• Title/Summary/Keyword: Management Factors

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The Short Term and Intermediate Term Results of using a T-tube in Patients with Tracheal Stenosis (기관 협착 환자에서의 T-튜브의 중단기 결과)

  • Sa, Young Jo;Moon, Seok-Whan;Kim, Young-Du;Jin, Ung;Park, Jae-Kil;Kim, Jae Jun;Kim, Chi-Kyung;Jo, Keon Hyon;Park, Chan Beom;Yim, Hyeon Woo
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.63-71
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    • 2009
  • Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.

Alternative Concept to Enhance the Disposal Efficiency for CANDU Spent Fuel Disposal System (CANDU 사용후핵연료 처분시스템 효율향상 개념 도출)

  • Lee, Jong-Youl;Cho, Dong-Geun;Kook, Dong-Hak;Lee, Min-Soo;Choi, Heui-Joo
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.9 no.3
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    • pp.169-179
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    • 2011
  • There are two types of nuclear reactors in Korea and they are PWR type and CANDU type. The safe management of the spent fuels from these reactors is very important factor to maintain the sustainable energy supply with nuclear power plant. In Korea, a reference disposal system for the spent fuels has been developed through a study on the direct disposal of the PWR and CANDU spent fuel. Recently, the research on the demonstration and the efficiency analyses of the disposal system has been performed to make the disposal system safer and more economic. PWR spent fuels which include a lot of reusable material can be considered being recycled and a study on the disposal of HLW from this recycling process is being performed. CANDU spent fuels are considered being disposed of directly in deep geological formation, since they have little reusable material. In this study, based on the Korean Reference spent fuel disposal System (KRS) which was to dispose of both PWR type and CANDU type, the more effective CANDU spent fuel disposal systems were developed. To do this, the disposal canister for CANDU spent fuels was modified to hold the storage basket for 60 bundles which is used in nuclear power plant. With these modified disposal canister concepts, the disposal concepts to meet the thermal requirement that the temperature of the buffer materials should not be over $100^{\circ}C$ were developed. These disposal concepts were reviewed and analyzed in terms of disposal effective factors which were thermal effectiveness, U-density, disposal area, excavation volume, material volume etc. and the most effective concept was proposed. The results of this study will be used in the development of various wastes disposal system together with the HLW wastes from the PWR spent fuel recycling process.

A Study on the Differentiation of a City image with City Identity (CI(City Identity)에 의한 도시이미지 차별화를 위한 연구)

  • 이충훈
    • Archives of design research
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    • v.15 no.4
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    • pp.57-66
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    • 2002
  • With the advanced localization followed by the settlement of the local autonomous systems, every city has faced new realities that it is inevitable to change its environment and image designs which have been uniformly made without consideration of its characteristics. Accordingly, they have failed to effectively achieve the development goal which make them distinctive.. The identity of a city means an image rather than its attribute. It can be drawn only when the city has its own municipality as well as the superiority to others. For Corporate Identity(CI) to function effectively as a comprehensive medium of communication, We should take into consideration all the situations which surround the city. It should be emphasized on the culture and environment oriented image. To do so we first of all have to analyze in detail the current situations and characteristics of the city. Hence, this paper tried to propose the strategies of making the CI which expresses the unique identity and communication of the city applying the CI program which have been used as the way of business management. The creation of the CI of the city takes the following steps. First, find the potentials for the image of the city through the survey of its resources. Second, provide the motive for citizens to actively participate in making plans with a dear vision for the improvement of the city image, physical development and so on. Third, provide with the events and the projects for specialized goods of the city to strengthen the ability of delivering the information, to design the city image and the street environment of the city. Fourth, apply the communication design system to use actively the administration organization, to enhance the citizenship, and to differentiate the city image. To do so, a variety of efforts should be followed to integrate and promote the regional culture, develope the structure and the facility functions of the city connecting those factors effectively. The establishment of the city identity is required a variety of activities to make the environment of the city, and the agreeable residential environment for a better life by differentiating the characteristics the city has.

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Development of simple tools for algal bloom diagnosis in agricultural lakes (농업용 호소의 조류 발생 진단을 위한 간편 도구의 개발)

  • Nam, Gui-Sook;Lee, Seung-Heon;Jo, Hyun-Jung;Park, Joo-Hyun;Cho, Young-Cheol
    • Korean Journal of Environmental Biology
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    • v.37 no.3
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    • pp.433-445
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    • 2019
  • This study was designed to develop simple tools to easily and efficiently predict the occurrence of algal bloom in agricultural lakes. Physicochemical water quality parameters were examined to reflect the phytoplankton productivity in 182 samples collected from 15 agricultural lakes from April to October 2018. Total phytoplankton abundance was significantly correlated with chlorophyll-a (Chl-a) (r=0.666) and Secchi depth (SD) (r= -0.351). The abundances of cyanobacteria and harmful cyanobacteria were also correlated with Chl-a (r=0.664, r=0.353) and SD (r= -0.340, r= -0.338), respectively, but not with total nitrogen (TN) and total phosphorus (TP). The Chl-a concentration was correlated with SD (r= -0.434), showing a higher similarity than phytoplankton abundance. Therefore, Chl-a and SD were selected as diagnostic factors for algal bloom prediction, instead of analyzing the standing crop of harmful cyanobacteria used in algae alarm systems. Specifically, accurate diagnoses were made using realtime SD measurements. The algal bloom diagnostic tool is an inverse cone-shaped container with an algal bloom diagnosis chart that modified SD and turbidity measurement methods. Lake water was collected to observe the number of rings visible in the container or the number indicated in each ring, depending on the degree of algal bloom,and to determine the final stage of algal blooming by comparison to the colorimetric level on the diagnosis chart. For an accurate diagnosis, we presented 4-step diagnostic criteria based on the concentration of Chl-a and the number of rings and a fan-shaped algal bloom diagnosis chart with Hexa code names. This tool eliminated the variables and errors of previous methods and the results were easily interpreted. This study is expected to facilitate the diagnosis of algal bloom in agricultural lakes and the establishment of an efficient algal bloom management plan.

Clinical Use and Complications of Percutaneous Central Venous Catheterization in Very Low Birth Weight Infants (극소 저출생 체중아에서 경피 중심정맥 도관의 유용성과 합병증)

  • Kim, Hyang;Kim, Sun Hui;Byun, Hyung Suck;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.953-959
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    • 2005
  • Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

Psychopathology, Self Esteem and Quality of Life in Cancer Patients with Radiotherapy (방사선 치료 중인 암환자의 정신병리, 자아존중감 및 삶의 질)

  • Jeong, Chan-Young;Yang, Jong-Chul;Shin, Il-Seon;Choi, Young;Yoon, Jin-Sang;Lee, Moo-Seok;Lee, Hyung-Young;Nah, Byung-Sik
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.92-100
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    • 2002
  • Objectives : As medical science develops, survival rate of cancer patients rises. Therefore, psychologic understanding and improving quality of life in cancer patients is getting greater significance. The Object of this study is to investigate sociodemographic and clinical characteristics, psychopathology, self esteem and quality of life in cancer patients and to provide useful information for therapeutic approach to cancer patients. Methods : The subjects were 41 patents who had been treated by radiotherapy and 20 normal people. Sociodemographic information and clinical characteristics of cancer patients were investigated, and SCL-90R for psychopathology, Rosenberg Self-esteem Scale for self esteem, WHOQOL-BREF for quality of life were administered to subjects. The results of both groups were compared and analysed, and correlation between variables were evaluated. Results : 1) The tendency of Somatization, obsession-compulsion, depression, anxiety, hostility, phobia, psychosis in cancer group were higher than normal group. Especially, somatization and anxiety in cancer group were significantly higher than normal group. 2) Self esteem and quality of life in cancer group were significantly lower than normal group. 3) No significance were found in comparison of psychopathology, self esteem and quality of life according to sociodemographic variables. Among clinical characteristics, higher somatization was shown in case of more weight loss, and higher somatization and lower quality of life was shown in the presence of pain. 4) Higher anxiety was significantly associated with lower self esteem, and Higher somatization and anxiety was significantly associated with lower quality of life. Conclusion : Cancer patients had various kinds of psychopathology, low self esteem and low quality of life. In particular, somatization and anxiety, self esteem and pain were found to be important factors to quality of life of cancer patients. Therefore, management of psychopathology, improving self esteem, pain control is necessary to improve quality of life in cancer patients.

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Effect of Myers-Briggs Type Indicator(MBTI) Personality Type, Emotional Intelligence, Sress Coping Strategies on Nursing student's Adjustment to College Life (간호대학생의 MBTI성격유형, 감성지능, 스트레스 대처방식이 대학생활적응에 미치는 영향)

  • Han, Young-Mi;Kim, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.124-134
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    • 2017
  • The purpose of this study was to investigate the MBTI personality type, emotional intelligence, and stress coping strategies of nursing students and to examine the influence of these factors on their level of college adjustment.The subjects were 267 nursing students who are located in Chonnam city. The survey was conducted from March 6th to March 31st, 2017. The level of college adjustment showed a close correlation with the emotional intelligence(r=.29, p<.001) and stress coping strategies(r=.27, p<.001), and the level of MBTI personality type was not statistically insignificant in the nursing students. It was found that the effect of the emotional intelligence and stress coping strategies on the college life adjustment was 17.5%(F=8.03, p<.001). According to the results of this study, it is necessary to develop a systematic management program to integrate the educational curriculum and extra-curricular activities(in order to enhance the) emotional intelligence and stress coping strategies in nursing students. In addition, the type of psychological function and psychological temperament of the MBTI personality type were found not to have influenced the level of college adaptation of the nursing students and this should be confirmedin a large scale sample.

Development of nutrition quotient for Korean preschoolers (NQ-P): Item selection and validation of factor structure (취학전아동 대상 영양지수 개발 : 평가항목 선정과 구성 타당도 검증)

  • Lee, Jung-Sug;Kang, Myung-Hee;Kwak, Tong-Kyung;Chung, Hae Rang;Kwon, Sehyug;Kim, Hye-Young;Hwang, Ji-Yun;Choi, Young-Sun
    • Journal of Nutrition and Health
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    • v.49 no.5
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    • pp.378-394
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    • 2016
  • Purpose: Screening of preschool-age children for nutrition programs to improve dietary intake and behaviors requires cost-effective and easily administered validated assessment tools. The purpose of this study was to develop a parent/caregiver-administered instrument for measuring diet quality and behaviors of preschoolers as a nutrition quotient for preschoolers (NQ-P). Methods: Development of NQ-P was carried out in three steps: item generation, item reduction, and validation. The 24-h dietary record was selected as the gold standard reference tool. The 38 items of the NQ-P checklist were derived from a systematic literature review, expert in-depth interviews, statistical analysis of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Self-administered questionnaires were delivered to parents who recorded 24-h dietary intakes of 100 responders aged 3~5 yr. Pearson's correlation was used to measure the level of agreement between questionnaires. Item reduction was performed, and 20 items were selected based on survey results, expert reviews, and priorities of national nutrition policy and recommendations. The 412 nationwide subjects sampled through daycare centers completed the 20-item checklist questionnaire. The construct validity of the NQ-P was assessed using confirmatory factor analysis, LISREL. Results: After analyses of exploratory factors, NQ-P items identified three dimensions of diet (balance, moderation, and environment). The three-factor structure accounted for 49.28% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-P and three-factor scores of the subjects were calculated by the obtained weights of the questionnaire items. Conclusion: A food behavior checklist for preschoolers' NQ would be a useful and suitable instrument for evaluating nutrition adequacy and dietary quality of Korean preschoolers.

Association of Metabolic syndrome, Metabolic syndrome score and Pulse pressure in Korean Adults: Korea National Health and Nutrition Survey, 2012 (한국 성인에서 대사증후군 및 Metabolic syndrome score와 맥압의 관련성-2012 국민건강영양조사에 근거하여)

  • Park, Sun-Young;Yoon, Hyun;Oh, Hye-Jong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.9
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    • pp.5660-5667
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    • 2014
  • The aim of this study was to assess the association of metabolic syndrome, metabolic syndrome score (MSS) and pulse pressure (PP) in Korean adults. The study subjects were Korean adults 20 years or older (n=5,889) who participated in the Korea National Health and Nutrition Examination Survey 2012. After adjusting for factors, such as year and gender and BMI, the mean PP increased with increasing MSS (MSS 0, $41.30{\pm}0.34mmHg$ and MSS 1, $42.16{\pm}0.31mmHg$ and MSS 2, $44.73{\pm}0.34mmHg$ and MSS, 3, $46.46{\pm}0.42mmHg$ and MSS 4, $48.62{\pm}0.58mmHg$ and MSS 5, $53.50{\pm}1.05mmHg$), and the mean PP for metabolic syndrome($47.25{\pm}0.34mmHg$) increased in comparison to Non-Metabolic syndrome ($42.77{\pm}0.19mmHg$). When logistic regression analysis was performed, the odds ratio (OR) of Hyper-PP (61> PP) for MSS 0 was 4.49 in MSS 1 (95% confidence interval[CI], 2.68-7.57) and 8.01 in MSS 2 (95% CI, 4.77-13.47) and 11.37 in MSS 3 (95% CI, 6.67-19.35) and 19.69 in MSS 4 (95% CI, 11.20-34.60) and 34.07 in MSS 5 (95% CI, 17.44-66.52), metabolic syndrome was associated with an increased Hyper-PP(OR 4.6, 95% CI, 2.0-10.4). Conclusion. These results suggest that an increase in MSS or metabolic syndrome might increase the pulse pressure.

Beak Trimming Methods - Review -

  • Glatz, P.C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.11
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    • pp.1619-1637
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    • 2000
  • A review was undertaken to obtain information on the range of beak-trimming methods available or under development. Beak-trimming of commercial layer replacement pullets is a common yet critical management tool that can affect the performance for the life of the flock. The most obvious advantage of beak-trimming is a reduction in cannibalism although the extent of the reduction in cannibalism depends on the strain, season, and type of housing, flock health and other factors. Beak-trimming also improves feed conversion by reducing food wastage. A further advantage of beak-trimming is a reduction in the chronic stress associated with dominance interactions in the flock. Beak-trimming of birds at 7-10 days is favoured by Industry but research over last 10 years has shown that beak-trimming at day-old causes the least stress on birds and efforts are needed to encourage Industry to adopt the practice of beak-trimming birds at day-old. Proper beak-trimming can result in greatly improved layer performance but improper beak-trimming can ruin an other wise good flock of hens. Re-trimming is practiced in most flocks, although there are some flocks that only need one trimming. Given the continuing welfare scrutiny of using a hot blade to cut the beak, attempts have been made to develop more welfare friendly methods of beak-trimming. Despite the developments in design of hot blade beak-trimmers the process has remained largely unchanged. That is, a red-hot blade cuts and cauterises the beak. The variables in the process are blade temperature, cauterisation time, operator ability, severity of trimming, age of trimming, strain of bird and beak length. This method of beak-trimming is still overwhelmingly favoured in Industry and there appears to be no other alternative procedures that are more effective. Sharp secateurs have been used trim the upper beak of both layers and turkeys. Bleeding from the upper mandible ceases shortly after the operation, and despite the regrowth of the beak a reduction of cannibalism has been reported. Very few differences have been noted between behaviour and production of the hot blade and cold blade cut chickens. This method has not been used on a large scale in Industry. There are anecdotal reports of cannibalism outbreaks in birds with regrown beaks. A robotic beak-trimming machine was developed in France, which permitted simultaneous, automated beak-trimming and vaccination of day-old chicks of up to 4,500 chickens per hour. Use of the machine was not successful because if the chicks were not loaded correctly they could drop off the line, receive excessive beak-trimming or very light trimming. Robotic beak-trimming was not effective if there was a variation in the weight or size of chickens. Capsaicin can cause degeneration of sensory nerves in mammals and decreases the rate of beak regrowth by its action on the sensory nerves. Capsaicin is a cheap, non-toxic substance that can be readily applied at the time of less severe beak-trimming. It suffers the disadvantage of causing an extreme burning sensation in operators who come in contact with the substance during its application to the bird. Methods of applying the substance to minimise the risk to operators of coming in contact with capsaicin need to be explored. A method was reported which cuts the beaks with a laser beam in day-old chickens. No details were provided on the type of laser used, or the severity of beak-trimming, but by 16 weeks the beaks of laser trimmed birds resembled the untrimmed beaks, but without the bill tip. Feather pecking and cannibalism during the laying period were highest among the laser trimmed hens. Currently laser machines are available that are transportable and research to investigate the effectiveness of beak-trimming using ablasive and coagulative lasers used in human medicine should be explored. Liquid nitrogen was used to declaw emu toes but was not effective. There was regrowth of the claws and the time and cost involved in the procedure limit the potential of using this process to beak-trim birds.