• Journal of Korean Academy of Nursing Administration
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• v.15 no.4
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• pp.527-538
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• 2009

Purpose: The purpose of this study was to reclassify the advanced nursing practices of critical care nurse practitioners(CCNPs) in intensive care unit and measure the time and frequency of CCNP's activities. Method: Practices of ICU nurses are divided into RN's and CCNP's practices by a panel of ICU nursing experts. Each practice of CCNP is defined and CCNP's working time and service frequencies are monitored in general hospitals. Result: Practices of CCNP were classified into 4 domains and 32 practices. Fourteen practices by CCNPs were completed in 10 minutes and the other 12 practices consumed 10-30 minutes. A priority of practice in respiratory therapy was given to artificial airway management, management of tracheostomy patient, lower respiratory care, and the priority of CRRT was management of anticoagulation. Conclusions: Advanced nursing practices of CCNPs were recognized from those of RNs. A further research of CCNPs practices should be extended to other advanced practices and it is required to evaluate economic value of advanced nursing practice in the national health insurance system.

• Women's Health Nursing
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• v.5 no.2
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• pp.222-229
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• 1999

These days, as the society has been in the trends of highly industrialized and the family has been downsized, there is remarkably increasing number of women who follow occupation. These changes have made it more difficult for the family to help post-partum mother, which had been performed in side of house. By the help of social believe that during at least 1 month after childbirth professional nursing program is indispensable for both maternity protection and physical-mental recuperation, now many post-partum care centers for post-partum mother have been in operation. Although these post-partum care center have in use for a long time, no study was performed before this study on the same subject. Data were analyzed using by SAS. The results of study are as follow : 1. The general features of the user of the post-partum care center. The predominant band of user's age is extended from 26 to 30. The users are mainly housewives and they are in higher level of incomes and educations. As for the feature of delivery methods, they performed the normal spontaneous vaginal delivery method by 58.0% and the Caesarean operation method by 42.0%. As for the sexuality for babies, 59.3% of infants are male, and 40.7% are female. The highest delivery order of users is first and admission after 1-3days delivery is highest. 2. The results for the investigation into the actual condition of the post-partum care center are as follow : About the main reason for entrance of the post-partum care center was found to be the needs for the better nursing programs for recuperation after childbirth. This demands are also supported by their husbands. The average length of stay in the post-partum care center is 17.6 days and the besides promised expense ; powdered milk, milk-suckers, disposable dippers, skin cares, body shape cares, entrophics, injections. The post-partum have private rooms for mother and infants. Over the half of average expense is 229 million won. They are paying accessory fees the post-partum care center have similar step organization : the nurses, the skin carers, the cleaners. Mostly both ways of feeding powdered milk and breast feeding are in use, and mother's milk is preserved in the night time to be given to infant by nurse in charge. 3. The results of the investigation on users' nursing demand to the post-partum care center and satisfaction are as follow : The ranking order of nursing demand of mothers who used the is that ; infant care demands, environmental demands, emotional and mental care demands, education and training demands. As much as 70% of the respondents have dissatisfaction in nursing program, The ranking order of service satisfaction of mothers who used appears to be higher following order ; satisfaction in infant care demand, satisfaction in physical nursing demand, satisfaction in emotional and mental nursing demand, satisfaction in education and training demand, satisfaction in environment nursing demand. The results of pearson correlation. between nursing demand and service satisfaction of mothers who used are found to be relative noticeable in the level of 0.05. only infant care. The 61.7% of the women who used the post-partum care center. are responding that they will reuse the same post-partum care center again.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.182-192
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• 2002

Childhood Cancer Foundation of ROC(CCFROC) has been founded since 1982. Its goal is to provide comprehensive care for cancer children and their families. And in turn, under the provision of good and complete care, they can be back to the school and society. To achieve this goal, it needs to get every body's effort of the society together. The foundation has been founder under this concept and tried to fulfil this task. The first step is to educate the public to know that childhood cancer can be cured and the process of treatment is long and expensive. In order to reach this life-saving procedure, campaigns for raising money is most important thing. Then, pediatric hematologists / oncologists try to organize study group, named Taiwan Pediatric Qncology Goupp(TPOG), to make treatment protocols for childhood cancers. Its primary purpose is to increase the cure rate to prove the earlier the diagnosis and treatment, the better the prognosis. The second step is to provide full support of medical expenses and further to give help for emergent need to living. Through the varieties of active exercises of cancer children or families, foundation provides opportunities for them to share the experience during the different periods of diseases. The third step is to extend the scope of training activities for many kinds of personnel who devote to the care for cancer children. On the other hand, it promotes the cooperation or communication with international organizations and sets up recreation playing ground in the communities. The aim is to provide a comprehensive and integrated care for cancer children during their education, breeding and even accomplishment period. Besides the financial support of medical care, it provides social services to give psychological support for children and their families, to strengthen doctor-patients or doctor-families relationship. The foundation provides the mourning religious activities to cherish the memory of their children who passed away and to comfort their sadness. Since the childhood cancer is curable, its treatment should be active, comprehensive and it needs to provide to all cancer children without exception. Indeed, the work of CCFROC should be changed according to the environment and different time period. But, it needs the full support from the society. We hope the scope and content of the work will be more extended and its achievement will be better than now in the future.

• Journal of Microbiology and Biotechnology
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• v.28 no.9
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• pp.1563-1572
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• 2018

Gold nanoparticles (AuNP) and their conjugates have been gaining a great deal of recognition in the medical field. Meanwhile, extended-spectrum ${\beta}$-lactamases (ESBL)-producing bacteria are also demonstrating a challenging problem for health care. The aim of this study was the biosynthesis of AuNP using Rosa damascenes petal extract and conjugation of ceftriaxone antibiotic (Cef-AuNP) in inhibiting ESBL-producing bacteria and study of in vitro anticancer activity. Characterization of the synthesized AuNP and Cef-AuNP was studied. ESBL-producing strains, Acinetobacter baumannii ACI1 and Pseudomonas aeruginosa PSE4 were used for testing the efficacy of Cef-AuNP. The cells of MCF-7 breast cancer were treated with previous AuNP and Cef-AuNP at different time intervals. Cytotoxicity effects of apoptosis and its molecular mechanism were evaluated. Ultraviolet-visible spectroscopy and Fourier transform infrared spectroscopy established the formation of AuNP and Cef-AuNP. Transmission electron microscope demonstrated that the formed nanoparticles were of different shapes with sizes of 15~35 nm and conjugation was established by a slight increase in size. Minimum inhibitory concentration (MIC) values of Cef-AuNP against tested strains were obtained as 3.6 and $4{\mu}g/ml$, respectively. Cef-AuNP demonstrated a decrease in the MIC of ceftriaxone down to more than 27 folds on the studied strains. The biosynthesized AuNP displayed apoptotic and time-dependent cytotoxic effects in the cells of MCF-7 at a concentration of $0.1{\mu}g/ml$ medium. The Cef-AuNP have low significant effects on MCF-7 cells. These results enhance the conjugating utility in old unresponsive ceftriaxone with AuNP to restore its efficiency against otherwise resistant bacterial pathogens. Additionally, AuNP may be used as an alternative chemotherapeutic treatment of MCF-7 cancer cells.

• Journal of Preventive Medicine and Public Health
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• v.23 no.3 s.31
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• pp.285-295
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• 1990

The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.

• Journal of Veterinary Clinics
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• v.26 no.3
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• pp.286-289
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• 2009

Perineal laceration commonly occurs due to dilation of the birth canal at the time of foaling in primiparous mares. A 7-year-old Thoroughbred mare was presented with faecal contamination of the external genitalia. She was having history of constant straining three days after the mare's first foaling. Physical examination revealed the tearing extended from the deep part of vagina through muscles of the perineal body involved rectal floor and anal sphincter. Tentative diagnosed was third-degree perineal laceration therefore one-stage surgical procedure and a modified surgical procedure at three-week intervals was performed. During postoperative care for 3 weeks, soft faces was a key factor in success. After 3 weeks, the patient was recovered to normal condition completely.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.11 no.12
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• pp.5855-5877
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• 2017

In view of personal health and disease management based on cost effective healthcare services, there is a growing need for real-time monitoring services. The electrocardiogram (ECG) signal is one of the most important of health information and real-time monitoring of the ECG can provide an efficient way to cope with emergency situations, as well as assist in everyday health care. In this system, it is essential to continuously collect and transmit large amount of ECG data within a given time and provide maximum user convenience at the same time. When considering limited wireless capacity and unstable channel conditions, appropriate signal processing and transmission techniques such as compression are required. However, ISO/IEEE 11073 standards for interoperability between personal health devices cannot properly support compressed data transmission. Therefore, in the present study, the problems for handling compressed data are specified and new extended agent and manager are proposed to address the problems while maintaining compatibility with existing devices. Extended devices have two PM-stores enabling compression and a novel transmission scheme. A variety of compression techniques can be applied; in this paper, discrete cosine transformation (DCT) is used. And the priority of information after DCT compression enables new transmission techniques for performance improvement. The performance of the compressed signal and the original uncompressed signal transmitted over the noisy channel are compared in terms of percent root mean square difference (PRD) using our simulation results. Our transmission scheme shows a better performance and complies with 11073 standards.

• Journal of Preventive Medicine and Public Health
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• v.24 no.4 s.36
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• Journal of Popular Narrative
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• v.25 no.2
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• pp.169-216
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• 2019

This study proposes the concept of Bachchin's Chronotope as a tool for analyzing coevolution between the genre of the epic and society. Bachchin says through the concept of chronotope, literary works are on the foundation on which the axs of time and space intersect, and the literary works standsuch intersections are always conversing with social and historical chronotopes and mutually penetrating. Thus, finding and analyzing chronotope in literary works and extended things such as films and dramas reveals how chronotope and chronotope of a society have created specific social realities through a process of resonance. To make analytical use of this concept, we proposed a "cronotope drama analysis method" and concretely analyzed the genre of Korean medical dramas. The naturalized categories of health care, health, and disease are socially constructed entities, and the analysis of public works that has a significant impact on this process of social construction is essential but was underperformed. According to the analysis, the Korean medical drama's "Chronotope" has evolved using "Chronotope of the school" and "Chronotope of the secret chamber". At this time, the genre of Chronotope was expanding spatially and converging in time. In other words, the influence of structures and systems within the genre has grown, and the capacity of individual actors has decreased. This change in chronotope was interpreted as resonating with the social reality of neo-liberalistic spatial expansion and simultaneous production. The neo-liberalistic trend that dominates Korean society has embraced the category of health care and was further influencing the chronotope of drama text. It can also be inferred that the popular understanding of health care produced by the medical drama genre has taken a break in the process of forming a social reality of health care again.

• Korean Journal of Hospice Care
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• v.2 no.2
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• pp.28-48
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• 2002

The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.