• 제목/요약/키워드: L2 experience

검색결과 348건 처리시간 0.034초

Outcomes after Extracorporeal Membrane Oxygenation in Neonates with Congenital Diaphragmatic Hernia: A Single-Center Experience

  • Choi, Wooseok;Cho, Won Chul;Choi, Eun Seok;Yun, Tae-Jin;Park, Chun Soo
    • Journal of Chest Surgery
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    • 제54권5호
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    • pp.348-355
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    • 2021
  • Background: Congenital diaphragmatic hernia (CDH) is a rare disease often requiring mechanical ventilation after birth. In severe cases, extracorporeal membrane oxygenation (ECMO) may be needed. This study analyzed the outcomes of patients with CDH treated with ECMO and investigated factors related to in-hospital mortality. Methods: Among 254 newborns diagnosed with CDH between 2008 and 2020, 51 patients needed ECMO support. At Asan Medical Center, a multidisciplinary team approach has been applied for managing newborns with CDH since 2018. Outcomes were compared between hospital survivors and nonsurvivors. Results: ECMO was established at a median of 17 hours after birth. The mean birth weight was 3.1±0.5 kg. Twenty-three patients (23/51, 45.1%) were weaned from ECMO, and 16 patients (16/51, 31.4%) survived to discharge. The ECMO mode was veno-venous in 24 patients (47.1%) and veno-arterial in 27 patients (52.9%). Most cannulations (50/51, 98%) were accomplished through a transverse cervical incision. No significant between-group differences in baseline characteristics and prenatal indices were observed. The oxygenation index (1 hour before: 90.0 vs. 51.0, p=0.005) and blood lactate level (peak: 7.9 vs. 5.2 mmol/L, p=0.023) before ECMO were higher in nonsurvivors. Major bleeding during ECMO more frequently occurred in nonsurvivors (57.1% vs. 12.5%, p=0.007). In the multivariate analysis, the oxygenation index measured at 1 hour before ECMO initiation was identified as a significant risk factor for in-hospital mortality (odds ratio, 1.02; 95% confidence interval, 1.01-1.04; p=0.05). Conclusion: The survival of neonates after ECMO for CDH is suboptimal. Timely application of ECMO is crucial for better survival outcomes.

와인 농축액을 첨가한 모짜렐라 치즈의 품질 특성 및 기능성 (Quality Characteristics and Functionality of Mozzarella Cheese with Wine Concentrate)

  • 신혜림;황온빛;박혜진;최성열;박의광;김민자
    • 한국식품영양학회지
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    • 제34권6호
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    • pp.641-649
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    • 2021
  • The objective of this study was to evaluate the quality characteristics of mozzarella cheese added wine concentrate. Mozzarella cheese was produced with different additives of wine concentrate which were 0~5%. The pH and the total acidity of the Cheese were analyzed. We also examined the radical scavenging activities for the antioxidant effect of samples and evaluated for their total polyphenol, and total flavonoid contents. The pH of Meoru wine cheese (6.28~6.37) was significantly higher and total acidity tended to decrease compared to that of the control. L* (lightness) of the wine cheese decreased with increasing amounts of wine concentrates whereas a* (redness) tended to increase. In the texture profile analysis, Meoru wine cheese showed higher values of hardness, gumminess, and chewiness. The ABTS radical scavenging activity of Meoru wine cheese showed the highest value when wine concentrate amounts were 2%. The DPPH radical scavenging activity was significantly increased in cheese added with wine concentrate. Total polyphenol contents and total flavonoid contents of Meoru wine cheese tended to increase with increasing amounts of wine concentrate. This research result highlights the positive influence of wine concentrate addition in cheese. Also, these results are expected to impact the experience programs in farm wineries.

고등학생의 SW 교육 경험 시점이 SW 관련 진로지향도에 미치는 영향 (The Effect of High School Students' First SW Education Experience on SW-related Career Orientation)

  • 이재호;이신영
    • 창의정보문화연구
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    • 제7권4호
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    • pp.225-234
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    • 2021
  • 우수한 SW 인재를 양성하는 것은 4차 산업혁명 시대를 맞이하는 우리 사회의 경쟁력을 높여 사회 발전에 긍정적인 영향을 줄 수 있다. 이에 본 연구에서는 우수한 SW 인재의 양성을 위하여 초, 중등 교육과정을 모두 경험한 경기도 S시 B고등학교 1학년부터 3학년까지 436명을 대상으로 고등학생이 SW 교육을 어떻게 인식하고 있는지 살펴보고, SW 교육 시작 시기가 학생들의 SW 관련 진로지향도에 어떤 영향을 주는지 분석하였다. 연구 결과, 공교육에서의 SW 교육의 확대가 필요하다는 것과 초등학교 시기부터 SW 교육을 받은 집단과 타 집단 사이에서 SW 관련 진로지향도에 유의미한 차이가 발생했다는 것을 확인하였다. 따라서 상대적으로 이른 시기에 SW 교육을 받는 것이 학생들의 SW 관련 진로지향도에 긍정적인 영향을 준 것으로 해석하였다. 향후 이른 시기의 SW 교육의 특정 요소가 학생들의 SW 관련 진로지향도에 구체적으로 어떻게 작용하는지 분석하는 연구가 필요할 것으로 판단된다.

A modified method of augmented distal clavicle fracture osteosynthesis with a Fibertape coracoclavicular cerclage

  • Wu, ChengHan;Teo, Timothy Wei Wen;Wee, Andy Teck Huat;Toon, Dong Hao
    • Clinics in Shoulder and Elbow
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    • 제25권3호
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    • pp.230-235
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    • 2022
  • Background: Unstable distal clavicles experience high non-union rates, prompting surgeons to recommend surgery for more predictable outcomes. There is a lack of consensus on the optimal method of surgical fixation, with an array of techniques described in the literature. We describe an alternative method of fixation involving the use of a distal clavicular anatomical locking plate with Fibertape cerclage augmentation in our series of patients. Methods: Nine patients (8 males and 1 female), with a mean age of 36 years, who sustained unstable fracture of the distal clavicle in our institution were treated with our described technique. Postoperative range of motion, functional and pain scores, and time to radiographic union were measured over a mean follow-up period of 10 months. Incidences of postoperative complications were also recorded. Results: At the last patient consult, the mean visual analog scale score was 0.88±0.35, with a mean Disabilities of the Arm, Shoulder, and Hand (DASH) score of 1.46±0.87 and American Shoulder and Elbow Surgeons (ASES) score of 94.1±3.57. The mean range of motion achieved was forward flexion at 173°±10.6°, abduction at 173°±10.6°, and external rotation at 74.4°±10.5°. All patients achieved internal rotation at a vertebral height of at least L2 with radiographical union at a mean of 10 weeks. No removal of implants was required. Conclusions: Our described technique of augmented fixation of the distal clavicle is effective, produces good clinical outcomes, and has minimal complications.

FACTOR ANALYSIS ON CONTRACTOR COMPETITION STRATEGY: A HONG KONG STUDY

  • L. Y. Shen;Y. T. Tan;S C Song;M X Yu
    • 국제학술발표논문집
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    • The 2th International Conference on Construction Engineering and Project Management
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    • pp.289-298
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    • 2007
  • The development of construction industry has led to the increase in the number of criteria imposed by project clients for selecting contractors. For example, clients often request tenderers to satisfy various conditions such as tight programme, financial strength, managerial ability, relevant work experiences, technical strength, high workmanship standard, safety requirement, quality specification, and yet others. This trend has attracted research interests of devising various methods for helping project clients to assess contractors' bids. For example, in recent development, the Works Bureau of the Hong Kong Government has introduced two mechanisms in tender evaluation for various public work contracts, namely, the Marking Scheme effective from June 2002 and the Formula Approach effective from November 2002 [1], [2]. These approaches evaluate a contractor's tender by considering collectively its tender price and performance attributes, the latter including contractor experience, past performance, technical resources and technical content of his proposal. The tender with the highest combined price and performance score (CPPS) will be normally recommended for acceptance. It appears, however, that there is little existing research in helping contractors to identify a competition strategy that enables the contractor to offer his most competitive bid collectively taking into account his resource capacities and project client's multiple performance criteria. This paper examines the factors affecting contractor's competition strategy to compete for works in Hong Kong. The understanding about the factors will contribute to identifying effective competition strategy. The data used for the analysis were collected from Hong Kong construction industry. The research findings may provide valuable references for investigating effective competition strategies in other construction industries outside the region.

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Determining chlorine injection intensity in water distribution networks: a comparison of backtracking and water age approaches

  • Flavia D. Frederick;Malvin S. Marlim;Doosun Kang
    • 한국수자원학회:학술대회논문집
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    • 한국수자원학회 2023년도 학술발표회
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    • pp.170-170
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    • 2023
  • Providing safe and readily available water is vital to maintain public health. One of the most prevalent methods to prevent the spread of waterborne diseases is applying chlorine injection to the treated water before distribution. During the water transmission and distribution, the chlorine will experience a reduction, which can imply potential risks for human health if it falls below the minimum threshold. The ability to determine the appropriate initial intensity of chlorine at the source would be significant to prevent such problems. This study proposes two methods that integrate hydraulic and water quality modeling to determine the suitable intensity of chlorine to be injected into the source water to maintain the minimum chlorine concentration (e.g., 0.2 mg/l) at each demand node. The water quality modeling employs the first-order decay to estimate the rate of chlorine reduction in the water. The first method utilizes a backtracking algorithm to trace the path of water from the demand node to the source during each time step, which helps to accurately determine the travel time through each pipe and node and facilitate the computation of time-dependent chlorine decay in the water delivery process. However, as a backtracking algorithm is computationally intensive, this study also explores an alternative approach using a water age. This approach estimates the elapsed time of water delivery from the source to the demand node and calculate the time-dependent reduction of chlorine in the water. Finally, this study compares the outcomes of two approaches and determines the suitable and effective method for calculating the chlorine intensity at the source to maintain the minimum chlorine level at demand nodes.

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What was the main factor in successful control of ascariasis in Korea?

  • Seung-Yull Cho;Sung-Tae Hong
    • Parasites, Hosts and Diseases
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    • 제61권2호
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    • pp.103-126
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    • 2023
  • In the l950s, under the legacy of traditional agriculture, Ascaris lumbricoides, spread epidemically in the war-bitten society of Korea. Consensus on the parasite control was drafted in the Parasite Disease Prevention Act, which passed a parliamentary agreement in 1966, and established safe disposal of feces and mass chemotherapy as control strategies. Biannual stool examinations and treating infected schoolchildren were basic scheme of the control activity through which revenue could be secured for organized business. In the 27 years following 1969, a maximum of 16 million stool examinations had been done every year. Cellophane thick smear enabled the task. The infection declined remarkably in the 1970s when industrialization and green revolution proceeded. A population study of A. lumbricoides in the late 1970s helped us better understand its epidemiology. The data also settled down the understandable protest of teachers against the repeated stool examinations. In the 9 years following 1987, the target population was gradually reduced when the egg positive rate was below 0.1%. An article in the Korean Law, stipulating obligatory stool examinations, was made optional. Although the long-term Korean effort of Ascaris control was a success, the effect of mass chemotherapy was not as succinct in terms of lowering reinfection. In the period of control, Korean agricultural technology changed, and the economy grew and supplied sanitary facilities by which the vicious cycle was disconnected. Reduction of morbidity was a benefit of mass chemotherapy, which is the only control method feasible in economically difficult countries. The most important hurdle of parasite control in the 1960s was poverty of general population and limited financial resources in Korea but the society formed a consensus on the priority of intestinal helminthiasis control during the ordeal period. The national consensus in the 1960s was the critical milestone for Ascaris control in Korea. Under the social agreement, application of timely technical and research advancements in parasitology achieved the success of ascariasis elimination. The successful experience of ascariasis elimination in Korea can be a benchmark for countries where neglected tropical diseases are endemically recycled.

부비동 단순 X선 촬영으로 확인한 소아 환자의 비염(鼻炎)과 부비동염(副鼻洞炎) 비교 (Comparison Between Rhinitis and Sinusitis in Young Patients Diagnosed by PNS Plain Radiograph)

  • 김진명;김윤범;남혜정
    • 한방안이비인후피부과학회지
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    • 제21권3호
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    • pp.140-149
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    • 2008
  • Objective : This study was performed to find out the difference of symptoms between rhinitis and sinusitis in young patients who were diagnosed by PNS plain radiograph( PNS series), Methods: We did statistical analysis about 147 new outpatients under 12 year-old who had visited the department of ophthalmology, otolaryngology, dermatology in Kyung Hee Oriental Medicine Center from March 2, 2006 to February 29, 2008. All of the patients were diagnosed by PNS series and we divided the patients with two groups; rhinitis group and sinusitis group. We checked the OPD records and explore the distribution on sex, experience of past western therapy, age and duration. Then we divided symptoms into nine; 'nasal obstruction', 'purulent rhinorrhea', 'cough & sneezing', 'watery rhinorrhea', postnasal drip', 'sputum', 'head problem', 'snoring & throat discomfort' and 'epistaxis'. We also divided age into 2 groups: $0\sim7$ years old and $8{\sim}12$ years old. We carried out chi-square test as a statistical method. Results : The results were as follows. 1. Sinusitis group were 102(69.5%); 62 have only sinusitis. 40 have both sinusitis and adenoidal hypertrophy. Rhinitis group were 45(30.5%); 13 have adenoidal hypertrophy and 32 were negative. 2. Male were 98(sinusitis 65, rhinitis 33), female were 49(sinusitis 37, rhinitis 12). 3. Patients who had experienced past western therapy were 120(sinusitis 81, rhinitis 39), no experienced patients were 27(sinusitis 21, rhinitis 6). 4. Distribution on age of sinusitis was 1(1 yr), 2(2 yrs), 3(3 yrs), 15(4 yrs), 15(5 yrs), 23(6 yrs), 13(7 yrs), 12(8 yrs), 8(9 yrs), 5(10 yrs), 1(11 yrs), 4(12 yrs). Distribution on age of rhinitis was 1(1 yr), 0(2 yrs), 1(3 yrs), 1(4 yrs), 9(5 yrs), 5(6 yrs), 3(7 yrs), 5(8 yrs), 1(9 yrs), 8(10 yrs), 6(11 yrs), 5(12 yrs), 5. Duration of sinusitis was 20(<2 months), 6($2{\sim}3$ months), 11($3\sim6$ months), 34($6\sim12$ months), 31(>12 months) and of Rhinitis was 11(<2 months), 0($2\sim3$ months), 5($3\sim6$ months), 18($6\sim12$ months), 11(>12 months) 6. Distribution on symptoms, sinusitis patients were 86(nasal obstruction), 52(purulent rhinorrhea), 46(cough & sneezing), 38(watery rhinorrhea), 41(postnasal drip), 23(sputum), 18(head problem), 15(snoring & throat discomfort), 6(epistaxis). The each symptom and sinusitis have no relation by chi-square test. 7. The number of patients who were 0 $\sim$ 7 years old was 92: sinusitis 72(49%), non-sinusitis 20(13.6%). The number of patients who were 8 $\sim$ 12 years old was 58: sinusitis 30(20.4%), non-sinusitis 25(l7%). By chi-square test(confidence level 95%), sinusitis and age under 7 have a significant relation(p=0.003). Conclusions : There is no relation between rhinologic symptoms and sinusitis. Patients under 7 years old with rhinologic symptoms tend to have sinusitis.

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간호학생의 임상실습 간호활동시간 분석 (Analysis of Nursing Care Activities of Nursing Students in Clinical Experience)

  • 이정희;성영희;정연이;김정숙
    • 한국간호교육학회지
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    • 제4권2호
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    • pp.249-263
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    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

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관상동맥질환자의 건강신념 및 자기효능감과 운동 및 식이요법 이행과의 관계 (The Relationship between Health Belief.Self-efficacy and Exercise.Diet Compliance in Coronary Heart Disease Patients)

  • 남명희;김정남;오윤정
    • 지역사회간호학회지
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    • 제8권2호
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    • pp.262-276
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    • 1997
  • This study evaluates the relationship between health belief. self-efficacy and exercise and diet compliance in coronary heart disease patients. The study subjects were 96 CHD patients who visited the outpatient clinic at 3 general hospitals in Taegu city from April 3, 1997 to May 3, 1997. Data was collected by the researcher and two registered nurses who work at a cardiac outpatient clinic. Face-to-face interview was conducted. Moon's health belief scale(l990) and Hicky and others' Cardiac Diet Self-Efficacy Instrument (CDSEI, 1992), Cardiac Exercise Self-Efficacy Instrument (CESEI, 1992) were used. The instrument developed by the researcher based on the reference review was used to measure exercise and diet compliance. The data were analyzed by using descriptive statistics, Pearson correlation coefficient, t-test, ANOVA, Tukey verification and Stepwise multiple regression with the SAS program. The results of this study were as follows; 1. The degree of health belief(score range: 1-4) perceived benefit: 3.06 barrier: 2.04 severity: 2.93 2. The degree of self-efficacy(score range: 1-5) exercise self-efficacy: 2.91 diet self-efficacy: 3.32 3. The degree of compliance (score range: 1-4) exercise compliance: 2.34 diet compliance: 2.95 4. The exercise compliance had a positive correlation with perceived benefit(r=0.5327, p=0. 0001), severity(r=0.2780, p=0.0061), exercise self-efficacy(r=0.6675, p=0.0001), and a negative correlation with barrier{r= -0.4236, p=0.0001). The diet compliance had a positive correlation with perceived benefit (r=0.6439, p=0.0001), severity(r=0.4244, p=0.0001), diet self-efficacy(r=0.6629, p=0.0001), and a negative correlation with barrier{r= -0.5098, p=0.0001). 5. According to pt's education level, (F=3.02, p=0.0336), received massage from mass media on exercise and diet(t=3.81, p=0.0002), presence of cardiac patients in the family members or friends(t=2.00, p=0.0478), created significant differences in exercise compliance. According to occuption(F=3.03, p=0.0215), hospitalized experience(t=4.59, p=0.0000), presence of chest pain(t=3.63, p=0.0005), there was also a significant difference in diet compliance. 6. The combination of exercise self-efficacy, perceived benefit and pt's education level explained 50.18% of the variance in exercise compliance. The combination of diet self-efficacy, perceived benefit and barrier explained 56.76% of the variance in diet compliance. On the basis of the above findings, the follow ing recommendations are suggested: 1. To promote the exercise. diet compliance for CHD patients, a well organized health teaching and nursing intervention program should be developed. 2. More research is needed to investigate other variables affecting exercise and diet compliance of CHD patients. 3. To promote self-efficacy and a positive health belief in CHD patients, a well organized and an approachable nursing intervention program should be developed. 4. Factors other than diet. exercise compliance should be evaluated to discover the impact on CHD patients.

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