• Title/Summary/Keyword: scale effect

Search Result 8,360, Processing Time 0.049 seconds

Administration of Yijung-tang, Pyeongwi-san, and Shihosogan-tang for Standardization of Korean Medicine Pattern Identification for Functional Dyspepsia: A Study Protocol of a Randomized, Assessor-blind, 3-Arm, Parallel, Open-label, Multicenter Clinical Trial (기능성 소화불량 한의 변증 표준화를 위한 이중탕, 평위산 및 시호소간탕 투여 : 무작위 배정, 평가자 눈가림, 3군 비교, 평행 설계, 공개, 다기관 임상시험 프로토콜)

  • Boram Lee;Min-Jin Cho;Young-Eun Choi;Ojin Kwon;Mi Young Lim;Seok-Jae Ko;So-yeon Kim;Yongjoo Kim;Donghyun Nam;Dong-Jun Choi;Jun-Hwan Lee;Jae-Woo Park;Hojun Kim
    • The Journal of Internal Korean Medicine
    • /
    • v.43 no.6
    • /
    • pp.1105-1121
    • /
    • 2022
  • Objectives: The purpose of this study is to explore the effectiveness and safety of frequently used clinical herbal medicines (Yijung-tang [Lizhong-tang, LJT], Pyeongwi-san [Pingwei-san, PWS], and Shihosogan-tang [Chaihu Shugan-tang, SST]) in patients with functional dyspepsia (FD) when administered according to herbal medicine and Korean medicine pattern identification. The results of this study will be used to standardize the diagnostic instrument used in Korean medicine and to investigate biomarkers of Korean medicine pattern identification. Methods: This study will be a randomized, assessor-blind, 3-arm, parallel, open-label, multi-center clinical trial. A total of 300 FD participants will be recruited from 3 Korean medical hospitals and assigned to the LJT (n=100), PWS (n=100), and SST (n=100) groups according to FD pattern identification. The patients will take the medication for 8 weeks, 3 times a day, before or between meals. The primary outcome will be total dyspepsia symptom (TDS) and the secondary outcomes will be adequate relief (AR) for dyspepsia, overall treatment effect (OTE), visual analogue scale (VAS), functional dyspepsia-related quality of life (FD-QoL), gastrointestinal symptom score (GIS), and pattern identification questionnaires. For the exploratory outcomes, we will analyze blood and fecal metabolome profiles, microbiota from fecal and saliva samples, single nucleotide polymorphism (SNP), and results of Korean medicine diagnosis device measurements (heart rate variability, and tongue, pulse, and abdominal diagnosis). Conclusions: The results of this study will prove objectivity for Korean medicine pattern identifications, and the effectiveness and safety of herbal medicines for the population with FD.

Application of unmanned helicopter on pest management in rice cultivation (무인 항공기 이용 벼 병해충 방제기술 연구)

  • Park, K.H.;Kim, J.K.
    • Journal of Practical Agriculture & Fisheries Research
    • /
    • v.10 no.1
    • /
    • pp.43-58
    • /
    • 2008
  • This research was conducted to determine the alternative tool of chemical spray for rice cultivation using the unmanned helicopter(Yamaha, R-Max Type 2G-remote controlled system) at farmer's field in Korea. The unmanned helicopter tested was introduced form Japan. In Korea the application of chemicals by machine sprayer for pest management in rice cultivation has been ordinarily used at the farmer's level. However, it involved a relatively high cost and laborious for the small scale of cultivation per farm household. Farm population has been highly decreased to 7.5% in 2002 and the population is expected to rapidly reduce by 3.5% in 2012. In Japan, pest control depending on unmanned helicopter has been increased by leaps and bounds. This was due in part to the materialization of the low-cost production technology under agricultural policy and demand environmentally friendly farm products. The practicability of the unmanned helicopter in terms of super efficiency and effectiveness has been proven, and the farmers have understood that the unmanned helicopter is indispensable in the future farming system that they visualized. Also, the unmanned helicopter has been applied to rice, wheat, soybean, vegetables, fruit trees, pine trees for spraying chemicals and/or fertilizers in Japan Effect of disease control by unmanned helicopter was partially approved against rice blast and sheath blight. However, the result was not satisfactory due to the weather conditions and cultural practices. The spray density was also determined in this experiment at 0, 15, 30, and 60cm height from the paddy soil surface and there was 968 spots at 0cm, 1,560 spots at 15cm, 1,923 spots at 30cm, and 2,999 spots at 60cm height. However, no significant difference was found among the treatments. At the same time, there was no phytotoxicity observed under the chemical stray using this unmanned helicopter, nor the rice plant itself was damaged by the wind during the operation.

A Study on the Spatial Control Effect of Panjang in Donggwoldo (동궐도(東闕圖) 판장(板墻)의 공간통제 효과에 관한 연구)

  • HA Yujeong;KIM Choongsik
    • Korean Journal of Heritage: History & Science
    • /
    • v.55 no.4
    • /
    • pp.196-209
    • /
    • 2022
  • This study compared and analyzed the spatial division function and role of partitions by comparing the entire space and the spatial changes before and after the installation of partitions in <Donggwoldo>, which was manufactured in the late Joseon Dynasty. As a research method, a set standard was prepared to decompose the space of <Donggwoldo> into a unit space, and the standard was set according to the role and height of the space by classifying it into a main space, sub space, and transition space. Two convex maps were prepared according to before and after the installation of the Panjang, and the values of connectivity, control, and integration, which are spatial syntax variables, were calculated and analyzed. The results of the study are as follows. First, the partition in <Donggwoldo(東闕圖)> did not affect the overall spatial arrangement and control or connection of Donggwol, but the movement and access of space is limited to specific areas. Second, the partition was a facility intensively distributed in Naejeon(內殿) and Donggung(東宮) to be used actively in the way of space utilization. It shows that the unit space increased rapidly due to the installation of the partition. Since the partition was installed in the spaces that were open and under high control in the case of Naejeon(內殿), it helped to secure private spaces as closed ones under low control. On the other hand, for Donggung(東宮), the spaces were compartmented and divided with the partition to guide the movement path through narrow gates of the partition and increase the depth of the space. This helped to create spaces that are free and can be hidden as it increased the number of spaces coming through. Third, In addition to the functions of "eye blocking, space division, and movement path control" revealed in prior research, the partition has created a "space that is easy to control" within a specific area. The installation of the partition reduced the scale through the separation of spaces, but it occurred the expansion of the movement path and space. Also, the partition functioned to strengthen hiding and closure or increase openness as well through space division. This study is significant in that it revealed the value of the spatial control function of panjang through the analysis of spatial control and depth by analyzing the function of the partition with a mathematical model in addition to the analysis and study of the function and role of panjang. In addition, it is valuable in that it has prepared a framework for analysis tools that can be applied to traditional residential complexes similar to palaces by applying space syntax to <Donggungdo> to create convex spaces according to unit space division and connection types of palace architecture and landscape elements.

Assessment of the Contribution of Weather, Vegetation and Land Use Change for Agricultural Reservoir and Stream Watershed using the SLURP model (II) - Calibration, Validation and Application of the Model - (SLURP 모형을 이용한 기후, 식생, 토지이용변화가 농업용 저수지 유역과 하천유역에 미치는 기여도 평가(II) - 모형의 검·보정 및 적용 -)

  • Park, Geun-Ae;Ahn, So-Ra;Park, Min-Ji;Kim, Seong-Joon
    • KSCE Journal of Civil and Environmental Engineering Research
    • /
    • v.30 no.2B
    • /
    • pp.121-135
    • /
    • 2010
  • This study is to assess the effect of potential future climate change on the inflow of agricultural reservoir and its impact to downstream streamflow by reservoir operation for paddy irrigation water supply using the SLURP. Before the future analysis, the SLURP model was calibrated using the 6 years daily streamflow records (1998-200398 and validated using 3 years streamflow data (2004-200698 for a 366.5 $km^2$ watershed including two agricultural reservoirs (Geumgwang8 and Gosam98located in Anseongcheon watershed. The calibration and validation results showed that the model was able to simulate the daily streamflow well considering the reservoir operation for paddy irrigation and flood discharge, with a coefficient of determination and Nash-Sutcliffe efficiency ranging from s 7 to s 9 and 0.5 to s 8 respectively. Then, the future potential climate change impact was assessed using the future wthe fu data was downscaled by nge impFactor method throuih bias-correction, the future land uses wtre predicted by modified CA-Markov technique, and the future ve potentiacovfu information was predicted and considered by the linear regression bpowten mecthly NDVI from NOAA AVHRR ima ps and mecthly mean temperature. The future (2020s, 2050s and 2e 0s) reservoir inflow, the temporal changes of reservoir storaimpand its impact to downstream streamflow watershed wtre analyzed for the A2 and B2 climate change scenarios based on a base year (2005). At an annual temporal scale, the reservoir inflow and storaimpchange oue, anagricultural reservoir wtre projected to big decrease innautumnnunder all possiblmpcombinations of conditions. The future streamflow, soossmoosture and grounwater recharge decreased slightly, whtre as the evapotransporation was projected to increase largely for all possiblmpcombinations of the conditions. At last, this study was analysed contribution of weather, vegetation and land use change to assess which factor biggest impact on agricultural reservoir and stream watershed. As a result, weather change biggest impact on agricultural reservoir inflow, storage, streamflow, evapotranspiration, soil moisture and groundwater recharge.

What are the Characteristics and Future Directions of Domestic Angel Investment Research? (국내 엔젤투자 연구의 특징과 향후 방향은 무엇인가?)

  • Min Kim;Byung Chul Choi;Woo Jin Lee
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
    • /
    • v.18 no.6
    • /
    • pp.57-70
    • /
    • 2023
  • The investigation delved into 457 pieces of scholarly work, encompassing articles, published theses, and dissertations from the National Research Foundation of Korea, spanning the period of the 1997 IMF financial crisis up to 2022. The materials were sourced using terms such as 'angel investment', 'angel investor', and 'angel investment attraction'. The initial phase involved filtering out redundant entries from the preliminary collection of 267 works, leaving aside pieces that didn't pertain directly to angel investment as indicated in their abstracts. The next stage of the analysis involved a more rigorous selection process. Out of 43 papers earmarked in the preceding cut, only 32 were chosen. The criteria for this focused on the exclusion of conference presentations, articles that were either not submitted or inconclusive, and those that duplicated content under different titles. The final selection of 32 papers underwent a thorough systematic literature review. These documents, all pertinent to angel investment in South Korea, were scrutinized under five distinct categories: 1) publication year, 2) themes of research, 3) strategies employed in the studies, 4) participants involved in the research, and 5) methods of research utilized. This meticulous process illuminated the existing landscape of angel investment studies within Korea. Moreover, this study pinpointed gaps in the current body of research, offering guidance on future scholarly directions and proposing social scientific theories to further enrich the field of angel investment studies and analysis also seeks to pinpoint which areas require additional exploration to energize the field of angel investment moving forward. Through a comprehensive review of literature, this research intends to validate the establishment of future research trajectories and pinpoint areas that are currently and relatively underexplored in Korea's angel investment research stream. This study revealed that current research on domestic angel investment is concentrated on several areas: 1) the traits of angel investors, 2) the motivations behind angel investing, 3) startup ventures, 4) relevant institutions and policies, and 5) the various forms of angel investments. It was determined that there is a need to broaden the scope of research to aid in enhancing and stimulating the scale of domestic angel investing. This includes research into performance analysis of angel investments and detailed case studies in the field. Furthermore, the study emphasizes the importance of diversifying research efforts. Instead of solely focusing on specific factors like investment types, startups, accelerators, venture capital, and regulatory frameworks, there is a call for research that explores a variety of associated variables. These include aspects related to crowdfunding and return on investment in the context of angel investing, ensuring a more holistic approach to research in this domain. Specifically, there's a clear need for more detailed studies focusing on the relationships with variables that serve as dependent variables influencing the outcomes of angel investments. Moreover, it's essential to invigorate both qualitative and quantitative research that delves into the theoretical framework from multiple perspectives. This involves analyzing the structure of variables that have an impact on angel investments and the decisions surrounding these investments, thereby enriching the theoretical foundation of this field. Finally, we presented the direction of development for future research by confirming that the effect on the completeness of the business plan is high or low depending on the satisfaction of the entrepreneurs in addition to the components.

  • PDF

Communities' Perception of the Effect of Ecosystem Services on the Forest Rehabilitation of Abandoned Mine Areas: A Case Study in Taebaek-si and Jeongseon-gun (강원도 폐광산 산림복구지의 지역사회 생태계서비스 인식조사: 태백시 및 정선군을 중심으로)

  • Bohwi Lee;Dawou Joung;Jihye Kim;Gwan-in Bak;Hakjun Rhee
    • Journal of Korean Society of Forest Science
    • /
    • v.113 no.1
    • /
    • pp.118-130
    • /
    • 2024
  • Rehabilitation of mining areas can reduce damage to ecosystems. However, the effects of rehabilitation on ecosystem services (ESs) and its contribution to local communities are not well known. Thus, the aims of this study were to clearly identify the ES beneficiaries affected by mining activities, to determine how the beneficiaries profit from surrounding areas in cooperation with local stakeholders, and to manage the rehabilitation areas for the ESs that the beneficiaries want. This study chose 18 ESs (4 provisioning, 7 regulating, 5 cultural, and 2 habitat services) based on The Economics of Ecosystems and Biodiversity. A semi-structured questionnaire survey using an 11-point Likert scale was conducted among 87 community residents to investigate social awareness and identify key ESs. The survey results from two local communities showed high awareness and demands mainly on cultural (mental and physical health, aesthetic appreciation, and recreation) and regulating services (local climate and air quality, and moderation of extreme events). These services were related to the daily lives of residents in local communities, provided positive benefits, and potentially improved the residents' future livelihoods. However, the average questionnaire scores were limited to 6-7 points, indicating that the benefits to local communities were meager. The residents' awareness of provisioning service was negative, even if it provided goods and profit opportunities. This indicated a disconnection between local communities and provisioning services due to forest rehabilitation that did not consider local communities that traditionally relied on specific provisioning services before the onset of mining activities. Future forest rehabilitation in abandoned mine areas must consider the welfare of local communities for sustainable use of rehabilitated forests and enhancing ESs. In this study, only a qualitative evaluation based on frequency analyses was conducted. The quantification and valuation of key ESs are warranted in the future to promote ESs from forest rehabilitation in abandoned mine areas. The study results would be useful for developing site-specific ES promotion strategies for reforesting mine areas.

Effect of K University Dental Hygiene Department students' participation in overseas clinical practice on satisfaction with practice, major, and intention to work abroad (K 대학교 치위생학과 학생의 해외임상실습참여가 임상실습만족도, 전공만족도 및 해외취업의사에 미치는 영향)

  • Min-Sun Lee;Ma I Choi
    • Journal of Korean Dental Hygiene Science
    • /
    • v.6 no.2
    • /
    • pp.151-160
    • /
    • 2023
  • Background: This study analyzed the differences in practice satisfaction, major, and willingness to work abroad among dental hygiene department students at K University in Gangwon-do based on their participation in international practicums. Methods: A survey was conducted on a total of 215 students through convenience sampling of dental hygiene students, and the final 214 responses were analyzed. General characteristics were examined. Major satisfaction and grades were measured on a 5-point Likert scale. And satisfaction with practice, intention to participate in international practicums, and employment were investigated by papers. Descriptive statistical analysis was performed on general characteristics using SPSS software (version 26.0). Due to the convenience sample, nonparametric analysis was used to determine satisfaction with practice and major according to general characteristics using the Mann-whitney U and Kruskal-wallis test. An independent samples t-test was conducted to determine the difference between practice satisfaction and major satisfaction depending on participation in international practicums, and Fisher's exact test was conducted to determine practice satisfaction, willingness to participate in overseas internships, and employment. Results: Concerning future participation in international clinical practicums, 66.7% of students who had previously participated in overseas training expressed willingness to engage again. 40.9% of those who had not participated showed no intention of participating, and there was a significant difference (p<0.05). Additionally, 76.2% of the participants expressed interest in overseas employment, with this difference also being statistically significant (p<0.05). Conclusion: It was confirmed that students' satisfaction with practice and major increased through participation in international practicums, and that they had a positive intention to work abroad and participate in overseas internship programs in the future.

Perceptional Change of a New Product, DMB Phone

  • Kim, Ju-Young;Ko, Deok-Im
    • Journal of Global Scholars of Marketing Science
    • /
    • v.18 no.3
    • /
    • pp.59-88
    • /
    • 2008
  • Digital Convergence means integration between industry, technology, and contents, and in marketing, it usually comes with creation of new types of product and service under the base of digital technology as digitalization progress in electro-communication industries including telecommunication, home appliance, and computer industries. One can see digital convergence not only in instruments such as PC, AV appliances, cellular phone, but also in contents, network, service that are required in production, modification, distribution, re-production of information. Convergence in contents started around 1990. Convergence in network and service begins as broadcasting and telecommunication integrates and DMB(digital multimedia broadcasting), born in May, 2005 is the symbolic icon in this trend. There are some positive and negative expectations about DMB. The reason why two opposite expectations exist is that DMB does not come out from customer's need but from technology development. Therefore, customers might have hard time to interpret the real meaning of DMB. Time is quite critical to a high tech product, like DMB because another product with same function from different technology can replace the existing product within short period of time. If DMB does not positioning well to customer's mind quickly, another products like Wibro, IPTV, or HSPDA could replace it before it even spreads out. Therefore, positioning strategy is critical for success of DMB product. To make correct positioning strategy, one needs to understand how consumer interprets DMB and how consumer's interpretation can be changed via communication strategy. In this study, we try to investigate how consumer perceives a new product, like DMB and how AD strategy change consumer's perception. More specifically, the paper segment consumers into sub-groups based on their DMB perceptions and compare their characteristics in order to understand how they perceive DMB. And, expose them different printed ADs that have messages guiding consumer think DMB in specific ways, either cellular phone or personal TV. Research Question 1: Segment consumers according to perceptions about DMB and compare characteristics of segmentations. Research Question 2: Compare perceptions about DMB after AD that induces categorization of DMB in direction for each segment. If one understand and predict a direction in which consumer perceive a new product, firm can select target customers easily. We segment consumers according to their perception and analyze characteristics in order to find some variables that can influence perceptions, like prior experience, usage, or habit. And then, marketing people can use this variables to identify target customers and predict their perceptions. If one knows how customer's perception is changed via AD message, communication strategy could be constructed properly. Specially, information from segmented customers helps to develop efficient AD strategy for segment who has prior perception. Research framework consists of two measurements and one treatment, O1 X O2. First observation is for collecting information about consumer's perception and their characteristics. Based on first observation, the paper segment consumers into two groups, one group perceives DMB similar to Cellular phone and the other group perceives DMB similar to TV. And compare characteristics of two segments in order to find reason why they perceive DMB differently. Next, we expose two kinds of AD to subjects. One AD describes DMB as Cellular phone and the other Ad describes DMB as personal TV. When two ADs are exposed to subjects, consumers don't know their prior perception of DMB, in other words, which subject belongs 'similar-to-Cellular phone' segment or 'similar-to-TV' segment? However, we analyze the AD's effect differently for each segment. In research design, final observation is for investigating AD effect. Perception before AD is compared with perception after AD. Comparisons are made for each segment and for each AD. For the segment who perceives DMB similar to TV, AD that describes DMB as cellular phone could change the prior perception. And AD that describes DMB as personal TV, could enforce the prior perception. For data collection, subjects are selected from undergraduate students because they have basic knowledge about most digital equipments and have open attitude about a new product and media. Total number of subjects is 240. In order to measure perception about DMB, we use indirect measurement, comparison with other similar digital products. To select similar digital products, we pre-survey students and then finally select PDA, Car-TV, Cellular Phone, MP3 player, TV, and PSP. Quasi experiment is done at several classes under instructor's allowance. After brief introduction, prior knowledge, awareness, and usage about DMB as well as other digital instruments is asked and their similarities and perceived characteristics are measured. And then, two kinds of manipulated color-printed AD are distributed and similarities and perceived characteristics for DMB are re-measured. Finally purchase intension, AD attitude, manipulation check, and demographic variables are asked. Subjects are given small gift for participation. Stimuli are color-printed advertising. Their actual size is A4 and made after several pre-test from AD professionals and students. As results, consumers are segmented into two subgroups based on their perceptions of DMB. Similarity measure between DMB and cellular phone and similarity measure between DMB and TV are used to classify consumers. If subject whose first measure is less than the second measure, she is classified into segment A and segment A is characterized as they perceive DMB like TV. Otherwise, they are classified as segment B, who perceives DMB like cellular phone. Discriminant analysis on these groups with their characteristics of usage and attitude shows that Segment A knows much about DMB and uses a lot of digital instrument. Segment B, who thinks DMB as cellular phone doesn't know well about DMB and not familiar with other digital instruments. So, consumers with higher knowledge perceive DMB similar to TV because launching DMB advertising lead consumer think DMB as TV. Consumers with less interest on digital products don't know well about DMB AD and then think DMB as cellular phone. In order to investigate perceptions of DMB as well as other digital instruments, we apply Proxscal analysis, Multidimensional Scaling technique at SPSS statistical package. At first step, subjects are presented 21 pairs of 7 digital instruments and evaluate similarity judgments on 7 point scale. And for each segment, their similarity judgments are averaged and similarity matrix is made. Secondly, Proxscal analysis of segment A and B are done. At third stage, get similarity judgment between DMB and other digital instruments after AD exposure. Lastly, similarity judgments of group A-1, A-2, B-1, and B-2 are named as 'after DMB' and put them into matrix made at the first stage. Then apply Proxscal analysis on these matrixes and check the positional difference of DMB and after DMB. The results show that map of segment A, who perceives DMB similar as TV, shows that DMB position closer to TV than to Cellular phone as expected. Map of segment B, who perceive DMB similar as cellular phone shows that DMB position closer to Cellular phone than to TV as expected. Stress value and R-square is acceptable. And, change results after stimuli, manipulated Advertising show that AD makes DMB perception bent toward Cellular phone when Cellular phone-like AD is exposed, and that DMB positioning move towards Car-TV which is more personalized one when TV-like AD is exposed. It is true for both segment, A and B, consistently. Furthermore, the paper apply correspondence analysis to the same data and find almost the same results. The paper answers two main research questions. The first one is that perception about a new product is made mainly from prior experience. And the second one is that AD is effective in changing and enforcing perception. In addition to above, we extend perception change to purchase intention. Purchase intention is high when AD enforces original perception. AD that shows DMB like TV makes worst intention. This paper has limitations and issues to be pursed in near future. Methodologically, current methodology can't provide statistical test on the perceptual change, since classical MDS models, like Proxscal and correspondence analysis are not probability models. So, a new probability MDS model for testing hypothesis about configuration needs to be developed. Next, advertising message needs to be developed more rigorously from theoretical and managerial perspective. Also experimental procedure could be improved for more realistic data collection. For example, web-based experiment and real product stimuli and multimedia presentation could be employed. Or, one can display products together in simulated shop. In addition, demand and social desirability threats of internal validity could influence on the results. In order to handle the threats, results of the model-intended advertising and other "pseudo" advertising could be compared. Furthermore, one can try various level of innovativeness in order to check whether it make any different results (cf. Moon 2006). In addition, if one can create hypothetical product that is really innovative and new for research, it helps to make a vacant impression status and then to study how to form impression in more rigorous way.

  • PDF

Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer (III 기 비소세포성 폐암에서 Cisplatin-방사선동시병합요법의 효과)

  • Kim In Ah;Choi Ihl Bhong;Kang Ki Mun;Jang Jie Young;Song Jung Sub;Lee Sun Hee;Kuak Mun Sub;Shinn Kyung Sub
    • Radiation Oncology Journal
    • /
    • v.15 no.1
    • /
    • pp.27-36
    • /
    • 1997
  • Purpose : This study was tried to evaluate the Potential benefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation therapy alone in stage III non-small cell lung cancer. The end points of analyses were response rate. overall survival, survival without locoregional failure, survival without distant metastasis, prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300 cGy given 10 times up to 3000 cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250 cGy given 10 times up to 2500 cGy) was combined with $6mg/m^2$ of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months. Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170-200 cGy) radiation therapy alone. Total radiation dose ranged from 5580 cGy to 7000 cGy with median of 5940 cGy. Follow-up Period ranged from 36 months to 105 months with median of 62 months. Result : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%, CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%. The overall survival rate had no significant differences in between CRT group and RT group (17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastasis (17% vs. 4.6% at 2 years) also had no significant differences. In subgroup analyses for Patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a Prognostic factors. RTOG/EORTC grade 2-3 nausea and vomiting(22% vs 6% and bone marrow toxicities (25% vs. 15.6% were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmonary toxicity had no significant differences in between CRT group and RT group (16% vs. 6%. The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group (38% vs. 25%. In analyses for relationship of field size and Pulmonary toxicity, the Patients who treated with field size beyond 200cm2 had significantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performance status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good performance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group Therefore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

  • PDF

An experimental study on the impact of an agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers and enhance their self-confidence and satisfaction in maternal role performance (산욕초기 초산모의 간호목표달성방번 합의가 어머니 역할수행에 대한 자신감 및 만족도에 미치는 영향에 관한 실험적 연구)

  • 이영은
    • Journal of Korean Academy of Nursing
    • /
    • v.22 no.1
    • /
    • pp.81-115
    • /
    • 1992
  • The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t=3.95, p<0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t=1.93, p<0.05), ‘I know that my baby wants most of the times’(t=2.75, p<0.01), ‘When the baby cries, 1 can tell what she/he wants’(t=2.10, p<0.05), ‘I have confidence in my ability to care for the baby’(t=3.72, p<0.01), ‘I trust my own judement in deciding how to care for the baby’(t=1.96, p<0.05), ‘I feel that I know my baby and what to do for him /her’(t=2.44, p<0.01), ‘I am concerned about being able to meet the baby's needs’(t=2.87, p<0.01), ‘I know what my baby likes and dislikes’(t=3.26, p<0.01), ‘I don't know to care for the baby as well as I should’(t=2.07, p<0.05), and ‘I am unsure about whether I give enough attention to the baby’(t=3.04, p<0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=3.95, p<0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t=2.31, p<0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t=2.29, p<0.05), ‘I enjoy taking care of the baby’(t=2.4g, p<0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t=2.87, P<0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t=2.51, p<0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t=2.43, p<0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=2.31, p<0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r=0.57, p<0.01)

  • PDF