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Paternal Childcare Time for Preschool Children and Its Determinants on Working and Nonworking Days (미취학자녀를 둔 아버지의 근무일과 비근무일의 자녀돌봄시간과 영향 요인 - 맞벌이 여부 및 돌봄유형별 차이를 중심으로 -)

  • Kim, Yookyung
    • Journal of Family Resource Management and Policy Review
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    • v.26 no.2
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    • pp.71-84
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    • 2022
  • This study analyzed 2019 time survey data from the National Statistical Office to examine the childcare behaviors of fathers with preschool children and their determinants, considering types of care and working/nonworking days. The main results of this study are as follows. First, paternal childcare time of nonworking days was three times more than that of working days, and the participation rate was also higher on nonworking days. Second, there was no significant difference in the amount of time spent on primary care and developmental care by fathers, whether from dual- or single-income families. Third, it seems that fathers adjust their participation in childcare between working days and nonworking days in consideration of the mother's time availability. Fourth, the variables related to childcare needs had a significant influence on paternal childcare time on both working and nonworking days. Fathers' developmental care time was not explained by the independent variables entered into the regression analysis. As a result of the study, it is necessary to reduce fathers' working hours and increase family-friendly systems to increase fathers' participation in childrearing. Fathers' perception of parental responsibility must also be changed.

Prognostic Factors in Patients Who Performed Angiographic Embolization for the Bleeding from Injury of the Intraabdominal Organ and Pelvic Area (외상성 복부 장기 손상 및 골반 손상에 의한 혈복강으로 동맥 색전술을 시행 받은 환자에서 예후 인자)

  • Lee, Jin Ho;Jang, Ji Young;Shim, Hong jin;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.166-171
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    • 2012
  • Purpose: In patients with traumatic hemoperitoneum or pelvic bone fracture who underwent angiography and embolization, we want to find the prognostic factors related with mortality. Methods: Patients(333 patients) who visited our hospital with traumatic injury from March 2008 to April 2012 were included in this study. Only 37 patients with traumatic hemoperitoneum or pelvic bone fracture underwent angiography and embolization. A retrospective review was conducted, and Glasgow coma scale (GCS), Revised trauma score (RTS), Injury severity score (ISS), initial laboratory finding and time interval, the amount of transfusion from the arrival at the ER to the start of embolization, and the vital signs before and after procedure were checked. Stastical analysis was conducted using the Chi square and Mann-Whitney U test. Results: In univariate analysis, the amount of transfusion, the base deficit before procedure, the systolic blood pressure before and after the procedure, the GCS, the RTS and the ISS were significantly associated with prognosis. In the multivariate analysis, the ISS and the base deficit had significant association with prognosis. Of the 37 patients who underwent angiography and embolization, 31 patients needed not additional procedure (Group A) while the other 6 patients needed an additional procedure (Group B). After procedure, a statistically significant higher blood pressure was observed in Group A than in Group B. As to the difference in blood pressure before and after the procedure, a statistically significant decrease in systolic blood pressure was observed in Group B, but an increase was observed in Group A. Conclusion: In traumatic hemoperitoneum or pelvic bone fracture patients who underwent angiography and embolization, GCS, ISS, RTS, transfusion amount before the procedure, initial base deficit and systolic blood pressure were factors related to mortality. When patients who underwent angiography and embolization only were compared with patients who underwent re-embolization or additional procedure after the first embolization, an increase in systolic blood pressure after embolization was a prognostic factor for successful control of bleeding.

Clinical Features of Distal Tibial Fractures and Treatment Results of Minimally Invasive Plate Osteosynthesis (원위 경골 골절의 임상양상 및 최소 침습적 금속판 고정술의 결과)

  • Kim, Weon-Yoo;Ji, Jong-Hun;Kwon, Oh-Soo;Park, Sang-Eun;Kim, Young-Yul;Kil, Ho-Jin;Jeong, Jae-Jung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.94-100
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    • 2012
  • Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

A Review on Health and Nursing Research Papers Published in the Journal of Korean Gerontological Society - From the first issue to the present (한국노년학에 게재된 건강·간호 분야 연구동향 - 한국노년학 창립 30주년에 즈음하여-)

  • Kim, Shinmi;Kim, Soon Yi;Lee, Yunjung;Choi, Jeong Sil;Lee, Miok
    • 한국노년학
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    • v.28 no.4
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    • pp.785-796
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    • 2008
  • The purpose of this study is to explore and analyze the trend of health and nursing researches published in the Journal of the Korean Gerontological Society for 30 years. Total 62 issues of the journal were reviewed and 135 articles(18.3%) were determined as health and nursing research. Among those 135 articles, studies with quantitative methodology were 110(81.5%) and ones with qualitative methodology were 10(7.4%). Less study adopt age criteria as elderly of 65 years old or older and most studies included community dwelling elderly in urban area. Among those quantitative researches survey was the most popular method(82.7%) compared to other types of studies including experimental studies. Experimental studies has been increased since the journal issued for the first time in the year of 1980, yet has occupied only minor portion in the journal until now. Qualitative studies appeared in the journal in the 90' for the first time. The findings of this review suggest that adequate amount of the studies has been published in the field of health and nursing, however more qualified researches are needed to be performed in terms of larger and more diverse subject groups, clearer and more objective criteria of elderly definition and health status, utilizing more objective and scientific instrument. Instruments of Korean culture oriented and phenomena sensitive are needed to be developed as well.

Optimal Scheduling for Efficient Waste Management in Isolated Regions from the Perspective of Waste Reduction Incentives (폐기물 저감 인센티브를 고려한 고립지역의 효율적 폐기물 관리 스케줄)

  • Hwang, Seok-Joon;Hwang, Uk;Kim, Hyun-Cheol
    • Environmental and Resource Economics Review
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    • v.26 no.3
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    • pp.399-416
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    • 2017
  • This study examines the problem of efficient scheduling of waste collection in isolated regions like islands when the waste accumulated amount surpasses the standard ceiling by effectively tracking the accumulating trends based on the optimum checking model of Keller (1974). To grasp whether the waste accumulated amount in isolated regions exceeds the standard ceiling, the relevant authorities can tightly check during a set period, but this entails higher monitoring costs. On the other hand, if the accumulated waste over the ceiling is not immediately checked and collected, and continues for a set period of time, innovative efforts for waste management may be highly demanded. As such, the tradeoffs are considered to draw the optimal checking schedule. This study shows that the authorities get to check less frequently the waste accumulation trends if the monitoring costs increase or when the failure rate of waste management systems drops. On the other hand, they get to check more frequently if the accumulated waste amount in isolated regions exceeds the standard ceiling and welfare loss grows as a result. It also shows that frequent checking is the optimal choice if the social marginal benefits enjoyed from innovative efforts made to keep accumulated waste below the standard ceiling, are not significant.

The Study on Service Design Development for Pharmacy Users: Using Smart Phone Application

  • Lee, Dong-Min;Park, Hye-Jung;Lee, Dong-In
    • Journal of the Ergonomics Society of Korea
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    • v.31 no.1
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    • pp.93-100
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    • 2012
  • Objective: This study is to review the current state of services offered to pharmacy users, and develop a service design converging a prescription service and a smart phone application service in order to enhance patients' experience at pharmacies and home. Background: Under the new medical system; separation of prescribing and dispensing drugs, a doctor writes a prescription to their patients and patients have their prescription filled at the pharmacy. As the number of flue, allergy and atopy patients has increased, waiting lines have been longer at pharmacies. Besides, the current medical service system lacks of providing proper information on prescribed pills to patients. There are already services offered during waiting times such as offering free drinks, magazines or suggesting general drugs which you can buy without prescription, however they neither cover the current medical service's shorts nor shorten the waiting time. Method: I researched objective and perceived waiting times reduction methods, the current service status at pharmacies, and the government's policy direction in a medical service. Also, I observed a patient's journey from the hospital to pharmacy and then home. I examined the circumstance at pharmacies, patients' behaviors and their thoughts during their journey, and extracted three main goals to design a service in order to help patients have positive perception during the waiting time; (1) to reduce the perceived time by the way of visualizing time and offering readings about what patients consider necessary, (2) to educate patients what they are into and how to get through, (3) to establish trust among patients, doctors and pharmacists. Based on three goals, I designed a structure and a wireframe for a new service application of smart phones. Results: With a new service design for pharmacy users, users can track their medical record and visit the information about their current medical treatments anytime. Also the service helps patients build reliable relationships with doctors and pharmacists. Conclusion: Experience is not just an activity but series of multiple activities. The serving range of a medical service should not be determined by stakeholders but user's holistic experience. By approaching a service design with a holistic vision, it can enrich not only a temporary experience but also a whole life well being. Application: Since there are already many service applications advising patients about their illness and finding right doctors, this service design is focused on the experience from getting a prescription till feeling better. The next move is to combine those two parts medical services and design an integrated service application. As a prescription is going to be coded in numbers, we might consider to design an un-attended pharmacy which can shorten huge amount of time for filling prescriptions.

Development of Geometrical Quality Control Real-time Analysis Program using an Electronic Portal Imaging (전자포탈영상을 이용한 기하학적 정도관리 실시간 분석 프로그램의 개발)

  • Lee, Sang-Rok;Jung, Kyung-Yong;Jang, Min-Sun;Lee, Byung-Gu;Kwon, Young-Ho
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.77-84
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    • 2012
  • Purpose: To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. Materials and Methods: A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align$^{TM}$ quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. Results: The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. Conclusion: When conducting a geometrical quality control using an electronic portal imaging, it was found that it is efficient as a quality control tool. It not only reduces costs through not using films, but also reduces the measurement and analysis time which enhances user convenience and can improve the execution process by leaving out film developing procedures etc. Also, images done with evaluation from the self-developed geometrical quality control real-time analysis program, data processing is capable which supports the storage of information.

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Analysis of Nursing Activities and Cost of Nursing Service Based on the ABC System (활동기준원가계산(ABC)을 이용한 간호활동 분석 및 간호서비스 원가분석;일 산부인과 간호단위를 중심으로)

  • Kang, Kyeong-Hwa
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.389-400
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    • 1999
  • The purpose of this study is to examine a possibility of applying the ABC system to analyze the cost of nursing service on one obstetrics and gynecology (OB/GYN) unit in a major medical center. The activities of nurses on an OB/GYN unit were analyzed for 4 days for 96 hours. 2 week days and 2 days on weekend. Total cases included in the study were activities of 12 charge nurses and 12 staff nurses. Activities were categorized into direct and indirect activities in order to calculate the cost of activities. Nursing activities were defined multidimesionally in order to utilize the ABC system. The 60 nursing activities were classified into the direct nursing activities and the indirect nursing activities based on a literature review, interview, and survey results. The direct activities were further categorized into the single nursing activities and the multiple nursing activities. The indirect activities were classified into the indirect nursing service activities and the general management activities. The major findings of this study were as follows : 1. There were differences in activities according to the positions and duties of the nurses. The charge nurses mostly performed the indirect nursing service activities and the general management activities. Almost all of their indirect nursing activities spent on each patient were similar. The staff nurses performed the single nursing activities and the multiple nursing activities. 2. The activities of staff nurses included medication, patient assessment, rounding and organizing the unit. patient education, nursing treatment, admission and discharging of patients. There was no differences in types and amount of time spent between the nurses on day-time duty and evening-time duty, but the patient assessment activity increased during the night-time. 3. The cost of post partum nursing services for women who had a normal vaginal delivery using the ABC system included the cost incurred by direct nursing activities provided by the staff nurses (85.9%), indirect nursing activities incurred by the staff nurses(19.0%) and the nursing activities by the charge nurses and the head nurse(14.1%). The ABC system is a relatively new method of cost analysis. The results of this study can provide the nursing and hospital managers with useful information on cost control. It is suggested that more studies should be done using the ABC system and extend the scope of studies to include value analysis to aid the Activity-Based Management(ABM) and/or the reengineering of hospital process.

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Is it Meaningful to Use the Serum Cholinesterase Level as a Predictive Value in Acute Organophosphate Poisoning? (혈청 콜린에스테라제 활성도를 이용하여 유기인계 농약 음독 환자의 증증도를 예측할 수 있는가?)

  • Lee, Sang-Jin;Jung, Jin-Hee;Jung, Koo-Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.72-76
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    • 2004
  • Purpose: Dealing patients with organophosphate poisoning, cholinesterase level has been used as a diagnostic and prognostic value. But there are some controversies that the cholinesterase level is significantly related to the severity or prognosis of acute organophosphate poisoning. We evaluated the correlation between initial serum level of cholinesterase and APACHE II score as an index for severity, and we assessed cholinesterase levels for predicting value of weaning from mechanical ventilation. Method: From August 1996 to March 2003, 23 patients with organophosphate poisoning who needed ventilatory care were enrolled. Retrospective review was done for the serum level of cholinesterase, APACHE II score, and the duration of ventilatory care. The percentage of measured serum cholinesterase to median normal value was used to standardize cholinesterase levels from different laboratories. Result: There were tendencies that the lower initial serum of cholinesterase, the higher the APACHE II score (r=0.297) and the longer the duration of mechanical ventilation (r=-0.204), but they were not significant (p=0.264 and p=0.351 respectively). In 9 patients whose serum cholinesterase level were checked at the time of weaning, mean of measured cholinesterase level was $10.3\pm7.60\%$ of normal value. Conclusion: There was no significant relationship between initial level of serum cholinesterase and severity or duration of mechanical ventilation. General health status of patient, amount of ingestion, toxicity of agent should be considered as important factors for severity of poisoning. And the decision of weaning should be based not solely on the cholinesterase level but on the consideration of general and respiratory state of individual patients.

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Development of Atopic Dermatitis Mouse Model with Spleen Deficiency (비허형 아토피 동물모델 개발)

  • Yang, Won Kyung;Lyu, Yee Ran;Kim, Ho Kyoung;Kim, Seung Hyeong;Park, Yang Chun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.4
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    • pp.213-219
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    • 2017
  • Atopic dermatitis (AD) is a common skin disease characterized by chronic and relapsing inflammatory dermatitis with immunological disturbances. Spleen deficiency (脾虛) is one of the major causes of AD, so development of animal model is required for AD research that reflects the pattern identification. The groups that we have used in this study included Senna folium extracts (SFE), 2,4-dinitrochlorobenzene (DNCB), and normal mice. Therefore, the present study was developed to atopic dermatitis mouse model with spleen deficiency in 2,4-dinitrochlorobenzene (DNCB) and senna leaves extracts induced AD in NC/Nga mice. The results demonstrated that senna leaves extract treatment significantly increased the dermatitis clinical score and epidermal thickness in AD-like skin lesions. We also proved beyond doubt that there was occurrence of erythema and skin moisture indices in the senna leaves extract groups. Further, we also found that the level of serum immunoglobulin E (IgE) in the senna leaves extract-treated group was increased. The amount of IL-4, IL-13, $TNF-{\alpha}$ and $TGF-{\beta}$ mRNA determined by real-time PCR was increased remarkably when senna leaves extract groups were treated on dorsal skin. Senna leaves extract groups significantly promoted the number of CD11B+/Gr-1 cell in skin, as well as the number of CD4+/CD8+ cell in dorsal skin compared with control. The review summarizes recent process in our understanding of the immunopathophysiology of spleen deficiency AD and the implications for spleen deficiency mouse models of AD on drug discovery from medical plants.