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Factors Related to Nurse Staffing Levels in Tertiary and General Hospitals

  • Kim Yun Mi;June Kyung Ja;Cho Sung-Hyun
    • Journal of Korean Academy of Nursing
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    • v.35 no.8
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    • pp.1493-1499
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    • 2005
  • Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

General Radiography Usage and Exposure Dose of Korean Elderly: Based on Data from Aged Patients in 2016 (한국 노인의 일반촬영 이용량 및 피폭선량: 2016년 고령환자데이터 기반)

  • Gil, Jong-Won;Yoo, Se-Jong;Lee, Won-Jeong
    • Journal of radiological science and technology
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    • v.44 no.5
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    • pp.495-502
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    • 2021
  • This study aims to provide basic data for elderly health insurance policy and medical radiation safety management by analyzing the general radiography usage and exposure dose of the elderly in Korea. The effective dose for each general radiography was calculated using the ALARA-GR program for 260 general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2016 elderly patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was applied. The general radiography usage and exposure dose per person aged 65 years and over was 6.47 cases and 0.56 mSv. Females showed higher value than males as 7.15 cases and 0.66 mSv(p<.001). By age, those between 75 and 79 showed the highest number as 6.97 cases and 0.62 mSv(p<.001). Those who were supported by Medical Aid showed higher value than those who were insured by National Health Insurance as 8.82 cases and 0.76 mSv(p<.001). In addition, the ratio by radiography was in the order of Chest 20.85%, Knee Joint 15.58%, and L-spine 14.67%, and the exposure dose was L-spine 29.40%, Chest 15.82%, Abdomen 7.97%, and Entire Spine 7.20%. General radiography, which is widely used due to the high frequency of diseases in the elderly population should be taken into consideration when establishing health insurance policies. In addition, it is necessary to check whether the general radiography with high exposure dose is performed as a routine examination without considering medical necessity.

Efficacy of endoscopy under general anesthesia for the detection of synchronous lesions in oro-hypopharyngeal cancer

  • Yoichiro Ono;Kenshi Yao;Yasuhiro Takaki;Satoshi Ishikawa;Kentaro Imamura;Akihiro Koga;Kensei Ohtsu;Takao Kanemitsu;Masaki Miyaoka;Takashi Hisabe;Toshiharu Ueki;Atsuko Ota;Hiroshi Tanabe;Seiji Haraoka;Satoshi Nimura;Akinori Iwashita;Susumu Sato;Rumie Wakasaki
    • Clinical Endoscopy
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    • v.56 no.3
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    • pp.315-324
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    • 2023
  • Background/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma. Methods: This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia. Results: Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness. Conclusions: Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.

Scintigraphy with Indium-111-oxine Labeled Leukocytes for Localization of Abscesses (복부농양진단을 위한 Indium-111 표지백혈구스캔)

  • Kim, Byung-Tae;Lee, Dong-Soo;Lee, Kyung-Soo;Choi, Hyung-Shik;Kim, Myung-Joon;Yang, Seung-O;Lee, Jae-Hoon;Choi, Chang-Soon;Kim, Taek-Kyu;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.1
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    • pp.37-48
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    • 1990
  • Detection of deep-seated abscesses is sometimes difficult with ultrasonogrpahy or computed tome graphy alone. Indium-111-labeled leukocyte has widely used in the localization of abscesses after introduction by Segal and Thakur in 1976. But there are some difficulties in using indium-111-oxine in our country because of hardness to get the radiopharmaceutical timely and long time for labeling leukocytes. So we peformed the indium-111-labeled leukocyte scan for establishment of the labeling procedure and clinical application. We labeled the mixed leukocytes from 36 ml of patient's blood using 4 ml of ACD solution, 7 ml of 6% hydroxyethyl starch solution $(HESPAN^{(R)})$, 1 mCi of indium-111 oxine, 5 ml of normal saline and centrifuge. It took about 2 hours for the preparation of radiolabeled leukocytes and attention for contamination was needed. The average injected dose of labeled mixed leukocytes was 465 uCi. The average number of injected leukocytes was $2.5\times10^8$ and the labeling ratio was $57{\pm}13%$ (Table 2, Fig. 5). These number and ratio were sufficient for the localization of abscess. About twenty per cent of indium was labeled to red blood cells and platelets (Fig. 6) and the half-life of injected radiolabeled leukocytes was 8.3 hours. Scan was performed in 9 patients who were suspected to have abscesses clinically or radiologically. Three patients were positive, in one patient who had abscess close to lower lumbar vertebrae was surgically drained and another 2 positive cases did not show abscess clearly on computed tomography, so only antibiotics were administrated and treated successfully. The negative 6 patients were improved without specific treatment. In conclusion, the use of indium-111 oxine labeled leukocytes for localization of abscesses were very specific and helpful in the decision of treatment considering its relatively simple labeling method, and could be easily performed providing timely supply of the radiopharmaceutical.

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BOOTSTRAP TESTS FOR THE EQUALITY OF DISTRIBUTIONS

  • Ping, Jing
    • Journal of applied mathematics & informatics
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    • v.7 no.2
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    • pp.467-482
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    • 2000
  • Testing equality of two and k distributions has long been an interesting issue in statistical inference. To overcome the sparseness of data points in high-dimensional space and deal with the general cases, we suggest several projection pursuit type statistics. Some results on the limiting distributions of the statistics are obtained, some properties of Bootstrap approximation are investigated. Furthermore, for computational reasons an approximation for the statistics the based on Number theoretic method is applied. Several simulation experiments are performed.

Number of Equivalence Classes of a Parallel Flats Fraction for the 3" Factorial Design

  • Um, Jung-Koog
    • Journal of the Korean Statistical Society
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    • v.10
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    • pp.122-127
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    • 1981
  • A parallel flats fraction for the $3^n$ factorial is symbolically written as $At=C=(C_1 C_2 \cdots C_f)$ where C is a rxf matrix and A is rxn matrix with rank r. It is shown that the set of all possible parallel flats fraction C for a given A and given size can be partitioned into equivalence classes. The number of those classes are enumerated in general.

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An analysis on the M/G/1 queueing model with multi-phase service (다중단계 서비스의 M/G/1 대기행렬에 대한 분석)

  • Kim, Jeong-Hyun;Hur, Sun
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.24 no.66
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    • pp.11-18
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    • 2001
  • In this paper, we analyze an M/G/1 two-phase gated service model with threshold. We consider compound Poison arrival Process and general service time, where the server fives two different modes of services in order, batch and individual services. Server starts his service when the number of arrived customers reaches the predetermined threshold . We find the PGF of the number of customers in system and LST of waiting time, with which we obtain the means of them.

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Some Stochastic Properties for Imperfect Repair Model

  • Lim, Jae-Hak;Park, Dong-Ho;Sohn, Joong-Kwon
    • Journal of the Korean Statistical Society
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    • v.28 no.3
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    • pp.389-398
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    • 1999
  • We consider an imperfect repair model under which either a perfect repair or a minimal repair can be performed at each failure of a unit. Some stochastic properties of the number of perfect repairs and the number of minimal repairs under the imperfect repair model are investigated. We also derive the expressions for evaluating the expected numbers of perfect and minimal repairs in general and apply these formulas for certain parametric families of life distributions.

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On a Multiple-cycle Binary Sequence Genrator Based on S-box (S-box 형태의 다 수열 발생기에 관한 연구)

  • Lee, Hun-Jae
    • The Transactions of the Korea Information Processing Society
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    • v.7 no.5
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    • pp.1474-1481
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    • 2000
  • The number of keystream cycle sequences has been proposed as a characteristic of binary sequence generator for cryptographic application, but in general the most of binary sequence generators have a single cycle. On the other hand, S-box has been used to block cipher for a highly nonlinear element and then we apply it to the stream cipher with a high crypto-degree. In this paper, we propose a multiple-cycle binary sequence generator based on S-box which has a high nonlinearity containing SAC property and analyze its period, linear complexity, randomness and the number of keystream cycle sequences.

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