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Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital (3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구)

  • Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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Development of computer program for the Growth Function in plant Growth Analysis: Effect of Seed Weight and Resources on Growth of Wild Radish (Raphanus raphanistrum) (植物의 成長과 成長解析에 對한 Computer Program 開發에 關한 硏究 - 種子의 무게, 資源이 植物의 成長에 미치는 影響)

  • Choe, Hyun Sup
    • The Korean Journal of Ecology
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    • v.13 no.3
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    • pp.225-236
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    • 1990
  • We studied that seeds of wild radish with different size of weight can be obtained for the purpose of differentiation and growth of these seeds by total growth periods. This study is practised a view of plant eco-physiological side and dry-matter production. Through whole growth periods, we knowthat seed weight of L plots was higher than that of M and S plots. In the 33th day after day after germination, growth values of L, M and S plots were 13.93, 7.77, and 4.61 g/plant, respectively. Growth of shoot (cotyledon and leaf) area and shoot weight were shown the similar trends with individual plant dry-amtter weight. In the 33th day after germination, shoot area of L, M and S plots were 21.55, 11.81 and 8.75 $cm^3$/plant and shoot dry weight of L, M and S plots were 10.83, 6.03, 3.50 g/plant, respectively. In the early stage of growth (the 10-14th day after germination), the values of RGR of seed weight of L, M, S plots were 0.2887, 0.2807 and 0.2365 g/g/day, in the late stage of growth, those values of RGR of L, M, S plote were 0.2721, 0.1716, 0.1727 g/g/day, respectively. In the early stage of growth (the 14th day after germination), the values of NAR or L, M and S plots were 0.1513, 0.1373, and 0.1094 g/$cm^2$/day, respectively. It is thought that seed weights were influenced seriously effect in the early stage of growth. The NAR value, in the late stage of growth (the-28-33th day after germination), of L, M and S plots were not large different as 0.1086, 0.1097 and 0.112 g/$cm^2$/day, respectively. The LAR values of M and S (2.0396, 2.1520 $m^2$/g) plots, in the early stage of growth, were higher than L (1.9037 $m^2$/g) plots. In the late stage of growth, the value of LAR of L plots were nearly same as M plots, but the value of S plots were higher than that of L and M plots (0.0458 $m^2$/g). And, in the early stage of growth, the values of SLA of L, M and S plots were 2.2123, 2.2107 and 2.8448 $m^2$/g, respectively. We measured the photosynthetic rates and the respiratory rates as the physiological characteristics of wild radish. In the early stage of growth, the photosynthetic rates of L, M and S plots were 12.4, 14.4, 9.8 $\mu$mol /$m^2$/sec and 9.4, 11.4, 9.8 $\mu$mol/$m^2$ /sec in the late stage of growth, respectively. In this result, it could be informed that photosynthetic rates in the late stage of growth were lower than the early stage. In the middle stage of growth, the respiratory rates were 0.793, $\mu$mol/$m^2$/min in shoot, and 3.28 $\mu$mol/$m^2$/min in root without relation to seed weight. The growth analysis of plants was used by Hunt & Parson s computer program (1974, 1981) and its results used this program were good. Therefore, in this sense, it could be expected that the computer program used and developed largely in researches of plant growth.

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The Concept of "Accident" under the Warsaw System (국제항공운송협약상(國際船空運送協約上) 사고(事故)의 개념(槪念))

  • Choi, Jun-Sun
    • The Korean Journal of Air & Space Law and Policy
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    • v.20 no.1
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    • pp.45-85
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    • 2005
  • The purpose of this paper is to examine the concept of "accident" under the Warsaw system including the Warsaw Convention for the Unification of certain Rules for International Carriage by Air of 1929 and the Montreal Convention of 1999. Most leading case on this subject is Air France v. Saks(470 U.S. 392 (1985)). In the Saks case, it was held that the definition of an accident must be applied flexibly, and most courts have adhered to the definition of accident in Saks case, the application of accident has been less than consistent. However, most cases have held that if the event is usual and expected operation of the aircraft, then no accident has occurred. Courts have also held that where the injury results from passenger's own internal reaction to the usual, normal, and expected operations of the aircraft, it is not caused by an accident. As the Warsaw drafters intended to create a system of liability rules that would cover all hazards of air travel, the carrier should liable for the inherent risks of air travel. It is right in that the carrier is in a better position than the passenger to control the risks during air travel. Most US courts have held that carriers are not liable for one passenger's assault on the other passenger. The interactions between passengers are not part of the normal operations of the aircraft and are therefore not covered by the word "accident" under Art 17 of the Warsaw Convention. It is regretful that the Montreal Convention did not attempt to clarify the concepts of accident in itself. In the light of an emerging tendency to hold the air carrier liable for occurrences that do not exactly go to the operation of the aircraft, it is desirable to regulate that the carrier is liable for an "event" instead of an "accident" in accordance with the Guatemala City protocol.

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A Review of the Supreme Court Decision on Damages for the Airport Noise (항공기소음피해에 대한 국가배상판결에 대한 고찰)

  • Chae, Young-Geun
    • The Korean Journal of Air & Space Law and Policy
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    • v.20 no.1
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    • pp.211-253
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    • 2005
  • Recently, the Korean Supreme Court released two important decisions concerning damages for the pain and suffering from Aircraft noise. The local people who are living near the Air Force practice site at Maehyang-ri and the Kimpo International Airport brought lawsuits against the Korean government requesting damages for their financial loss from the severe noise and the damages for their pain and suffering. Plaintiffs alleged that they suffered physical malfunctions, extreme disturbances and the reduction of property values from the extreme noises which were daily repeated. District Court of Seoul Province did not allow plaintiffs all but the damages for pain and suffering. Plaintiffs could not prove the causation between their financial loss and the noise. The Supreme Court confirmed the lower court's decision. Article V of the National Compensation Act (analogous to the Federal Tort Claims Act of the USA) reads, "the government shall be liable for any loss caused by the defect on establishment or maintenance of public facilities." In the two cases, the major issue was whether the government's establishment or maintenance of Air Force practice site and the airport was defective because they caused serious noise to surrounding neighbors. Previously, the Supreme Court interpreted the clause "defect on establishment or maintenance of public facilities" as failure of duty to provide safety measures to the degree generally required to ordinary manager. However the Court at this time interpreted differently that the defect could be found if the facility caused to any person loss to the degree intolerable. In the two cases the Court confirmed the lower court's finding that noise level at the site was severe enough to be intolerable. This standard is based on the severity of the loss rather than the failure of duty. It became easier for plaintiffs to prove the cause of action under this interpretation. The consequence of the ruling of these two cases is 'rush to the courtroom' by the local people at similar situations. The ruling of these two cases was not appropriate both in theory and in consequence. The Korean tort system is basically based on the theory of negligence. Strict liability is exceptional only when there is special legislation. The Court created strict liability rule by interpreting the Art. V of the National Compensation Act. This is against the proper role of the court. The result of the cases is also dismal. The government was already sued by a number of local people for damages. Especially the Department of Defense which is operating many airports nationwide has financial hardship, which will cause downsizing military practice by the Air Force in the long run, This is no good to anyone. Tens of millions of dollars which might be used for compensation might be better used to prevent further noise problem surrounding airports.

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Comparison of Sleep Patterns and Autonomic Nervous System Activity among Three Shifts in Shiftworkers (교대근무자에서 각 교대근무간의 수면양상 및 자율신경계 활성도 비교)

  • Yoon, In-Young;Ha, Mi-Na;Park, Jung-Sun;Song, Byoung-Gun
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.96-101
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    • 2000
  • Objectives: Through comparing sleep variables and autonomic activities among three shifts in shift workers, the authors intended to clarify which shift is most tolerable and to identify the characteristics of their psychological and physical problems. This study is also expected to help shift workers to adapt themselves to their work more effectively. Methods: Fifty one shift workers took part in this study. They were working in a rapidly rotating system in which they worked for 3 days in one shift with one day off between each shift. Based on a sleep diary, sleep latency (SL), sleep period time (SPT), and number of wake after sleep onset (NWASO) were estimated and compared among the three shifts. In assessing sleepiness, Epworth sleepiness scale (ESS) and visual analogue scale (VAS) were used. To evaluate mood states among the three shifts, profile of mood states (POMS) was administered. Heart rate variability (HRV), and the level of adrenaline and noradrenaline were measured to assess autonomic activities. HRV included low frequency power (LF), high frequency power (HF), and LF/HF. Results: SPT was significantly lengthened during the evening shift and SL was shortened during the night shift. The workers showed a drop in alertness at wake-up during morning shift and a drop in alertness at work during night shift. During night shift the subjects complained of physical fatigue and cognitive decline. Comparison of HRV showed that parasympathetic activity was most prominent during the evening shift. Secretion of adrenaline and noradrenaline decreased during the evening shift, though statistically not significant. Conclusion: We found that the evening shift was most tolerable among the three shifts. It is recommended that morning light exposure be done during the morning shift and nocturnal light exposure during the night shift.

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Drug Resistance Rate of New Pulmonary Tuberculosis Patients Treated from the Private Sector in 2003~2005 (2003~2005년도 민간 병의원 신환자에서 분리된 결핵균의 항결핵약제 내성률)

  • Park, Young Kil;Park, Yoon Sung;Bai, Jeong Ym;Kim, Hee Jin;Lew, Woo Jin;Chang, Chul Hun;Lee, Hee Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.87-94
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    • 2008
  • Background: Surveillance of TB drug resistance (DR) is essential for providing information on the magnitude and trends in resistance, for developing treatment guidelines and for monitoring the effect of interventions. Up to now national surveys of drug resistance of M. tuberculosis have been conducted four times since 1994 among patients registered at health centers. The purpose of this study is to estimate the prevalence of primary drug resistance among new cases identified in private sector, and to compare it with the previous national drug resistance surveys. Methods: The study collected results of drug susceptibility testing (DST) performed at the Korean Institute of Tuberculosis by the request of private sector from January 2003 to December 2005, and then finally selected new cases for the analysis from the database of Korean TB Surveillance (KTBS) by matching patients' name and social identification numbers. Results: Of the 5,132 new patients included in the study, 689 (13.4%) patients were found to have drug resistance at least one drug, 530 patients (10.3%) were isoniazid resistant, 195 patients (3.8%) were multi-drug resistant (MDR), and 21 patients (0.4%) were extensively drug resistant (XDR). The rate of drug resistance tended to decrease annually but it was not statistically significant. When compared with previous national DR surveys in 2003 and in 2004 respectively, they were not significantly different. Conclusion: The prevalence of DR among new cases managed in the private sector did not show significant difference from that of new patients registered in the public sector in the same year.

Linolenic Acid in Association with Malate or Fumarate Increased CLA Production and Reduced Methane Generation by Rumen Microbes

  • Li, X.Z.;Choi, S.H.;Jin, G.L.;Yan, C.G.;Long, R.J.;Liang, C.Y.;Song, Man K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.22 no.6
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    • pp.819-826
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    • 2009
  • An in vitro study was conducted to investigate the effect of malate or fumarate on fermentation characteristics, and production of conjugated linoleic acid (CLA) and methane ($CH_4$) by rumen microbes when incubated with linolenic acid (${\alpha}-C_{18:3}$). Sixty milligrams of ${\alpha}-C_{18:3}$ alone (LNA), or ${\alpha}-C_{18:3}$ with 24 mM malic acid (M-LNA) or ${\alpha}-C_{18:3}$ with 24 mM fumaric acid (F-LNA) were added to the 150 ml culture solution consisting of 75 ml strained rumen fluid and 75ml McDougall's artificial saliva. Culture solution for incubation was also made without malate, fumarate and ${\alpha}-C_{18:3}$ (Control). Two grams of feed consisting of 70% concentrate and 30% ground alfalfa (DM basis) were also added to the culture solution of each treatment. In vitro incubation was made anaerobically in a shaking incubator up to 12 h at $39^{\circ}C$. Supplementation of malate (M-LNA) or fumarate (F-LNA) increased pH at 6 h (p<0.01) and 12 h (p<0.001) incubation times compared to control and linolenic acid (LNA) treatments. Both malate and fumarate did not influence the ammonia-N concentration. Concentration of total VFA in culture solution was higher for M-LNA and F-LNA supplementation than for control and LNA treatments from 6 h (p<0.040) to 12 h (p<0.027) incubation times, but was not different between malate and fumarate for all incubation times. Molar proportion of $C_3$ was increased by F-LNA and M-LNA supplementation from 6 h (p<0.0001) to 12 h (p<0.004) incubation times compared to control and LNA treatments. No differences in $C_{3}$ proportion, however, were observed between M-LNA and F-LNA treatments. Accumulated total gas production for 12h incubation was increased (p<0.0002) by M-LNA or F-LNA compared to control or LNA treatment. Accumulated $CH_4$ production for 12 h incubation, however, was greatly reduced (p<0.0002) by supplementing malate or fumarate compared to the control, and its production from M-LNA or F-LNA treatment was smaller than that from LNA treatment. Methane production from LNA, M-LNA or F-LNA treatment was steadily lower (p<0.01 - p<0.001) from 3 h incubation time than that from the control, and was also lower for M-LNA or F-LNA treatment at incubation times of 6 h (p<0.01) and 9 h (p<0.001) than for LNA treatment. Methane production from LNA, however, was reduced (p<0.01 - p<0.001) from 3 h to 9 h incubation times compared to the control. Both malate and fumarate increased concentration of trans11-$C_{18:1}$ from 3 h to 12 h incubation (p<0.01), cis9,trans11-CLA up to 6 h incubation (p<0.01 - p<0.01), trans10,cis12-CLA at 3 h (p<0.05) and 12 h (p<0.01), and total CLA for all incubation times (p<0.05) compared to corresponding values for the ${\alpha}-C_{18:3}$ supplemented treatment (LNA). In conclusion, malate and fumarate rechanneled the metabolic $H_2 pathway to production of propionate and CLA, and depressed the process of biohydrogenation and methane generation. Linolenic acid alone would also be one of the optimistic alternatives to suppress the $CH_4$ generation.

A Study on the Influence of Young Entrepreneurs' Entrepreneurship and Entrepreneurial preparation upon the Entrepreneurial Performance: Centered on Mediated Effect of Entrepreneurial infra system using (기업가정신과 창업준비가 사업성과에 미치는 영향에 관한 연구: 창업인프라 활용 매개효과 중심으로)

  • Park, Jaehwan;Ahn, Taeuk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.1
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    • pp.39-47
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    • 2016
  • Younger starters to be ready on the entrepreneurial performance and raising and producing potential creative person who demonstrates entrepreneurial spirit are not only important factor for added value creation along with national growth but also economic development to join the ranks of advanced countries. Thereby, a lots of interests and supports are focused in entrepreneurship and the startup activities. However, to create business achievement, we should nurture successful entrepreneurship based on using infrastructure in entrepreneurial ecosystem induced by aggressive investments and supports of the policy. Therefore, this study is empirical test of 203 young CEO of techniques which possibly create added value and national development, inventive type in knowledge service and opportunity type. Research finding is that entrepreneurship and entrepreneurial preparation have meaningful effects on the performance and the ready state. Entrepreneurship has no direct effects on entrepreneurial infra system. Entrepreneurial preparation has meaningful effects on entrepreneurial infra system. We induced that it is hard to earn business achievement by only using entrepreneurial infra system in that entrepreneurial infra system has no effect on business achievement. Lastly, entrepreneurship infra system has no relationship as mediating effects with effects of entrepreneurship on business achievement in mediating effect test. While young CEOs with entrepreneurship create business achievement without using entrepreneurship infra, entrepreneurship infra has relationship as mediating effect with effect of entrepreneurial preparation on business achievement. Namely, we induced the result that using entrepreneurship infra aggressively improve achievement in entrepreneurial preparation. Through this study, we need entrepreneurship education for young CEOs and effort to develop entrepreneur's competence to improve achievement and we concluded that approaching systematically in entrepreneurial preparation and using various entrepreneurship infra aggressively are important factors to improve achievement.

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Factors Analysis Related to Health Administration Students' Satisfaction on Hospital Practice (보건행정 전공 대학생들의 병원실습 만족도에 영향을 미치는 요인분석)

  • Park, Eun-Young;Jang, Young-Jin;Hong, Jong-Pil
    • Journal of Korean Clinical Health Science
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    • v.5 no.1
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    • pp.825-833
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    • 2017
  • Purpose .This study aims to assess the influence factors on the level of satisfaction with hospital training and to provide basic data for more efficient hospital practice of students' public health administration . Methods . We have conducted a survey on students satisfaction with their hands on practice against 200 students in Busan, Kyeongnam and Kyungbook area, who have completed their practice in public health administration. We have identified the general characteristics of the target respondents, the current training status of the department for the hospital practice and training venue; also analyzed the characteristics composed of the apprentice student's attitude before the practice, satisfaction with the department training program and hospital for practice, as well as their practice at hospital. The general characteristics of the target respondents and clinic practice status at the hospital were measured in percentage and frequency analysis; the average and standard deviations of hospital size were also measured; and the correlations between satisfaction with the department, attitude towards the practice and satisfaction with the hospital were analyzed. Results . Most public health administration students experienced their practice at the hospital after the first semester on the $2^{nd}$year and they have received the foundation training for the practice. The survey allowed multiple responses and the results are as follows: medical terminology 49.5%, medical coordinator 36.7%, Hospital administration 26.5%, Health insurance 17.3%, and medical recording and practice 13.8% respectively. In terms of each individual student's attitude towards the practice at the hospital, the respondents answered as follows: I have completed the obligatory subjects for the practice before the practice 89.5%; I have been fully informed on the hospital for my practice. 74.5%; I responsibly practiced and worked with professionalism and sense of belonging to the hospital as a member of staff 90%; I have actively learned and adopted 95%; My knowledge and skills from the practice was relevant to the theory and practice from my course 83.5%. The findings of satisfaction by size of hospital were in order of a small clinic($3.24{\pm}0.63$), medium sized clinic($3.27{\pm}0.65$), hospital ($3.20{\pm}0.61$), and large sized comprehensive hospital ($2.93{\pm}0.74$). Consequently the satisfaction rate shows no significant difference by size of hospital. In relations between practice attitude and satisfaction with subject, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.04), the matter of a sense of belonging and responsibility at hospital during practice(p=0.33). the matter of active adaptation attitude during practice (p=0.42), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. In relations between practice attitude and satisfaction with the hospital for practice, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.01), the matter of a sense of belonging and responsibility at hospital during practice(p=0.04), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. Conclusion . The most essential subject for the practice in public health administration is medical terminology and there is no significance in satisfaction with the practice by size of hospital. Students were content with the hospital where they can experience as much as possible. Students content with their major show positive attitude towards the practice and so do those content with the hospital. Those with the positive attitude towards the practice show the high correlation of satisfaction with both the major and hospital. As a result, the satisfaction with the major is the significant attribute to the practice in the hospital.

Development of $^{166}Ho$-Stent for the Treatment of Esophageal Cancer (식도암 치료용 $^{166}Ho$-Stent 개발)

  • Park, Kyung-Bae;Kim, Young-Mi;Kim, Kyung-Hwa;Shin, Byung-Chul;Park, Woong-Woo;Han, Kwang-Hee;Chung, Young-Ju;Choi, Sang-Mu;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.62-73
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    • 2000
  • Purpose: Esophageal cancer patients have a difficulty in the intake of meals through the blocked esophageal lumen, which is caused by an ingrowth of cancer cells and largely influences on the prognosis. It is reported that esophageal cancer has a very low survival rate due to the lack of nourishment and immunity as the result of this. In this study a new radioactive stent, which prevents tumor ingrowth and restenosis by additional radiation treatment, has been developed. Materials and Methods: Using ${\ulcorner}HANARO{\lrcorner}$ research reactor, the radioactive stent assembly ($^{166}Ho$-SA) was prepared by covering the metallic stent with a radioactive sleeve by means of a post-irradiation and pre-irradiation methods. Results: Scanning electron microscopy and autoradiography exhibited that the distribution of $^{165/166}Ho\;(NO_3)$ compounds in polyurethane matrix was homogeneous. A geometrical model of the esophagus considering its structural properties, was developed for the computer simulation of energy deposition to the esophageal wall. The dose distributions of $^{166}Ho$-stent were calculated by means of the EGS4 code system. The sources are considered to be distributed uniformly on the surface in the form of a cylinder with a diameter of 20 mm and length of 40 mm. As an animal experiment, when radioactive stent developed in this study was inserted into the esophagus of a Mongrel dog, tissue destruction and widening of the esophageal lumen were observed. Conclusion: We have developed a new radioactive stent comprising of a radioactive tubular sleeve covering the metallic stent, which emits homogeneous radiation. If it is inserted into the blocked or narrowed lumen, it can lead to local destruction of the tumor due to irradiation effect with dilatation resulting from self-expansion of the metallic property. Accordingly, it is expected that restenosis esophageal lumen by the continuous ingrowth and infiltration of cancer after insertion of our radioactive stent will be decreased remarkably.

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