• Journal of the Ergonomics Society of Korea
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• v.28 no.1
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• pp.37-51
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• 2009

The nuclear power industry in the world has recognized the importance of integrating non-technical and team skills training with the technical training given to its control room operators to reduce human errors since the Three Mile Island and Chernobyl accidents. The Nuclear power plant (NPP) industry in Korea has been also making efforts to reduce the human errors which largely have contributed to 120 nuclear reactor trips from the year 2001 to 2006. The Crew Resource Management (CRM) training was one of the efforts to reduce the human errors in the nuclear power industry. The CRM was developed as a response to new insights into the causes of aircraft accidents which followed from the introduction of flight recorders and cockpit voice recorders into modern jet aircraft. The CRM first became widely used in the commercial airline industry, but military aviation, shipboard crews, medical and surgical teams, offshore oil crews, and other high-consequence, high-risk, time-critical industry teams soon followed. This study aims to develop a CRM training program that helps to improve plant performance by reducing the number of reactor trips caused by the operators' errors in Korean NPP. The program is; firstly, based on the work we conducted to develop a human factors training from the applications to the Nuclear Power Plant; secondly, based on a number of guidelines from the current practicable literature; thirdly, focused on team skills, such as leadership, situational awareness, teamwork, and communication, which have been widely known to be critical for improving the operational performance and reducing human errors in Korean NPPs; lastly, similar to the event-based training approach that many researchers have applied in other domains: aircraft, medical operations, railroads, and offshore oilrigs. We conducted an experiment to test effectiveness of the CRM training program in a condition of simulated control room also. We found that the program made the operators' attitudes and behaviors be improved positively from the experimental results. The more implications of the finding were discussed further in detail.

• The Journal of Advanced Prosthodontics
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• v.5 no.1
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• pp.29-35
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• 2013

PURPOSE. To longitudinally assess the quality of life in maxillectomy patients rehabilitated with obturator prosthesis. MATERIALS AND METHODS. Thirty-six subjects were enrolled in the span of 16 months, out of which six were dropouts. Subjects (age group 20-60 years) with maxillary defects, irrespective of the cause, planned for definite obturator prosthesis, were recruited. The Hindi version of European Organization for Research and Treatment of Cancer, Head and Neck version 1 of Quality of Life Questionnaire was used before surgical intervention and one month after definitive obturator. Questionnaire includes 35 questions related to the patient's physical health, well being, psychological status, social relation and environmental conditions. The data were processed with statistical package for social science (SPSS). Probability level of P<.05 was considered statistically significant. RESULTS. The quality of life after rehabilitation with obturator prosthesis was 81.48% (${\pm}13.64$) on average. On item-level, maximum mean scores were obtained for items problem with teeth ($1.87{\pm}0.94$), pain in mouth ($1.80{\pm}0.92$), trouble in eating ($1.70{\pm}0.88$), trouble in talking to other people ($1.60{\pm}1.22$), problems in swallowing solid food ($1.57{\pm}1.22$) and bothering appearance ($1.53{\pm}1.04$); while minimum scores were obtained for the items coughing ($1.17{\pm}0.38$), hoarseness of voice ($1.17{\pm}0.53$), painful throat ($1.13{\pm}0.43$), trouble in having social contacts with friends ($1.10{\pm}0.40$) and trouble having physical contacts with family or friends ($1.10{\pm}0.31$). CONCLUSION. Obturator prosthesis is a highly positive and non-invasive approach to improve the quality of life of patients with maxillectomy defects.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.966-972
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• 1997

Between June 1994 to August 1996, 13 patients underwent emergency coronary artery bypass operations. There were 3 males and 10 females and ages ranged from 56 to 80 years with the mean of 65.5 years. The indications for emergency operations were cardiogenic shock in 12 cases and intractable polymorphic VT(ve'ntricular tachycardia) in 1 case. The causes of cardiogenic shock were acute evolving infarction in 6 cases, PTCA failure in 4 cases, acute myocardial infarction in 1 case, and post-AMI VSR(ventricular septal rupture) in 1 case. Pive out of 13 patients could go to operating room within 2 hours. However, the operations were delayed from 3 to 10 hours in 8 patients due to non-medical causes. In 12 patients, 37 distal anastomoses were constructed with only 3 LITA's(left internal thoracic arteries) and 34 saphenous veins. In a patient with post-AMI VSR, VSR repair was added. In a patient with intractable VT and critical sten sis limited to left main coronary artery, left main coronary angioplasty was performed. Pive patients died after operation with the operative mortality of 38.5%. Three patients died in the operating room due to LV pump failure, one patient died due to intractable ventricular tachycardia on postoperative second day, and one patient died on postoperative 7th day due to multi-organ failure with complications of mediastinal bleeding, low cardiac output syndrome, ARF, and lower extremity ischemia due to IABP. In 8 survived patients, 3 major complications (mediastinitis, PMI, UGI bleeding) developed but eventually recovered. We think that the aggressive approach to critically ill patients will salvage some of such patients and the most important factor for patient salvage is early surgical intervention before irreversible damage occurs.

• Journal of Korean Academy of Nursing
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• v.20 no.3
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• pp.324-340
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• 1990

Support has always been considered an important nursing concept. However, there is no agreement among nurse researchers as to a conceptual definition of supportive nursing or meaningful supportive behaviors. Clarification of the concept, support in nursing, is necessary to promote communication among nurses on nursing behaviors that are effective in providing support and on understanding the relevant properties and charcteristics of the concept, supportive nursing care. The objectives of the study were : 1. to analyse the concept, support in nursing, in order to provide a definition of supportive nursing care, and 2. to operationalize the definition of supportive nursing care and use it as an experimental nursing intervention for patients with low back pain. The first part of the study used the concept analysis approach developed by Walker and Avant(1983) to define the concept of supportive nursing care. The properties of supportive nursing care, defined by this analysis, included perception of supportive need, reciprocal interaction(Transaction), listening, providing empathy and information related to health, and confirmation of the patient's verbal and non - verbal response. The second part, the experimental part of the study, was done using King's(1970) Interpersonal Theory for Nursing. The concept, supportive nursing care, as defined in the concept analysis was operationalized and used as the experimental intervention. The experiment tested the effectiveness of the independent variable, supportive nursing care on the dependent variables, depression, mood and patient satisfaction, in the patients with low back pain in army hospitals. The instruments used to measure the dependent variables were Zung's(1965) Self- Rating Depression Scale, Ryman and Colleagues'(1974) Mood Questionnaire and LaMonica and Colleagues'(1986) Patient Satisfaction Scale. The experimental design used for this study was a Solomon 4 group experimental design. This design has the strength of allowing for observation of the main effects of supportive nursing care and pretesting, and for observation of the interaction effects of pretesting and supportive nursing care. The design includes one experimental group and three control groups. The Subjects of this study were 150 young male patients with low back pain on Neuro - Surgical Wards in three general army hospitals. There were 35 in the experimental group, 39 in the pre - posttest control group, 36 in the treatment - posttest control group and 40 in the posttest only control group. Supportive nursing care, as operationalized by the researcher according to the concept analysis, was given to the patients in the experimental group and the treatment -posttest control group, individually for 30 minute sessions, every other day for 5 days. Data collection was done using a questionnaire. The data were collected in a pretest one week before the supportive nursing care sessions, a posttest immediately after the sessions and follow- up test one week later. Hypotheses testing was done using 2×2 factorial analysis of variance and Meta analysis(Stouffer's Z method). The results of this study are summarized as follows : 1. Hypothesis Ⅰ, “There will be a difference on depression level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F＝8.49, p＜.05). 2. Hypothesis Ⅱ, “There will be a difference on mood level between the patients with low back pain who receive supportive nursing care and those who to not receive supportive nursing care”, was supported (Z meta＝2.17, p＜.05). 3. Hypothesis Ⅲ, “There will be a difference on satisfaction level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F＝13.67, p＜.05). 4. ANOVA, done to examine the interaction effect of history and maturation, showed no significant difference on the dependent variables between the observations of the pretest scores of the experimental group, the pretest scores of the pre- posttest control group and the posttest score of the posttest only control group. 5. To test for continuing effect of supportive nursing care, paired t-test was done to compare the scores for the dependent variables at the posttest and at the one week later follow-up test. No significant difference on the scores for the dependent variables was found between the posttest scores and the follow-up test scores for the two groups that received supportive nursing care, the experimental group and the treatment-posttest control group. In conclusion, it was found that in the case of young soldiers with low back pain in army hospitals, their depression level was decreased, their mood state was changed positively and their satisfaction level was increased by receiving supportive nursing care. Further, the effectiveness of the supportive nursing care lasted for at least one week in this study. The significance of this study to nursing is in the analysis of the concept of supportive nursing care and the demonstration of the effectiveness of supportive nursing care as an intervention within the limits of the study.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.35-45
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• 2011

Purpose: The purpose of this study was to document the structural features of the tendinous portions within the non-pathologic subscapularis muscle by performing high resolution MR imaging of the shoulder. Materials and Methods: Between April 2007 and May 2010, we retrospectively obtained the MR scans of 88 consecutive young patients (88 shoulders) who were in their twenties. MRI and MR arthrography were performed using a 3.0-T system for the evaluation of glenohumeral instability and nonspecific shoulder pain. None of the patient in this study had any evidence of injury to the tendon or muscle belly of the subscapularis. On MR images, we recorded the transverse length of a stout tendinous band and the total tendinous portion of the subscapularis. In addition, we recorded the number of intramuscular tendinous slips of the susbscapularis. Results: The mean transverse length of the tendinous band was 15.0 mm (range: 8 to 20 mm). The mean transverse length of the total tendinous portion was 48.9 mm (range: 40 to 60 mm). The number of intramuscular tendinous slips on the base of the glenoid fossa was 3 in 20 (22.72%), 4 in 45 (51.14%) and 5 in 23 shoulders (26.14%). On the lateral portion, the intramuscular tendinous slips became gradually rounder and thicker and they gave converge in the superior direction. Conclusion: In this study, the structural features of the tendinous portions of the subscapularis on the MR scans were identified. This will in return give good justification for the lines to be pulled during biomechanical stimulation and also for the surgical approach to restore the biomechanical function.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.27-32
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• 2006

Purpose : Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). Methods : A retrospective analysis was made on 45 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. Results : Median follow-up time was 30 months(range 2-102 months). All patients under-went radionuclide scans and voiding eystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). Conclusion : In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.