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CLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH CONDUCT PROBLEMS ADMITTED INTO A PSYCHIATRIC UNIT (소아정신과 병동에 입원한 품행장애 소아 청소년의 임상 특성)

  • Pyo, Kyung-Sik;Kang, Yun-Hyong;Bahn, Geon-Ho;Cho, Soo-Churl;Lee, Eun-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.227-236
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    • 1998
  • Objectives:Conduct disorder is one of the most frequent diagnosis in outpatient and inpatient mental health facilities for children and adolescents. This study investigated the clinical characteristics of children and adolescents with conduct disorder. Methods:The study employed a retrospective review of 45 inpatients diagnosed with conduct disorder by DSM-IV criteria at SNUH Child Psychiatric Unit from 1993, March to 1998, September. Results:The results were as follows:1) The sex ratio was 2:1, male dominant. Mean age on admission was $12.8{\pm}2.4$ years old(male:$12.2{\pm}2.3$, female:$14.1{\pm}2.1$). The mean age of male subjects was significantly lower than that of female subjects(p<.05). 2) We classified all subjects according to child- or adolescent-onset type by DSM-Ⅳ. Childhoodonset type was 42.2%, and adolescent-onset, 57.8%. The onset of male subjects were significantly earlier than that of female subjects(p<.05). 3) The most common complaint was 'serious violation of rules'(77.8%) by DSM-Ⅳ dimensions, while the most common single symtom was 'run away from home overnight at least twice while living in parental or parental surrogate home'(48.9%). 4) The comorbid psychopathology of the subjects were frequently described as follows, in order of frequency:substance use(42.2%), ADHD(35.6%), depression(20.0%), tic disorder(11.1%), bipolar disorder(4.4%). 5) On MMPI, both Pd and Ma subscales got the highest scores. The mean of total IQ by KEDIWISC was $100.0{\pm}15.1$. Female subjects' IQ was higher than that of male subjects. 6) Regarding the number of visits to the OPD after discharge, many subjects(33.3%) had visited OPD fewer than four times. Conclusions:In this study, the male to female ratio of adolescent type showed a decreasing trend. An interesting finding was the fact that socio-economic circumstances, as well as the level of education among patients, were higher than those of previous studies. The subjects' problem were also principally self contered and posed no threat to others.

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A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis (조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구)

  • 박경숙;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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Nutrient Balance and Vegetable Crop Production as Affected by Different Sources of Organic Fertilizers (유기자원에 따른 양분수지 및 작물생산)

  • Agus, Fahmuddin;Setyorini, Diah;Hartatik, Wiwik;Lee, Sang-Min;Sung, Jwa-Kyung;Shin, Jae-Hoon
    • Korean Journal of Soil Science and Fertilizer
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    • v.42 no.1
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    • pp.1-13
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    • 2009
  • Understanding the net nutrient balance in a farming system is crucial in assessing the system's sustainability. We quantified N, P and K balances under vegetable organic farming in a Eutric Haplud and in West Java, Indonesia in five planting seasons from 2005 to 2007. The ten treatments and three replications, arranged in a completely randomized block design, included single or combined sources of organic fertilizers: barnyard manure, compos ts or green manures. The organic matter rates were adjusted every planting season depending on the previous crop responses. The result sshowed that the application of ${\geq}20$ t $ha^{-1}$ barnyard manure per crop resulted in positive balances of N, P, and K, except in the second crops of 2006 where potassium balance were -25 to -11 kg $ha^{-1}$ under the treatments involving cattle barnyard manure, because of low K content of these treatments and high K uptake by Chinese cabbage. Application of 20 to 25 t $ha^{-1}$ of plant residue or 5 t $ha^{-1}$ of Tithonia compost also resulted in a negative K balance. Soil available P increased significantly under ${\geq}25$ t $ha^{-1}$ barnyard manure and that under chicken manure had the highest available P. Accordingly, chicken barnyard manure gave the highest crop yield because of relatively higher N, P, and K contents. Plant residues gave the lowest yield due to the lowest nutrient content among all sources. Reducing the use of barnyard manure to 12.5 t $ha^{-1}$ and substituting it with Tithonia compost, Tithonia green manure or vegetable plant residue compost gave insignificantly different yield compared to the application of 25 t $ha^{-1}$ barnyard manure singly. In the long run, application of 25 t ha-1 cattle, goat, and horse manure or about 20 t $ha^{-1}$ chicken manure is recommendable for sustaining the fertility of this Andisol for vegetable production.

The Formation and Types of Business Archives m Germany (독일 경제아카이브즈의 형성과 유형)

  • Kim, Young-Ae
    • The Korean Journal of Archival Studies
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    • no.8
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    • pp.137-180
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    • 2003
  • The term 'Business Archives' is not familiar with us in our society. Some cases can be found that materials are collected for publishing the history of a firm on commemoration of some decades of its foundation. However, the appropriate management of these collected materials doesn't seem to be followed in most of companies. The Records and archives management is inevitable in order to maximize the utility of Information and knowledge in the business world. The interest in records management has been grown, especially in the fields of business management and information technology. However, the importance of business archives hasn't been conceived yet. And also no attention has been paid to the business archives as social resources and the responsibility of the society as a whole for their preservation. The company archives doesn't have a long history in Germany although the archives of the nation, the aristocracy, communes and churches have a long tradition. However the company archives of Krupps which was established in 1905, is regarded as the first business archives in the world, It means that Germany has taken a key role to lead the culture of business archives. This paper focuses on the process of the establishment of business archives in Germany and its characteristics. The business archives in Germany can be categorized in three types: company archives, regional business archives and branch archives. It must be noted here that each type of these was generated in the context of the accumulation of the social resources and its effective use. A company archives is established by an individual company for the preservation of and use of the archives that originated in the company. The holdings in the company archives can be used as materials for decision making of policies, reporting, advertising, training of employees etc. They function not only as sources inside the company, but also as raw sources for the scholars, contributing to the study of the social-economic history. Some archives of German companies are known as a center of research. A regional business archives manages materials which originated m commerce chambers, associations and companies in a certain region. There are 6 regional business archives in Germany. They collect business archives which aren't kept in a proper way or are under pressure of damage in the region for which they are responsible. They are also open to the public offering the sources for the study of economic history, social history like company archives, so that they also play a central role as a research center. Branch business archives appeared relatively late in Germany. The first one is established in Bochum in 1969. Its general duties and goals are almost similar with ones of other two types of archives. It has differences in two aspects. One is that the responsibility of the branch business archives covers all the country, while regional business archives collects archives in a particular region. The other is that a branch business archives collects materials from a single industry. For example, the holdings of Bochum archives are related with the mining industry. The mining industry-specialized Bochum archives is run as an organization in combination with a museum, which is called as German mine museum, so that it plays a role as a cultural center with the functions of exhibition and research. The three types of German business archives have their own functions but they are also closely related each other under the German Association of Business Archivists. They are sharing aims to preserve primary materials with historical values in the field of economy and also contribute to keeping the archives as a social resources by having feed back with the public, which leads the archives to be a center of information and research. The German case shows that business archives in a society should be preserved not only for the interest of the companies, but also for the utilities of social resources. It also shows us how business archives could be preserved as a social resource. It is expected that some studies which approach more deeply on this topic will be followed based on the considerations from the German case.

Radiomics Analysis of Gray-Scale Ultrasonographic Images of Papillary Thyroid Carcinoma > 1 cm: Potential Biomarker for the Prediction of Lymph Node Metastasis (Radiomics를 이용한 1 cm 이상의 갑상선 유두암의 초음파 영상 분석: 림프절 전이 예측을 위한 잠재적인 바이오마커)

  • Hyun Jung Chung;Kyunghwa Han;Eunjung Lee;Jung Hyun Yoon;Vivian Youngjean Park;Minah Lee;Eun Cho;Jin Young Kwak
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.185-196
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    • 2023
  • Purpose This study aimed to investigate radiomics analysis of ultrasonographic images to develop a potential biomarker for predicting lymph node metastasis in papillary thyroid carcinoma (PTC) patients. Materials and Methods This study included 431 PTC patients from August 2013 to May 2014 and classified them into the training and validation sets. A total of 730 radiomics features, including texture matrices of gray-level co-occurrence matrix and gray-level run-length matrix and single-level discrete two-dimensional wavelet transform and other functions, were obtained. The least absolute shrinkage and selection operator method was used for selecting the most predictive features in the training data set. Results Lymph node metastasis was associated with the radiomics score (p < 0.001). It was also associated with other clinical variables such as young age (p = 0.007) and large tumor size (p = 0.007). The area under the receiver operating characteristic curve was 0.687 (95% confidence interval: 0.616-0.759) for the training set and 0.650 (95% confidence interval: 0.575-0.726) for the validation set. Conclusion This study showed the potential of ultrasonography-based radiomics to predict cervical lymph node metastasis in patients with PTC; thus, ultrasonography-based radiomics can act as a biomarker for PTC.

DEVELOPMENT OF STATEWIDE TRUCK TRAFFIC FORECASTING METHOD BY USING LIMITED O-D SURVEY DATA (한정된 O-D조사자료를 이용한 주 전체의 트럭교통예측방법 개발)

  • 박만배
    • Proceedings of the KOR-KST Conference
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    • 1995.02a
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    • pp.101-113
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    • 1995
  • The objective of this research is to test the feasibility of developing a statewide truck traffic forecasting methodology for Wisconsin by using Origin-Destination surveys, traffic counts, classification counts, and other data that are routinely collected by the Wisconsin Department of Transportation (WisDOT). Development of a feasible model will permit estimation of future truck traffic for every major link in the network. This will provide the basis for improved estimation of future pavement deterioration. Pavement damage rises exponentially as axle weight increases, and trucks are responsible for most of the traffic-induced damage to pavement. Consequently, forecasts of truck traffic are critical to pavement management systems. The pavement Management Decision Supporting System (PMDSS) prepared by WisDOT in May 1990 combines pavement inventory and performance data with a knowledge base consisting of rules for evaluation, problem identification and rehabilitation recommendation. Without a r.easonable truck traffic forecasting methodology, PMDSS is not able to project pavement performance trends in order to make assessment and recommendations in the future years. However, none of WisDOT's existing forecasting methodologies has been designed specifically for predicting truck movements on a statewide highway network. For this research, the Origin-Destination survey data avaiiable from WisDOT, including two stateline areas, one county, and five cities, are analyzed and the zone-to'||'&'||'not;zone truck trip tables are developed. The resulting Origin-Destination Trip Length Frequency (00 TLF) distributions by trip type are applied to the Gravity Model (GM) for comparison with comparable TLFs from the GM. The gravity model is calibrated to obtain friction factor curves for the three trip types, Internal-Internal (I-I), Internal-External (I-E), and External-External (E-E). ~oth "macro-scale" calibration and "micro-scale" calibration are performed. The comparison of the statewide GM TLF with the 00 TLF for the macro-scale calibration does not provide suitable results because the available 00 survey data do not represent an unbiased sample of statewide truck trips. For the "micro-scale" calibration, "partial" GM trip tables that correspond to the 00 survey trip tables are extracted from the full statewide GM trip table. These "partial" GM trip tables are then merged and a partial GM TLF is created. The GM friction factor curves are adjusted until the partial GM TLF matches the 00 TLF. Three friction factor curves, one for each trip type, resulting from the micro-scale calibration produce a reasonable GM truck trip model. A key methodological issue for GM. calibration involves the use of multiple friction factor curves versus a single friction factor curve for each trip type in order to estimate truck trips with reasonable accuracy. A single friction factor curve for each of the three trip types was found to reproduce the 00 TLFs from the calibration data base. Given the very limited trip generation data available for this research, additional refinement of the gravity model using multiple mction factor curves for each trip type was not warranted. In the traditional urban transportation planning studies, the zonal trip productions and attractions and region-wide OD TLFs are available. However, for this research, the information available for the development .of the GM model is limited to Ground Counts (GC) and a limited set ofOD TLFs. The GM is calibrated using the limited OD data, but the OD data are not adequate to obtain good estimates of truck trip productions and attractions .. Consequently, zonal productions and attractions are estimated using zonal population as a first approximation. Then, Selected Link based (SELINK) analyses are used to adjust the productions and attractions and possibly recalibrate the GM. The SELINK adjustment process involves identifying the origins and destinations of all truck trips that are assigned to a specified "selected link" as the result of a standard traffic assignment. A link adjustment factor is computed as the ratio of the actual volume for the link (ground count) to the total assigned volume. This link adjustment factor is then applied to all of the origin and destination zones of the trips using that "selected link". Selected link based analyses are conducted by using both 16 selected links and 32 selected links. The result of SELINK analysis by u~ing 32 selected links provides the least %RMSE in the screenline volume analysis. In addition, the stability of the GM truck estimating model is preserved by using 32 selected links with three SELINK adjustments, that is, the GM remains calibrated despite substantial changes in the input productions and attractions. The coverage of zones provided by 32 selected links is satisfactory. Increasing the number of repetitions beyond four is not reasonable because the stability of GM model in reproducing the OD TLF reaches its limits. The total volume of truck traffic captured by 32 selected links is 107% of total trip productions. But more importantly, ~ELINK adjustment factors for all of the zones can be computed. Evaluation of the travel demand model resulting from the SELINK adjustments is conducted by using screenline volume analysis, functional class and route specific volume analysis, area specific volume analysis, production and attraction analysis, and Vehicle Miles of Travel (VMT) analysis. Screenline volume analysis by using four screenlines with 28 check points are used for evaluation of the adequacy of the overall model. The total trucks crossing the screenlines are compared to the ground count totals. L V/GC ratios of 0.958 by using 32 selected links and 1.001 by using 16 selected links are obtained. The %RM:SE for the four screenlines is inversely proportional to the average ground count totals by screenline .. The magnitude of %RM:SE for the four screenlines resulting from the fourth and last GM run by using 32 and 16 selected links is 22% and 31 % respectively. These results are similar to the overall %RMSE achieved for the 32 and 16 selected links themselves of 19% and 33% respectively. This implies that the SELINICanalysis results are reasonable for all sections of the state.Functional class and route specific volume analysis is possible by using the available 154 classification count check points. The truck traffic crossing the Interstate highways (ISH) with 37 check points, the US highways (USH) with 50 check points, and the State highways (STH) with 67 check points is compared to the actual ground count totals. The magnitude of the overall link volume to ground count ratio by route does not provide any specific pattern of over or underestimate. However, the %R11SE for the ISH shows the least value while that for the STH shows the largest value. This pattern is consistent with the screenline analysis and the overall relationship between %RMSE and ground count volume groups. Area specific volume analysis provides another broad statewide measure of the performance of the overall model. The truck traffic in the North area with 26 check points, the West area with 36 check points, the East area with 29 check points, and the South area with 64 check points are compared to the actual ground count totals. The four areas show similar results. No specific patterns in the L V/GC ratio by area are found. In addition, the %RMSE is computed for each of the four areas. The %RMSEs for the North, West, East, and South areas are 92%, 49%, 27%, and 35% respectively, whereas, the average ground counts are 481, 1383, 1532, and 3154 respectively. As for the screenline and volume range analyses, the %RMSE is inversely related to average link volume. 'The SELINK adjustments of productions and attractions resulted in a very substantial reduction in the total in-state zonal productions and attractions. The initial in-state zonal trip generation model can now be revised with a new trip production's trip rate (total adjusted productions/total population) and a new trip attraction's trip rate. Revised zonal production and attraction adjustment factors can then be developed that only reflect the impact of the SELINK adjustments that cause mcreases or , decreases from the revised zonal estimate of productions and attractions. Analysis of the revised production adjustment factors is conducted by plotting the factors on the state map. The east area of the state including the counties of Brown, Outagamie, Shawano, Wmnebago, Fond du Lac, Marathon shows comparatively large values of the revised adjustment factors. Overall, both small and large values of the revised adjustment factors are scattered around Wisconsin. This suggests that more independent variables beyond just 226; population are needed for the development of the heavy truck trip generation model. More independent variables including zonal employment data (office employees and manufacturing employees) by industry type, zonal private trucks 226; owned and zonal income data which are not available currently should be considered. A plot of frequency distribution of the in-state zones as a function of the revised production and attraction adjustment factors shows the overall " adjustment resulting from the SELINK analysis process. Overall, the revised SELINK adjustments show that the productions for many zones are reduced by, a factor of 0.5 to 0.8 while the productions for ~ relatively few zones are increased by factors from 1.1 to 4 with most of the factors in the 3.0 range. No obvious explanation for the frequency distribution could be found. The revised SELINK adjustments overall appear to be reasonable. The heavy truck VMT analysis is conducted by comparing the 1990 heavy truck VMT that is forecasted by the GM truck forecasting model, 2.975 billions, with the WisDOT computed data. This gives an estimate that is 18.3% less than the WisDOT computation of 3.642 billions of VMT. The WisDOT estimates are based on the sampling the link volumes for USH, 8TH, and CTH. This implies potential error in sampling the average link volume. The WisDOT estimate of heavy truck VMT cannot be tabulated by the three trip types, I-I, I-E ('||'&'||'pound;-I), and E-E. In contrast, the GM forecasting model shows that the proportion ofE-E VMT out of total VMT is 21.24%. In addition, tabulation of heavy truck VMT by route functional class shows that the proportion of truck traffic traversing the freeways and expressways is 76.5%. Only 14.1% of total freeway truck traffic is I-I trips, while 80% of total collector truck traffic is I-I trips. This implies that freeways are traversed mainly by I-E and E-E truck traffic while collectors are used mainly by I-I truck traffic. Other tabulations such as average heavy truck speed by trip type, average travel distance by trip type and the VMT distribution by trip type, route functional class and travel speed are useful information for highway planners to understand the characteristics of statewide heavy truck trip patternS. Heavy truck volumes for the target year 2010 are forecasted by using the GM truck forecasting model. Four scenarios are used. Fo~ better forecasting, ground count- based segment adjustment factors are developed and applied. ISH 90 '||'&'||' 94 and USH 41 are used as example routes. The forecasting results by using the ground count-based segment adjustment factors are satisfactory for long range planning purposes, but additional ground counts would be useful for USH 41. Sensitivity analysis provides estimates of the impacts of the alternative growth rates including information about changes in the trip types using key routes. The network'||'&'||'not;based GMcan easily model scenarios with different rates of growth in rural versus . . urban areas, small versus large cities, and in-state zones versus external stations. cities, and in-state zones versus external stations.

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