• Journal of Home Health Care Nursing
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• v.6
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Journal of the Korean Society of Radiology
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• v.12 no.1
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• pp.47-52
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• 2018

Brain perfusion CT scanning is often employed usefully in clinical conditions as it accurately and promptly provides information about the perfusion state of patients having acute ischemic stroke with a lot of time constraints and allows them to receive proper treatment. Despite those strengths of it, it also has a serious weakness that Lens may be exposed to a lot of dose of radiation in it. In this study, as a way to reduce the dose of radiation to Lens in brain perfusion CT scanning, this researcher conducted an experiment with Bismuth shielding and change of patients' position. TLD (TLD-100) was placed on both lens using the phantom (PBU-50), and then, in total 4 positions, parallel to IOML, parallel to IOML (Bismuth shielding), parallel to SOML, and parallel to SOML (Bismuth shielding), brain perfusion scanning was done 5 times for each position, and dose to Lens were measured. Also, to examine how the picture quality changed in different positions, 4 areas of interest were designated in 4 spots, and then, CT number and noise changes were measured and compared. According to the results of conducting one-way ANOVA on the doses measured, as the significance probability was found to be 0.000, so there was difference found in the doses of radiation to crystalline lenses. According to the results of Duncan's post-hoc test, with the scanning of being parallel to IOML as the reference, the reduction of 89.16% and 89.66% was observed in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding) respectively, so the doses to Lens reduced significantly. Next, in the scanning of being parallel to IOML (Bismuth shielding), the reduction of 37.12% was found. According to the results, reduction in the doses of radiation was found the most significantly both in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding). With the limit of the equivalent dose to Lens as the reference, this researcher conducted comparison with the dose to occupational exposure and dose to Public exposure in the scanning of being parallel to IOML and found 39.47% and 394.73% respectively; however in the scanning of being parallel to SOML (Bismuth shielding), considerable reduction was found as 4.08% and 40.8% respectively. According to the results of evaluation on picture quality, every image was found to meet the evaluative standards of phantom scanning in terms of the measurement of CT numbers and noise. In conclusion, it would be the most useful way to reduce the dose of radiation to Lens to use shields in brain perfusion CT scanning and adjust patients' position so that their lens will not be in the field of radiation.

• Korean Journal of Acupuncture
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• v.31 no.2
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• pp.66-78
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• 2014

Objectives : The specificity of acupuncture point has been a highly controversial subject. Existing researches said that ion-distribution differences are observed on the acupuncture point. This study was conducted under the assumption that multiple ionic changes induced by muscle fatigue would be different between the acupuncture point with non-acupuncture point. Methods : To induce the identical fatigue, twenty subjects performed the knee extension/flexion exercise using the Biodex System 3. ST32 and ST33 as well as adjacent non-acupuncture points were selected. We measured blood lactate and analyzed the median frequency(MF) and peak torque. To obtain the information on the extracellular fluid(ECW), intracellular fluid(ICW) and cell membrane indirectly, we used the multi-frequency bioelectrical impedance analysis(MF-BIA) method. Results : MF, peak torque and blood lactate level of all measurement sites were gradually returned to normal. Re resistance of ST32 had a stronger response, but a non-acupuncture point adjacent to ST33 had a larger response up to 20 minutes post exercise. Ri resistances were similar for both acupoints and non-acupoints. The $C_m$ capacitance of ST32 had a stronger response after inducing fatigue, but ST33 had a smaller response than a non-acupuncture point adjacent to it. Conclusions : In comparison with before and after inducing fatigue, the specificity of acupuncture points was not clearly observed. Hence, we concluded that the body composition factors extraction method had the limitation as a method of finding the specificity of acupuncture points by inducing fatigue.

• Korean Journal of Health Education and Promotion
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• v.24 no.4
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• pp.1-22
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• 2007

Objectives: This study attempted to understand the relationship between handwashing knowledge, attitude and practice of middle school students and to provide the basic information for handwashing training of the students and help them to form a healthy habit. Methods: Data was collected by a standardized self-administered questionnaire between Sep. 20 to Oct. 6 2006 with a total of 710 students in 1, 2, 3 grades at 6 middle schools in metropolitan cities(490 students from four schools situated in an urban center, 220 from 2 in a suburban district). The data was then analyzed using the SPSS WIN 12.0 program, employing many statistical techniques such as chi-square($x^2$) test, t-test, ANOVA analysis with post hoc test, correlations analysis, and regression analysis. Results: The results of the study were as follows. First, total number of handwashing times of middle school students is 6.69 per day. 66.1% of the students used soap and most of the students washed hands for $6{\sim}10$ seconds(44.7%). Second, in the knowledge of handwashing, "both of the parents"(p<0.01), "catholic", "city"(p<0.05) were the highest and the practice of handwashing was active with "city", "high economic level"(p<0.05) and "both of the parents"(p<0.01). In the experience of teaching handwashing, "Yes" was 24.3% which was statistically significant with handwashing knowledge(p<0.05), attitude and practice(p<0.01). Third, in the correlation of handwashing knowledge, attitude and practice, there was statistical significancy between handwashing attitude and knowledge(p<0.01) and showed positive correlation with the knowledge(.534). The practice of handwashing has meaningful difference from the knowledge and the attitude and the coefficient of correlation shows positive co-relation in knowledge(.335) and attitude(0525). Fourth, based on the result for regression analysis with handwashing knowledge, attitude and practice as dependent variables, handwashing knowledge showed statistical significancy with sex, type of school(p<0.05) and residential area(p<0.01). There were also statistical significancy between handwashing attitude and knowledge(p<0.01) and between handwashing practice and religion, knowledge(p<0.05) and economic level, attitude(p<0.01). Conclusion: There were consistent results with handwashing knowledge, attitude and practice. If they had better knowledge, their attitude was more positive and if they had better knowledge and more positive attitude, their practice was active. The knowledge, attitude and practice of the students who learned about handwashing were higher than those of the students who had no experience of learning handwashing. To enhance handwashing habit of middle school students, the handwashing environment should be maintained. The training plans should also be made according to sex, type of school, economic level, residential area, and the consistent study on handwashing training is required.

• The Korean Journal of Health Service Management
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• v.2 no.1
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• pp.37-55
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• 2008

This study aims to enhance work efficiency and satisfaction by offering data that make a physical therapist cope with stress coming from the job efficiently by identifying and analyzing the job satisfaction and work stress perceived by a physical therapist, and the level of reaction of a physical therapist. The study distributed survey questionnaires to 300 physical therapists working in medical institutions in Busan via mail and by visit from March 3, 2007 by selecting them simply and randomly from the physical therapist list, and collected the questionnaires by March 20, 2007, 103 respondents were working at 17 general hospitals including a university hospital, 65 respondents at 12 medical centers, and 79 respondents at 39 doctor's offices. The study collected 251 copies, which showed the collection rate of 83.7%, and analyzed 247 copies (82.3%) excluding 4 copies of insincere answers. As a research tool for measuring job satisfaction the study used a tool employed for research into the job satisfaction of physical therapists who work at medical institutions in Gwangju, Jeonnam, and Jeonbuk by Kim Hee-Gwon(1992) and research regarding job satisfaction by Jeong Jeong-Hee(2004) as well as research regarding the factors of job satisfaction by Flippo(1980) & Seberhagen(1970) after adjusting the research tools to the purpose of the study. Also for questions about work stress, the study employed nurses' job stress measurement tool developed by Kim Mae-Ja and em Mi-Ok(1984) by modifying the tool to the purpose of the study, and for a measurement tool for reaction to stress, the study used a tool employed for research into reaction to stress of nurses at general hospitals by Choi Eun-Deok(2005) without modification. For data analysis, the study used the SPSS12.0 as a statistical method, and then used t-test or ANOVA for verifying actual numbers, percentile, average :score, standard deviation, rank, and difference. Also, the study conducted which is a post-test method for variables that show a significant difference at the level of p<.05 level after the analysis. The findings include the following. 1) The respondents' job satisfaction score was 3.21 points on the average (out of 5 full points). The peer relationship ranked the highest, posting 4.02 points on the average, and the job satisfaction with rewards was proven the lowest, posting 2.51 points. For the job satisfaction level by characteristics, there were significant differences (p<.05) in gender, hospital type, weekly working hours, monthly working days, number of patients per day, department in charge of therapy, and number of peers, and there was no significant difference in characteristics other than that. 2) The respondents' work stress score was 2.72 points (out of 5 full points) on the average. The respondents were shown to be under the highest stress when they suffered from excessive workload, posting 3.49 points on the average, and they were shown to be under the least stress when they had a conflict with peers at another department, recording 1.90 points on the average. for the job stress level by the characteristics of job, there was a significant difference in the reflection of job assessment(p<.05). 3) 1n respondents' reaction to stress, most of them were shown to make efforts in coping with stress, posting 2.80 points (out of 5 full points). For their experience of being wider stress, they answered that 'they felt depressed (2.85 points)" for their experience of coping with stress, they answered that 'they were indifferent to it or thought about something else' (2.62 points). Also, for their efforts in coping with stress, they answered that 'they were motivated to remove their strain by taking leave, playing, or using their preferences' (3.52 points), which ranked higher. For the level of reaction to stress by characteristics, there were significant differences by age, gender, marital status, total service years as a physical therapist, monthly working days, and department in charge of therapy(p<.05). It is necessary to offer correct information by conducting an in-depth analysis of the stressful situations of physical therapists who exert efforts in rehabilitating patients at hospitals by factor, and seeking management plans based on the research results. Also, it is necessary to develop a program for coping with stress efficiently for removing stress and to conduct research into the understanding and cooperation of administrators and persons in charge of physical therapists for reducing physical therapists' stress at hospitals.

• Journal of Food Hygiene and Safety
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• v.35 no.3
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• pp.271-278
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• 2020

Enterotoxigenic Escherichia coli is one of the major causative infectious agents of diarrhea in newborn and post-weaning pigs and leads to a large economic loss worldwide. However, there is limited information on the distribution and characterization of virulence genes in E. coli isolated from diarrheic piglets, which also applies to the current status of pig farms in Korea. To investigate the prevalence and characterization of virulence genes in E. coli related to diarrhea in piglets, the rectal swab samples of diarrheic piglets (aged 2 d to 6 w) were collected from 163 farms between 2013 and 2016. Five to 10 individual swab samples from the same farm were pooled and cultured on MacConkey agar plates, and E. coli were identified using the API 32E system. Three sets of multiplex PCRs were used to detect 13 E. coli virulence genes. As a result, a total of 172 E. coli isolates encoding one or more of the virulence genes were identified. Among them, the prevalence of individual virulence gene was as follows, (1) fimbrial adhesins (43.0%): F4 (16.9%), F5 (4.1%), F6 (1.7%), F18 (21.5%), and F41 (3.5%); (2) toxins (90.1%): LT (19.2%), STa (20.9%), STb (25.6%), Stx2e (15.1%), EAST1 (48.3%); and (3) non-fimbrial adhesin (19.6%): EAE (14.0%), AIDA-1 (11.6%) and PAA (8.7%), respectively. Taken together, various pathotypes and virotypes of E. coli were identified in diarrheic piglets. These results suggest a broad array of virulence genes is associated with coliform diarrhea in piglets in Korea.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.638-645
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• 2003

The purposes of this study were to evaluate the effect of myocardial protection with our cold blood cardioplegic solution and to observe the relationship between ultrastructural study and other evaluation methods and its effectiveness. Material and Method: We evaluated the changes of myocardial ultrastructure using semi-quantitative scoring system, CK-MB fraction, SGOT and LDH1/LDH2, and EKG in 18 patients undergoing valvular heart surgery and coronary artery bypass grafting (CABG). Right atrial auricular biopsies were taken before the cardiopulmonary bypass (CPB) and shortly after the end of CPB. Myocardium-related serum enzymes ＆ EKG were checked for 3 days of postoperative period and their postoperative peak enzyme value and observed new Q wave ＆ ST segment elevation in EKG were choosen. Result: There were 8 males and 10 females, and their mean age was 55.6$\pm$13. Eight patients underwent valvular heart surgery and ten coronary artery bypass grafting, The mean CPB time was 119$\pm$29 minutes and the mean aortic cross-clamp (ACC) time was 75.4$\pm$24 minutes. Before the start of CPB, the mean mitochondrial score was 4.28$\pm$0.53 and after the end of CPB, it significantly increased to 2.35$\pm$0.79. There was no evidence of perioperative myocardial infarction in terms of myocardiumrelated serum enzyme value and Q wave and ST change in EKG. There was no significant relationship between pre-CPB and post-CPB mitochondrial score and the mean time of CPB and ACC, and the mean value of postoperative peak CK-MB, SGOT and LDH1/LDH2, but there was relatively positive correlation of CPB time with peak LDH1/LDH2. Conclusion: Despite the apparent satisfactory results in myocardium-related serum enzymes ＆ EKG, with this study using the cold blood cardioplegic solution, there were many changes in myocardial ultrastructures, and more studies are needed to obtain further information.

• Korean Journal of Soil Science and Fertilizer
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• v.11 no.4
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• pp.283-295
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• 1979

A new Farmland Expansion and Development Promotion Law was enacted in 1975. This law authorizes the Government to undertake development within a declared "reclamation area", wherever the land owners are unable to do so. In order to give additional impetus to conversion of waste hilly land into productive farmland, these hilly land development projects were conducted as large scale scheme which include soil fertility improvements such as the application of lime and phosphate. Farmland Expansion and Development Promotion Corps has attempted to undertake annual farm surveys in order to obtain some information about hilly land agriculture and farming operations within the reclamation project areas since 1976. As survey data accumulates, more and more clear picture of hilly land farming come to appear and enable us to conduct in-depth study. Effects of such upland reclamation include converting of previously unproductive slopeland into cultivable farmland for lucrative and commercial farming or food production. Furthermore, idle or marginal resources such as farm labor, equipment and compost would be fully employed. Socio-economic effects would include increases in land value and attitude change of farmers. On the other hand the preservation of natural environments might be damaged to the some extend by the projects. As shown in Table 7, the average farm size increased from 3,156 pyeong($3.3m^2$) to 5,562 pyeong, a 76.2% increase. The proportion of small farms with less than I ha dropped from 59.8% to 34.4%, but that of the large farms over 2 ha rose from 13.1% to 32.0% (See Table 8). The survey results indicate that as the farming on reclaimed uplands become time-honored, the acreage devoted for food crop production decreases against the economic crop growing acreage (see Table 6). For example, in the case of uplands reclaimed in 1972, the ratio of food crop acreages decreased from 99.7% in 1972 to 62.5% in 1977, whereas that of economic crop acreages increased from 0.3% in 1972 to 37.5% in 1977. The government used to actively encourage the farmers to carry out food crop production in the reclaimed upland targting toward the realization of self-sufficiency in food grains. It is, however, apparent that the farmers did hardly take the government advises as far as their economic interest were concerned. Yield per 10a. of various crops from the reclaimed uplands by year were surveyed as seen in Table 12. On the average, barley production in the reclaimed areas achieved 83.3% of the average unit yield from the existing upland in its 5 th year. Soybean yields showed a modest increase from 64% in the first year to 95%, in the 5 th year. In contrast, economic crops such as red pepper, totacco and radish achieved their maximum target yields in 3 years from starting to cultivate on the reclaimed farms. In order to test the post economic viability, an economic analysis was performed for each of selected subprojects on the basis of the data obtained through survey. The average actual internal economic rate of return on upland reclamation investments was found to be 20.3% which exceeded other types of projects of land and water development such as tidal land reclamation, irrigation or paddy rearrangement. The actual IRRs of subcategories of upland reclamation projects varied from 17.9% to 21.4% depending upon the kinds of cropping system adopted in each reclaimed areas such as food, economic, fruit or forage crops.

• Korean Journal of Environment and Ecology
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• v.29 no.5
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• pp.693-702
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• 2015

In order to identify the species and to reveal the phylogenetic relationship of rook populations found in Jeju-do Province in winter seasons, we determined the sequences of mitochondrial cytochrome c oxidase I (COI) gene and analyzed the genetic structure of maternal lineages and phylogenetic relationship. The rook DNAs were isolated from the post-mortem specimens and plumages collected from agricultural farms in Jeju-do Province including U-do Island. The obtained COI sequences (n=41) showed over 97.0% identities with those previously reported from Corvus frugeligus. Three COI haplotypes (J01-J03) were detected from COI sequences of the rooks obtained in Jeju-do Province but those did not show the site-specific patterns, showing that they might be derived from a common maternal origin. Eight maternal haplotypes were detected from all COI sequences obtained. Among those three haplotypes contained the COI sequences from Northeast Asia including eastern Russia, Mongolia and South Korea. On the other hand, the other five haplotypes contained the COI sequences reported from Central Asia, Middle East, western Russia and European countries. The COI sequences from Jeju-do Province were located on three haplotypes (CF01-CF03) belonging to Northeast Asian rook lineages. The NJ tree showed the distinct branch patterns suggesting two different maternal lineages of C. frugilegus, which proposed as two parapatric subspecies, C. f. frugilegus (Western) and C. f. pastinator (Eastern). These findings using DNA barcoding approaches will be contributed to provide the information about avian fauna for understanding the genetic structure of maternal lineage, phylogenetic relationship and their molecular ecology.

• Pediatric Infection and Vaccine
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• v.20 no.1
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• pp.9-16
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• 2013

Purpose : This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. Methods : This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. Results : Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. Conclusion : To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.