• Clinical and Experimental Pediatrics
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• v.48 no.11
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• pp.1162-1165
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• 2005

Purpose : The objective of this survey was to develop an operational plan for breast feeding education. In order to comprehend current breast feeding patterns, we aimed to examine the knowledge, attitude and practices regarding breast feeding of mothers and to compare the data with a similar study done 6 years ago. Methods : A total of 127 mothers who delivered healthy babies at Ewha Womans University Dongdaemun Hospital were interviewed and asked to complete a survey on their perception of breast feeding during their postpartum stay in the hospital. A follow up phone interview was carried out at 1, 2 and 3 months after delivery and similar questions were asked. Results : At the time of delivery, 96.1 percent of mothers planned to breast feed, including 73.2 percent of exclusive breast feeding and 22.8 percent of mixed feeding. The duration of breast feeding planned was mostly 7-12 months. Breast feeding had been recommended by family members. Between 1-3 months, exclusive breast feeding was maintained at least 50 percent but a large number of mothers who had practiced mixed feeding changed to formula feeding. This trend demonstrates an increase in the rate of breast feeding at 3 months compared to a similar study done in 1999. The main reasons for discontinuing breast feeding were insufficient amount of milk(35.0 percent) and return to work(27.5 percent). Conclusion : Breast feeding rate has increased in Korea since 1999 but failure to continue exclusive breast feeding still occurs mainly within the first month after delivery. Breast feeding education should focus on supportive care to mothers practicing mixed feeding.

• Journal of Preventive Medicine and Public Health
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• v.36 no.1
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• pp.77-84
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• 2003

Objectives : Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. Methods : We peformed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we peformed rectal swabs on the cattle raised by the household of the index patient. Results : We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. Conclusions : We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.58-67
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• 1995

Background: This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a tertiary hospital. Methods: Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05. Results: The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients' medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients' age, type of services, and a day of the week visited. Conclusion: We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.

• Journal of the Korean Society of Food Culture
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• v.26 no.5
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• pp.478-489
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• 2011

Student and dietitian reactions to a multicultural food service menu were studied. Food habits in a multicultural family could delay the acculturation of the children to traditional Korean food and could cause the isolation of children from the community. Also, Korean students need to be exposed to other cultures and foods because it can be a challenge to eat novel foods when students grow up. To help both multicultural and Korean children adjust to new foods, a multicultural menu was included in a school's food service. Students regarded the multicultural menu as access to another culture, but they felt that improvement of the food quality and menu diversity were required. The degree of satisfaction with the food quality, appearance, freshness, temperature, and menu diversity were all moderate. The multicultural menu was served as a single menu item or a combination menu item. The main dish single items - pasta, jajangmyeon, onigiri, hamburgers, rice and curry, kaupatmu, kaupatkung, and donburi - were liked, but nasi goreng was liked only moderately. The soup - based dish single item, tempura soba, was liked, while tomyum was disliked. The side dish single items - tangsuyook, Japanese donkatsu, baked sausage and potatoes, tandoori chicken, chicken britto, Vienna schnitzels, tender tortillas, and fried chicken wings - were liked. The desserts single items-sandwiches, pineapples, waffles, pizza, bread with strawberry jam, mangoes, and tacoyaki - were liked. The combination menus - Italian, Indian, and American - were liked, but the southeast Asian menu was the least favored. Acceptance of combination and single menu items were similar. Male students liked multicultural menu items more than female students in all categories. Approximately 60% of dietitians had experience serving the single menu items for multicultural food service. The appropriate serving times were twice per month. Dietitians guessed that 80% of the students liked the multicultural menu. The dietitians preferred serving American or Chinese foods to southeast Asian food. There were two difficulties in serving the multicultural menu, which were voiced as as lack of skill in cooking the items and improper cooking utensils and tableware for the items. Despite all the difficulties, the dietitians served the multicultural menu because it provided menu diversity, rather than for educational reasons.

• Health Policy and Management
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• v.16 no.2
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• The Journal of the Korea Contents Association
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• v.9 no.11
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• pp.475-486
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• 2009

Regular activity program is needed for managing chronic disease and obesity and preventing falls as a nursing intervention. It seems that serious game will be very important for older people to keep them active with fun to improve their health. This study was conducted to explore the correlations between health problems and computer game needs in the elderly. This was a cross-sectional study. A questionnaire was developed and administered to a convenience sample of adults who are older than 55 years, recruited from several places through trained research assistants and research center that has online pools in Korea. 778 subjects (mean age: $61.4\;{\pm}\;5.6$) were participated in this study. The majority of subjects was male (68.6%). We found that there was higher needs for exercise or serious game in the group of ma1e(55.4%), below undergraduate(66.2%), under two family members(32.5%), over 350,000 won of pocket money/month (40.1%), mild depressive symptom (51.7%), and online responser(68%). Especially, they wanted to overcome physical limitations through games. Higher education, more experiences and skills of using computer/internet was statistically and positively significant to the needs for exercise or serious game. In conclusion, there exists a potential market within this demographic group for the use of serious games. Thus, we need to develop senior games in Korean to improve quality of life and health promotion.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.1
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• pp.43-60
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• 1997

This study was to identify the nursing intervention method in finding out the incidence, risk factor, prevention and treatment of bed sore cilents who received regional home care nursing services. The eleven home care nurse practitioners took the survey on 97 patients who received home care nursing service from Seoul City Nurses Association for one month from September 26 to October 26 1996. A modified version of Braden's bed sore assessment tool for bed sore risks and a tool for assessment of bed sore stage and measurement bed sore sizes by Bergstrom, Braden, Laguzza and Holman(1987) were as research tools for this study and a questionnare with 40 questions and 12 items on nursing activities was used to find out the prevention and treatment of bed sores. Also, two open ended questions were used on current approaches and efforts of the treatment being applied to clients. The finding of the study were summarized as following : 1. The rate of bed sore occurrence was 47.4% 2. The areas of bed sore occurrence were hip(28.9%), sacrum(18.6%), great trochanter(14.4%) and the average number of sore spots were 2.26 3. Two groups-one with bed sores and the other without-were studied to determine prediction factors for bed sore risks. Sensory function, humidity, level of activity, mobility, nutrition, skin friction and chapping and body temperature turned out to be statistically significant factors for bed sores. Also the age of clients turned out to be a individual characteristic variable significantly affecting the rate of bed sore occurrences. 4. The education for clients and family on systematic skin assessment and bed sores and practice of active/passive R.O.M. are mainly used as nursing activities for bed sore care. 5. The treatment method varied by stages of bed sores. Sometimes folk remedies like applying the powders of dried elm tree roots to sores were used. Good nutrition, frequent position change and skin care turned to be the most effective means to fast recovery of sores.

• Korean Journal of Health Education and Promotion
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• v.11 no.2
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• pp.48-56
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• 1994

In order to study the factors influencing upon right medication of antibiotic for the consumers who can easily buy antibiotic from pharmacy, the study carried out questionnaires to 568 consumers who bought antibiotics from pharmacies located in Seoul And Kyung-gi do from the 1st of February, 1994 to the 28th of the same month. Materials have been analyzed with $X^-test$ of SAS, and its results are as follows. 1. Among 568 objects of this study, the group which can medicare antibiotic properly (the right use group of antibiotic) is 45.5% with 258, while the group which does not recognize correctly the use of antibiotic or does not have any information about it (the abuse group of antibiotic) is 54.6% with 310. 2. Knowledge for advantage of antibiotic the right use group has is high in comparing with that of the abuse group (p<0.001), and also in case of pregnancy, understanding for an adverse reaction of antibiotic is high (p<0.001). The right use group has had many chances to take health education (p<0.001), and the way to buy antibiotic is very safe (p<0.001). But there is no outstanding difference for recognition of an adverse reaction of antibiotic between two groups. 3. In comparing with the abuse group, the right use group keeps well taking time of antibiotics as directions (p<0.001), and keeping rate of antibiotic dosage is high (p<0.001). Also the experiences of an adverse reaction of antibiotic is low (p<0.001). 4. In comparing with the abuse group, the right use group has high educational backgrounds (p<0.001) and many experiences of the education for health promotion (p<0.001), while there is no difference in age, sex, and economic status. 5. In comparing with the abuse group, the right use group has taken antibiotic many times (p<0.001), and there are many antibiotic takers of his/her family (p<0.01). 6. In comparing with the abuse group, the right use group has made much effort not only to check blood pressure and the pulse (p<0.05) but also for food habits (p<0.05). But there is no outstanding difference in the effort to get health information and the effort for regular exercises between these two group. 7. In comparing with the abuse group, the right use group has made an exertion in buying foodstuffs (p<0.001). But there is no big difference in efforts to keep the good attitude for physical health and mental heath, and sleeping hours between these two group.

• Korean Journal of Health Education and Promotion
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• v.22 no.4
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• pp.73-90
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• 2005

Objectives: Smokers who had failed to quit smoking were frequently reported that life stress mostly interrupted their abstention. Stress vulnerability model for smoking cessation has been considered, and most of contemporary smoking cessation programs help smokers develop coping strategies for stressful situations. This study aims to investigate the appropriate coping styles for stress of abstention from smoking. The result of investigating the relationship between abstention following smoking cessation program and coping styles would suggest useful information for those who want to stop smoking and health practitioners who help them. Methods: Participants were 69 smokers (62 males, 7 females) participated in a hospitalized smoking cessation program, whose mean age was 44.89 (SD=9.61). Participants took medical test and completed questionnaires and psychological tests including: Fagerstrom Test for Nicotine Dependence and Multidimensional Coping Scale. To identify participants' abstention, researchers followed them for 2 years. To identify whether abstained or not and encourage them to abstain, researchers called them on the telephone once a week for 3 months. After 3 months, they were contacted every other week till 6 months passed since they left smoking cessation program. And they were contacted once a month for other 18months. Researchers also contacted their family to identify their abstention. Data Mining Decision Tree was performed with 37 variables (13 variables for the coping styles and 24 smoking-related variables) by Answer Tree 3.0v Results: Forty four (63.8%) out of sixty nine for 2 weeks, 34 (49.3%) for 6 months, 25 (36.2%) abstained for 1 year, and 22 (31.9%) abstained for 2 years. Participants of this study abstained average of 286.77 days from smoking. Included variables of a Decision Tree model for this study were positive interpretation, emotional expression, self-criticism, restraint and emotional social support seeking. Decision Tree model showed that those (n=9) who did not interpret positively (<=7.5) and criticized themselves (>6.5) abstained 23 days only, while those (n=9) who interpreted positively (>7.5), expressed their emotion freely (>6.5), and sought social support actively (>11.5) abstained 730 days, till last day of the investigation. Conclusion: The results of this study showed that certain coping styles such as positive interpretation, emotional expression, self-criticism, restraint and emotional social support seeking were important factors for long-term abstention from smoking. These findings reiterate the role of stress for abstention from smoking and suggest a model of coping styles for successful abstention from smoking. Despite of limitation of this study, it might help smokers who want to stop smoking and health practitioners who help them.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.766-770
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• 2008

Gingival fibromatosis is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. It usually appears at the time of eruption of permanent dentition but, can develop at the time of eruption of the primary dentition and rarely at birth. It may deform palatal contour and subsequently restrict the tongue movement, resulting in interference during speech and mastication. In addition, it incapacitates maintenance of normal lip closure. A 14-month-old girl visited the department of pediatric dentistry, Yonsei University Dental Hospital, for the congenital gingival overgrowth. There was no one in the family, who showed similar pattern of gingival growth. The intraoral clinical examination revealed generalized severe gingival enlargement throughout the maxillary and the mandibular arches. Enlarged gingival tissue was pink and had firm consistency. She was referred for chromosomal analysis, which confirmed absence of any known syndrome. Under local anesthesia, "Punch-biopsy" was performed on the labial area, and the specimen was histologically diagnosed as gingival fibromatosis. For she did not have any medical problem nor familiar history, she was diagnosed as having idiopathic gingival fibromatosis. Regarding her age and behavior, close follow-up was decided.