Background: A clinical pathway (CP) can standardize and improve perioperative care for a number of interventions. In hepatic surgery, however, pertinent evidence is very limited. This study was conducted to implement a CP for hepatocellular carcinoma (HCC) patients undergoing hepatectomy, and to evaluate its effects on hospital costs, length of hospital stay (LOHS) and early clinical outcomes. Materials and Methods: Medical records for HCC patients undergoing hepatectomy were retrospectively reviewed before implementation of a CP (the non-CP group) from March 2012 to August 2012. This information was compared with the data collected prospectively from patients after implementation of the CP (the CP group) between September 2012 and April 2013. Hospital costs, LOHS and early clinical outcomes were evaluated and compared between groups. Results: There were no significant differences in terms of patient clinical characteristics between the two groups. For clinical outcome measures, no significant differences were found in postoperative complications, mortality and readmission rate. The hospital costs were significantly reduced from 24,844 RMB in the non-CP group to 19,761 RMB in the CP group (p<0.01). In addition, patients of the CP group also had shorter LOHS compared with the non-CP group (8.3 versus 12.3 days, p<0.001). Conclusions: The CP proved to be an effective approach to minimize hospital costs and LOHS with hepatectomy for HCC without compromising patient care.
Journal of Korean Academy of Nursing Administration
/
v.11
no.2
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pp.129-145
/
2005
Purpose: This research was, by investigating the relations between the cultural types of a nursing organization in military hospital and performance, to ascertain the cultural types to be able to improve performance. Method: The date were gathered from 255 nurse officers who were in 19 military hospitals by using the self-report type of questionnaire. The period of data collection was from April 20, 2003 to July 15, 2003. For this research, the following tools were used: the tools for measuring the organizational characteristics, organizational culture, and job satisfaction, the tool for measuring organizational commitment. For data analysis the SPSS Win 12.0 program was used. Result: 1) Most of the cultural types of a nursing organization in military hospital is Relation-oriented. 2) In the relation between general the characteristics of subject and the organizational cultural type, there was a difference in the innovation-oriented, relation-oriented, hierarchy-oriented, and task-oriented culture according to nurse officers careers, hospital types, year in hospital, marital status, and unit(p<0.05). 3) In the relation between general characteristics of subject and organizational performance, there was a difference in the job satisfaction, affective commitment, transactional commitment, and normative commitment according to nurse officers careers, education, madrigal status and unit(p<0.05). 4) In the relationship between the of a military hospital were correlated with the type of each culture(p=0.00), 5) In the relation between the organizational culture type of military hospital and its performance, there was a positive correlation among job satisfaction and innovation-oriented culture, relation-oriented culture, task-oriented culture(p<0.05). And hierarchy-oriented culture showed that they had a weak negative correlation with job satisfaction(p<0.05). There was a positive correlation among affective commitment and innovation-oriented culture, relation-oriented culture, task-oriented culture(p<0.05). And hierarchy-oriented culture showed that they had a weak negative correlation with affective commitment(p<0.05). There was no culture type significantly related to continuance commitment and there was a weak positive correlation among normative commitment and innovation-oriented culture, relation-oriented culture, task-oriented culture. The types to have an influence upon nurse officers' job satisfaction were relation-oriented culture and innovation-oriented culture(p=0.00). And relation-oriented culture and innovation-oriented culture were major variances for affective commitment and only relation-oriented culture was influential variance for normative commitment(p=0.00). Conclusion: The organizational culture type was found which had an influence upon nurse officers' job satisfaction and organizational commitment. These result are very significant in having showed the persons in charge of nursing administration a basic data for creation of an effective organizational culture.
Objective: This study was conducted to investigate the efficacy of pancreatic drainage for pain relief in advanced pancreatic cancer. Method: Seventy-one patients with pancreatic carcinoma were divided into two groups: dilated and non-dilated pancreatic ducts. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP), endoscopic biliary stenting and pancreatic stenting. Visual Analog Scale (VAS) scores, pain remission rates and survival time were evaluated during follow-up. Results: The post-ERCP VAS score of the dilated group was lower than that of the non-dilated group at 1 and 3 months post-ERCP. There was no difference at 6 months. The pain remission rate in the dilated duct group was significantly higher than that in non-dilated duct group in 1 and 3 months post-ERCP. The median survival times were 8.17 and 8.22 months respectively. Conclusion: Endoscopic pancreatic drainage can relieve pain of advanced pancreatic cancer accompanied by safe dilation of the pancreatic duct.
This study included empirical methods of study such as surveys and interviews with military hospital administrators from 14 military hospitals across the country. The results of the study is described below. First, results by demographic characteristics show that higher level of organizational commitment was found in males than females and in singles than married couples. Also, by organizational units, major units of military hospitals showed higher level of organizational commitment as well as job satisfaction. Second, Fair compensation had positive(+) effects on the study participants' job satisfaction and organizational commitment as the research hypothesized. Compensation included monetary and social benefits for the work performed. A transparent compensation system to reward members that performed the best for the department and the corps with appropriate amounts must be in place. Third, the organization culture of being considerate had positive(+) effects on job satisfaction and organizational commitment while the culture of giving commands had negative(-) effects. Fourth, Conflict factors had negative(-) effects on job satisfaction with no direct effect on organizational commitment. Any organization must take measures when adverse effects of conflicts surface. As shown by the analysis results, conflict factors bring negative results to job satisfaction and organizational commitments. Department managers should utilize the proper function of conflicts as an accelerator in organization operation.
Journal of Korean Academy of Nursing Administration
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v.12
no.4
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pp.541-554
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2006
Purpose: The purpose of this study is to provide basic data for the improvement of the quality in the emergency nursing services by investigating the expectation level and actual received level with nursing care and identifying the factors that influence patient satisfaction with the emergency nursing care in the military hospitals. Method: Using a self report questionnaire, data were collected from 150 patients who had been admitted in military hospitals emergency department. The data collection was done between April 17 and April 30, 2006. At least, 145 questionnaires were analyzed and used in this study. Results: The average sum score was 61.93 out of 76 with standard deviation 9.590. The mean of the patient's expectation levels with the overall emergency nursing services was $(3.25{\pm}.504)$ out of the highest score 4. the average sum score was 63.27 out of 76 with standard deviation 9.902. The mean score of the patient's actual levels with the overall emergency nursing services was $(3.33{\pm}.521)$ out of the highest score 4. Conclusion: nursing management strategies must be established to remove patient's dissatisfaction factors and to improve the emergency nursing care quality through continuous measurement and assessment of the patient's satisfaction with emergency nursing services in military hospitals.
Journal of Korean Academy of Nursing Administration
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v.16
no.1
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pp.73-85
/
2010
Purpose: This study was to construct a useful nursing language system on military nursing field. Method: Military hospital nursing records were analyzed using NANDA(North American Nursing Diagnosis Association), NIC(Nursing Interventions Classification), and NOC(Nursing Outcomes Classification) systems. All kinds of nursing statements from 80 sets of orthopedics inpatient's records were deduced. All nursing statements were mapped to 167 NANDA diagnoses, 433 NIC interventions, and 260 NOC outcomes. Result: 14,744 nursing statements were extracted. Among the extracted nursing statements, 11.75% were linked with NANDA diagnosis, 83.62% were connected with NIC intervention, and 0.96% was tied to NOC outcome. 3.66% of nursing statements were not linked with NANDA-NIC-NOC system. In the nursing statements, 18 diagnoses of NANDA, 63 interventions of NIC, 8 outcomes of NOC were used. Conclusions: The majority of those nursing statements focused on nursing intervention of the nursing process; few nursing plans or goals were found in nursing records. Therefore, it's difficult to make the nursing process network with the nursing statements. Documenting nursing records using a nursing process will contribute to strengthen nursing practice in patient care and to develop nursing as science. Continuous further researches related to nursing records are needed to provide basic data for developing nursing language system and nursing record system.
Background: Ginsenoside Rd (GSRd), a main component of the root of Panax ginseng, exhibits anti-inflammation functions and decreases infarct size in many injuries and ischemia diseases such as focal cerebral ischemia. M1 Macrophages are regarded as one of the key inflammatory cells having functions for disease progression. Methods: To investigate the effect of GSRd on renal ischemia/reperfusion injury (IRI) and macrophage functional status, and their regulatory role on mouse polarized macrophages in vitro, GSRd (10-100 mg/kg) and vehicle were applied to mice 30 min before renal IRI modeling. Renal functions were reflected by blood serum creatinine and blood urea nitrogen level and histopathological examination. M1 polarized macrophages infiltration was identified by flow cytometry analysis and immunofluorescence staining with $CD11b^+$, $iNOS^+$/interleukin-12/tumor necrosis factor-${\alpha}$ labeling. For the in vitro study, GSRd ($10-100{\mu}g/mL$) and vehicle were added in the culture medium of M1 macrophages to assess their regulatory function on polarization phenotype. Results: In vivo data showed a protective role of GSRd at 50 mg/kg on Day 3. Serum level of serum creatinine and blood urea nitrogen significantly dropped compared with other groups. Reduced renal tissue damage and M1 macrophage infiltration showed on hematoxylin-eosin staining and flow cytometry and immunofluorescence staining confirmed this improvement. With GSRd administration, in vitro cultured M1 macrophages secreted less inflammatory cytokines such as interleukin-12 and tumor necrosis factor-${\alpha}$. Furthermore, macrophage polarization-related pancake-like morphology gradually changed along with increasing concentration of GSRd in the medium. Conclusion: These findings demonstrate that GSRd possess a protective function against renal ischemia/reperfusion injury via downregulating M1 macrophage polarization.
Purpose: The global fight against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to widespread vaccination efforts, yet the optimal dosing schedule for SARS-CoV-2 vaccines remains a subject of ongoing research. This study aims to investigate the effectiveness of administering two booster doses as the third and fourth doses at different intervals to enhance vaccine protection. Materials and Methods: This study was conducted at a military regional hospital operated by the Ministry of National Defense in Taiwan. A cohort of vaccinated individuals was selected, and their vaccine potency was assessed at various time intervals following their initial vaccine administration. The study participants received booster doses as the third and fourth doses, with differing time intervals between them. The study monitored neutralizing antibody titers and other relevant parameters to assess vaccine efficacy. Results: Our findings revealed that the potency of the SARS-CoV-2 vaccine exhibited a significant decline 80 days after the initial vaccine administration. However, a longer interval of 175 days between booster injections resulted in significantly higher neutralizing antibody titers. The individuals who received the extended interval boosters exhibited a more robust immune response, suggesting that a vaccine schedule with a 175-day interval between injections may provide superior protection against SARS-CoV-2. Conclusion: This study underscores the importance of optimizing vaccine booster dosing schedules to maximize protection against SARS-CoV-2. The results indicate that a longer interval of 175 days between the third and fourth doses of the vaccine can significantly enhance the neutralizing antibody response, potentially offering improved protection against the virus. These findings have important implications for vaccine distribution and administration strategies in the ongoing battle against the SARS-CoV-2 pandemic. Further research and largescale trials are needed to confirm and extend these findings for broader public health implications.
Objective : This study was aimed to discover the correlation between those getting tattoos and their psychopathology relating to their delinquent behavior and emotional problems. Methods : Data for this study was collected from 19-year-old men who were receiving a physical examination for conscription at the Military Manpower Administration. 400 data sheets were collected among them. All of the subjects were evaluated on the following measures : sociodemographic variants, Juvenile delinquency scale, State-trait anger expression inventory, Beck depression inventory, State-trait anxiety inventory, and Positive affect and negative affect schedule. Results : In comparison with those without tattoos, those with a tattoo scored higher in the scales that were related to delinquency, anger, depression, and negative emotion. Furthermore, there were positive correlations between the number of tattoos and the scores for the Juvenile delinquent tendency and behavior scale as well as on the, State-trait anxiety scale. Conclusion : Those with tattoos had experienced anger, anxiety and depression more strongly in comparison with those without tattoos. These results recommend that tattooed males should be evaluated more on their regarding psychopathology compared to those without tattoos.
On September 24th of 1945, the existing Health Department under the Bureau of Economy and Trade was abolished complying with the Article 1 of the Ordinance of US military occupation "Establishment of Health Bureau". After the establishment of the Health Bureau, one of its first priorities was to select South Korean medical doctors and send them away to the US for training "in order to educate the talents necessary for the Health Bureau to address the public hygiene and health issues of Korea". Under the sponsorship of Rockefeller Foundation, the US Military Government sent 10 Korean medical doctors to three universities. After they came back to Korea from the training in the US, they played significant roles in building and managing the Korean health and medical system under the US Military Government as well as during the post-war of Korea and in the 1960s-1970s. Furthermore, they made a great contribution to expanding and transplanting the 'American-style' health and medical system in heath administration, health research and medical education in Korea. On the one hand, this means the limitation and elimination of an independent, progressive idea in the health and medical field as the influence of the US within the country after the liberation expanded. The lives of 10 doctor represent an important symbol of how the Korean health and medical field has been established under the domestic and overseas political conditions, 'colonization-liberation-military occupation of the Powers', and one part of the concrete history.
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