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A Clinical Study for Promoting Quality Nusing Care in a University Hospital (질적 간호제공을 위한 간호단위 시범 운영 효과에 관한 임상적 연구)

  • Lee, A.J.;Kim, S.H.;Seong, Y.H.;Yoo, S.A.;Kwon, I.G.;Jeong, Y.I.;Nam, H.K.;Kwon, E.J.
    • The Korean Nurse
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    • v.32 no.5
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    • pp.66-77
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    • 1994
  • The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower. For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remedies to the problems a hospital-wide survey and a workshop were performed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of bed-side nursing care were adopted as main principles for operating model unit, This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992. To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other. The results of the study were as follows; 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 ; 70.4 and that of the control unit was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body temperature, hygiene, and communication and health education were longer than that of the con" trol unit. 2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than that of the control unit. 3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=-0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were significantly higher than before. 4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit(Z=2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before (Z=-2.0732, P=.0382). 5. After operating the model unit, quality care index was increased from 89 to 93. With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial increase in direct nursing care hours, nurses satisfaction to their job and patients' satisfaction to nursing care. In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be considered sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.

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A Study on Park Gye-hyeong -Focusing on the Change of Romantic writing (박계형론 -낭만적 글쓰기의 변주를 중심으로)

  • Jin, Sun-Young
    • Journal of Popular Narrative
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    • v.25 no.2
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    • pp.247-275
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    • 2019
  • We hope that more diverse interests will arise in the novels by Park Gye-hyeong By looking at writers and works in time, we identified the key element of Park Gye-hyeong's novels as 'romantic'. Romantic nature of this time is lyrical, sentimental, spiritual, unrealistic and idealistic. Based on a romantic understanding of the world, the core sanction of the novel is love, focusing on feelings of sadness, and on the aspects of joy, separation, and pain that arise from loving relationships rather than the aspects of joy. Based on the feelings of grief, the novels end with failure, death and betrayal, thus embodying tragic romanticism. Before her marriage, Park Gye-hyeong's novels were love stories that revealed her longing for beautiful love based on sensibility. The idyllic world and longing for nature reveal a romantic world-view. Ultimately, it is a fictional worldview that the author seeks to despair and long for, and to find the sincerity and morality of love in an environment that does not. Park Gye-hyeong, who became a housewife, expressed that she wanted to write a piece that can give readers a sense of nostalgia by embodying "romance at a high level," not "sentimental." In subsequent works, physical relationships are treated as failures of love and spiritual relationships as the fruit of love, revealing the lofty spirituality, idealistic longing and religious nature of love. Park Gye-hyeong confessed her shame about her previous work when she published a new one after more than two decades of writing. And after more than two decades of reflection, her new novel had a new theme of "recovering destroyed humanity." However, the search for "humanity" in the two novels released after the write-off tends to be somewhat hasty at the end of the novel. The question of human nature, sin and forgiveness, is the next best thing to save as a way of life, rather than as a result of the intense inner agony and behavior of the characters within the narrative, and this also shows a sudden shift in religiousness at the end of the novel. Therefore, the romantic meaning of the superficial is superficial.

Syllabus Design and Pronunciation Teaching

  • Amakawa, Yukiko
    • Proceedings of the KSPS conference
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    • 2000.07a
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    • pp.235-240
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    • 2000
  • In the age of global communication, more human exchange is extended at the grass-roots level. In the old days, language policy and language planning was based on one nation-state with one language. But high waves of globalizaiton have allowed extended human flow of exchange beyond one's national border on a daily basis. Under such circumstances, homogeneity in Japan may not allow Japanese to speak and communicate only in Japanese and only with Japanese people. In Japan, an advisory report was made to the Ministry of Education in June 1996 about what education should be like in the 21st century. In this report, an introduction of English at public elementary schools was for the first time made. A basic policy of English instruction at the elementary school level was revealed. With this concept, English instruction is not required at the elementary school level but each school has their own choice of introducing English as their curriculum starting April 2002. As Baker, Colin (1996) indicates the age of three as being the threshold diving a child becoming bilingual naturally or by formal instruction. Threre is a movement towards making second language acquisition more naturalistic in an educational setting, developing communicative competence in a more or less formal way. From the lesson of the Canadian immersion success, Genesee (1987) stresses the importance of early language instruction. It is clear that from a psycho-linguistic perspective, most children acquire basic communication skills in their first language apparently effortlessly and without systematic and formal instruction during the first six or seven years of life. This innate capacity diminishes with age, thereby making language learning increasingly difficult. The author, being a returnee, experienced considerable difficulty acquiring L2, and especially achieving native-like competence. There will be many hurdles to conquer until Japanese students are able to reach at least a communicative level in English. It has been mentioned that English is not taught to clear the college entrance examination, but to communicate. However, Japanese college entrance examination still makes students focus more on the grammar-translation method. This is expected to shift to a more communication stressed approach. Japan does not have to aim at becoming an official bilingual country, but at least communicative English should be taught at every level in school Mito College is a small two-year co-ed college in Japan. Students at Mito College are basically notgood at English. It has only one department for business and economics, and English is required for all freshmen. It is necessary for me to make my classes enjoyable and attractive so that students can at least get motivated to learn English. My major target is communicative English so that students may be prepared to use English in various business settings. As an experiment to introduce more communicative English, the author has made the following syllabus design. This program aims at training students speak and enjoy English. 90-minute class (only 190-minute session per week is most common in Japanese colleges) is divided into two: The first half is to train students orally using Graded Direct Method. The latter half uses different materials each time so that students can learn and enjoy English culture and language simultaneously. There are no quizes or examinations in my one-academic year program. However, all students are required to make an original English poem by the end of the spring semester. 2-6 students work together in a group on one poem. Students coming to Mito College, Japan have one of the lowest English levels in all of Japan. However, an attached example of one poem made by a group shows that students can improve their creativity as long as they are kept encouraged. At the end of the fall semester, all students are then required individually to make a 3-minute original English speech. An example of that speech contest will be presented at the Convention in Seoul.

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Quantitative Analysis of Magnetization Transfer by Phase Sensitive Method in Knee Disorder (무릎 이상에 대한 자화전이 위상감각에 의한 정량분석법)

  • Yoon, Moon-Hyun;Sung, Mi-Sook;Yin, Chang-Sik;Lee, Heung-Kyu;Choe, Bo-Young
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.2
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    • pp.98-107
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    • 2006
  • Magnetization Transfer (MT) imaging generates contrast dependent on the phenomenon of magnetization exchange between free water proton and restricted proton in macromolecules. In biological materials in knee, MT or cross-relaxation is commonly modeled using two spin pools identified by their different T2 relaxation times. Two models for cross-relaxation emphasize the role of proton chemical exchange between protons of water and exchangeable protons on macromolecules, as well as through dipole-dipole interaction between the water and macromolecule protons. The most essential tool in medical image manipulation is the ability to adjust the contrast and intensity. Thus, it is desirable to adjust the contrast and intensity of an image interactively in the real time. The proton density (PD) and T2-weighted SE MR images allow the depiction of knee structures and can demonstrate defects and gross morphologic changes. The PD- and T2-weighted images also show the cartilage internal pathology due to the more intermediate signal of the knee joint in these sequences. Suppression of fat extends the dynamic range of tissue contrast, removes chemical shift artifacts, and decreases motion-related ghost artifacts. Like fat saturation, phase sensitive methods are also based on the difference in precession frequencies of water and fat. In this study, phase sensitive methods look at the phase difference that is accumulated in time as a result of Larmor frequency differences rather than using this difference directly. Although how MT work was given with clinical evidence that leads to quantitative model for MT in tissues, the mathematical formalism used to describe the MT effect applies to explaining to evaluate knee disorder, such as anterior cruciate ligament (ACL) tear and meniscal tear. Calculation of the effect of the effect of the MT saturation is given in the magnetization transfer ratio (MTR) which is a quantitative measure of the relative decrease in signal intensity due to the MT pulse.

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A study on an application of 'Virtual Reality Therapy' concerning a technology of real-time interaction. (실시간 상호작용 기술의 '가상현실치료' 적용에 관한 연구)

  • Kim, Jeong-Hwan
    • Cartoon and Animation Studies
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    • s.22
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    • pp.81-97
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    • 2011
  • The technology of 'Virtual Reality' has placed in advanced tools for human beings' joy and anger together with sorrow and pleasure in our generation. It has recently tried in a variety ways to use as an implication for treatment in the field of Cognitive Psychology. Especially, it widely approaches to human in terms of that a sense of reality in a virtual world through the five senses should reinterpret the meaning of cognition in the real world. Based on this paradigm shift, it allows for new treatment using the technology of virtual reality. A typical example is a field of Therapy in order to overcome panic disorder. It has advantages that in particular development of flexible interaction technologies in a virtual space can lead patients to experience psychological environments rather than physical one. the interaction technology provides environments in which users' five senses can be actively stimulated, it is very useful that information from the experiences in the virtual world allows people to learn through real experiences by renewing potential energies, advantages of Virtual Reality Therapy can be customized treatment by depending on symptoms in patients with panic disorder and are capable of differentiate application for the cure at each stage. It is to treat by leading patients to get accustomed to environments and situations in real world through care process with each symptom and stage. It is helpful that based on A Human-Sensibility Ergonomics, technologies like immersive virtual reality equipment, force-relative feedback and stereophonic sound, and like stimulating the sense of smell make people to induce experiences by stimulating human's five senses. There are many advantages of immersion in virtual world in that the phenomenon such as challenge, interaction, reality, illusion, and cooperation is expanded. As an application for therapy by growing such augmented reality, virtual space and sharing of data through the Internet and also inexpensive its availability have recently expanded the base. There are other benefits of Virtual Reality Therapy offering active interaction environments for cognitive experience which can provide appropriately adjusted environments for patients who are hard to overcome the real situation because of phobia. In addition to that it is safe and economical and patients' confidentiality is assured. Moreover, due to the principles of applying real-time navigation the Virtual Reality Therapy makes modification and supplementation easier and also it can reduce cybersickness because of the supply of Lenticular allowing people to see stereoscopy without eyeglasses, which makes sense of presence clearer. On top of that due to the development of interactive technologies, it is becoming close to sense of reality similar to real world by leading users to navigate by themselves and to operate objects in a virtual space. This paper will therefore examine, although it is of limited, characteristics of application of virtual reality technology based on A Human-Sensibility Ergonomics used for treatment for a disorder. this paper will analyse a range of its application and problems and it will suggest the future possibilities.

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Implantable Flexible Sensor for Telemetrical Real-Time Blood Pressure Monitoring using Polymer/Metal Multilayer Processing Technique (폴리머/ 금속 다층 공정 기술을 이용한 실시간 혈압 모니터링을 위한 유연한 생체 삽입형 센서)

  • Lim Chang-Hyun;Kim Yong-Jun;Yoon Young-Ro;Yoon Hyoung-Ro;Shin Tae-Min
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.599-604
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    • 2004
  • Implantable flexible sensor using polymer/metal multilayer processing technique for telemetrical real-time blood pressure monitoring is presented. The realized sensor is mechanically flexible, which can be less invasively implanted and attached on the outside of blood vessel to monitor the variation of blood pressure. Therefore, unlike conventional detecting methods which install sensor on the inside of vessel, the suggested monitoring method can monitor the relative blood pressure without injuring blood vessel. The major factor of sudden death of adults is a disease of artery like angina pectoris and myocardial infarction. A disease of circulatory system resulted from vessel occlusion by plaque can be preventable and treatable early through continuous blood pressure monitoring. The procedure of suggested new method for monitoring variation of blood pressure is as follows. First, integrated sensor is attached to the outer wall of blood vessel. Second, it detects mechanical contraction and expansion of blood vessel. And then, reader antenna recognizes it using telemetrical method as the relative variation of blood pressure. There are not any active devices in the sensor system; therefore, the transmission of energy and signal depends on the principle of mutual inductance between internal antenna of LC resonator and external antenna of reader. To confirm the feasibility of the sensing mechanism, in vitro experiment using silicone rubber tubing and blood is practiced. First of all, pressure is applied to the silicone tubing which is filled by blood. Then the shift of resonant frequency with the change of applied pressure is measured. The frequency of 2.4 MHz is varied while the applied pressure is changed from 0 to 213.3 kPa. Therefore, the sensitivity of implantable blood pressure is 11.25 kHz/kPa.

Suggestions for improving data quality assurance and spatial representativeness of Cheorwon AAOS data (철원 자동농업기상관측자료의 품질보증 및 대표성 향상을 위한 제언)

  • Park, Juhan;Lee, Seung-Jae;Kang, Minseok;Kim, Joon;Yang, Ilkyu;Kim, Byeong-Guk;You, Keun-Gi
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.20 no.1
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    • pp.47-56
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    • 2018
  • Providing high-quality meteorological observation data at sites that represent actual farming environments is essential for useful agrometeorological services. The Automated Agricultural Observing System (AAOS) of the Korean Meteorological Administration, however, has been deployed on lawns rather than actual farm land. In this study, we show the inaccuracies that arise in AAOS data by analyzing temporal and vertical variation and by comparing them with data recorded by the National Center for AgroMeteorology (NCAM) tower that is located at an actual farming site near the AAOS tower. The analyzed data were gathered in August and October (before and after harvest time, respectively). Observed air temperature and water vapor pressure were lower at AAOS than at NCAM tower before and after harvest time. Observed reflected shortwave radiation tended to be higher at AAOS than at NCAM tower. Soil variables showed bigger differences than meteorological observation variables. In August, observed soil temperature was lower at NCAM tower than at AAOS with smaller diurnal changes due to irrigation. The soil moisture observed at NCAM tower continuously maintained its saturation state, while the one at AAOS showed a decreasing trend, following an increase after rainfall. The trend changed in October. Observed soil temperature at NCAM showed similar daily means with higher diurnal changes than at AAOS. The soil moisture observed at NCAM was continuously higher, but both AAOS and NCAM showed similar trends. The above results indicate that the data gathered at the AAOS are inaccurate, and that ground surface cover and farming activities evoke considerable differences within the respective meteorological and soil environments. We propose to shift the equipment from lawn areas to actual farming sites such as rice paddies, farms and orchards, so that the gathered data are representative of the actual agrometeorological observations.

Early Management of Total Parenteral Nutrition Induced Hepatic Dysfunction with Cyclic Parenteral Nutrition (정맥영양 관련 간기능 장애에서 조기 주기성 정맥영양법의 유용성)

  • Lee, Sung Soo;Chang, Ju Young;Yang, Hye Ran;Ko, Jae Sung;Choi, Kyung Hee;Seo, Jeong Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.61-73
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    • 2004
  • Purpose: Liver function test abnormalities have been reported frequently in patients receiving total parenteral nutrition (TPN). In adults, it is known that liver complications decrease with the use of cyclic parenteral nutrition (CPN), especially if the shift to cycling was not too late. However, there are few studies about the effects of cycling on liver injury in children beyond the neonatal period. The aim of this study is to evaluate the effect of the early use of CPN on total parenteral nutrition induced hepatic dysfunction. Methods: Twelve sets of CPN in 11 children (2 months to 17 years) were included in this study. Data on underlying diseases, age, length of time on TPN, macronutrient intake, complications, and biochemical parameters were collected from clinical records. All children had received CPN in the early period of persistent transaminase elevation or cholestasis complicated by previous continuous PN. The duration of infusion off-time in CPN was 2 hours in patients less than 3 months of age and 4 hours in the older children. Results: All 12 cases showed elevated aminotransferase and 5 of them also showed cholestasis. Serum total bilirubin concentration was normalized in all 5 cases with median periods of 8 days (p<0.05) after initiation of CPN. ALT either decreased significantly or was normalized in all cases with median periods of 30 days (p<0.05) on CPN. The CPN was well tolerated without significant complication except for one case of hyperglycemia. Conclusion: The early use of cyclic parenteral nutrition had a beneficial effect in improving hepatic dysfunction complicated by TPN in children.

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The Effects of Transcutaneous Electric Nerve Stimulation (TENS) on the EMG Power Spectrum and Pressure Pain Threshold (PPT) (경피성 신경자극이 근전도 Power Spectrum과 압력통각역치에 미치는 영향)

  • Kim, Cheul;Park, Moon-Soo
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.403-411
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    • 2007
  • This investigation was carried out to evaluate the effect of Transcutaneous Electric Nerve Stimulation (TENS) to experimentally induced masticatory muscle pain and muscular fatigue. Twenty-nine healthy volunteers (18 men and 11 women, aged $26.1{\pm}4.7$ years) without past history or present symptoms of temporomandibular disorders were participated in this study. All of the subjects were randomly assigned to experimental group and control group, after at least 3 days interval, two groups were reassigned conversely. Subjects assigned to experimental group were received TENS and others assigned to control group were received sham-TENS therapy for 45 minutes, respectively. The changes of Visual Analogue Scale (VAS), Pressure Pain Threshold (PPT), and EMG power spectrum were measured on the masseter muscle both before and after sustained fatiguing contraction in each group. The major findings of this study are as follows : 1. PPTs and median frequencies of masseter muscles were significantly decreased after sustained isometric contraction resulting in muscular fatigue. 2. In experimental group received TENS therapy, PPTs measured both before and after occurrence of experimentally induced muscular fatigue were significantly increased. 3. In experimental group received TENS therapy, the changes of PPTs during sustained isometric contraction resulting in muscular fatigue were significantly decreased. 4. In experimental group received TENS therapy, VAS measured after occurrence of experimentally induced muscular fatigue was significantly decreased. 5. Although there were not statistical significances, endurance time was increased in experimental group received TENS therapy and decreased in control group received sham-TENS therapy. 6. In experimental group received TENS therapy, the changes of median frequencies were the less decreased and the slope of median frequency shift was the more increased during endurance time than in control group, however, there were not statistical significances.

Analysis of Interactions in Multiple Genes using IFSA(Independent Feature Subspace Analysis) (IFSA 알고리즘을 이용한 유전자 상호 관계 분석)

  • Kim, Hye-Jin;Choi, Seung-Jin;Bang, Sung-Yang
    • Journal of KIISE:Computer Systems and Theory
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    • v.33 no.3
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    • pp.157-165
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    • 2006
  • The change of external/internal factors of the cell rquires specific biological functions to maintain life. Such functions encourage particular genes to jnteract/regulate each other in multiple ways. Accordingly, we applied a linear decomposition model IFSA, which derives hidden variables, called the 'expression mode' that corresponds to the functions. To interpret gene interaction/regulation, we used a cross-correlation method given an expression mode. Linear decomposition models such as principal component analysis (PCA) and independent component analysis (ICA) were shown to be useful in analyzing high dimensional DNA microarray data, compared to clustering methods. These methods assume that gene expression is controlled by a linear combination of uncorrelated/indepdendent latent variables. However these methods have some difficulty in grouping similar patterns which are slightly time-delayed or asymmetric since only exactly matched Patterns are considered. In order to overcome this, we employ the (IFSA) method of [1] to locate phase- and shut-invariant features. Membership scoring functions play an important role to classify genes since linear decomposition models basically aim at data reduction not but at grouping data. We address a new function essential to the IFSA method. In this paper we stress that IFSA is useful in grouping functionally-related genes in the presence of time-shift and expression phase variance. Ultimately, we propose a new approach to investigate the multiple interaction information of genes.