• 간호행정학회지
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• 제6권2호
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• pp.211-225
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• 2000

With the drastically changing healthcare market, the adoption of DRG system and the use of Critical Pathway will be increased gradually in order to care hospitalized patients qualitatively and manage cost-effectively in Korea. The purpose of this quasi-experimental research is to apply and analyze the developed critical pathway to the patients with Cesarean section. 35 eligible subjects for the control group were chosen from postpartum patients who has delivered at H-hospital in Kwang-ju, and were questioned after appling previous care plan from May to December, 1998. For the experimental group, 37 subjects were chosen and questioned after applying Critical Pathway service from January to June, 1999. The instruments are a critical pathway for the patients with Cesarean section developed by chung(1998) and a questionnaire that evaluate patients and family members' satisfaction level. Also, educational materials were used to inform them in the process of Critical Pathway application. As a result of chi-square test on general characteristics, there is significant difference between control group and experimental group only in terms of room size(p= .010). There are no significant differences in the average length of stay in the hospital between control group and experimental group(t=.078). Also, the average medical consult fee has no difference significantly between two groups(t= .105). The findings showed that the experimental group with critical pathway service scored significantly higher than control group on the satisfaction level toward care services(p=.000). The items are post-operative care, postpartum exercise technique, breast feeding and breast manage through educational materials. In conclusion, the research indicates that the application of planned Critical Pathway can have a positive impact on satisfaction level of inpatients with Cesarian section.

• Structural Engineering and Mechanics
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• 제70권1호
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• pp.33-41
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• 2019

The influence of two parameters on fatigue damage predictions of a variably loaded cantilever beam has been examined. The first parameter is the geometry of the cantilever beam and the weld connecting it to a rear panel. Variables of the geometry examined here include the cantilever length, the weld width on the critical cross-section and the angle of the critical cross-section. The second parameter is the safety factor, as set out by the Eurocode 3 standard. An analytical approach has been used to calculate the stresses at the critical cross-section and standard rainflow counting has been used for the extraction of the load cycles from the load history. The results here suggest that a change in the width and angle of the critical cross-section has a non-linear impact on the fatigue damage. The results also show that the angle of the critical cross-section has the biggest influence on the fatigue damage and can cause the weld to withstand fatigue better. The second parameter, the safety factor, is shown to have a significant effect on the fatigue damage calculation, whereby a slight increase in the endurance safety factor can cause the calculated fatigue damage to increase considerably.

• 한국간호교육학회지
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• 제4권1호
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• pp.66-80
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• 1998

With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

• 한국농공학회지
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• 제29권3호
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• pp.153-162
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• 1987

A numerical procedure for the analysis of slender arch buckling problems for uniform dead weight is presented in this paper. Such loading changes in the arch profile. The problem is nonlinear. The numerical procedure is limited to an inextensible analysis and to elastic behavior. Based upon a numerical integration technique developed by Newmark for straight beams, a large deflection bending analysis is combined with small deflection buckling routines to formulate the numerical procedure. The numerical procedure is composed of a combination of the numerical integration and successive approximations procedure. The results obtained in this study are as follows : 1.The critical loads obtained in this study coincide with the results by Austin so that the algorithm developed in this study is verified. 2.The numerical results are converged with good precision when the half arch is divided into 10 segments in both Prime and Quadratic section. 3.The critical loads are decreased as the ratios of rise versus span are increased. 4.The critical loads are increased as the moments of inertia at the ends are increased. 5.The critical loads of Prime section are larger than that of Quadratic section under the same profile conditions.

• 한국콘크리트학회:학술대회논문집
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• 한국콘크리트학회 2006년도 춘계학술발표회 논문집(I)
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• pp.370-373
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• 2006

According to current design provisions for shear strength of reinforced concrete slabs, critical slab sections around columns should be modified in the presence of openings in slabs to consider the effect of openings on the shear strength of slabs. Although the method of estimating the ineffective part of critical section due to openings are explained in codes, the real math for calculating it is somewhat complex and cumbersome. This paper classifies different cases of the location and geometry of columns and openings, respectively, and derives corresponding equations for estimating ineffective part of critical section for each case.

• Steel and Composite Structures
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• 제33권1호
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• pp.133-142
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• 2019

In the present study, microstructure-dependent static stability analysis of inhomogeneous tapered micro-columns is performed. It is considered that the micro column is made of functionally graded materials and has a variable cross-section. The material and geometrical properties of micro column vary continuously throughout the axial direction. Euler-Bernoulli beam and modified couple stress theories are used to model the nonhomogeneous micro column with variable cross section. Rayleigh-Ritz solution method is implemented to obtain the critical buckling loads for various parameters. A detailed parametric study is performed to examine the influences of taper ratio, material gradation, length scale parameter, and boundary conditions. The validity of the present results is demonstrated by comparing them with some related results available in the literature. It can be emphasized that the size-dependency on the critical buckling loads is more prominent for bigger length scale parameter-to-thickness ratio and changes in the material gradation and taper ratio affect significantly the values of critical buckling loads.

• Neonatal Medicine
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• 제25권1호
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• pp.1-6
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• 2018

Extremely low birth weight infants remain at increased risk of intraventricular hemorrhage from the fragile vascular bed of the germinal matrix; the roles of hypotension (ischemia) and reperfusion (hyperemia) in the development of intraventricular hemorrhage are still debated. Cerebrovascular pressure autoregulation protects the brain by maintaining constant cerebral blood flow despite changes in blood pressure. The ontogeny of cerebrovascular pressure autoregulation has not been well established and uncertainty remains about the optimal arterial blood pressure required to support brain perfusion. Another important aspect of premature cerebral hemodynamics is the critical closing pressure--the arterial blood pressure at which cerebral blood flow ceases. Interestingly, in premature infants, the critical closing pressure approximates the mean arterial blood pressure. Often in this unique population, cerebral blood flow occurs only during systole when the diastolic arterial blood pressure is equal to the critical closing pressure. Moreover, the diastolic closing margin, a metric of cerebral perfusion that normalizes diastolic arterial blood pressure to the critical closing pressure, may be a better measure than arterial blood pressure for defining cerebral perfusion in premature infants. Elevated diastolic closing margin has been associated with intraventricular hemorrhage. This review summarizes the current state of understanding of cerebral hemodynamics in premature infants.

• Structural Engineering and Mechanics
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• 제82권4호
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• pp.517-542
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• 2022

The effect of mean angle of wind attack on the flutter critical wind speed of two generic bridge deck cross-sections, viz, one closed box type streamlined section (deck-1) and closed box trapezoidal bluff type section with extended flanges/overhangs (deck-2) type of section have been studied using Computational Fluid Dynamics (CFD) based forced vibration simulation method. Owing to the importance of the effect of the amplitude of forcing oscillation on the flutter onset, its effect on the flutter derivatives and flutter onset have been studied, especially at non-zero mean angles of wind attack. The flutter derivatives obtained have been used to evaluate flutter critical wind speeds and flutter index of the deck sections at non-zero mean angles of wind attack studied and the same have been validated with those based on experimental results reported in literature. The value of amplitude of forcing oscillation in torsional degree of freedom for CFD based simulations is suggested to be in the range of 0.5° to 2°, especially for bluff bridge deck sections. Early onset of flutter from numerical simulations, thereby conservative estimate of occurrence of instability has been observed from numerical simulations in case of bluff bridge deck section. The study aids in gaining confidence and the extent of applicability of CFD during early stages of bridge design, especially towards carrying out studies on mean incident wind effects.

• 한국의료질향상학회지
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• 제7권1호
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2001년도 춘계학술대회논문집D
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• pp.195-200
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• 2001

An experimental study on critical heat flux (CHF) has been performed for water flow in a uniformly heated vertical 3 by 3 rod bundle under low flow and a wide range of pressure conditions. The objective of this study is to investigate the parametric trends of CHF with 3 by 3 rod bundle test section where three unheated rods exist. The general trends of the CHF are coincident with previous understandings. At low flow and system pressure above 3 MPa, some critical qualities are larger than 1.0 due to counter-current flow in test sections. Since there is a supply of water to the heated section from unheated section, the maximum CHFs at system pressure between 2 and 4 MPa are not shown.