• 제목/요약/키워드: problem analysis

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Development of the Information Delivery System for the Home Nursing Service (가정간호사업 운용을 위한 정보전달체계 개발 I (가정간호 데이터베이스 구축과 뇌졸중 환자의 가정간호 전산개발))

  • Park, J.H;Kim, M.J;Hong, K.J;Han, K.J;Park, S.A;Yung, S.N;Lee, I.S;Joh, H.;Bang, K.S
    • Journal of Home Health Care Nursing
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    • v.4
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    • pp.5-22
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    • 1997
  • The purpose of the study was to development an information delivery system for the home nursing service, to demonstrate and to evaluate the efficiency of it. The period of research conduct was from September 1996 to August 31, 1997. At the 1st stage to achieve the purpose, Firstly Assessment tool for the patients with cerebral vascular disease who have the first priority of HNS among the patients with various health problems at home was developed through literature review. Secondly, after identification of patient nursing problem by the home care nurse with the assessment tool, the patient's classification system developed by Park (1988) that was 128 nursing activities under 6 categories was used to identify the home care nurse's activities of the patient with CAV at home. The research team had several workshops with 5 clinical nurse experts to refine it. At last 110 nursing activities under 11 categories for the patients with CVA were derived. At the second stage, algorithms were developed to connect 110 nursing activities with the patient nursing problems identified by assessment tool. The computerizing process of the algorithms is as follows: These algorithms are realized with the computer program by use of the software engineering technique. The development is made by the prototyping method, which is the requirement analysis of the software specifications. The basic features of the usability, compatibility, adaptability and maintainability are taken into consideration. Particular emphasis is given to the efficient construction of the database. To enhance the database efficiency and to establish the structural cohesion, the data field is categorized with the weight of relevance to the particular disease. This approach permits the easy adaptability when numerous diseases are applied in the future. In paralleled with this, the expandability and maintainability is stressed through out the program development, which leads to the modular concept. However since the disease to be applied is increased in number as the project progress and since they are interrelated and coupled each other, the expand ability as well as maintainability should be considered with a big priority. Furthermore, since the system is to be synthesized with other medical systems in the future, these properties are very important. The prototype developed in this project is to be evaluated through the stage of system testing. There are various evaluation metrics such as cohesion, coupling and adaptability so on. But unfortunately, direct measurement of these metrics are very difficult, and accordingly, analytical and quantitative evaluations are almost impossible. Therefore, instead of the analytical evaluation, the experimental evaluation is to be applied through the test run by various users. This system testing will provide the viewpoint analysis of the user's level, and the detail and additional requirement specifications arising from user's real situation will be feedback into the system modeling. Also. the degree of freedom of the input and output will be improved, and the hardware limitation will be investigated. Upon the refining, the prototype system will be used as a design template. and will be used to develop the more extensive system. In detail. the relevant modules will be developed for the various diseases, and the module will be integrated by the macroscopic design process focusing on the inter modularity, generality of the database. and compatibility with other systems. The Home care Evaluation System is comprised of three main modules of : (1) General information on a patient, (2) General health status of a patient, and (3) Cerebrovascular disease patient. The general health status module has five sub modules of physical measurement, vitality, nursing, pharmaceutical description and emotional/cognition ability. The CVA patient module is divided into ten sub modules such as subjective sense, consciousness, memory and language pattern so on. The typical sub modules are described in appendix 3.

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EFFECT OF NUMBER OF IMPLANTS AND CANTILEVER DESIGN ON STRESS DISTRIBUTION IN THREE-UNIT FIXED PARTIAL DENTURES: A THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS

  • Park, Ji-Hyun;Kim, Sung-Hun;Han, Jung-Suk;Lee, Jai-Bong;Yang, Jae-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.3
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    • pp.290-297
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    • 2008
  • STATEMENT OF PROBLEM: Implant-supported fixed cantilever prostheses are influenced by various biomechanical factors. The information that shows the effect of implant number and position of cantilever on stress in the supporting bone is limited. PURPOSE: The purpose of this study was to investigate the effect of implant number variation and the effect of 2 different cantilever types on stress distribution in the supporting bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-D FE model of a mandibular section of bone with a missing second premolar, first molar, and second molar was developed. $4.1{\times}10$ mm screw-type dental implant was selected. 4.0 mm height solid abutments were fixed over all implant fixtures. Type III gold alloy was selected for implant-supported fixed prostheses. For mesial cantilever test, model 1-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 1-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 1-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with mesial cantilever were simulated. And then, 155N oblique force was applied to the buccal cusp of second premolar. For distal cantilever test, model 2-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 2-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 2-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with distal cantilever were simulated. And then, 206N oblique force was applied to the buccal cusp of second premolar. The implant and superstructure were simulated in finite element software(Pro/Engineer wildfire 2.0). The stress values were observed with the maximum von Mises stresses. RESULTS: Among the models without a cantilever, model 1-1 and 2-1 which had three implants, showed lower stress than model 1-2 and 2-2 which had two implants. Although model 2-1 was applied with 206N, it showed lower stress than model 1-2 which was applied with 155N. In models that implant positions of models were same, the amount of applied occlusal load largely influenced the maximum von Mises stress. Model 1-1, 1-2 and 1-3, which were loaded with 155N, showed less stress than corresponding model 2-1, 2-2 and 2- 3 which were loaded with 206N. For the same number of implants, the existence of a cantilever induced the obvious increase of maximum stress. Model 1-3 and 2-3 which had a cantilever, showed much higher stress than the others which had no cantilever. In all models, the von Mises stresses were concentrated at the cortical bone around the cervical region of the implants. Meanwhile, in model 1-1, 1-2 and 1-3, which were loaded on second premolar position, the first premolar participated in stress distribution. First premolars of model 2-1, 2-2 and 2-3 did not participate in stress distribution. CONCLUSION: 1. The more implants supported, the less stress was induced, regardless of applied occlusal loads. 2. The maximum von Mises stress in the bone of the implant-supported three unit fixed dental prosthesis with a mesial cantilever was 1.38 times that with a central pontic. The maximum von Mises stress in the bone of the implant-supported three-unit fixed dental prosthesis with a distal cantilever was 1.59 times that with a central pontic. 3. A distal cantilever induced larger stress in the bone than a mesial cantilever. 4. A adjacent tooth which contacts implant-supported fixed prosthesis participated in the stress distribution.

A Meta-Analysis on the Effects of Integrated Education Research (통합교육의 효과에 대한 메타분석)

  • Kim, Jiyoung;Park, Eunmi;Park, Jieun;Bang, Dami;Lee, Yoonha;Yoon, Heojoeng
    • Journal of The Korean Association For Science Education
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    • v.35 no.3
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    • pp.403-417
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    • 2015
  • The purpose of this study was to investigate the effectiveness of integrated education research conducted in Korea and to propose a meaningful discussion for further research. Among the studies conducted for last three years, the relevant 161 research articles were selected, and 236 effect sizes were calculated. Effect sizes were analyzed with different dependant variables including creativity, problem solving ability, academic achievement, inquiry skills, creative personality, scientific attitude, and interests. In addition, effect sizes with different moderating variables, such as characteristics of subjects, sample sizes, class types, core disciplines and publication types, were compared. The results are as follows: The overall effect size of integrated education program produced a huge effect (effect size=0.88, U3=81.06%). Integrated education program showed the highest effect size on scientific attitude among other dependant variables. However, all of the other dependant variables represented more than medium size effect size. Integrated program proved to be more effective on kindergarten pupils and gifted students compared to other school levels and regular students. The effect size for group of less then thirty students were larger than other groups. Programs implemented in after school hours were more effective than in regular school hours. Considering the core subject of program, arts-centered integrated programs showed the largest effect size, while all the others showed above medium effect sizes. Finally, doctoral dissertation showed the highest effect size compared to master's thesis and academic journal articles. Conclusions and recommendations for further research were provided.

The Correlation Between Sensory Integration Function and Scholar Achievement in the Lower Classes Children (저학령기 아동의 감각통합 기능과 학업성취도간의 상관관계)

  • Shin, Joong-Il;Choi, Yung-Gun;Jang, Woo-Heuk;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.6 no.1
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    • pp.1-12
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    • 2008
  • Objective : The purpose of this study is to provide reference to functional level of sensory integration of in the low-grads school age, based on the Clinical Observation of Motor and Postural Skills (COMPS) and to examine correlation between the function of sensory integration and academic achievement. Method : Two schools ("J" and "S") have been selected indiscriminately among 56 elementary schools located in Gimhae-si, GyeongNam and then one class from each school was voluntarily chosen among all second-grade classes of the schools. The total number of students in those two classes was 69 (34 boys and 35 girls). Subjects had no developmental problem and no history of referral regarding neurological conditions. Three skilled researchers administrated the COMPS together, and each researcher executed two sub-items of the COMPS. As result of the academic achievement, score data of midterm- and final-exam in the spring semester were collected. The scores of 'Korean language' and 'Math', common examination subjects in both schools, were utilized for data analysis in this study. Results : Statically, there was no significant correlation between the COMPS Weighted Scores and any academic achievements. In a dispersion graphic analysis, however, the total achievement showed significant negative-correlation with the area of 'Rapid Forearm Rotation' and significant positive-correlation with the area of 'Supine Flexion'. In terms of the Math achievement, there are significant negative-correlation with rapid forearm rotation and asymmetrical tonic neck reflex, and significant positive-correlation with the area of 'Supine Flexion'. Students with higher score of the Korean language showed a tendency to get higher Weighted Score and Minus Adjustment Score, and those with lower score of the Math showed a tendency to get higher COMPS scores in all area except the area of 'Supine Flexion'. There was a statically significant difference in the COMPS scores depend on the age among general characteristics. As student older, all COMPS scores, except those in the area of 'Slow Motion' and 'Supine Flexion, were higher. Conclusions : There is somehow reliable correlation between sensory integration function and academic achievement although no statistical significance found in this study. The information from this study may contribute to initiate developing a normative-reference to screen earlier and more alertly sensory integration dysfunctions for school-age children. Further study is recommended trying to find out more reliable matter regarding low grade- schooler's academic achievement.

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The Development and Effectiveness of a PBL Based Career Education Program (PBL 기반 진로교육 프로그램의 개발 및 효과검증)

  • Lee, Hye-Suk;Kim, You-Me
    • The Korean Journal of Elementary Counseling
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    • v.8 no.1
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    • pp.33-50
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    • 2009
  • The purpose of this study was to develop a PBL-based career education program and to examine its effectiveness on school children's career maturity. It's specifically meant to prepare a career education program to assist students to get an accurate grip on their aptitude, interest and personality and explore various sorts of occupations in the course of solving authentic and contextual career-related problems. After children's developmental characteristics and needs were analyzed, task analysis was implemented, and the objectives were defined. And then the core of the program, PBL problems were developed, and the validity of the problems were verified Evaluation plans and tools were prepared to assess children's problem-solving process and presentation, and an online learning space was designed. The program that consisted of 10-minute 21 sessions was provided to fifth-grade elementary schoolers for eight weeks. The findings of the study were as follows: The experimental group that participated in the PBL-based career education program showed a more significant improvement than the control group that didn't in career attitude and three career attitude subfactors involving planness, disposition and compromise. And the former made a more significant progress than the latter in career ability and its subfactors including vocational comprehension, self-understanding and decision-making skills as well. As a result of making a content analysis to make up for the survey, the students reported that they were able to get an objective understanding of themselves and acquire diverse and profound knowledge on work and the business world in the middle of solving the given PBL problems related to different areas in group and giving a presentation. In conclusion, a PBL based career education program developed by this researcher encouraged the students to have an objective self-understanding, to have a dynamic interactive discussion with their group members. Therefore the program had a positive impact on boosting the career attitude and career ability of the elementary schoolers. The findings suggested that in the field of elementary career education, autonomous learning attitude and subjecthood are the crucial factors to stimulate school children to explore and create their own future.

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The Influence of Fat-Free Mass to Maximum Exercise Performance in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서 제지방량이 최대운동능력에 미치는 영향)

  • Mun, Yeung Chul;Park, Hye Jung;Shin, Kyeong Cheol;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.346-354
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    • 2002
  • Background : Dyspnea and a limitation in exercise performance are important cause of disability in patients with chronic obstructive pulmonary disease(COPD). A depleted nutritional state is a common problem in patients with a severe degree of chronic airflow limitation. This study was carried out to assess the factors determining the maximum exercise capacity in patients with COPD. Methods : The resting pulmonary function, nutritional status, and maximum exercise performance was assessed in 83 stable patients with moderate to severe COPD. The nutritional status was evaluated by bioelectrical impedance analysis. Maximum exercise performance was evaluated by maximum oxygen uptake($VO_2max$). Results : Among the 83 patients, 59% were characterized by nutritional depletion. In the depleted group, a significantly lower peak expiratory flow rate(p<0.05), Kco(p<0.01) and maximum inspiratory pressure(p<0.05), but a significantly higher airway resistance(p<0.05) was observed. The maximum oxygen uptake and the peak oxygen pulse were lower in the depleted group. The $VO_2max$ correlated with some of the measures of the body composition : fat-free mass(FFM), fat mass(FM), body mass index(BMI), intracellular water index(ICW index), and pulmonary function : forced vital capacity(FVC), forced inspiratory vital capacity(FIVC), diffusion capacity(DLCO) : or maximum respiratory pressure : maximum inspiratory pressure(PImax), maximum expiratory pressure(PEmax). Stepwise regression analysis demonstrated that the FFM, DLCO and FIVC accounted for 68.8% of the variation in the $VO_2max$. Conclusion : The depletion of the FFM is significant factor for predicting the maximum exercise performance in patients with moderate to severe COPD.

Delayed Treatment of Pulmonary Tuberculosis in a University Hospital (대학병원에서 발생하는 폐결핵 치료지연)

  • Kang, Shin Myung;Lee, Jun Gu;Chung, Jae Ho;Han, Chang Hoon;Byun, Min Kwang;Chung, Wou Youn;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.277-284
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    • 2006
  • Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.

Survey of ICT Apply to Plastic Greenhouse, Rack·Pinion Adaption to Single Span and CFD Analysis (온실 ICT융복합 실태조사와 복숭아형 랙피니언천창 적용 단동온실 및 CFD 유동해석)

  • Cho, Kyu Jeong;Kim, Ki Young;Yang, Won Mo
    • Journal of Bio-Environment Control
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    • v.24 no.4
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    • pp.308-316
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    • 2015
  • This study was conducted to investigate the situation of ICT apply to plastic greenhouse, and the results be apply to design of new one. A CFD analysis were conducted to monitering the ventilation and energy saving of the single span greenhouse newly designed. The causes of delay to apply ICT to plastic greenhouse are the high cost for installation(24%), insufficiency of after services(19%), often disorder(16%), unskillful management of soft ware(15%), insufficient ICT efficiency(13%) and unsatisfying of income increase(12%). The parts of problem occurred in ICT plastic greenhouse are the structure, actuator, environmental control system and sensor(approximate 14%, respectively), remote control technique(13%), plant management technique(12%), energy saving technique(10%) and utilization of software(8%). In the condition of lateral window closed, the average wind speed changed to slow, but it was faster in the condition of leeward side window opened than in the condition of lee and winward side window opened. The air movement in the condition of lateral window closed occur by air moving fan not by out air. It is not affect the room temperature but effective the uniformity of room temperature. The average temperature of low height greenhouse was uniform than high height one. The average temperature in condition of 3rd curtain opened become same with outside temperature after 2 hours, but take more 5 hours in condition of 3rd curtain closed.

On the Determinants of Health Care Utilization of the Physically Disabled (지체장애인의 의료이용에 영향을 미치는 요인)

  • Kim, Keon-Yeop;Lee, Young-Sook;Park, Ki-Soo;Son, Jae-Hee;Kam, Sin;Chun, Byung-Yeol;Park, Jae-Yong;Yeh, Min-Hae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.2 s.61
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    • pp.323-334
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    • 1998
  • To investigate determinants of health care utilization of the physically disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization .ate was 81.9%(69.1% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically significant relationship with health care utilization(p<0.05). By path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.1%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health concern toward physically disabled should be implemented to increase health care utilization rate.

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Optimized Methods of Preimplantation Genetic Diagnosis for Trinucleotide Repeat Diseases of Huntington's Disease, Spinocerebellar Ataxia 3 and Fragile X Syndrome (삼핵산 반복서열 질환인 헌팅톤병, 척수소뇌성 운동실조증, X-염색체 취약 증후군의 착상전 유전진단 방법에 대한 연구)

  • Kim, Min-Jee;Lee, Hyoung-Song;Lim, Chun-Kyu;Cho, Jae-Won;Kim, Jin-Young;Koong, Mi-Kyoung;Son, In-Ok;Kang, Inn-Soo;Jun, Jin-Hyon
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.3
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    • pp.179-188
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    • 2007
  • Objectives: Many neurological diseases are known to be caused by expansion of trinucleotide repeats (TNRs). It is hard to diagnose the alteration of TNRs with single cell level for preimplantation genetic diagnosis (PGD). In this study, we describe methods optimized for PGD of TNRs related diseases such as Huntington's disease (HD), spinocerebellar ataxia 3 (SCA3) and fragile X syndrome (FXS). Methods: We performed the preclinical assays with heterozygous patient's lymphocytes by single cell PCR strategy. Fluorescent semi-nested PCR and fragment analysis using automatic genetic analyzer were applied for HD and SCA 3. Whole genome amplification with multiple displacement amplification (MDA) method and fluorescent PCR were carried out for FXS. Amplification and allele drop-out (ADO) rate were evaluated in each case. Results: The fluorescent semi-nested PCR of single lymphocyte showed 100.0% of amplification and 14.0% of ADO rate in HD, and 94.7% of amplification and 5.6% of ADO rate in SCA3, respectively. We could not detect the PCR product of CGG repeats in FXS using the fluorescent semi-nested PCR alone. After applying the MDA method in FXS, 84.2% of amplification and 31.3% of ADO rate were achieved. Conclusions: Fluorescent semi-nested PCR is a reliable method for PGD of HD and SCA3. The advanced MDA method overcomes the problem of amplification failure in CGG repeats of FXS case. Optimization of methods for single cell analysis could improve the sensitivity and reliability of PGD for complicated single gene disorders of TNRs.