• Title/Summary/Keyword: Medical Delivery System

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A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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Sensory Information Processing

  • Yoshimoto, Chiyoshi
    • Journal of Biomedical Engineering Research
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    • v.6 no.2
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    • pp.1-8
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    • 1985
  • The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70$\pm$1.32mmHg/min)compared to CF dialyzers(4.32$\pm$0.55mmHg/min)(p<0.05). However, there was no observable difference in the UFR between the two dialyzers. Neither APD nor UFR showed any significant increase with an increasing number of reuses for up to more than 20reuses. A substantial number of failures observed in APD(larger than 20mmHe/min)on the reused dialyzers(2 out of 40 CP and S out 26 C-DAK) were attributed to the Possible damage on the fibers. The CF 15-11 HFDs which failed APD test did not show changes in the UFR compared to normal dialyzers indicating that APD is a more sensitive test than UFR test to evaluate the integrity of the fibers. 30527 T00401030527 ^x For quantitative measurement of reflected light from a clinical diagnostic strip, a prototype old reflectance photometer was designed. The strip loader and cassette were made to obtain more accurate reflectance parameters. The strip was illuminated at 45˚c through optical fiber and the intensity of reflected light was determined at rectanguLat angle using a photodiode. The kubelka-munk coefficient and reflection optical density were determined ar four different wavelengths(500, 550, 570 and 610nm) for blood glucose strip. For higher concentration than 300mg/41 about glucose, a saturation state of abforbance was observed at 500, 550 and 570nm. The correlation between glucose concentration and parameters was the best at 610nm. 30535 T00401030535 ^x Radiation-induced fibrosarcoma tumors were grown on the flanks of C3H mice. The mice were divided into two groups. One group was injected with Photofrin II, intravenously (2.5mg/kg body weight). The other group received no Photofrin II. Mice from both groups were irradialed for approximately 15 minutes at 100, 300, or 500 mW/cm2 with the argon (488nm/514.5 nm), dye(628nm) and gold vapor (pulsed 628 nm) laser light. A photosensitizer behaved as an added absorber. Under our experimental conditions, the presence of Photolfrin II increased surface temperature by at least 40% and the temperature rise due to 300 mW/cm2 irradiation exceeded values for hyperthermia. Light and temperature distributions with depth were estimated by a computer model. The model demonstrated the influence of wavelength on the thermal process and proved to be a valuable tool to investigate internal temperature rise. 30536 T00401030536 ^x We investigated the structural geometry of thirty-eight Korean femurs. The purpose of this study is to identify major geometrical differences between Korean femurs 3nd others that we believe belong to Caucasians so that we would be able to get insights into the femoral component design that fits Asians including Koreans. We utilized computerized tomography (CT) images of femurs extracted from cadavers. The CT images were transformed into bitmap data by using a film scanner, and then analyzed by using a commercially available software called Image v.1.0 and a Macintosh IIci computer.The resulting data were compared with already published data. The major results show that the geometry of the Korean femurs is significantly different from that of Caucasians: (1) the anteversion angle and the canal flare index are greater by the amount of approximately 8˚ and 0.5, respectively, (2) the shape of the isthmus cross section is more round, and (3) the distance between the teaser trochanter and the proximal border of the isthmus is shelter by about 15 mm. The results suggested that the femoral component suitable for Asians should be different from the currently-used components designed and manufactured mostly by European or American companies. 30537 T00401030537 ^x It is well known that nonlinear propagation characteristics of the wave in the tissue may give very useful information for the medical diagnoisis. In this paper, a new method to detect nonlinear propagation characteristics of the internal vibration in the tissue for the low frequency mechanical vibration by using bispectral analysis is proposed. In the method, low frequency vibration of f0( = 100Hz) is applied on the surface of the object, and the waveform of the internal vibration x (t) is measured from Doppler frequency modulation of silmultaneously transmitted probing ultrasonic waves. Then, the bispectra of the signal x (t) at the frequencies (f0, f0) and (f0, 2f0) are calculated to estimate the nonlinear propagation characteristics as their magnitude ratio, w here since bispectrum is free from the gaussian additive noise we can get the value with high S/N. Basic experimental system is constructed by using 3.0 MHz probing ultrasonic waves and the several experiments are carried out for some phantoms. Results show the superiority of the proposed method to the conventional method using power spectrum and also its usefulness for the tissue characterization. 30541 T00401030541 ^x This paper describes the implementation of a computerized radial pulse diagnosis by aids of a clinical expert. On this base, we composed of the radial pulse diagnosis system in korean traditional medicine. The system composed of a radial pulse wave detection system and a radial pulse diagnosis system. With a detection system, we detected Inyoung and Cheongu radial pulse wave and processed it. Then, we have got the characteristic parameters of radial pulse wave and also quantified that according to the method of Inyoung-Cheongu Comparison Radial Pulse Diagnosis. We defined the jugement standard of radial pulse diagnosis system and then we confirmed the possibility for realization of automatic radial pulse diagnosis in korean traditional medicine. 30545 T00401030545 ^x Microspheres are expected to be applied to biomedical areas such as solid-phase immunoassays, drug delivery systems, immunomagnetic cell separation. To synthesize microspheres for biomedical application, "two stage shot growth method" was developed. The uniformity ratio of synthesized microspheres was always smaller than 1.05. And the surface charge density (or the number of ionizable functional groups) of the microspheres synthesized by "two stage shot growth method" was 6~13 times higher than that of the microspheres synthesized by conventional seeded batch copolymerization. As a previous step for biomedical application, adsorption experiments of bovine albumin on microspheres were carried out under various conditions. The maximum adsorbed amount was obtained in the neighborhood of pH 4.5. Isoelectric point of bovine albumin is pH 5.0, so experimental result shows that it shifted to acid area. The adsorption isotherm was obtained, the plateau region was always reached at 2.Og/L (bulk concentration of bovine albumin).The effect of the kind and the amount of surface functional group was also examined. 30575 T00401030575 ^x A medical image workstation was developed using multimedia technique. The system based on PC-486DX was designed to acquire medical images produced by medical imaging instruments and related audio information, that is, doctors' reporting results. Input information was processed and analyzed, then the results were presented in the form of graph and animation. All the informations of the system were hierarchically related with the image as the apex. Processing and analysis algorithms were implemented so that the diagnostic accuracy could be improved. The diagnosed information can be transferred for patient diagnosis through LAN(local area network). 30592 T00401030592 ^x In the conventional infrared imaging system, complex infrared lens systems are usually used for directing collimated narrow infrared beams into the high speed 2-dimensional optic scanner. In this paper, a simple reflective infrared optic system with a 2-dimensional optic scanner is proposed for the realization of medical infrared thermography system. It has been experimentally proven that the intfrared thermography system composed of the proposed optic system has the temperature resolution of 0.1˚c under the spatial resolution of lmrad, the image matrix size of 256 X 240, and tile imaging time of 4 seconds. 30593 T00401030593 ^x In this paper, MIIS (Medical Image Information System) has been designed and implemented using INGRES RDBMS, which is based on a client/server architecture. The implemented system allows users to register and retrieve patient information, medical images and diagnostic reports. It also provides the function to display these information on workstation windows simultaneously by using the designed menu-driven graphic user interface. The medical image compression/decompression techniques are implemented and integrated into the medical image database system for the efficient data storage and the fast access through the network. 30594 T00401030594 ^x In this paper, computerized BEAM was implemented for the space domain analysis of EEG. Trans-formation from temporal summation to two-dimensional mappings is formed by 4 nearest point inter-polaton method. Methods of representation of BEAM are two. One is dot density method which classify brain electrical potential 9 levels by dot density of gray levels and the other is colour method which classify brain electrical 12 levels by red-green colours. In this BEAM, instantaneous change and average energy distribution over any arbitrary time interval of brain electrical activity could be observed and analyzed easily. In the frequency domain, the distribution of energy spectrum of a special band can easily be distinguished normality and abnormality. 30608 T00401030608 ^x Laboratory information system (LIS) is a key tool to manage laboratory data in clinical pathology. Our department has developed an information system for routine hematology using down-sized computer system. We have used an IBM 486 compatible PC with 16MB main memory, 210 MB hard disk drive, 9 RS-232C port and 24 pin dot printer. The operating system and database management system were SCO UNIX and SCO foxbase, respectively. For program development, we used Xbase language provided by SCO foxbase. The C language was used for interface purpose. To make the system use friendly, pull-down menu was used. The system connected to our hospital information system via application program interface (API), so the information related to patient and request details is automatically transmitted to our computer. Our system interfaced with fwd complete blood count analyzers(Sysmex NE-8000 and Coulter STKS) for unidirectional data tansmission from analyzer to computer. The authors suggests that this system based on down-sized computer could provide a progressive approach to total LIS based on local area network, and the implemented system could serve as a model for other hospital's LIS for routine hematology. 30609 T00401030609 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed a composite that is consisted of calcium phosphate and collagen. To use as the structural matrix of the composite, collagen was purified from human umbilical cord. The obtained collagen was treated by pepsin to remove telopeptides, and finally, the immune-free atelocollagen was produced: The cross linked atelocollagen was highly resistant to the collagenase induced collagenolysis. The cross linked collagen demonstrated an improved tensile strength. 30618 T00401030618 ^x This paper is a study on the design of adptive filter for QRS complex detection. We propose a simple adaptive algorithm to increase capability of noise cancelation in QRS complex detection with two stage adaptive filter. At the first stage, background noise is removed and at the next stage, only spectrum of QRS complex components is passed. Two adaptive filters can afford to keep track of the changes of both noise and QRS complex. Each adaptive filter consists of prediction error filter and FIR filter The impulse response of FIR filter uses coefficients of prediction error filter. The detection rates for 105 and 108 of MIT/BIH data base were 99.3% and 97.4% respectively. 30619 T00401030619 ^x To develop an artificial bone substitute that is gradually degraded and replaced by the regenerated natural bone, the authors designed and produced a composite that is consisted of calcium phosphate and collagen. Human umbilical cord origin pepsin treated type I atelocollagen was used as the structural matrix, by which sintered or non-sintered carbonate apatite was encapsulated to form an inorganic-organic composite. With cross linking atelocollagen by UV ray irradiation, the resistance to both compressive and tensile strength was increased. Collagen degradation by the collagenase induced collagenolysis was also decreased. 30620 T00401030620 ^x We have developed a monoleaflet polymer valve as an inexpensive and viable alternative, especially for short-term use in the ventricular assist device or total artificial heart. The frame and leaflet of the polymer valve were made from polyurethane, To evaluate the hemodynamic performance of the polymer valve a comparative study of flow dynamics past a polymer valve and a St. Jude Medical prosthetic valve under physiological pulsatile flow conditions in vitro was made. Comparisons between the valves were made on the transvalvular pressure drop, regurgitation volume and maximum valve opening area. The polymer valve showed smaller regurgitation volume and transvalvular pressure drop compared to the mechanical valve at higher heart rate. The results showed that the functional characteristics of the polymer valve compared favorably with those of the mechanical valve at higher heart rate. 30621 T00401030621 ^x Explosive evaporative removal process of biological tissue by absorption of a CW laser has been simulated by using gelatin and a multimode Nd:YAG laser. Because the point of maximun temperature of laser-irradiated gelatin exists below the surface due to surface cooling, evaporation at the boiling temperature is made explosively from below the surface. The important parameters of this process are the conduction loss to laser power absorption (defined as the conduction-to-laser power parameter, Nk), the convection heat transfer at the surface to conduction loss (defined as Bi), dimensionless extinction coefficient (defined as Br.), and dimensionless irradiation time (defined as Fo). Dependence of Fo on Nk and Bi has been observed by experiment, and the results have been compared with the numerical results obtained by solving a 2-dimensional conduction equation. Fo and explosion depth (from the surface to the point of maximun temperature) are increased when Nk and Bi are increased.To find out the minimum laser power for explosive evaporative removal process, steady state analysis has been also made. The limit of Nk to induce evaporative removal, which is proportional to the inverse of the laser power, has been obtained. 30622 T00401030622 ^x N1 and N2 gross neural action potentials were measured from the round window of the guinea pig cochlea at the onset of the acoustic stimuli. N1-N2 audiograms were made by means of regulating stimulant intensities in order to produce constant N1-N2 potentials as criteria for different input tone pip frequencies. The lowest threshold was measured with an input tone pip I5 dB SPL in intensity and 12 KHz in frequency when the animal was in normal physiological condition. The procedure of experimental measurements is explained in detail. This experimental approach is very useful for the investigation of the Cochlear function. Both noN1inear and active functions of the Cochlea can be monitored by N1-N2 audiograms. 30623 T00401030623 ^x In electrical impedance tomography(EIT), we use boundary current and voltage measurements toprovide the information about the cross-sectional distribution of electrical impedance or resistivity. One of the major problems in EIT has been the inaccessibility of internal voltage or current data in finding the internal impedance values. We propose a new image reconstruction method using internal current density data measured by NMR. We obtained a two-dimensional current density distribution within a phantom by processing the real and imaginary MR images from a 4.77 NMR machine. We implemented a resistivity mage reconstruction algorithm using the finite element method and sensitivity matrix. We presented computer simulation results of the mage reconstruction algorithm and furture direction of the research. 30624 T00401030624 ^x A new method of digital image analysis technique for discrimination of cancer cell was presented in this paper. The object image was the Thyroid eland cells image that was diagnosed as normal and abnormal (two types of abnormal: follicular neoplastic cell, and papillary neoplastic cell), respectively. By using the proposed region segmentation algorithm, the cells were segmented into nucleus. The 16 feature parameters were used to calculate the features of each nucleus. A9 a consequence of using dominant feature parameters method proposed in this paper, discrimination rate of 91.11% was obtained for Thyroid Gland cells. 30625 T00401030625 ^x An electrical stimulator was designed to induce locomotion for paraplegic patients caused by central nervous system injury. Optimal stimulus parameters, which can minimize muscle fatigue and can achieve effective muscle contraction were determined in slow and fast muscles in Sprague-Dawley rats. Stimulus patterns of our stimulator were designed to simulate electromyographic activity monitored during locomotion of normal subjects. Muscle types of the lower extremity were classified according to their mechanical property of contraction, which are slow muscle (msoleus m.) and fast muscle (medial gastrocneminus m., rectus femoris m., vastus lateralis m.). Optimal parameters of electrical stimulation for slow muscles were 20 Hz, 0.2 ms square pulse. For fast muscle, 40 Hz, 0.3 ms square pulse was optimal to produce repeated contraction. Higher stimulus intensity was required when synergistic muscles were stimulated simultaneously than when they were stimulated individually. Electrical stimulation for each muscle was designed to generate bipedal locomotion, so that individual muscles alternate contraction and relaxation to simulate stance and swing phases. Portable electrical stimulator with 16 channels built in microprocessor was constructed and applied to paraplegic patients due to lumbar cord injury. The electrical stimulator restored partially gait function in paraplegic patients. 30626 T00401030626 ^x Two-Dimensional modelling of the Cochlear biomechanics is presented in this paper. The Laplace partial differential equation which represents the fluid mechanics of the Cochlea has been transformed into two-dimensional electrical transmission line. The procedure of this transformation is explained in detail. The comparison between one and two dimensional models is also presented. This electrical modelling of the basilar membrane (BM) is clearly useful for the next approach to the further. Development of active elements which are essential in the producing of the sharp tuning of the BM. This paper shows that two-dimension model is qualitatively better than one-dimensional model both in amplitude and phase responses of the BM displacement. The present model is only for frequency response. However because the model is electrical, the two-dimensional transmission line model can be extended to time response without any difficult. 30627 T00401030627 ^x A method has been proposed for the fully automatic detection of left ventricular endocardial boundary in 2D short axis echocardiogram using geometric model. The procedure has the following three distinct stages. First, the initial center is estimated by the initial center estimation algorithm which is applied to decimated image. Second, the center estimation algorithm is applied to original image and then best-fit elliptic model estimation is processed. Third, best-fit boundary is detected by the cost function which is based on the best-fit elliptic model. The proposed method shows effective result without manual intervention by a human operator. 30628 T00401030628 ^x The intelligent trajectory control method that controls moving direction and average velocity for a prosthetic arm is proposed by pattern recognition and force estimations using EMG signals. Also, we propose the real time trajectory planning method which generates continuous accelleration paths using 3 stage linear filters to minimize the impact to human body induced by arm motions and to reduce the muscle fatigue. We use combination of MLP and fuzzy filter for pattern recognition to estimate the direction of a muscle and Hogan's method for the force estimation. EMG signals are acquired by using a amputation simulator and 2 dimensional joystick motion. The simulation results of proposed prosthetic arm control system using the EMf signals show that the arm is effectively followed the desired trajectory depended on estimated force and direction of muscle movements. 30638 T00401030638 ^x A new neural network architecture for the recognition of patterns from images is proposed, which is partially based on the results of physiological studies. The proposed network is composed of multi-layers and the nerve cells in each layer are connected by spatial filters which approximate receptive fields in optic nerve fields. In the proposed method, patterns recognition for complicated images is carried out using global features as well as local features such as lines and end-points. A new generating method of matched filers representing global features is proposed in this network. 30659 T00401030659 ^x An implementation scheme of the magnetic nerve stimulator using a switching mode power supply is proposed. By using a switching mode power supply rather than a conventional linear power supply for charging high voltage capacitors, the weight and size of the magnetic nerve stimulator can be considerably reduced. Maximum output voltage of the developed magnetic nerve stimulator using the switching mode power supply is 3, 000 volts and switching time is about 100 msec. Experimental results or human nerve stimulations using the developed stimulator are presented. 30768 T00401030768 ^x In this paper, we describe the design methodology and specifications of the developed module-based bedside monitors for patient monitoring. The bedside monitor consists of a main unit and module cases with various parameter modules. The main unit includes a 12.1" TFT color LCD, a main CPU board, and peripherals such as a module controller, Ethernet LAN card, video card, rotate/push button controller, etc. The main unit can connect at maximum three module cases each of which can accommodate up to 7 parameter modules. They include the modules for electrocardiograph, respiration, invasive blood pressure, noninvasive blood pressure, temperature, and SpO2 with Plethysmograph.SpO2 with Plethysmograph.

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A Study on Curriculum Development for CHPs (보건진료원 직무교육 교과과정개선을 위한 연구)

  • Kwon Myung-Soon
    • Journal of Korean Public Health Nursing
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    • v.13 no.2
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    • pp.26-44
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    • 1999
  • The study was done to improve the job training course for Community Health Practioners (CHPs) by evaluating the level of help that the training provided to the CHPs in carrying out their work and to analyze the management activities of the CHPs in order to develop a more effective CHP training program. The methodologies used in the study were a questionnaire survey. The survey results were analyzed using SPSS Windows. The study results are as follows. 1. The total average level of help from the job training(Theory. Practice and Field Practice) for carrying out the CHP work was found to be $3.04\pm.53$ (of a possible 4), which indicates a high level of help. The average for clinical practices was $3.16\pm.60$. for theory. $3.11\pm.40$ and for field practice. $2.84\pm.60$. 2. For the theory content of the job training courses. the help level was low in the area of mother and child health management/family planning with an average of $2.65\pm.62$ and in the area of health information system development with an average of $2.62\pm.83$. The reason for these deficiencies were. in order of frequency. few opportunities to apply learning. training content that was inadequate. training methodologies which were incongruent with content. improper training items and insufficient class hours. For the practice. the clinical work in rehabilitation/orthopedics departments and in ENT/Opthalmology departments had averages of $2.96\pm.86$ and $2.97\pm.80$ respectively. This low level resulted from the lack of direct experience. lack of sincerity during the practice time. lack of practice guidance. insufficient time and lack of practice equipment. in that order. For the field practice. the delivery management averaged $2.06\pm.90$ as the lowest help level. In this case 68% of respondents replied that there were no relevant reasons for this deficiency. 21% responsed that there was a lack of direct experience, 7%, a lack of practice guidance and 4.8%, insufficient time. 3. There were significant differences for several demographic variables when comparing the help level of the clinical courses (practice and Field Practice). A higher help level was reported by older nurses as compared to younger ones, experienced nurses as compared to scholarship nurses, and married over single. Also for nurses who had finished more other programs and were qualified or licensed in several areas the level was high. Although it was not statistically significant the level was higher if the work area was in a rural county, not a city, and if one had more recently completed the job training(P<,05). 4. Of the respondents 58.6% replies stated the period of job training for the CHP was adequate, but 51.7% reported that the period for theory courses was too short while an other 48.3% responded that it was sufficient. For practice locations, 50% responsed that it was good to practice in medical institutions(primary, secondary and tertiary) at the same time. While 48.3% agreed that doing theory and practice simultaneously was good, and 56.9% agreed that field practice should be done after completing theory and practice training. Hence, the development of new field practice guidelines suitable for changing environments of health management are required in place of the existing ones which were considered low in help level to the practical work of the CHPs.

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Implementation of KV Cone Beam CT for Image Guided Radiation Therapy (영상유도 방사선치료에서의 KV 콘빔CT 이용)

  • Yoo, Young-Seung;Lee, Hwa-Jung;Kim, Dae-Young;Yu, Ri
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.1
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    • pp.43-49
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    • 2007
  • Purpose: The aim of this study was the clinical implementation of IGRT using KV CBCT for setup correction in radiation therapy. Materials and Methods: We selected 9 patients (3 patient for each region; head, body, pelvis)and acquired 135 CBCT images with CLINAC iX (Varian medical system, USA). During the scan, the required time was measured. We analyzed the result in 3 direction; vertical, longitudinal, lateral. Results: The mean setup errors at the couch position of vertical, lateral, and longitudinal direction were 0.07, 0.12, and 0.1 cm in the head region, 0.3, 0.26, and 0.22 cm in the body region, 0.21, 0.18, and 0.15 cm in the pelvis region respectively. The mean time required for CBCT was $6{\sim}7$ minute. Conclusion: The CBCT on the LINAC provides the capacity for soft tissue imaging in the treatment position and real time monitoring during treatment delivery. With presented workflow, the setup correction within reasonable time for more accurate radiation therapy is possible. And it's image can be very useful for adaptive radiation therapy(ART) in the future with improved image quality.

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A Study on the Sasang Constitution and Type A/B Personality in Kangwon Province (사상체질과 A/B형 성격에 관한 연구)

  • Lee Kyu-Eun;Kim Nam-Sun;Ryu Jae-Gyu
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.2
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    • pp.201-212
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    • 2002
  • Purpose: The purpose of this study was to identify the association between Sasang constitution and type A/B personality. Method: The subjects for this study were 113 Korean adults living in Kangwon Province, the northeastern part of Korea. The data were collected from March 10 to April 13. 2002 using a structured questionnaire. The instrument for this study were QCSSII (Questionnaire for Sasang Constitution Clsssification II) by Kim et al.(1996), and the Revised Type A/B personality by Eysenck & Fulker(1983). The data were analyzed through the SPSS 10.0 for Windows program using frequency, percentage, $x^2$-test, ANOVA, and Pearson correlation coefficient. Results: The results of the study are as follows : 1. Of 113 Korean adults, the portion who were Taieum-in, Soeum-in, Soyang-in was 39.8%, 34.5%, 25.7% respectively. 2. For type A/B personality, mixed type was most common, 19.4% of the participants were of type B and 8.0%., type A. 3. For type A/B behavior, mixed type was most common at 47.8% and type A was 2.7%. 4. There were statistically significant differences in the Sasang constitutional type according to BMI (F=14.542, P<.001), and alcohol consumption (F=4.256, p<.018). 5. There were significant difference between type A/B Personality and BMI (F=3.592, P<.032). 6. The data shows correlations between BMI and amount smoked per day (r=2.74, P<.004), between BMI and alcohol consumption (r=-.303, p<.008), between BMI and Sasang constitutional type (r= -.592, p<.0001), between BMI and type A/B personality (r=285, p<.011), between amount smoked per day and alcohol consumption (r= .-361, p<.001). between alcohol consumption and Sasang constitutional type (r=-.306, p<.019). between perceived health state and type A/A personality (r= .246, p<.011). Conclusion: According to the above findings, it can be concluded that further research is need to understand the Sasang constitution for the discipline of Nursing and for nurses to prepare nursing protocols relevant to Sasang constitutional care. Also, Sasang constitution has to be considered in research and practice in the health care delivery system.

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Pastor's Expectations from Parish Nurses (목회자의 목회간호에 대한 역할기대)

  • Kim, Chung-Nam;Kwon, Young-Sook
    • Research in Community and Public Health Nursing
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    • v.7 no.1
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    • pp.154-169
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    • 1996
  • Parish nursing is a community health nursing role developed in 1983 by Lutheran chaplain Granger Westberg. An increasing emphasis on holistic care, personal reseponsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment and nurturance of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The autors conducted a study on pastor's expectations from parish nurses. Results of this study will be useful to those instrumental in planning, initiating, supporting, and evaluating a parish nurses program The research was done on 130 pastors in Taegue and Kyong Sang Buck Do, of various ages ranging from their 20's to 60's: and pastoring churches of various sizes, ranging from under 100 to over 300 members. 94.6% agreed that they needed a parish nurse on their staff; and 86.2% said they wanted to start a parish nurse program in their churches if certain basic conditions were met. The pastors responded that some would hire the nurses on a full-time basis(22.3%), a part -time basis (37.7%) or use volunteer nurses (40%). The pastors said they would expect the following from a parish nurse: health counselling (80.0%) regular health check-ups (78.5%) health care for the elderly (78.5%) health information and education (72.3%) hospice care (72.3%) visiting sick church members at home (69.2%) arranging and training volunteers to help the seek (59.2%) health care for expectant mothers (50.0%) introducing and taking people to health care facilities (46.2%) The pastors were surveyed about specific areas of health education they would want the parish nurse to teach(for example, high blood pressure and heart disease prevention and management(76.2%) ; stress management(74.6%); and diabetes prevention and management(73.8%). The pastors were surveyed about specific areas of health counselling they would expect the parish nurse to do (for example, drug abuse, (73.1), alcohol abuse(64.6%), marriage conflict(60.0%), recovery after the loss of a loved one(56.9%), and women's conflict with parents-in-law(53.8%). The pastors were surveyed about types of things they would want included in regular health check-ups, what they would want a parish nurse to do on home visits, and what they would want included in home care for the elderly. They were also surveyed on what kind of spiritual care they would like parish nurses to give. Most (90.7%) wanted their parish, parishioners to be involved in the parish nurses program as volunteers, and in a variety of ways(such as visiting sick in their homes(68.5%) and helping with housework(63.1%) and taking sick people to health facilities(60%). Parish nurses role, activities, and boundaries of practice should be continuously monitored and refined and a 'case manager' should be conceptualized as an additional or all-encompassing role. An initial parish / community needs and readiness assessment should be done prior to establishing a program to detemine if the congregation is ready, willing, and able to support such a position for at least a 2 to 3 year period.

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NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY-NEW LONG-ACTING PSYCHOSTIMULANTS (소아청소년 정신과 영역에서의 새로운 약물치료:새로운 장기작용형 중추신경자극제)

  • Choi, Sung-Ku
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.3-11
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    • 2003
  • Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations:the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

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Optimization Model for the Mixing Ratio of Coatings Based on the Design of Experiments Using Big Data Analysis (빅데이터 분석을 활용한 실험계획법 기반의 코팅제 배합비율 최적화 모형)

  • Noh, Seong Yeo;Kim, Young-Jin
    • KIPS Transactions on Computer and Communication Systems
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    • v.3 no.10
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    • pp.383-392
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    • 2014
  • The research for coatings is one of the most popular and active research in the polymer industry. For the coatings, electronics industry, medical and optical fields are growing more important. In particular, the trend is the increasing of the technical requirements for the performance and accuracy of the coatings by the development of automotive and electronic parts. In addition, the industry has a need of more intelligent and automated system in the industry is increasing by introduction of the IoT and big data analysis based on the environmental information and the context information. In this paper, we propose an optimization model for the design of experiments based coating formulation data objects using the Internet technologies and big data analytics. In this paper, the coating formulation was calculated based on the best data analysis is based on the experimental design, modify the operator with respect to the error caused based on the coating formulation used in the actual production site data and the corrected result data. Further optimization model to correct the reference value by leveraging big data analysis and Internet of things technology only existing coating formulation is applied as the reference data using a manufacturing environment and context information retrieval in color and quality, the most important factor in maintaining and was derived. Based on data obtained from an experiment and analysis is improving the accuracy of the combination data and making it possible to give a LOT shorter working hours per data. Also the data shortens the production time due to the reduction in the delivery time per treatment and It can contribute to cost reduction or the like defect rate reduced. Further, it is possible to obtain a standard data in the manufacturing process for the various models.

A Study on the Special Needs of the Hearing-Impaired Person for Disaster Response (청각장애인 재난대응 욕구에 관한 연구)

  • Kim, Soungwan;Kim, Hey Sung;Roh, Sungmin
    • 재활복지
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    • v.21 no.2
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    • pp.63-88
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    • 2017
  • This study evaluated the actual status of special needs of the hearing-impaired person for disaster response. The analysis revealed a significant level of unmet needs in disaster response for hearing-impaired person. The 5 special needs in disaster response include: 1) communication needs, which involve securing the means to make an emergency rescue request and communicating information during the rescue process; 2) transportation needs, which indicate the effective evacuation capacity and the level of training; 3) medical needs, which address the degree of preparedness for physical and mental emergency measures and the delivery of health information for rescue and first aid process; 4) maintaining functional independence needs, which refer to the level of self-preparedness to minimize damage in disaster situations, and; 5) supervision needs, which correspond to a personalized support system provided to disaster-vulnerable groups.

A Review of Clinical Research Trends on Korean Medicine Treatment for Bell's Palsy during Pregnancy (임신 중 벨 마비 한방치료에 대한 국내외 증례 연구 고찰)

  • Hyo-Jeong Kim;Young-Tae Ahn;Ji-Soo Hyun;So-Youn Choi;Back-Jun Kim;Yoon-Jae Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.37 no.3
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    • pp.1-19
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    • 2024
  • Objectives: The purpose of this study is to analysis the clinical study trends on Korean Medicine treatment for Bell's palsy during pregnancy. Methods: Key words such as 'facial palsy', 'Bell's palsy, 'Korean medicine', 'herbal medicine', 'acupuncture', 'pregnancy' were searched through the 'RISS', 'OASIS', 'KISS', 'PubMed' and 'CNKI' databases. Results: Ten clinical studies with 107 patients were selected, and 1 randomized controlled trial and 9 case reports were included as the target studies. In the 9 case reports, the gestational age at the onset of facial palsy was most common in the third trimester (29-42 weeks) in 38 cases (56.7%). The most commonly used Korean medicine interventions were acupuncture, with the most frequently used acupoints being ST4, ST2, ST6, BL2, TE23, LI20, GB1, GB14, SI18, and CV24. The herbal medicine treatment most commonly utilized was Geumgwedanggwi-san (金匱當歸散), which is related to the principles of clearing heat, nourishing blood, and stabilizing the fetus (淸熱養血安胎). Among the 65 participants evaluated using the House-Brackmann facial nerve grading system, 81.5% showed complete recovery to grade 1, while 6% remained at grade 4 with no effect, indicating the efficacy of Korean medicine treatment for facial palsy during pregnancy. All the selected studies reported no abnormalities in the mothers or fetal growth, and all participants who had the reported delivery had full-term childbirth. Conclusions: The effect on Korean Medicine treatment for Bell's palsy during pregnancy had mostly positive results. However, further large, well-designed clinical trials are needed to establish the foundation of Korean Medicine treatment for Bell's palsy during pregnancy.