• Title/Summary/Keyword: quality assessment.

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Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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Characteristics of Phytoplankton Succession Based on the Functional Group in the Enclosed Culture System (대형 배양장치에서 기능그룹에 기초한 식물플랑크톤 천이 특성)

  • Lee, Kyung-Lak;Noh, Seongyu;Lee, Jaeyoon;Yoon, Sungae;Lee, Jaehak;Shin, Yuna;Lee, Su-Woong;Rhew, Doughee;Lee, Jaekwan
    • Korean Journal of Ecology and Environment
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    • v.50 no.4
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    • pp.441-451
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    • 2017
  • The present study was conducted from August to December 2016 in a cylindrical water tank with a diameter of 1 m, a height of 4 m and a capacity of 3,000 L. The field water and sediment from the Nakdong River were also sampled for the experimental culture (field water+sediment) and control culture (field water), respectively. In this study, we aimed to investigate phytoplankton succession pattern using the phytoplankton functional group in the enclosed culture system. A total of 50 species in 27 genera including Chlorophyceae (30 species), Bacillariophyceae (11 species), Cyanophyceae (7 species), and Cryptophyceae (2 species) were identified in the experimental and control culture systems. A total of 19 phytoplankton functional groups (PFGs) were identified, and these groups include B, C, D, F, G, H1, J, K, Lo, M, MP, N, P, S1, $T_B$, $W_0$, X1, X2 and Y. In particular, $W_0$, J and M groups exhibited the marked succession in the experimental culture system with higher biovolumes compared to those of the control culture system, which may be related to the internal cycling of nutrients by sediment in the experimental culture system. The principal component analyses demonstrated that succession patterns in PFG were associated with the main environmental factors such as nutrients(N, P), water temperature and light intensity in two culture systems. In conclusion, the present study showed the potential applicability of the functional group for understanding the adaptation strategies and ecological traits of the phytoplankton succession in the water bodies of Korea.

An Assessment of Post-Injection Transmission Measurement for Attenuation Correction With Rotating Pin Sources in Positron Emission Tomography (양전자방출단층촬영(PET)에서 회전 핀선원과 투과 및 방출 동시 영상 방법을 이용한 감쇠보정 방법 특성에 관한 고찰)

  • Lee, J.R.;Choi, Y.;Lee, K.H.;Kim, S.E.;Chi, D.Y.;Shin, S.A.;Kim, B.T.
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.533-540
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    • 1995
  • Attenuation correction is important in producing quantitative positron emission tomography (PET) images. Conventionally, photon attenuation effects are corrected using transmission measurements performed before tracer administration. The pre-injection transmission measurement approach may require a time delay between transmission and emission scans for the tracer studies requiring a long uptake period, about 45 minutes for F-18 deoxyglucose study. The time delay will limit patient throughput and increase the likelihood of patient motion. A technique lot performing simultaneous transmission and emission scans (T+E method) after the tracer injection has been validated. The T+E method substracts the emission counts contaminating the transmission measurements to produce accurate attenuation correction coefficients. This method has been evaluated in experiments using a cylindrical phantom filled with background water (5750 cc) containing $0.4{\mu}Ci/cc$ of F-18 fluoride ion and one insert cylinder (276 cc) containing $4.3{\mu}Ci/cc$. GE $Advance^{TM}$ PET scanner and Ge-68 rotating pin sources for transmission scanning were used for this investigation. Post-injection transmission scan and emission scan were peformed alternatively over time. The error in emission images corrected using post-infection transmission scan to emission images corrected transmission scan was 2.6% at the concentration of $1.0{\mu}Ci/cc$. No obvious differences in image quality and noise were apparent between the two images. The attenuation correction can be accomplished with post-injection transmission measurement using rotating pin sources and this method can significantly shorten the time between transmission and omission scans and thereby reduce the likelihood of patient motion and increase scanning throughput in PET.

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Technical Standards and Safety Review of the Low and Intermediate Level Radioactive Waste Disposal Facility (중.저준위 방사성폐기물 처분시설에 대한 기술기준 및 안전심사)

  • Cheong, Jae-Hak;Lee, Kwan-Hee;Lee, Yun-Keun;Jeong, Chan-Woo;Rho, Byung-Hwan
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.6 no.4
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    • pp.357-368
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    • 2008
  • On July 31, 2008, the Government issued the construction and operation permit for the first low and intermediate level radioactive waste disposal facility in the Republic of Korea. In this paper, the fundamental regulatory framework, regulatory requirements and technical standards of the disposal facility are introduced, and the phased review process adopted for evaluation of the safety of the facility is briefly described. The Atomic Energy Act sets forth a stepwise regulatory framework for the whole life-cycle of the disposal facility such as siting, design, construction, operation, closure and institutional control. More detailed regulatory requirements and technical standards are stipulated in the subsequent regulations of the Atomic Energy Act and a series of Notices issued by the Ministry of Eduction, Science and Technology. The Korea Institute of Nuclear Safety, as entrusted by the Ministry under the Atomic Energy Act, conducted safety review on the disposal facility, and evaluated the compliance with relevant criteria in all technical elements(i.e. siting and structural safety, radiological environmental impact, operational safety, systems and components, quality assurance, and total systematic performance assessment, etc.). The overall safety review process can be phased into inception phase, initial review phase, main review phase and completion phase. The review results were reported to and deliberated by the five Sub-committees of the Special Committee on Nuclear Safety, and then reported to the Ministry. The Ministry issued the construction and operation permit of the disposal facility through the deliberation of the review results by the Nuclear Safety Commission. Hereafter, the safety of the repository will be reassured by a series of subsequent regulatory inspections and reviews under the Atomic Energy Act. In addition, the licensee's continuous implementation of the "Safety Promotion Plan" may also enhance the long-term safety of the repository and contribute to build-up the confidence of the safety case.

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Overwintering and Succession of the Phytoplankton in Pilot Culture System (현장규모 대형 배양장치에서 식물플랑크톤의 월동 및 천이)

  • Noh, Seongyu;Lee, Kyung-Lak;Shin, Yuna;Lee, Jaeyoon;Song, Mi-Ae;Lee, Jaean;Rhew, Doughee;Lee, Jaekwan
    • Korean Journal of Ecology and Environment
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    • v.50 no.1
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    • pp.57-69
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    • 2017
  • Overwintering and succession of phytoplankton community with physicochemical and biological characteristics were investigated in pilot culture system. Water and phytoplankton samples were collected twice a week from February 23 to June 28, 2016. A total of 17 overwintering taxa including cyanophyceae, chlorophyceae, bacillariophyceae were identified in the experimental group in winter (February), and these overwintering species showed a marked succession pattern along with environment changes. In the process of phytoplankton succession, a total of 56 species in 28 genera were identified in two (experimental, control) pilot culture system. In the experimental group, 52 phytoplankton species in 24 genera were identified, and the number of taxa was highest in chlorophyceae (35 species), followed by Bacillariophyceae (9 species), Cyanophyceae (5 species) and others (3 species). In the control group, 25 phytoplankton species in 14 genera were classified and these taxa consisted of 17 chlorophyceae, 3 cyanophyceae, 2 Bacillariophyceae and 3 others. The standing crops ranged from 40 to $325,450cells\;mL^{-1}$ in the experimental group, and from 900 to $37,100cells\;mL^{-1}$ in the control group, respectively. The dominant species were represented by Monoraphidium minutum, Microcystis aeruginosa, Rhodomonas lacustris, Ankyra judai and Chlorella vulgaris in the experimental group; and M. minutum and Coenochloris cf. pyrenoidosa in the control group. In conclusion, overwintering and succession of predominant phytoplankton species developed due to interactions of internal environmental factors(physicochemical and biological factors) in the pilot culture system.

Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Assessment of Nitrogen Impaction on Watershed by Rice Cultivation (벼농사에서 질소유출이 수질에 미치는 영향평가)

  • Roh, Kee-An;Kim, Min-Kyeong;Lee, Byeong-Mo;Lee, Nam-Jong;Seo, Myung-Chul;Koh, Mun-Hwan
    • Korean Journal of Environmental Agriculture
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    • v.24 no.3
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    • pp.270-279
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    • 2005
  • It is important to understand and evaluate the environmental impacts of rice cultivation for developing environmentally-friendly agriculture because rice is main crop in Korea and rice cultivation have both functions of water pollution and purification with environmental and cultivation conditions. This paper presents the evaluation of nitrogen impact by rice cultivation on water system. A simple protocol was proposed to assess the potential amount of nitrogen outflow from paddy field and most of parameters affect on the nitrogen outflow from paddy field such as the amount of fertilizer application, water balance, the quality and quantity of irrigation water, soil properties, nitrogen turnover in the soil and cultivation method were considered. To develop the protocol, coefficients for parameters affected nitrogen turnover and outflow were gotten and summarized by comparison and analysis of all possible references related, and by additional experiments at field and laboratory. And potential amount of nitrogen input and output by water in paddy field were estimated with the protocol at the conditions of the nitrogen contents of irrigation water, amount of fertilizer application, and irrigation methods. Where irrigation water was clean, below 1.0 mg $L^{-1}$ of nitrogen concentration, rice cultivation polluted nearby watershed. At the conditions of 2.0 mg $L^{-1}$ of nitrogen concentration, 110 kg $ha^{-1}$ of nitrogen fertilizer application and flooding irrigation, rice cultivation had water pollution function, but it had water purification function with intermittent irrigation. At the conditions of 3.0 mg $L^{-1}$ of nitrogen concentration and 110 kg $ha^{-1}$ of nitrogen fertilizer application, rice cultivation had water purification function, but that had water pollution function with 120 kg $ha^{-1}$ of nitrogen application. Where irrigation water was polluted over 6.0 mg $L^{-1}$ of nitrogen, it was evaluated that rice cultivation had water purifying effect, even though the amount of nitrogen application was 120 kg $ha^{-1}$.

Human Blastocysts;The Correlation Between Embryo Microscopical Assessments and Their Cell Number (인간 배반포기 배의 현미경적 분류와 세포수의 상관관계에 관한 연구)

  • Kim, E.Y.;Uhm, S.J.;Kim, M.K.;Yoon, S.H.;Park, S.P.;Chung, K.S.;Lim, J.H.
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.3
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    • pp.319-326
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    • 1996
  • The objective of this study was to investigate correlation between the morphology by microscopic assessments of surplus blastocysts produced in human IVF program and their cell number obtained by differential labelling method. For these experiments, 76 surplus human blastocysts were obtained from 36 patients on day 5 after IVF, the embryos were classified to early (ErB), early expanding (EEB), middle expanding (MEB), expanded blastocyst (EdB) according to their blastocoel expansion and zona thickness. When the ovum size and zona thickness of the classified blastocysts were measured using micrometer, although the embryos were produced in the same culture condition, there were significant variances in ovum size ($148.8 217.6{\mu}m$) and zona thickness ($1.2-14.4{\mu}m$). Total blastomere cell number counted after hoechst staining was increased by two to three fold during the transition period from ErB ($39.1{\pm}3.6$) to EdB ($(89.6{\pm}3.3)$) stage on day 5 after IVF. ICM ($11.9{\pm}1.8-22.2{\pm}4.3$) and TE ($24.5{\pm}3.6-70.0{\pm}7.7$) cell numbers using differential labelling were also showed the increased pattern according to the developmental level. Especially, EdB which showed poor ICM morphologically also indicated the low ICM cell number after differential labelling. This demonstrated that there is good correlation between the morphological assessment and the cell number. The count of ICM and TE nuclei using differential labelling can be used as an important criterion, if it is accompanied with morphological assessments, in selecting the better embryos for improving the pregnancy rates in human blastocyst transfer program.

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Statistical Errors in Papers Published in the Journal of the Korean Society for Therapeutic Radiology and Oncology (대한방사선종양학회지 게재 논문의 통계적 오류 현황)

  • Park, Hee-Chul;Choi, Doo-Ho;Ahn, Song-Vogue;Kang, Jin-Oh;Kim, Eun-Seog;Park, Won;Ahn, Seung-Do;Yang, Dae-Sik;Yun, Hyong-Geun;Chung, Eun-Ji;Chie, Eui-Kyu;Pyo, Hong-Ryull;Hong, Se-Mie
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.289-294
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    • 2008
  • Purpose: To improve the quality of the statistical analysis of papers published in the Journal of the Korean Society for Therapeutic Radiology and Oncology (JKOSTRO) by evaluating commonly encountered errors. Materials and Methods: Papers published in the JKOSTRO from January 2006 to December 2007 were reviewed for methodological and statistical validity using a modified version of Ahn's checklist. A statistician reviewed individual papers and evaluated the list items in the checklist for each paper. To avoid the potential assessment error by the statistician who lacks expertise in the field of radiation oncology; the editorial board of the JKOSTRO reviewed each checklist for individual articles. A frequency analysis of the list items was performed using SAS (version 9.0, SAS Institute, NC, USA) software. Results: A total of 73 papers including 5 case reports and 68 original articles were reviewed. Inferential statistics was used in 46 papers. The most commonly adopted statistical methodology was a survival analysis (58.7%). Only 19% of papers were free of statistical errors. Errors of omission were encountered in 34 (50.0%) papers. Errors of commission were encountered in 35 (51.5%) papers. Twenty-one papers (30.9%) had both errors of omission and commission. Conclusion: A variety of statistical errors were encountered in papers published in the JKOSTRO. The current study suggests that a more thorough review of the statistical analysis is needed for manuscripts submitted in the JKOSTRO.

The Comparative Analysis of Male and Female of Adult on the Base Crve, Power and Astigamtism of the Cornea (각막의 곡율반경, 굴절력, 난시에 대한 성인 남녀의 비교 분석)

  • Chio, Ho Seong;Kim, Douk Hoon
    • Journal of Korean Ophthalmic Optics Society
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    • v.5 no.2
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    • pp.27-31
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    • 2000
  • As the functional test of cornea. The clinical value of keratometric information was important for assessment the curvature of the cornea, the quality of the corneal surface, the stability of the corneal curvature, and the direction of the corneal astigmatism. This study was performed the comparative analysis of male and female of adult on the base curve, power and astigmatism of the Cornea. On the corneal base curve, the male right eye was 7.656 mm in vertical and 7.966 mm in horizontal. But, the male left cornea was 7.714 mm in vertical base curve and 8.026 mm in horizontal base curve. On the other hand, the female right eye cornea was 7.559 mm in vertical base curve and 7.695 mm in horizontal base curve. But, the female left eye cornea was 7.444 mm in vertical base curve and 7.742 mm in horizontal base curve. On the corneal diopter power, the male right eye was 44.063 diopter in vertical and 43.738 diopter in horizontal. But the male left eye was 44.046 diopter in vertical and 42.304 diopter in horizontal. On the other hand, the female right eye was 44.082 diopter in vertical and 43.77 diopter in horizontal. But, the female left eye was 44.347 diopter in vertical and 43.495 diopter in horizontal. According to the corneal astigmatism axis. The male right eye have 89.9% positive for with the - rule astigmatism, and 8.1 % positive for against - the - rule astigmatism. But, he male left eye have 91.89% positive for with - the - rule astigmatism, and 8.11 % positive for against - the - rule astigmatism. On the other hand, The female right eye have 76.92% positive for with - the - rule astigmatism, and 23.08 % positive for against - the - rule astigmatism. But, the female left have 80.76 % positive for with - the - rule astigmatism, and 17.31 % positive for against - the - rule as tigmatism. The diopter power of corneal astigmatism have 25.57% positive for behind 1 diopter, 44.89% positive for 1 diopter, 18.18% positive for 2 diopter, 5.11% positive for 3 diopter and 6.25% positive for over 4 diopter.

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