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A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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Effect of Dietary Streptococcus faecium on the Performances and the Changes of Intestinal Microflora of Broiler Chicks (Streptococcus faecium의 급여가 육계의 성장과 장내 세균총 변화에 미치는 영향)

  • Kim, K.S.;Chee, K.M.;Lee, S.J.;Cho, S.K.;Kim, S.S.;Lee, W.
    • Korean Journal of Poultry Science
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    • v.18 no.2
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    • pp.97-119
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    • 1991
  • Effect of Streptococcus faecium(SF) and an antibiotic, Colistin(Col), supplemented to diets singly or in combination, on the performances and changes of intestinal population of microflora of broiler chicks studied. A total of 252, day-old chicks(Arbor Acre) of mixed sex(M:F=1:1) were alloted into six groups. A diet with no Col and SF was referred as a control diet. The basal diets were added with two levels of SF, 0.04 and 0.08%, singly or in combination with Col 10ppm Another diet was prepared by adding only Col 10 ppm. Numbers of the microorganism in diets added with SF 0.04% and 0.08% were 7$\times$10$^{4}$ and 1.4$\times$10$^{5}$ /g diet respectively The diets consisting of corn and soybean meal as major ingredients were fed for a period of seven weeks . During the feeding trial, fresh excreta were sampled at the end of every week in a sterilized condition to count microbial changes from each dietary group. Microbial changes of large intestine were also measured from nine birds sacrificed at the end of the 4th and 7th weeks each time per dietary group. Excreta from all the groups were also collected quantitatively at the end of 3rd and 6th weeks to measure digestibility of the diets, At the end of 7th week, nine birds from each group were also sacrificed to measure weight changes of gastrointestinal tracts . Average body weight gains of broilers fed the diets added with SF 0.08% (2.37kg) or SF 0. 08%+col 10ppm(2.34kg) were significantly larger than that of the control(2.18kg). The weight gains of the other groups were not statistically different from that of the control Feed/gain ratios of the supplemental groups were better than that of control (P<0.05) except that of birds fed the diet added only with SF 0.04%. Digestibilities of nutrients such as dry matter, crude protein, crude fat and total carbohydrates were not altered by the consumption of the diets added with SF and/or Col throughout the whole feeding period. As expected, the numbers of Streptococci in the excreta from birds fed diets added with SF increased significantly with a statistical difference between groups with SF 0.04% and SF 0.08% most of the time. However. addition of Colistin to the diets supplemented with SF did not give any effects on the number of the microorganism. Numbers of coliforms in the excreta were apparently reduced by feeding the diets added with SF and/or Col(P<0.05). There were, however, no additive effects observed between the two feed additives in this regard when supplementing Col to the SF diets. Distributions of intestinal microflora exhibited exactly the same pattern as those of the excreta. Length of small intestine of the birds fed diets added with SF 0.08% with or without Col 10 ppm became significantly longer with a range of about 10% than those of the birds fed diets without SF. However, the empty weight of the small inestine of the former group was lighter than that of control These changes resulted in a significant reduction in weight/unit length of the intestine of the birds fed diets supplemented with Col and SF singly or in combination. In overall conclusion, diet added with SF 0.08% appeared most effective in improving broiler performances. Colistin added at a level of 10ppm was not beneficial at all in itself or in combination with SF in terms of broiler performances or changes of intestinal microflora population. The efficacy of SF and Col could be attributed to the changes of wall thickness of the small intestine.

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Effect of Different PE Mulching Duration on the Competition Ability of Sesame Growing in Association with Various Weed Communities (비닐피복기간(被覆期間)이 잡초군락형성(雜草群落形成)에 참깨의 경합력(競合力)에 미치는 영향(影響))

  • Lee, J.I.;Kang, C.W.;Kwon, Y.W.
    • Korean Journal of Weed Science
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    • v.6 no.1
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    • pp.33-41
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    • 1986
  • This experiment was conducted to determine the influence of weed competition in sesame and the periods for weed control. Competition periods (days), for which sesame was seeded under transparent polyethylene film at May 15, were 10, 15, 30, 45, 60, 75, 90, and full growth season of sesame. Weed control periods (days), for which sesame was seeded under black polyethylene film at June 15, were 10, 15, 30, 45, 60, and full growth season of sesame. Dominant weeds were Ponulaca oleracea, Digitaria sanguinalis, Acalypha australis, L. Cyperus arnuricus, Arenaria aesrphllifolia, Cardamine flexucosa, Mollugo Stricta and Digitaria eschaemum. The number of weeds was maximum at the 30 days after planting. Broad leaf weeds were dominant than grass weeds, and then decreased the total number of weeds by the reason of major decrease of broad leaf weeds. However, the weight of weeds increased continuously. No weeds appeared until the 15 days after planting and the weight of broad leaf weeds was heavier than that of grass weeds until 45 days after planting. However, grass weeds were heavier than broad leaf weeds after 60 days after planting. The hazards of weeds on the growth and development appeared seriously from the 60 to 75 days after planting, but main yield reduction appeared from 30 days after planting. Therefore once more hand weeding should be practiced within 30 days after planting to minimize yield decrease. Serious hazards by weed growing appeared by removing black PE film after 15 to 30 days after planting in growth characteristics and 30 days later in grain yield. Leaf growth showed maximum from 45 to 60 days after planting and then decreased as compared with the continuous increase of stem and root in optimum planting, transparent PE film mulch and hand weeding. Leaf growth didn't show reducing in PE film mulch and weedy check but total weight of weeds increased and growth of sesame decreased as compared to PE film mulch and hand weeding. Leaf, stem and root growth of sesame, and weed weight under black PE film mulch showed same tendancy and lower growth of sesame as compared with optimum planting, transparent PE film mulch. Correlation between sesame yield and weeds weight were r =$ -0.874^{**}$ in the optimum planting and r = $-0.712^{**}$ in the late planting, so that the more weeds increase, the lesser sesame yield.

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Characteristics and classification of paddy soils on the Gimje-Mangyeong plains (김제만경평야(金堤萬頃平野)의 답토양특성(沓土壤特性)과 그 분류(分類)에 관(關)한 연구(硏究))

  • Shin, Yong Hwa
    • Korean Journal of Soil Science and Fertilizer
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    • v.5 no.2
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    • pp.1-38
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    • 1972
  • This study, designed to establish a classification system of paddy soils and suitability groups on productivity and management of paddy land based on soil characteristics, has been made for the paddy soils on the Gimje-Mangyeong plains. The morphological, physical and chemical properties of the 15 paddy soil series found on these plains are briefly as follows: Ten soil series (Baeggu, Bongnam, Buyong, Gimje, Gongdeog, Honam, Jeonbug, Jisan, Mangyeong and Suam) have a B horizon (cambic B), two soil series (Geugrag and Hwadong) have a Bt horizon (argillic B), and three soil series (Gwanghwal, Hwagye and Sindab) have no B or Bt horizons. Uniquely, both the Bongnam and Gongdeog series contain a muck layer in the lower part of subsoil. Four soil series (Baeggu, Gongdeog, Gwanghwal and Sindab) generally are bluish gray and dark gray, and eight soil series (Bongnam, Buyong, Gimje, Honam, Jeonbug, Jisan, Mangyeong and Suam) are either gray or grayish brown. Three soil series (Geugrag, Hwadong and Hwagye), however, are partially gleyed in the surface and subsurface, but have a yellowish brown to brown subsoil or substrata. Seven soil series (Bongnam, Buyong, Geugrag, Gimje, Gongdeog, Honam and Hwadong) are of fine clayey texture, three soil series (Baeggu, Jeonbug and Jisan) belong to fine loamy and fine silty, three soil series (Gwanghwal, Mangyeong and Suam) to coarse loamy and coarse silty, and two soil series (Hwagye and Sindab) to sandy and sandy skeletal texture classes. The carbon content of the surface soil ranges from 0.29 to 2.18 percent, mostly 1.0 to 2.0 percent. The total nitrogen content of the surface soil ranges from 0.03 to 0.25 percent, showing a tendency to decrease irregularly with depth. The C/N ratio in the surface soil ranges from 4.6 to 15.5, dominantly from 8 to 10. The C/N ratio in the subsoil and substrata, however, has a wide range from 3.0 to 20.25. The soil reaction ranges from 4.5 to 8.0. All soil series except the Gwanghwal and Mangyeong series belong to the acid reaction class. The cation exchange cpacity in the surface soil ranges from 5 to 13 milliequivalents per 100 grams of soil, and in all the subsoil and substrata except those of a sandy texture, from 10 to 20 milliequivalents per 100 grams of soil. The base saturation of the soil series except Baeggu and Gongdeog is more than 60 percent. The active iron content of the surface soil ranges from 0.45 to 1.81 ppm, easily-reduceable manganese from 15 to 148 ppm, and available silica from 36 to 366 ppm. The iron and manganese are generally accumulated in a similar position (10 to 70cm. depth), and silica occurs in the same horizon with that of iron and manganese, or in the deeper horizons in the soil profile. The properties of each soil series extending from the sea shore towards the continental plains change with distance and they are related with distance (x) as follows: y(surface soil, clay content) = $$-0.2491x^2+6.0388x-1.1251$$ y(subsoil or subsurface soil, clay content) = $$-0.31646x^2+7.84818x-2.50008$$ y(surface soil, organic carbon content) = $$-0.0089x^2+0.2192x+0.1366$$ y(subsoil or subsurface soil, pH) = $$-0.0178x^2-0.04534x+8.3531$$ Soil profile development, soil color, depositional and organic layers, soil texture and soil reaction etc. are thought to be the major items that should be considered in a paddy soil classification. It was found that most of the soils belonging to the moderately well, somewhat poorly and poorly drained fine and medium textured soils and moderately deep fine textured soils over coarse materials, produce higher paddy yields in excess of 3,750 kg/ha. and most of the soils belonging to the coarse textured soils, well drained fine textured soils, moderately deep medium textured soils over coarse materials and saline soils, produce yields less than 3,750kg/ha. Soil texture of the profile, available soil depth, salinity and gleying of the surface and subsurface soils etc. seem to be the major factors determining rice yields, and these factors are considered when establishing suitability groups for paddy land. The great group, group, subgroup, family and series are proposed for the classification categories of paddy soils. The soil series is the basic category of the classification. The argillic horizon (Bt horizon) and cambic horizon (B horizon) are proposed as two diagnostic horizons of great group level for the determination of the morphological properties of soils in the classification. The specific soil characteristics considered in the group and subgroup levels are soil color of the profile (bluish gray, gray or yellowish brown), salinity (salic), depositonal (fluvic) and muck layers (mucky), and gleying of surface and subsurface soils (gleyic). The family levels are classified on the basis of soil reaction, soil texture and gravel content of the profile. The definitions are given on each classification category, diagnostic horizons and specific soil characteristics respectively. The soils on these plains are classified in eight subgroups and examined under the existing classification system. Further, the suitability group, can be divided into two major categories, suitability class and subclass. The soils within a suitability class are similar in potential productivity and limitation on use and management. Class 1 through 4 are distinguished from each other by combination of soil characteristics. Subclasses are divided from classes that have the same kind of dominant limitations such as slope(e), wettness(w), sandy(s), gravels(g), salinity(t) and non-gleying of the surface and subsurface soils(n). The above suitability classes and subclasses are examined, and the definitions are given. Seven subclasses are found on these plains for paddy soils. The classification and suitability group of 15 paddy soil series on the Gimje-Mangyeong plains may now be tabulated as follows.

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The Effects of Nitrogen Type and Fertilized Depth on Leaching and Absorption of Nitrogen in Paddy Soil and Growth and Yields of Rice (질소비료(窒素肥料)의 형태(形態)와 시용심도(施用深度)가 질소(窒素)의 용탈흡수(溶脫吸收) 및 수도(水滔) 생육수량(生育收量)에 미치는 영향(影響))

  • Maeng, D.W.;Cho, C.Y.;Lee, D.S.
    • Korean Journal of Soil Science and Fertilizer
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    • v.1 no.1
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    • pp.43-60
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    • 1968
  • In order to find the effects of nitrogen type (ammonium sulfate and urea fertilizer) and fertilized depth, (0~10cm, 0cm, 5~10cm, 10~15cm, 15~20cm, and 20cm below) on leaching and absorption of nitrogen in paddy soil, and growth and yields of rice, the pot culture experiment was carried out, using the variety Jaekun, one of the Korean leading variety. Experimental results were Summarized as follows: 1. No variations of the pH of percolating water were induced by the differences of nitrogen types and their fertilized depth (Table. 2). 2. The leaching of nitrogen was less in ammonium sulfate and top soil fertilizing plots than in urea and subsoil fertilizing plot, and the growth of rice in early stage was more promoted in ammonium sulfate and topsoil fertilizing plots (Table. 1, 7 and 8). 3. Leachng of nitrogen through the percolating water almost came to an end at the most numerous tiller stage (Table 1). 4. The absorption of nitrogen of each part of the rice plant in the harvesting stage correlated closely with the yields of each part (Table 5, 6, 9 and 10) and the leaching of nitrogen in the early stage was inversely proportion to the absorption of nitrogen of rice plant in the harvesting time (Table 1, 5, 6, 9 and 10). 5. The number of spikes was more numerous in ammonium sulfate plots than in urea plots on an average, so that the yields were higher in the ammonium sulfate plots than in urea plots although no differences in the grain number per spike were found in above two plots. The number of spikes was more numerous in topsoil fertilizing plots than in subsoil fertilizing plots, but the grain number per spike was less in former than in latter, so that no difference in yields was found. The absorption of nitrogen correlated closely with the yields in complete paddy grains (Table 5, 9, and 10). 6. At the ammonium sulfate fertilizing plots, the number of spikes was more numerous in topsoil fertilizing plots than in subsoil fertilizing plots, (among the each of the topsoil plots, 0~10cm and 5~10cm fertilizing plots kept more spikes than the 0cm fertilizing plots), but the grain number per spike was less in former than in latter (among the each of topsoil plots, no differences were found), so that no significant difference in yields was showed between the topsoil and subsoil fertilizing plots, but the results showed the tendency that the yields were highest in 0~10cm plots and the lowest in 20cm below plots. At the urea fertilizing plots, the number of spikes decreased in proportion to the increasing of fertilized depth, but no variations were found in the grain number per spike, so that the yields decreased in proportion to the increasing of fertilized depth. The absorption of nitrogen correlated closely with the yields in complete paddy grains (Table 5, 6, 9, and 10). 7. When fertilized in topsoil, the number of spikes was more numerous in ammonium sulfate plot than in urea plot, but the grain number per spike variated reversely, so that no differences were found in the yields between the ammonium sulfate and the urea plots, when fertilized in subsoil, both the number of spikes and the grain number per spike were larger in ammonium sulfate than in urea plot, so that the yields were also higher in ammonium sulfate plots (Table 5, 6, 9 and 10). 8. The weight of straw and its nitrogen absorption were higher in ammonium sulfate plot than in urea plot and decreased in proportion to the increasing of fertilized depth. Among the each of topsoil fertilizing plots, the 0~10cm and the 5~10cm fertilizing plots excelled the 0cm plot (Table 5, 6, 9 and 10). 9. No significant variations in the fertilizer treatments were found in the characters of heading date, maturing date, length of culm, length of spike, weight of empty grain, 1,000 grain weight, and one liter weight.

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