Byung-Ryul;Kim,, Yong-Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.79-85
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    • 2005
  • Purpose: With the recent boom in 'eating healthy', many adults are interested in dieting to prevent future diseases. However only well trained experts can distinguish between what are edible vegetables and herbs from their poisonous look-alikes. In cases where a patient unknowingly ingests a poisonous herb, is caught off guard by the poisonous side effects that occur because of their lack of knowledge of what they have ingested. This paper will focus on the need to educate the public about the risks involved with ingesting wild vegetables and herbs and study the emergency diagnosis and treatment of poisoned patients that enter the emergency room. Method: This study was done in the spring of 2004 (from March to May) in the Kangwon Young-Seo districts of Korea. 15 subjects used in this study, entered the emergency room showing signs of toxic symptoms. Data was collected by examining subject's records. Additional data was collected by collaborating with physicians in the hospital that diagnosed and treated the subjects. Identifying the poisonous vegetable or herb is the first step to proper diagnosis and treatment. Subjects admitted to the emergency room, underwent a battery of tests: laboratory examination, ECG, radiological exam and etc. Results: The demographics of the study encompassed subjects with the average age of $50{\pm}19$ years old. There were 10 men and 5 women. Common symptoms of this study included; gastrointestinal symptoms such as nausea, vomiting, epigastric pain and so on. In the case of Caltha palustris ingestion, additional symptoms were present; bradycardia and hypotension which lasted for a long time. While cases that ingested Scopolia parviflora had little effect on vital signs but manic episodes lasted for about three days. Veratrum patulum ingestion showed signs of bradycardia and hypotension but contrary to Caltha palustris recovery was shorten by treating with dopamine. However, dizziness, headache and paresthesia of the extremities continued for a long time. Finally Sium ninsi ingestion showed visual disturbance, paresthesia of the extremities, dizziness as their initial symptoms. Conclusion: The risks involved with ingesting wild plants without the proper knowledge can lead to serious side effects and steps need to be taken to educate the public. In addition, all emergency physicians need to have a working knowledge of the symptoms and signs associated with ingesting toxic wild plants and need to treat accordingly.

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A Comparison on the Characteristics of Cerebrovascular Disease Patients Admitted to Some Western and Oriental Hospitals (일부 양·한방 병원에 입원한 뇌혈관질환 환자의 특성 비교)

  • Yu, Dae-Jin;Ryu, So-Yeon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.65-79
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    • 2001
  • Cerebrovascular disease(CVD) is one of the major causes of death in Korea as well as most countries in the world and the disease gives great burden to humans socio-economically due to its high fatality and common occurrence of disability as the sequelae. This study was performed to investigate the utilization of western hospital(WH) or oriental hospital(OH) due to CVD and compare the type and the clinical characteristics of patients with CVD between WH and OH located in Kwangju City, Chonnam Province and Chonbuk Province. We reviewed the medical records of 1,070 patients who were discharged from 12 WIT and 6 OH from January to March, 2000 and confirmed for the diagnosis of CVD. Fifty-one percent of the subjects were treated at WH and forty-nine percent at OH. Females were more prevalent than males. As well, the most common age group among these subjects was found to be 70 years and older. About 92% in W~H and 80% in OH received brain imaging diagnostic procedures such as CT or MRI. The cerebral infarction was the most common type of CVD when compared by the kind of utilized hospitals, sex, age group except patient Group who was treated at WH and whose age was lower than 50 years old. The cerebral hemorrhage was more frequent than cerebral infarction among this group. The proportion of cerebral hemorrhage was decreasing and that of cerebral infarction was increasing with age. The most common clinical manifestations of undetermined type of CVD was paralysis of lower extremity in WIT and paralysis of upper extremity in OH. In cerebral hemorrhage loss of consciousness in WIT and dysarthria in OH were most frequently manifested, while in the case of cerebral infarction hemiplegia in WIT and dysarthria in OH were the most common complaints. The interval from the onset of disease to admission to the hospital was 5.5 days in WH arid 31.4 days in OH and the difference was statistically significant. Average admission duration of patients at OH was longer than WH, but it was not statistically significant. In conclusion these results suggest that the effort for systematic and efficient management of CVD patients was necessary for close co-operation and role arrangement between WH and OH considering the positive and negative points of western and oriental medicines.

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Clinical Studies about diagnostic Yields according to Variable Diagnostic Methods in Lung Cancer (폐암에서 각종 진단수기에 따른 진단율에 관한 연구)

  • Kang, Dae-Song;Cho, Jin-Ung;Kim, Sang-Gyun;Kim, Mi-Ae;Yang, Sung-Uk;Lee, Tae-Quan;Lee, Tae-Hun;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.700-708
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    • 1993
  • Background: Lung cancer has become one of the most common cancers in Korea. It is important to determine the accurate histologic types and stages because of different therapeutic modlaity, especially in small cell carcinoma. This study was designed to evaluate diagnostic yields according to variable diagnostic methods in lung cancer. Methods: The records of 683 patients with a confirmed diagnosis of primary lung cancer during the period of 7 years, from January, 1986 until December, 1992 at Presbyterian Medical Center were analyzed retrospectively. Results: 1) Age and sex distributions Male: female sex ratio was 5.57:1 and age distributions were 7th decade 41.4%, 6th decade 30.2%, 8th decade 17.0%, 5th decade 7.9%, 4th decade 2.5%, 9th decade 1.3%, and 3rd decade 0.2% in decreasing order. 2) The frequencies according to histologic cell types were squamous cell carcinoma 44.7%, small cell carcinoma 23.9%, adenocarcinoma 22.8%, alveolar cell carcinoma 2.5%, large cell carcinoma 1.2%. mixed forms 1.2%, undifferenciated cell carcinoma 0.6% and malignant fibrous histiocytoma 0.2%(1 case) in decreasing order. 3) The most common locations of lung cancer were in left upper lobe and right lower lobe, and no differences of diagnostic methods according to locations were noted. 4) In central lesions, bronchoscopic examination was very accurate and frequently used diagnostic method, and in peripheral lesions, transthoracic lung biopsy(TTLB) was apparent1y accurate method. 5) The diagnostic yields of bronchoscopic biopsy, bronchial brushing, sputum cytology, transthoracic lung biopsy and transbronchial lung biopsy(TBLB) were 81.3%, 57.5%, 31.1%, 69.6% and 61.6%, respectively. 6) The concordance rates between the histologic diagnosis with bronchial brushing and sputum-cytology were 91.3% and 98.4%, respectively. 7) It was appropriate in lung cancer to repeat sputum cytology 3 to 5 times. Conclusion: Bronchoscopic examination is important to determine the histologic cell types in lung cancer. In addition, we should be interrested in improving diagnostic yields of sputum cytology as an easy method.

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Evaluation of the Satellite-based Air Temperature for All Sky Conditions Using the Automated Mountain Meteorology Station (AMOS) Records: Gangwon Province Case Study (산악기상관측정보를 이용한 위성정보 기반의 전천후 기온 자료의 평가 - 강원권역을 중심으로)

  • Jang, Keunchang;Won, Myoungsoo;Yoon, Sukhee
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.19 no.1
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    • pp.19-26
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    • 2017
  • Surface air temperature ($T_{air}$) is a key variable for the meteorology and climatology, and is a fundamental factor of the terrestrial ecosystem functions. Satellite remote sensing from the Moderate Resolution Imaging Spectroradiometer (MODIS) provides an opportunity to monitor the $T_{air}$. However, the several problems such as frequent cloud cover and mountainous region can result in substantial retrieval error and signal loss in MODIS $T_{air}$. In this study, satellite-based $T_{air}$ was estimated under both clear and cloudy sky conditions in Gangwon Province using Aqua MODIS07 temperature profile product (MYD07_L2) and GCOM-W1 Advanced Microwave Scanning Radiometer 2 (AMSR2) brightness temperature ($T_b$) at 37 GHz frequency, and was compared with the measurements from the Automated Mountain Meteorology Stations (AMOS). The application of ambient temperature lapse rate was performed to improve the retrieval accuracy in mountainous region, which showed the improvement of estimation accuracy approximately 4% of RMSE. A simple pixel-wise regression method combining synergetic information from MYD07_L2 $T_{air}$ and AMSR2 $T_b$ was applied to estimate surface $T_{air}$ for all sky conditions. The $T_{air}$ retrievals showed favorable agreement in comparison with AMOS data (r=0.80, RMSE=7.9K), though the underestimation was appeared in winter season. Substantial $T_{air}$ retrievals were estimated 61.4% (n=2,657) for cloudy sky conditions. The results presented in this study indicate that the satellite remote sensing can produce the surface $T_{air}$ at the complex mountainous region for all sky conditions.