• 한국의료질향상학회지
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• 제6권1_2호
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• pp.92-106
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• 1999

Background : In many university hospitals, intravenous(IV) therapies and samplings had been one of the most important works of doctors who are in training. However, recently as patient oriented care is becoming more weighted for qualified health service IV therapies should be the works of specialized personnels. This study was conducted to investigate the medical staff's perception on IV team, to survey patient or parent's expectation on IV team, and to assess the frequency of IV therapy related complications and the characteristics of phlebitis among the hospitalized children. Methods : We collected data prospectively before the start of IV team from February 22 to February 29. 1999 and from September 27 to October 3, 1999, 6 months after beginning of IV team at Seoul National University Children's Hospital. IV team started their activities from March 1, 1999. General pediatric wards were not included for the IV and sampling team and oncology ward and surgical units were all included for the IV and sampling team's work. IV specialist was the well trained nurse who had been working in the field of pediatrics especially for the oncology patients. The subjects of this study were medical staffs who were working in children's hospital as doctors in training and patients who were treated with IV therapies in children's hospital during the same period. Results : Doctors responded that IV team need to be organized for IV care and expected IV team could reduce their work load. Parents of patients also responded IV team was very improtant to perform high quality IV care. They had willingness to pay extra charge for IV team care. In the wards where IV team did not work, they used various kinds and sizes of catheters, but in the wards where IV team worked, they needed just one or two types of catheters. As the exact role of IV team is not still established, job description is needed between the IV team and medical doctors. In the aspects of medical costs. it could save the materials for the IV also. Conclusion : This study showed that IV team could increase patient's satisfaction with decrease of medical doctors work load and concomitantly could save the costs of IV materials. And for the expansion of the IV team, job description is needed and for the total care of the children IV specialist and sampling team should expand their roles.

• 한국임상수의학회지
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• 제28권6호
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• pp.603-606
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• 2011

11년 령의 중성화된 수컷 코커 스파니엘견이 구취, 식욕부진과 좌측 안면부의 부종 증상을 보여 내원하였다. 신체 검사 상에서 좌측 구강점막의 단단한 종괴가 확인되었다. 가는 침 흡인 세포검사 결과 악성의 중간엽 유래 종양이 가장 의심되어 생검을 실시하였고 조직검사 결과 섬유육종으로 진단되었다. 보호자의 거부로 수술적인 치료가 아닌 카보플라틴 (carboplatin, 300 $mg/m^2$, IV, q 21 days)을 이용한 항암치료를 실시하였다. 항암치료 시작 후 육안적으로 종양의 크기가 현저히 줄어들어 약 89일 후에는 육안적으로 완전 경감되었다. 총 4회의 항암치료 이후 항암치료를 중단하였고 종양의 재발은 일어나지 않았다. 본 증례보고는 개의 구강 섬유육종에서 carboplatin을 이용한 항암 치료가 육안적인 종양의 완전 경감을 유도할 수 있음을 보여준다.

• Journal of Korean Biological Nursing Science
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• 제6권1호
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• pp.33-42
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• 2004

Background : Intravenous(IV) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by IV CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the IV CNS during a 10-month period form November, 14, 2002, to October 2, 2002. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, $2{\sim}61$ days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of IV therapy.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2467-2471
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• 2012

Introduction: Although bleomycin/etoposide/cisplatinum (BEP) chemotherapy is established as the standard treatment for germ cell tumours, it requires significant experience in administration and toxicity management to maintain optimal dose intensity. A retrospective review of 30 patients was conducted at UKMMC to study treatment outcomes. Methods & Materials: Patients with GCTs and treated with at least two cycles of BEP chemotherapy between January 2003 and Oct 2009 were eligible for this study. Patients received 4-6 cycles of bleomycin 30,000IU IV D1, D8 & D15 and either etoposide $100mg/m^2$ IV D1-D5 and cisplatin $20mg/m^2$ IV D1-D5 (5 day BEP regimen) or etoposide $165mg/m^2$ D1-D3 and cisplatin $50mg/m^2$ D1-3 (3 day BEP regimen) every three weeks per cycle. All patients received prophylactic granulocyte colony-stimulating factor (GCSF) from days 6 to 10 of each cycle. The overall response rates, 2 year progression-free survival and overall survival of the whole cohort were assessed. Results: Thirty patients fulfilled the inclusion criteria. Non-seminomatous GCTs comprised 93.3% of cases and gonadal and mediastinal primary sites were the most common. Sixty percent were classified as IGCCCG poor risk disease. Median follow-up was 26.6 months. The overall response rate (CR+PR) was 70%. The two year PFS and OS were 70% and 66%. There was a significant difference in terms of the overall response rate (85% vs 40%, p = 0.03) and in PFS (94.7% vs 50%, p = 0.003) between gonadal and extragonadal primary sites. Conclusion: It is possible to achieve outcomes similar to those in international clinical trials with close monitoring and good supportive care of patients undergoing BEP chemotherapy. There is a strong argument for patients with IGCCCG poor prognosis disease to be treated in specialist tertiary centres to optimize treatment outcomes.

• 대한물리치료과학회지
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• 제3권2호
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• pp.1021-1036
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• 1996

The purpose of this study are ( i ) to examine operating situation of physical therapy department and job satisfaction of physical therapists in health centers, (ii) to analyze utilization patterns and patient satisfaction of physical therapy services among health center visitors, and finally, (iii) to suggest policy implications in facilitating improvement on physical therapy services of health centers. The materials are collected from 105 physical therapists among nationwide health centers and 203 patients of 5 health centers in Pusan, Korea. The survey is conducted from February 13 to March 30, 1996 with a structured self - administered questionnaire. Major results of the study are as follows. First, the result of regression analysis between job satisfaction and affecting factors identify following variables as the significant determinants; self-development(+), job itself(+), and co-worker support (+). Second, the current operating situation of physical therapy department shows such problem as; i )shortage and unstable job security of physical therapists, ii )absence of rehabilitation specialist, iii )lack of understanding on physical therapy of co-workers, iv)shortage of physical therapy equipment and facility, v)burdensome task of physical therapists, and vi) inappropriate purchase process of equipment. Third, patient satisfaction for physical therapy services are revealed relatively high. And the result of regression analysis between patient satisfaction and affecting factors identify following variables as the significant determinants; credibility of physical therapist(+), satisfaction for waiting time(+), cleanliness(+). Fourth, the patients appeal about physical therapy services such problem as; i) shortage of physical therapists, physical therapy equipment, and facility, ii) inconvenient administrative procedure for utilization physical therapy services. Fifth and last, recommendations for the improvement of physical therapy services of health centers are as follows; i )recruiting more physical therapists, ii )regular employment of physical therapists instead of daily use employment, iii )re-arrangement of facility for patient's convenience, iv )establishing reasonable purchasing system of equipment for physical therapy, v) reforming administrative procedure for patient focused care.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권4호
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• pp.325-336
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• 2021

The occurrence of functional gastrointestinal disorders (FGIDs) is a formidable challenge for infants, parents, and healthcare professionals. Although data from the Middle East are scarce, experts consider FGIDs a prevalent condition in everyday clinical practice. The new Rome IV criteria revisited the definitions from a clinical perspective to provide a practical and consistent diagnostic protocol for FGIDs. However, the treatment practices for functional disorders vary considerably among Middle Eastern countries, often resulting in mismanagement with unnecessary investigations and treatments. In addition, the role of various treatment modalities, including probiotics such as Lactobacillus reuteri DSM 17938, in FGIDs requires further discussion and evaluation. During a consensus meeting, a locally relevant approach for treating common FGIDs such as infant regurgitation, infant colic, and functional constipation was discussed and approved by regional experts. The participants suggested a simplified treatment plan and protocol for general pediatricians and other primary care physicians managing FGIDs. This easy-to-follow standardized protocol will help streamline the initial management of this complex disorder in the Middle East region and even globally.

• 간호행정학회지
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• 제6권3호
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• pp.389-404
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• 2000

This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

• Asian-Australasian Journal of Animal Sciences
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• 제25권1호
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• pp.122-142
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• 2012

The importance of rainfed areas and animal agriculture on productivity enhancement and food security for economic rural growth in Asia is discussed in the context of opportunities for increasing potential contribution from them. The extent of the rainfed area of about 223 million hectares and the biophysical attributes are described. They have been variously referred to inter alia as fragile, marginal, dry, waste, problem, threatened, range, less favoured, low potential lands, forests and woodlands, including lowlands and uplands. Of these, the terms less favoured areas (LFAs), and low or high potential are quite widely used. The LFAs are characterised by four key features: i) very variable biophysical elements, notably poor soil quality, rainfall, length of growing season and dry periods, ii) extreme poverty and very poor people who continuously face hunger and vulnerability, iii) presence of large populations of ruminant animals (buffaloes, cattle, goats and sheep), and iv) have had minimum development attention and an unfinished wanting agenda. The rainfed humid/sub-humid areas found mainly in South East Asia (99 million ha), and arid/semi-arid tropical systems found in South Asia (116 million ha) are priority agro-ecological zones (AEZs). In India for example, the ecosystem occupies 68% of the total cultivated area and supports 40% of the human and 65% of the livestock populations. The area also produces 4% of food requirements. The biophysical and typical household characteristics, agricultural diversification, patterns of mixed farming and cropping systems are also described. Concerning animals, their role and economic importance, relevance of ownership, nomadic movements, and more importantly their potential value as the entry point for the development of LFAs is discussed. Two examples of demonstrated success concern increasing buffalo production for milk and their expanded use in semi-arid AEZs in India, and the integration of cattle and goats with oil palm in Malaysia. Revitalised development of the LFAs is justified by the demand for agricultural land to meet human needs e.g. housing, recreation and industrialisation; use of arable land to expand crop production to ceiling levels; increasing and very high animal densities; increased urbanisation and pressure on the use of available land; growing environmental concerns of very intensive crop production e.g. acidification and salinisation with rice cultivation; and human health risks due to expanding peri-urban poultry and pig production. The strategies for promoting productivity growth will require concerted R and D on improved use of LFAs, application of systems perspectives for technology delivery, increased investments, a policy framework and improved farmer-researcher-extension linkages. These challenges and their resolution in rainfed areas can forcefully impact on increased productivity, improved livelihoods and human welfare, and environmental sustainability in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• 한국조경학회지
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• 제40권4호
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• pp.114-126
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• 2012

본 연구는 대규모 택지개발 예정지로 계획되어 있는 대구광역시 달성군 옥포면 논공읍 일대 약 $10km^2$를 대상으로 비오톱 유형분류를 기반으로 한 미 시각 측면에서의 경관가치 평가 모형을 설정해 보고, 이를 실사례지에 적용해 봄으로써 평가모형의 타당성을 검증해 보는데 가장 큰 의의를 두었다. 연구결과를 요약하면 아래와 같다. 비오톱 유형분류 결과, 평가대상이 되는 23개의 비오톱 유형과 이에 귀속되는 140개의 세부 비오톱 유형으로 분류되었다. 또한 평가지표 선정을 위한 설문조사는 1차, 2차, 3차 설문으로 나누어 수행하였다. 먼저 1차 설문분석은 우선 문헌연구 및 현장조사를 바탕으로 선정된 22개의 평가지표 항목들에 대한 중요도를 분석하는 단계이다. 다음으로 2차 설문분석은 요인분석을 실시, 내재된 상관관계를 이용하여 지표들을 재분류하였다. 3차 설문분석은 선정된 평가지표 항목의 가중치를 산정하는 단계로서, 평가지표 항목의 중요도 평균을 기준으로 합이 10이 되도록 표준화하는 방법을 사용하였으며, 2차 평가 시 각 지표항목의 점수에 가중치를 곱하여 최종 평가에 활용하였다. 이상과 같은 전문가 설문분석 결과, 최종 선정된 평가지표는 활력충전요소, 시각적 방해요소 등 총 19개 항목으로 조사되었다. 1차 평가 결과, 특별히 가치 있는 I등급은 식생이 풍부한 자연형 하천유형(D), 습지 및 늪지 유형(I) 등 총 7개 유형으로 나타났다. 또한 II등급으로는 식생이 풍부한 인공형 하천유형(E), 침엽수림 중심의 산림유형(Q) 등 총 4개 유형, III등급은 식생이 풍부한 자연형 실개천 및 도랑유형(F) 등 총 5개 유형으로 나타났다. 상대적으로 가치가 낮은 IV등급, V등급은 각각 식생이 빈약한 실개천 및 도랑유형(G) 등 총 2개 유형과 녹지가 빈약한 복합형 주거지역(B) 등 총 5개 유형으로 분석되었다. 2차 평가 결과, 경관 가치가 특별히 높은 비오톱 유형(1a, 1b)은 15개 공간으로 조사되었으며, 경관의 가치가 높은 유형(2a, 2b, 2c)은 총 28개 공간으로 분석되었다. 그러나 본 연구에서 제시된 경관평가 모형이 타 유사지역에서도 높은 적용성을 가지기에는, 본 연구에서 설정한 하나의 연구대상지만으로는 부족함이 있었던 바, 차후에는 다양한 사례지를 종합하고 표준화하여 객관성을 높여 나갈 필요가 있을 것으로 사료된다.