• 대한물리치료과학회지
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• 제10권2호
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• pp.246-257
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• 2003

Even though the automation of industrial machinery has dramatically increased, most industries still require human hands for the production of goods. Our hands are essential to our existence. For this reason, hand injuries caused by industrial accidents have become an important issue lately. Most hand injuries are external wounds and constitute 38.6% of disabling industrial accidents. This significant statistic cannot be ignored by rehabilitation programs. The rate of success in operations of finger and hand injuries has increased, but relatively less consideration has been given to physical therapy, rehabilitation, research, or systematic installment in terms of welfare, which would help the injured carry on the nominal life they lived before their injury. Therefore, it is necessary to study systematically all related aspects to provide patients with physical therapy, rehabilitation, and social welfare, in order to restore their social, professional, and economical capabilities. Physical considerations, functional usability, and cosmetic restoration, as well as the patients' mental state must be addressed. The results of the study shows several problems. Medical appliances, manpower, and the environment of the treatment rooms are very poor. The patients cannot receive treatment early enough nor enough treatment because of too many patients for too few physical therapists. Close cooperation between physical therapists and doctors, nurses, or related departments is lacking. Furthermore, it is irrational that industrial accident premiums for the exert; e treatment of hand injury patients are not itemized. Lack of recognition of the importance of specialty in hand injury therapists leads to the lack of professionalization of systematic hand injury treatment In order to solve these problems, the professonalism of physical therapy should be acknowledged and particular treatment courses should be available and/or required. Based on the understanding of the hand injury patients' needs, new theories of physical therapy should be developed and modem medical appliances and facilities should be available, in order to provide the patients with qualitative medical treatment, which then will facilitate the patients' recovery.

• 한국의학물리학회지:의학물리
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• 제29권2호
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• pp.66-72
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• 2018

The proper position of a multi-leaf collimator (MLC) is essential for the quality of intensity-modulated radiation therapy (IMRT) and volumetric modulated arc radiotherapy (VMAT) dose delivery. Task Group (TG) 142 provides a quality assurance (QA) procedure for MLC position. Our study investigated the QA validation of the mechanical leaf gap measurement and the maintenance procedure. Two $VitalBeam^{TM}$ systems were evaluated to validate the acceptance of an MLC position. The dosimetric leaf gaps (DLGs) were measured for 6 MV, 6 MVFFF, 10 MV, and 15 MV photon beams. A solid water phantom was irradiated using $10{\times}10cm^2$ field size at source-to-surface distance (SSD) of 90 cm and depth of 10 cm. The portal dose image prediction (PDIP) calculation was implemented on a treatment planning system (TPS) called $Eclipse^{TM}$. A total of 20 VMAT plans were used to confirm the accuracy of dose distribution measured by an electronic portal imaging device (EPID) and those predicted by VMAT plans. The measured leaf gaps were 0.30 mm and 0.35 mm for VitalBeam 1 and 2, respectively. The DLG values decreased by an average of 6.9% and 5.9% after mechanical MLC adjustment. Although the passing rates increased slightly, by 1.5% (relative) and 1.2% (absolute) in arc 1, the average passing rates were still within the good dose delivery level (>95%). Our study shows the existence of a mechanical leaf gap error caused by a degenerated MLC motor. This can be recovered by reinitialization of MLC position on the machine control panel. Consequently, the QA procedure should be performed regularly to protect the MLC system.

• 보건행정학회지
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• 제29권4호
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• pp.502-512
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• 2019

Background: The purpose of this study was to identify role ambiguity of comprehensive nursing care unit nurses. Methods: A concept analysis method by Walker and Avant was used to understand role ambiguity of comprehensive nursing care unit nurses. Results: The antecedents of role ambiguity of nurses at comprehensive nursing units were shortage of nurses, unclear admission criteria, and demands for customized nursing care according to severity. Attributes include ambiguity in role delegation, patient placement ambiguity, and professional ambiguity among nursing staff. The consequences were diminished job satisfaction due to excessive workload, difficulty in resolving role ambiguity due to the lack of work analysis studies, and poor outcome of nursing indicators. Conclusion: Improvement of nationwide awareness for comprehensive nursing care unit is required. Clear division at scope of practice for nursing staff in accordance of each medical institution's characteristics is essential. Nurses at comprehensive nursing care unit should understand nature of role ambiguity that occurs as they work in large groups. Nurses should promote communications between nursing staff and they must have volition to improve status quo. An additional research of comprehensive nursing care on the causes of role ambiguity in the practice of nursing care for ward nurses is needed, and management measures should be sought at the organizational level.

• 중환자간호학회지
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• 제16권1호
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• pp.28-43
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• 2023

Purpose : Intensive care unit (ICU) diaries have been implemented across the international ICU community. This study aimed to comprehend the meaning and nature of the lived experience of patients' families using the ICU diary in Korea. Methods : This qualitative study adopted van Manen's hermeneutic phenomenology. The participants comprised eight women and two men who were the family members of patients in the ICU for more than three days. Data were collected using in-depth interviews and observation from July 2018 to January 2019. Results : Patients' families who experienced the ICU diary recognized it with six beings according to time: a good idea, forgotten stuff, burdensome work, touching service, my stuff, and a thing in the memory. The ICU diary had three essential meanings for the families: communication, solace and hope, and a record of life. These findings were rearranged according to van Manen's fundamental existential, and the lived things and lived others were remarkably confirmed. Conclusion : Patients' families experienced various ICU diary forms over time and recognized an ICU diary as a means of communication. Therefore, the ICU diary is expected to be used as an intervention between families and healthcare providers in the ICU to support mutual communication.

• 한국산학기술학회논문지
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• 제19권11호
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• pp.126-136
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• 2018

본 연구는 머신러닝을 활용하여 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발을 목적으로 시행하였다. 전국 단위의 퇴원손상심층조사 2006~2015년 자료 중 한국표준질병사인분류(Korean standard classification of disease-KCD 7)에 따라 뇌졸중 코드 I60-I63에 해당하는 대상자를 추출하여 분석하였다. 동반질환 중증도 보정 도구로는 Charlson comorbidity index(CCI), Elixhauser comorbidity index(ECI), Clinical classification software(CCS)의 3가지 도구를 사용하였고 중증도 보정 모형 예측 개발은 로지스틱회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신 기법을 활용하여 비교해 보았다. 뇌졸중 환자의 동반질환으로는 ECI에서는 합병증을 동반하지 않은 고혈압(hypertension, uncomplicated)이 43.8%로, CCS에서는 본태성고혈압(essential hypertension)이 43.9%로 다른 질환에 비해 가장 월등하게 높은 것으로 나타났다. 동반질환 중중도 보정 도구를 비교해 본 결과 CCI, ECI, CCS 중 CCS가 가장 높은 AUC값으로 분석되어 가장 우수한 중증도 보정 도구인 것으로 확인되었다. 또한 CCS, 주진단, 성, 연령, 입원경로, 수술유무 변수를 포함한 중증도 보정 모형 개발 AUC값은 로지스틱 회귀분석의 경우 0.808, 의사결정나무 0.785, 신경망 0.809, 서포트 벡터 머신 0.830로 분석되어 가장 우수한 예측력을 보인 것은 서포트 벡터머신 기법인 것으로 최종 확인되었고 이러한 결과는 추후 보건의료정책 수립에 활용될 수 있을 것이다.

• 보건의료산업학회지
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• 제2권1호
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• pp.105-124
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• 2008

The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

• 한국컴퓨터정보학회논문지
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• 제24권11호
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• pp.21-27
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• 2019

임베디드 시스템에서는 서비스 특성에 따라 정해진 시간 내에 처리해야하는 하드 실시간 시스템과 처리 시간이 더 유연한 유연한 실시간 시스템을 분리해야합니다. 실시간을 동시에 수행하기 위해 운영 체제를 8BIT MCU와 같은 저 성능 임베디드 장치로 이식하는 것은 어렵습니다. RTOS (실시간 OS)를 사양이 낮은 MCU에 포팅하고 여러 작업을 수행 할 때 실시간 및 일반 처리 성능이 크게 저하되어 8BIT MCU와 같은 저 성능 MCU로 포팅 된 운영체제에 하드 실시간 시스템이 필요한 경우 성능 저하로 인해 하드웨어 및 소프트웨어를 다시 설계하는 문제가 발생되고 있습니다. 저성능 MCU에 이식 된 RTOS (저 성능 MCU로 포팅)에서 실시간 처리 시스템 요구 사항을 처리에 대하여 연구하고 프로세스 스케줄링에 대하여 연구가 진행되었습니다.

• 대한치과기공학회지
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• 제33권4호
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• pp.413-425
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• 2011

Purpose: This study conducted a survey on the elderly with physical debilities, who are in a medically vulnerable social class, to examine closely their demo-sociological characteristics, unmet needs, dental states, and living qualities and satisfaction levels relating to oral health and social supports to them, and also to prepare the basis for effective public medical policies and health improvement programs aimed at improving the quality of life for the elderly with physical debilities. Methods: Twenty-two elderly care facilities within Jeju Special Self-Government Province participated in the survey. Between 11 January and 5 March 2010, a total of 250 elderly persons(65 and over) with physical debilities were interviewed and their dental health was checked. Results: The results of the survey are as follows. The need for social support for dental care of the elderly with physical debilities was high in the medical institution-supported service (49.6%). The unmet needs for physical care were high in bathing (49.6%) and using public transportation (71.6%). More than half of these surveyed had ten or fewer teeth. The survey found that 31.6% of the participants experienced problems eating, due to poor dental health. Concerning quality of life, 30.5% of those surveyed experienced physical pain. Conclusion: In summary, the ages of the survey participants directly relates to the degree of behavioral debility experienced. The more debility a participant exhibits, the greater is the need for social support and dental care. The dental health of a participant directly relates to a higher quality of life. Good dental health of a participant translate to better quality of life. In light of the fact that the elderly with physical debilities suffer from a lack of accessibility to medical care and worse oral health than do other elderly persons, it is essential to increase accessibility to medical institutions that can provide such services as door to door dental care. Current insurance policies, funding for denture insurance, and free denture and denture-upgrade programs desperately need to be expanded. Therefore, to improve effectively the quality of life for the elderly with physical debilities civil dental medical resources should be encouraged to provide inclusive and prevention-focused medical care. In the public domain, door to door dental care services and cooperation with civil dental care resources need to be improved to increase impartial accessibility to dental medical institutions.

• 한국병원경영학회지
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• 제14권1호
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• pp.123-144
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• 2009

Recently, a long strike by hospital labor union emerged as a serious social issue. During the Worldcup Games in June, 2002, labor strikes broke up at 'C', 'K' and other hospitals, and in 2007, 'Y' hospital suffered much from a strike. Such series of extreme labor disputes have awakened people of importance of a more stable labor-management relationship for the medical institutions responsible for people's health than any other business organization. The purpose of this study was to examine the labor-management disputes at 'Y' hospital in 2007 and 'C' and 'K' hospitals in 2002. The results of this study can be summarized as follows; First, requests of the labor union such as pay raise, reemployment of the irregular workers as regular employees and participation of the labor union in personnel affairs are the long-held or core issues suffered by the medical institutions. Such issues are not independent from each other but complicated with each other surrounding the pay raise. Accordingly, it is not easy to determine the genuine bone of issue for labor-management disputes. Second, the model type of disputes between labor and management at medical institutions may be strike. However, it is conceived that the type of disputes would be subject to change as the essential medical service area system began to be operated since 2008. Third, the common characteristic of the labor strike among the 3 sample hospitals was occupation of the hospital lobby for a sit-in strike to maximize the negative effects of strike. Article 42 (Prohibition of Violence) of Labor Union and Labor Relation Coordination Act prohibits occupation of production or other important business facilities. In addition, since Ministry of Labor interprets that the hospital lobby belongs to the important business facilities enumerated by Article 42 of the above act, occupation of the hospital lobby for a sit-in strike may be too controversial to be admitted as a fair act of labor dispute when its legitimacy should be judged. Fourth, the counter-measures taken by the hospitals against the strike were observance of the principle 'no labor no pay,' closure, legal action, accusation, claim for recovery of damage, provisional seizure, disciplinary punishment, etc., but the principle of 'no labor, no pay' was not applied in a fair manner by 'C' and 'K' hospitals. However, 'Y' hospital applied this principle thoroughly to the strike; the hospital conduced to correction of the wrong labor-management relationship by refusing inclusion in the labor collective agreement of a provision about payment of wage during the period of strike or labor union's request to that effect during a strike. In addition, 'Y' hospital took an effective measure to end the strike earlier by notifying the labor union of cancellation of the collective agreement and banning the unionists from entering the hospital.

• Asian-Australasian Journal of Animal Sciences
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• 제21권4호
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• pp.532-537
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• 2008

In order to investigate the factors affecting the culture of mouse preantral follicles in vitro, we examined the effect of culture media, protein supplements, and culture period on their growth. The oocyte diameter (initial size: $55.6{\pm}2.5{\mu}m$) was progressively increased during culture, and the maximum size ($72.0{\pm}2.4{\mu}m$) was reached on day 10 of the in vitro culture. The chromatin configuration in the germinal vesicle (GV) oocyte progressively shifted from a non-surrounded nucleolus (NSN) to a surrounded nucleolus (SN). On day 10 of the culture, most of the oocytes progressed to the SN pattern. The survival and metaphase II rates of the oocytes in alpha-minimal essential medium (alpha-MEM) were significantly higher (p<0.05) than those in Waymouth and tissue culture medium (TCM)-199. As a protein source, fetal bovine serum (FBS) was more suitable for the culture of mouse preantral follicles as compared to human follicular fluid (hFF) and bovine serum albumin (BSA); the optimal concentration of FBS was 5%. These results suggest that in a culture of mouse preantral follicles, alpha-MEM and 5% FBS are an optimal medium and a protein source, respectively; further, the 10 days of culture is required for the complete growth of oocytes in this culture system.