• Structural Engineering and Mechanics
• /
• 제34권6호
• /
• pp.719-738
• /
• 2010

The aim of this paper concerns with the nonlinear analysis of cable-stayed bridges including the vibration effect of cable stays. Two models for the cable stay system are built up in the study. One is the OECS (one element cable system) model in which one single element per cable stay is used and the other is MECS (multi-elements cable system) model, where multi-elements per cable stay are used. A finite element computation procedure has been set up for the nonlinear analysis of such kind of structures. For shape finding of the cable-stayed bridge with MECS model, an efficient computation procedure is presented by using the two-loop iteration method (equilibrium iteration and shape iteration) with help of the catenary function method to discretize each single cable stay. After the convergent initial shape of the bridge is found, further analysis can then be performed. The structural behaviors of cable-stayed bridges influenced by the cable lateral motion will be examined here detailedly, such as the static deflection, the natural frequencies and modes, and the dynamic responses induced by seismic loading. The results show that the MECS model offers the real shape of cable stays in the initial shape, and all the natural frequencies and modes of the bridge including global modes and local modes. The global mode of the bridge consists of coupled girder, tower and cable stays motion and is a coupled mode, while the local mode exhibits only the motion of cable stays and is uncoupled with girder and tower. The OECS model can only offers global mode of tower and girder without any motion of cable stays, because each cable stay is represented by a single straight cable (or truss) element. In the nonlinear seismic analysis, only the MECS model can offer the lateral displacement response of cable stays and the axial force variation in cable stays. The responses of towers and girders of the bridge determined by both OECS- and MECS-models have no great difference.

• 보건행정학회지
• /
• 제15권3호
• /
• pp.94-113
• /
• 2005

The purpose of this study was to determine the level of appropriateness in hospital stays and factors influencing inappropriate hospital stays. The study was conducted at fifteen general care units in a tertiary university hospital. Appropriateness of hospital stay was assessed using Appropriateness Evaluation Protocol by trained head nurses. The total of 447 patient records were reviewed. Among them, 352 patient data were included in the final data set. A unit of observation was patient day. A rate of appropriate hospital stay was calculated per patient as a unit of analysis. Multiple regression analysis was performed to determine the factors affecting inappropriate hospital stay. The eighty-three percent (2030/2651) of hospital stays were evaluated as appropriate. There were significant differences in appropriateness of hospital stay according to patient's age, type of health insurance, medical specialty, and length of stay(p<0.05). In the multiple regression analysis, medical speciality was the most significant factor to predict the inappropriate hospital stay. The study showed a substantial proportion of hospital stay was found to inappropriate. Level of appropriateness was significantly different from medical specialty. Interdepartmental approach should be required to coordinate and improve appropriate resource utilization.

• 한국콘크리트학회:학술대회논문집
• /
• 한국콘크리트학회 2005년도 추계 학술발표회 제17권2호
• /
• pp.25-28
• /
• 2005

The elastic buckling load or strength of a concentrically loaded slender metal column may be increased many times by reinforcing it with an assemblage of pretensioned stays and rigidity connected crossarm members. The complete system is herein referred to as a 'stayed column'. The purpose of the pretensioned stays and crossarm members is to introduce, at several points along the length of the column, restraint against translation and rotation and thereby decrease the effective unsupported buckling length of the column. This paper verifies that pretensioned cable of stayed column is effective for cyclic load and increases strength of shear wall against earthquake by reinforcing side of wall. Design process of stayed column which satisfies demanded capacity and ductility of wall is presented by analyzing result of experiment.

• Smart Structures and Systems
• /
• 제18권1호
• /
• pp.17-29
• /
• 2016

In this paper, the possibility of using human induced loading (HIL) to detect a decrease of tension in the cable-stays of an existing footbridge is investigated. First, a reliable finite elements model of an existing footbridge is developed by calibration with experimental data. Next, estimates of the tension in the cables are derived and their dependency on the modal features of the deck is investigated. The modelling of the HIL is briefly discussed and used to perform the nonlinear, large strain, dynamic finite elements analyses. The results of these analyses are assessed with focus on characterizing the time histories of the tension in the cables under pedestrian crossing and their effects on the deck response for different initial conditions. Finally, the control perspective is introduced in view of further research.

• Tuberculosis and Respiratory Diseases
• /
• 제83권2호
• /
• pp.167-174
• /
• 2020

Background: The purpose of this study was to investigate the effect of early tracheostomy on clinical outcomes in patients requiring prolonged acute mechanical ventilation (≥96 hours). Methods: Data from 575 patients (69.4% male; median age, 68 years), hospitalized in the medical intensive care unit (ICU) of a university-affiliated tertiary care hospital March 2008-February 2017, were retrospectively evaluated. Early and late tracheostomy were designated as 2-10 days and >10 days after translaryngeal intubation, respectively. Results: The 90-day cumulative mortality rate was 47.5% (n=273) and 258 patients (44.9%) underwent tracheostomy. In comparison with the late group (n=115), the early group (n=125) had lower 90-day mortality (31.2% vs. 47.8%, p=0.012), shorter stays in hospital and ICU, shorter ventilator length of stay (median, 43 vs. 54; 24 vs. 33; 23 vs. 28 days; all p<0.001), and a higher rate of transfer to secondary care hospitals with post-intensive care settings (67.2% vs. 43.5% p<0.001). Also, the total medical costs of the early group were lower during hospital stays than those of the late group (26,609 vs. 36,973 USD, p<0.001). Conclusion: Early tracheostomy was associated with lower 90-day mortality, shorter ventilator length of stay and shorter lengths of stays in hospital and ICU, as well as lower hospital costs than late tracheostomy.

• 중환자간호학회지
• /
• 제16권3호
• /
• pp.11-23
• /
• 2023

Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences. Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: "awareness of surroundings," "frightening experiences," "satisfaction with care," and "recall of experiences." We used multiple linear regression to identify factors associated with the ICU experience. Results : Low income (𝛽 = -.08, p = .016), unplanned hospitalization (𝛽 = -.09, p = .006), sedation (𝛽 = -.16, p < .001), and delirium (𝛽 = -.15, p < .001) reduce patients' awareness of their surroundings. Frightening experiences are associated with being female (𝛽 = -.07, p = .027), experiencing delirium(𝛽= -.15, p<.001), and longer stays in the ICU (𝛽= -.14, p <.001). Using sedatives decreases satisfaction with care (𝛽 = -.08, p = .048). Living alone (𝛽 = -.08, p = .013) and using painkillers (𝛽 = -.08, p = .020) reduces recall of experiences. Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.

• 정신신체의학
• /
• 제6권2호
• /
• pp.120-125
• /
• 1998

Objectives : The purposes of present study were to identify weight increment in female psychiatric patients during hospitalization and to evaluate the relationship between weight gain and daily calorie intake, daily activity and other variables of disease itself. Methods : 20 patients were studied. Body weight were measured once a week, and daily activity(total amounts of walking/day) and total amount of daily calorie intake were measured twice a week. We examined psychiatric and medical illness history, eating disorders' history and family history of eating disorders and obesity. Results: Mean body weight and Body Mass Index(BMI) at admission are 49.40kg and 19.59kg/$m^2$. Mean weight increment during hospital stays of mean 65 days is 4.90kg. Mean amounts of daily calorie intake and daily activity(daily walks) were increased during hospital stays, but not statistically significant. The degree of weight increment is higher in longer hospital stay group, but not statistically significant. Mean body weight at admission of mood disorder group is higher than that of schizophrenia group, but not statistically significant. Conclusion : This results suggested that weight increment in female psychiatric hospitalized patients is present. However, it is not resulted by amount of calorie intake and daily activity level.

• 기본간호학회지
• /
• 제12권1호
• /
• pp.113-120
• /
• 2005

Purpose: To identify risk factors for surgical site infections in patients undergoing general surgery, to analyze the prolonged hospital stay and extra cost for antibiotics, and to provide basic data for control of surgical site infections. Method: Surgical site infection was defined using the definition of the CDC and the data were analyzed by $x^2$-test and unpaired t-test. Results: The prevalence of surgical site infections was 9.7%, and it was related to wound class, duration of operation, number of operations, whether the operation was an emergency, trauma, drains, preoperative stays, presence of remote infection during operative period, and previous history of recent surgery. The mean duration for post-operative stay when a surgical site infection occurred was 9.5 days and in 56.9 % of the patients the surgical site infection appeared 7 days after the operation. Post-operative stays for infected patients were 20.3 days longer than that of uninfected patients. The mean cost of antibiotics for infected patients was higher than that for uninfected patients by 561,067 won per person. Conclusion: Surgical site infection results in an increased length of stay and extra-cost, thus, hospitals need to create strategies to reduce nosocomial infections through effective infection surveillance and by considering factors related to surgical site infections.

• 여성건강간호학회지
• /
• 제21권4호
• /
• pp.262-271
• /
• 2015

Purpose: This study was to explore association of maternal role adjustments, parenting stresses, and demographic factors to breastfeeding adaptation. Methods: A correlational survey design was used to recruit 183 mothers who breastfeed or breastfed their babies. Participants' visited outpatient departments and were admitted to pediatric ward at 2 hospitals in metropolitan city of Korea. Inclusion criteria for subjects were mothers whose babies were from 1 month to 24 months old. Data were collected using a self-report questionnaire for mothers' and babies' demographic variables, maternal role adjustments, parenting stresses, and maternal breastfeeding adaptations. Results: Higher levels of maternal adaptations and low levels of parenting stresses were associated with greater maternal breastfeeding adaptations. Types of feeding during hospital stays and baby's health status at birth were also associated with maternal breastfeeding adaptation. Conclusion: Results showed that a higher level of mothers' adjustment to breastfeeding; indicated lesser parenting stresses with higher levels of maternal adaptation. Nursing interventions for breastfeeding should be applied for appropriate breastfeeding adaptation during mothers' hospital stay. As baby's poor health status at birth medical team should provide a proper breastfeeding education.

• 한국간호교육학회지
• /
• 제4권1호
• /
• pp.66-80
• /
• 1998

With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.