• Title/Summary/Keyword: feeding unit

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Current Situation on Signing Advance Medical Directives and Actual Life-sustaining Treatment Given at a University Hospital (일개 대학병원의 연명치료 선택 및 사전의료의향서 작성 현황)

  • Yoon, Ho-Min;Choi, Youn-Seon;Hyun, Jong-Jin
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.91-100
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    • 2011
  • Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

The Effect of Hen Age on Egg Quality in Commercial Layer (실용산란계의 산란연령이 계란의 품질에 미치는 영향)

  • Lee, Min Hee;Cho, Eun Jung;Choi, Eun Sik;Bang, Min Hee;Sohn, Sea Hwan
    • Korean Journal of Poultry Science
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    • v.43 no.4
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    • pp.253-261
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    • 2016
  • Egg quality is a very important factor for both consumers and producers. Factors affecting egg quality include strain and age of hens; egg storage temperature, time, and humidity; laying season; and feeding. This study aimed to determine the effect of hen age and egg storage time on egg quality. A total of 700 eggs obtained from Hyline Brown commercial layers were used for this experiment, and they were separated into two hen age groups (30 vs. 60 weeks) with eight treatments and four storage times (day 0, 10, 20, and 30). The egg weight; shell color, thickness, and density; albumen height; Haugh unit (HU); yolk color; and the yolk and albumen pH and viscosity were measured for the egg quality assessment. The results showed that the age of the hen and egg storage time significantly affected almost all parameters of the internal and external egg quality. The shell thickness, albumen height, HU, yolk color, pH of yolk and albumen, and yolk viscosity significantly decreased with increasing hen age. The egg shell color was significantly lighter in eggs from 60-week-old hens than in those from 30 weeks-old hens. The egg weight; shell weight, thickness, and density; albumen height, HU; and albumen viscosity significantly decreased, but the yolk color and pH of the yolk and albumen increased with increasing egg storage time. The interaction effects between the storage time and hen age were significant in shell thickness, albumen height, yolk color, and yolk and albumen pH and viscosity. The eggs obtained from 60-week-old hens showed significantly lower shell thickness, albumen height, and HU values, which are considered typical egg quality measurements, than values of eggs from 30-week-old hens. Therefore, increasing hen age and egg storage time caused the deterioration of egg quality. In conclusion, this study demonstrated that hen age is the major factor affecting the quality of fresh eggs, whereas the storage time is the determinant factor affecting the quality of stored eggs.

Hepatic Oxygen Free Radical and Alcolhol Metabolizing Enzyme Activities in Rats Fed Diets Supplemented with Lycium chinense Ethanol Extract (흰쥐에 있어서 구기자 추출물 첨가식이가 간조직의 유해산소 및 알콜대사 효소활성에 미치는 영향)

  • 윤종국;김현희;채순님;오만진;이규희
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.4
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    • pp.668-672
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    • 2001
  • To investigate the oxygen free radical and alcohol metabolizing system in liver of rats fed diets with 30% ethanol extract of Lycium chinense (LCEE), Sprague-Dawley male rats weighing 225~235g have been fed a diet supplemented with 2% or 4% LCEE for a month. The rats fed LCEE supplemented diets gained less body weight compared with the control, and had no remarkable changes of liver function. In rats fed 2% LCEE supplemented diet, hepatic cytochrome P450 contents appeared to be increased, but catalase (204.88$\pm$20.06 $H_2O$$_2$nmoles/mg protein/min), and superoxide dismutase (13.18$\pm$0.74 Unit/mg protein) activities were significantly increased compared with control 120.28$\pm$26.99 $H_2O$$_2$nmoles/mg protein/min and 10.49$\pm$0.80 Units/mg protein). There was no difference in hepatic glutathione content, glutathione peroxidase, and glutathione-S-transferase ctivities between the rats fed LCEE suplemented diets and the control diet. On the other hand, hepatic alcohol dehydrogenase activity were not changed by LCEE feeding, but hepatic aldehyde dehydrogenase activities were significantly increased in rats fed both 2 and 4% LCEE diets(5.01$\pm$0.21 and 4.47$\pm$0.06 $\mu$moles NADPH/mg protein/min) compared with control (3.28$\pm$0.21 $\mu$moles NADPH/mg protein/min) and its Vmax value was 1.9 fold increased in rats fed 2% LCEE and 1.5 fold in those fed 4% LCEE compared with control. In conclusion, it is likely that rats receiving a diet supplemented with LCEE may have the oxygen free radicals and alcohol detoxication potential.

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Development of a Home-based Nursing Intervention, Mothering Program for Low-Birth-Weight Infants (저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구)

  • Han, Kyung-Ja
    • Journal of Home Health Care Nursing
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    • v.8 no.1
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    • pp.5-24
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    • 2001
  • The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

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Effects of Supplementary Immune Modulators(MOS, Lectin) and Organic Acid Mixture(Organic acid F, Organic acid G) on the Performance, Profile of Leukocytes and Erythrocytes, Small Intestinal Microflora and Immune Response in Laying Hens (면역기능 조절제(MOS, Lectin)와 유기산제(Organic acid F, Organic acid G)가 산란계의 생산성, 혈액성상과 소장내 미생물 균총 및 면역체계에 미치는 영향)

  • Woo, K.C.;Kim, C.H.;Paik, I.K.
    • Journal of Animal Science and Technology
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    • v.49 no.4
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    • pp.481-490
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    • 2007
  • An experiment was conducted to investigate the effects of dietary supplementation of MOS, lectin and organic acid mixture(Organic acid F, Organic acid G) on the egg production, egg quality, profile of leukocytes and erythrocytes, small intestinal microflora and immune response in laying hens. A total of 900 Hy-line BrownⓇ laying hens of 48 wks old were assigned to one of the following 6 dietary treatments:control(C), C+AvillamycinⓇ 6ppm, C+MOS 250ppm, C+lectin 12.5ppm, C+Organic acid F(formic acid 35.4%, formate 34.6%, potassium 30.0%) 0.3% and C+0rgarnic acid G(fumaric acid 23%, calcium formate 14%, potassium sorbate 5%, calcium propionate 7%) 0.06%. Each treatment was replicated five times with thirty birds per replicate, housed in 2 bird cages. Feeding trial lasted for 6 wks under 16 hours lighting regimen. All supplemental groups were higher than the control in 6 wks hen-day and hen-housed egg production showing the highest with MOS treatment(P<0.05). Soft & broken egg productions were lower in supplemental groups than in the control except lectin treatment(P<0.05). Eggyolk color of supplemental groups was higher than that of the control except Organic acid G treatment(P<0.05). The values of RBC, HB, MCHC were highest in lectin treatment and lowest in MOS treatment(P<0.05). The numbers of intestinal microflora were not significantly different among the treatments. Serum IgG levels of all supplemental groups were higher than those of the control(P<0.05). In conclusion, for supplementation of antibiotics, immune modulators and organic acid mixture improved production parameters in general. Among the supplements, MOS showed the best performance in egg production and eggyolk color.

Effect of Planned Nursing Intervention on the Stress, the Maternal Role Strain, and the Maternal Role Performance of Mothers of Premature Infants (계획된 간호 중재가 미숙아 어머니의 스트레스, 모성 역할 긴장과 역할 수행에 미치는 영향)

  • Joung Kyoun -Hwa
    • Child Health Nursing Research
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    • v.5 no.1
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    • pp.70-83
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    • 1999
  • The birth of a premature infant is distressing for its parents. The parents of a premature infant experience stress according to the infant's physical appearance and behavior, the environment of the neonatal intensive care unit (NICU) , and the alteration in the parental role. Especially, a mother of a premature infant feels distressed even after the discharge of the infant : therefore, she has difficulties in maternal role performance. The main purpose of this study is to identify the effects of the planned infant care information program in order to lower the stress level for mothers of premature infants caused by the birth and hospitalization in NICU of premature infants, to reduce the maternal role strain, and to promote the maternal role performance after the infants' discharge. This study employed two methods of research at the same time : quasi -experimental non-equivalent pre and post test to compare : non-equivalent post test to compare. The total number of subjects was 19 who were assigned to the research program : 12 mothers of premature infants at the NICU at the Ch university hospital and 7 at the NICU at the Y general hospital located in Chounju city. The data were collected for 79 days from August 18 to November 5, 1998. The questionnaire method was applied for the data collection, and the measures used in this study were Parental Stressor Scale : NICU(Miles, 1993), the Maternal Role Strain Measures ( Hobbs, 1968 ; Steffensmeier, 1982) , and Self Confidence Scale (Pharis, 1978). Research procedure is as follows : after preliminary examination, the experimental subjects, the mothers of premature infants at the Nl CU at Ch university hospital were provided with slide films and information developed by the researcher based on existing documents and data. It took two 60-minute sessions a week for two weeks, and the mothers' stress level was measured using the same instrument twice one week and two week after the infants' hospitalization. The stress level of the contrast subjects, the mothers at Y general hospital was measured during the same period. The experimental subjects were provided with booklets on matters that require attention after the infants' discharge and on developmental project, and they were educated to play the maternal role in person for 2-3 hours a week : breast-feeding, burping a baby, and changing diapers. One week after the infants' discharge, the maternal role strain and the maternal role performance were examined in two groups of the subjects. The analysis of collected data was done using descriptive statistics including real numbers, percentages, averages, and standard deviations. Mann-Whitney test ; x² test ; Repeated Measures Analysis of Variance ; ANCOVA Spearman's rho correlation coefficients. The results on this study were as follows. (1) The examination of the same quality showed that there were no differences in the general and obstetrical characters between the two groups. However, in terms of the characters of premature infants. just right after their birth, the infants at the contrast group weighed more than those at the experimental group(U=16.5, p=.02), and the former was in mother's womb longer than the latter(U=15.5, p=.02). (2) The stress level of the mothers provided with the plannned nursing intervention program became lower as time passed compared to the others'(F=16.61, p=.00) Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization depending on treatment (F=8.00, p=.01) (3) The maternal role strain of the mothers provided with the planned nursing intervention program was lower than the others'(U=2.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the maternal role strain levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=14.72, p=.00). (4) The maternal role performance level of the mothers provided with the planned nursing program was higher than the others'(U=.0, p=.00). Even when the influence of weight at birth and the length of gestation was removed among the premature infants' characters, the mothers' stress levels made a statistical difference 2 weeks after the infants' hospitalization, depending on treatment(F=8.00, p=.01). (5) The correlation between a mother's stress level 2 weeks after her infant's hospitalization, the maternal role strain and the maternal role performance were compared : the stress and the maternal role strain were statistically irrelevant to each other(r=.33, p=.12) : the stress was found to be in inverse proportion to the maternal role performance(r=-.53, p=.02). The maternal role strain was in inverse proportion to the maternal role performance as well(r=-.50, p=.00). In conclusion, for the mothers provided with the planned nursing intervention program, their stress level was getting lower as time passed during the infants' hospitalization, their maternal role strain reduced when they took care of their infants after their discharge, and their maternal role performance level was high compared to the other mothers. Besides, the lower the stress level of mothers of premature infants was during the infants' hospitalization, the higher the maternal role performance after their discharge was. The lower maternal role strain was, the higher the maternal role performance was as well. These results of the study suggested that the nursing intervention program for the mothers of premature infants developed by the researcher would be effectively applied to nursing practice, and it would be a foundation for the development of this kind of program.

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The Effects of Supplemental Bacterial Phytase to the Calcium and Nonphosphorus Levels in Feed of Laying Hens (산란계 사료 내 칼슘 및 무기태 인 수준에 따른 Bacterial Phytase 급여 효과)

  • Kang, H.K.;Park, S.Y.;Yu, D.J.;Kim, J.H.;Kang, G.H.;Na, J.C.;Kim, D.W.;Suh, O.S.;Lee, S.J.;Lee, W.J.;Kim, S.H.
    • Korean Journal of Poultry Science
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    • v.35 no.2
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    • pp.143-151
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    • 2008
  • This study was conducted to identify the correlation of bacterial phytase ($Transphos^{(R)}$) to the calcium level in feed. Of all 21-week-old 720 HyLine brown laying hens, 2 birds of similar weight were placed on each individual cage. The experiment was conducted by $3{\times}2{\times}3$ factorial design with including 3 different levels of phytase (0, 300, and 1,000 DPU/kg), 2 different levels of calcium (3.5% and 4.0%), and 3 different levels of no NPP addition 0% (0.095 NPP), 0.5% (0.185% NPP), and 1.0% (0.275% NPP). The feeding trial maintained the ME level of 2,800 kcal/kg and 16% for crude protein. The diet was fed ad libitum and 17 hours of lighting was provided throughout the experimental period. Egg production seemed to increase, in the 300 DPU of bacterial phytase added group and the cracked egg tended to reduce in Transphos added group. The egg productivity between treatment groups did not show significant difference by dietary calcium level, whereas non NPP added group (0.095% NPP) was found to be low compared to NPP added groups (P<0.05). The highest mean egg weight and the highest daily egg mass were detected in 300 DPU phytase added group. Although the mean egg weight was significantly higher in treatment groups fed with 3.5% calcium containing feeds (P<0.05), daily egg mass was no among treatment groups. The mean egg weight and daily egg mass were the lowest in non NPP added group (0.095% NPP) compared to other treatment groups (P<0.05). The feed intake showed similar pattern regardless of the bacterial phytase and calcium levels in the diet. However, the treatment groups fed diets containing NPP level of 0.275% and 0.165% showed significantly higher feed intake than the group fed with 0.095% NPP (P<0.05). Although the feed conversion was not affected by calcium and NPP levels in the diet, the most improved result was obtained from 300 DPU phytase added group (P<0.05). The eggshell breaking strength and thickness increased as dietary calcium level increase the level of calcium increases in diet. The treatment groups fed diet containing 0.275% and 0.165% NPP revealed to show improvement in eggshell breaking strength and yolk color index compared to the NPP non added (0.095% NPP) treatment group. The result of the present study suggests that the appropriate level of microbial phytase is 300 DPU and at this level, tricalciumphosphate supplementation in feed can be reduced to 40% of NRC recommendation. Higher calcium level in feed fail to show synergistic effect by adding microbial phytase.

A study on Development Process of Fish Aquaculture in Japan - Case by Seabream Aquaculture - (일본 어류 양식업의 발전과정과 산지교체에 관한 연구 : 참돔양식업을 사례로)

  • 송정헌
    • The Journal of Fisheries Business Administration
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    • v.34 no.2
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    • pp.75-90
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    • 2003
  • When we think of fundamental problems of the aquaculture industry, there are several strict conditions, and consequently the aquaculture industry is forced to change. Fish aquaculture has a structural supply surplus in production, aggravation of fishing grounds, stagnant low price due to recent recession, and drastic change of distribution circumstances. It is requested for us to initiate discussion on such issue as “how fish aquaculture establishes its status in the coastal fishery\ulcorner, will fish aquaculture grow in the future\ulcorner, and if so “how it will be restructured\ulcorner” The above issues can be observed in the mariculture of yellow tail, sea scallop and eel. But there have not been studied concerning seabream even though the production is over 30% of the total production of fish aquaculture in resent and it occupied an important status in the fish aquaculture. The objectives of this study is to forecast the future movement of sea bream aquaculture. The first goal of the study is to contribute to managerial and economic studies on the aquaculture industry. The second goal is to identify the factors influencing the competition between production areas and to identify the mechanisms involved. This study will examine the competitive power in individual producing area, its behavior, and its compulsory factors based on case study. Producing areas will be categorized according to following parameters : distance to market and availability of transportation, natural environment, the time of formation of producing areas (leaderㆍfollower), major production items, scale of business and producing areas, degree of organization in production and sales. As a factor in shaping the production area of sea bream aquaculture, natural conditions especially the water temperature is very important. Sea bream shows more active feeding and faster growth in areas located where the water temperature does not go below 13∼14$^{\circ}C$ during the winter. Also fish aquaculture is constrained by the transporting distance. Aquacultured yellowtail is a mass-produced and a mass-distributed item. It is sold a unit of cage and transported by ship. On the other hand, sea bream is sold in small amount in markets and transported by truck; so, the transportation cost is higher than yellow tail. Aquacultured sea bream has different product characteristics due to transport distance. We need to study live fish and fresh fish markets separately. Live fish was the original product form of aquacultured sea bream. Transportation of live fish has more constraints than the transportation of fresh fish. Death rate and distance are highly correlated. In addition, loading capacity of live fish is less than fresh fish. In the case of a 10 ton truck, live fish can only be loaded up to 1.5 tons. But, fresh fish which can be placed in a box can be loaded up to 5 to 6 tons. Because of this characteristics, live fish requires closer location to consumption area than fresh fish. In the consumption markets, the size of fresh fish is mainly 0.8 to 2kg.Live fish usually goes through auction, and quality is graded. Main purchaser comes from many small-sized restaurants, so a relatively small farmer and distributer can sell it. Aquacultured sea bream has been transacted as a fresh fish in GMS ,since 1993 when the price plummeted. Economies of scale works in case of fresh fish. The characteristics of fresh fish is as follows : As a large scale demander, General Merchandise Stores are the main purchasers of sea bream and the size of the fish is around 1.3kg. It mainly goes through negotiation. Aquacultured sea bream has been established as a representative food in General Merchandise Stores. GMS require stable and mass supply, consistent size, and low price. And Distribution of fresh fish is undertook by the large scale distributers, which can satisfy requirements of GMS. The market share in Tokyo Central Wholesale Market shows Mie Pref. is dominating in live fish. And Ehime Pref. is dominating in fresh fish. Ehime Pref. showed remarkable growth in 1990s. At present, the dealings of live fish is decreasing. However, the dealings of fresh fish is increasing in Tokyo Central Wholesale Market. The price of live fish is decreasing more than one of fresh fish. Even though Ehime Pref. has an ideal natural environment for sea bream aquaculture, its entry into sea bream aquaculture was late, because it was located at a further distance to consumers than the competing producing areas. However, Ehime Pref. became the number one producing areas through the sales of fresh fish in the 1990s. The production volume is almost 3 times the production volume of Mie Pref. which is the number two production area. More conversion from yellow tail aquaculture to sea bream aquaculture is taking place in Ehime Pref., because Kagosima Pref. has a better natural environment for yellow tail aquaculture. Transportation is worse than Mie Pref., but this region as a far-flung producing area makes up by increasing the business scale. Ehime Pref. increases the market share for fresh fish by creating demand from GMS. Ehime Pref. has developed market strategies such as a quick return at a small profit, a stable and mass supply and standardization in size. Ehime Pref. increases the market power by the capital of a large scale commission agent. Secondly Mie Pref. is close to markets and composed of small scale farmers. Mie Pref. switched to sea bream aquaculture early, because of the price decrease in aquacultured yellou tail and natural environmental problems. Mie Pref. had not changed until 1993 when the price of the sea bream plummeted. Because it had better natural environment and transportation. Mie Pref. has a suitable water temperature range required for sea bream aquaculture. However, the price of live sea bream continued to decline due to excessive production and economic recession. As a consequence, small scale farmers are faced with a market price below the average production cost in 1993. In such kind of situation, the small-sized and inefficient manager in Mie Pref. was obliged to withdraw from sea bream aquaculture. Kumamoto Pref. is located further from market sites and has an unsuitable nature environmental condition required for sea bream aquaculture. Although Kumamoto Pref. is trying to convert to the puffer fish aquaculture which requires different rearing techniques, aquaculture technique for puffer fish is not established yet.

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