• The Journal of the Korea Contents Association
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• v.17 no.10
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• pp.19-29
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• 2017

Purpose : To describe and understand the experience of QI (quality improvement) nurses related to the hospital QI activities in public general hospitals. Methods : Purposive sampling was conducted 10 QI nurses and who have QI work experience for more than 1 year. Data were collected through focus group interviews. Interviews were recorded, transcribed and analyzed with qualitative content analysis using Strauss and Corbin's methodology. Results : The core categories of experience with QI activities were 'the success and failure of the medical care and overall health service sector', 'the degree of activation of current QI activities', 'characteristics of public hospital QI activities', 'what is needed to activate future QI activities'. The key themes were derived as follows. 'Success of quality enhancement activities according to the characteristic of public hospitals', 'activation of public hospital QI activities through leadership and QI education', 'reorganizing the role of regional hospitals in public hospitals'. Conclusion : Physician participation is important in the success of QI activities in public hospital practice. To lead these physician participation, Sharing doctor's QI experience and providing the necessary knowledge in QI activities and helping their leadership in QI activities are needed. QI nurses at public hospitals should lead QI activities to improve national hospitals' care quality through cooperating with local hospitals.

• Quality Improvement in Health Care
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• v.4 no.2
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• pp.260-278
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• 1997

Background : Quality of professional nursing care is the most essential factor for survival and growth of nursing profession. Then, nursing professionals have responsibility for the evaluation of quality of professional nursing care. The purpose of this study was to develope an evaluation tool of nursing care for patients received gastrointestinal surgery with general anesthesia. This study was a primary work for the developement of a computer program for the evaluation of nursing care. Methods : This study was done through some consecutive steps. They were (1) Developement of items for the tool (2) Developement of an evaluation tool of nursing care quality for the G-I surgery patient (3) Test of reliability and validity of the tool. Two groups of experts and expert pannels who had much experience of the QA and the care of G-I surgery patients participated for developement of the items. 85 nursing records were used for the test of reliability and validity of the developed tool. The evaluation tools were developed with two types of scoring, norm-referenced tool and criterion-referenced tool. Results The system of items for tool was evaluation area evaluation item-indicator. There were 7evaluation areas which contained 32evaluation items which contained 7lindicators. Evaluation areas 1, 2, 3, 4 were for the evaluation of process and 5, 6, 7 were for the evaluation of outcome of nursing care for G-I surgery patient. For the test of interrator reliability, correlation coefficients of each scores of items and intragroup correlation coefficients were calculated. The average correlation coefficients between two rators were 0.65, 0.54 and the intragroup correlation coefficient were 0.99 and 1.00 by the types of scoring. The Cronbach alpha coefficients of the tools were 0.54 and 0.46 by the types of scoring. The average content validity index of the items was 0.95 from 4 pairs of experts. Because there were significant differences between some scores of quality of nursing care of 3 general hospitals regardless of the types of scoring, the tools could be thought to have some construct validity. And also, there were significant correlations between some scores of quality of nursing care and admission days and admission days after surgery regardless of the types of scoring, the tools could be thought to have predictive validity. Conclusion In this study, the evaluation tool of nursing care was developed for the very specified group of patient, G-I surgery patient. And the items were developed and tested by the experts of nursing practice. Because of these reasons, it was supposed that the tool could be used effectively in nursing pratice. And the procedures for the development and the test of the evaluation tool of nursing care in this study were supposed to be used for the developement of other tools.

• School Mathematics
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• v.15 no.1
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• pp.101-120
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• 2013

International comparative studies of students' performance in mathematics have shown that Korean students possess very negative attitudes toward mathematics, while they are ranked as one of the highest in the cognitive achievement of mathematics. This has prompted mathematics educators to seek for a way to improve the quality of mathematics education. In this context, this research has been conducted to investigate the learning style of Korean middle school students under the assumption that it is of essence to understand the characteristics of our students as mathematics learners. For the purpose, in-depth interview had been conducted and sixteen middle students participated in the interview. The students were chosen to represent the average group of their age-cohorts based on their performance in mathematics and their SES. The interview was designed as a semi-structured clinical interview. In the interview, the students were given mathematical tasks dealing with central themes in the domain of function. Each student was given about 30 to 50 minutes to solve the tasks. After an interviewee finished the tasks, s/he was asked to explained how s/he solved the tasks. The researchers asked additional questions to clarify the students' understanding of the mathematical themes in the tasks and to identify their strategies for learning mathematics. The analysis of the in-depth interview has primarily identified the characteristics of the students' understanding of the main themes in function and then has been extended to investigate their characteristic styles for learning mathematics. The analysis of the interview identified the learning styles of the students as 'inductive learning based on prototypical cases', 'repeated practice of exemplar mathematics problems', 'disengaged learning', and 'double standards in learning mathematics'. Based on the results of the analysis, this research presents the implications for the improvement of mathematics education.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.324-334
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• 1998

Background : Strategic planning is an organizationwide or systemwide, ongoing look into the future usually of 2~3 years, based on objective analysis of the current environment and trends, but it can incorporate both short-term and long-term goals. The strategic planning process includes external analysis, internal analysis, issue analysis, development of mission, vision and values, and lastly development of organizational goals and objectives. As a part of the strategic quality planning process, certain service lines, important organizationwide functions, or key processes supporting these functions can be prioritized to expedite and roll out certain strategic goals. This is called strategic quality initiatives. Methods : We organized a quality improvement team, a subgroup of 21st century vision planning corps of our medical center, and pursued QI activities for improvement of healthcare environment, particularly in the admission setting. We developed a strategic quality initiative based on the results of patient satisfaction surveys, and carried out functions of self-directed work team. Results : The strategic goal was to be the benchmark for peer group hospitals in Korea for providing cost-effective best-practice. The QI team included 3 medical doctors, 1 nurse, 1 social worker, and 1 QI consultant as well as many operational members to support services and quality initiatives met every Tuesday for 18 weeks. Outcome objectives were to improve patient satisfaction score. The issues included in the objectives were comfort, temperature, noise, cleanliness of the admission wards, quality and education of patient meals, matters regarding the admission process, and an appurtenant facility such as restaurant or convenience store. Every issue was discussed and recommendations, conclusions and opportunities were implemented. Conclusions : By developing a strategic quality initiative as a part of the strategic quality planning process, and pursuing a self-directed work team, certain sen/ice lines, important organizationwide functions, or key processes supporting these functions can be improved effectively within a short period. Strategic quality initiatives serve to support, or roll out, certain strategic goals that are relevant to performance improvement and development of specific measurable outcome objectives, and associated performance measure for each initiative. Each strategic quality initiative should include a statement of intent outcome objectives, and performance measures. We will come back with follow up of the strategic quality initiative, for improvement of healthcare environment, and results of patient satisfaction re-survey.

• Nutrition Research and Practice
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• v.9 no.2
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• pp.137-143
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• 2015

BACKGROUND/OBJECTIVES: Mulberry leaves contain quercetin derivatives, which have the effects of reducing obesity and improving lipid and glucose metabolism in mice with obesity. It is not clear whether or not mulberry leaves can directly affect metabolic disorders, in the presence of obesity, because of the interaction between obesity and metabolic disorders. The aim of the current study was to assess the direct action of quercetin derivatives on metabolic disorders in non-obese conditions in short-term high-fat diet fed mice. MATERIALS/METHODS: C57BL/6N mice were fed a high-fat diet, supplemented with either 0% (control), 1%, or 3% mulberry leaf powder (Mul) or 1% catechin powder for five days. Anthropometric parameters and blood biochemistry were determined, and hepatic gene expression associated with lipid and glucose metabolism was analyzed. RESULTS: Body and white fat weights did not differ among the four groups. Plasma triglycerides, total cholesterol, and free fatty acids in the 1%, 3% Mul and catechin groups did not differ significantly from those of the controls, however, plasma glucose and 8-isoprostane levels were significantly reduced. Liver gene expression of gp91phox, a main component of NADPH oxidase, was significantly down-regulated, and PPAR-${\alpha}$, related to ${\beta}$-oxidation, was significantly up-regulated. FAS and GPAT, involved in lipid metabolism, were significantly down-regulated, and Ehhadh was significantly up-regulated. Glucose-metabolism related genes, L-PK and G6Pase, were significantly down-regulated, while GK was significantly up-regulated in the two Mul groups compared to the control group. CONCLUSIONS: Our results suggest that the Mul quercetin derivatives can directly improve lipid and glucose metabolism by reducing oxidative stress and enhancing ${\beta}$-oxidation. The 1% Mul and 1% catechin groups had similar levels of polyphenol compound intake ($0.4{\times}10^{-5}$ vs $0.4{\times}10^{-5}$ mole/5 days) and exhibited similar effects, but neither showed dose-dependent effects on lipid and glucose metabolism or oxidative stress.

• Nutrition Research and Practice
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• v.8 no.2
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• pp.183-191
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• 2014

BACKGROUND/OBJECTIVES: The objective of this study was to measure and/or estimate the total antioxidant capacity of the Korean diet. MATERIALS/METHODS: Eighty-one plant foods that were expected to exhibit rather high antioxidant activities were selected from the Korean diet using the Fifth Korean National Health and Nutrition Survey (KNHANES V). These foods were categorized into 11 food groups: cereals, potatoes, legumes, nuts, vegetables, kimchies, mushrooms, fruits, fruit juices, sea weeds, and oils. The foods were mixed in the proportions specified in traditional Korean recipes and analyzed. The measured indicators for antioxidant capacities were total phenolics, 2,2-diphenyl-1-picrylhydrazyl (DPPH), oxygen radical absorbance capacity (ORAC), and Trolox equivalent antioxidant capacity (TEAC). RESULTS: Total phenolics were high in the fruit juices, nuts, vegetables, and fruits; and the average DPPH, ORAC, and TEAC values were high in the vegetables, fruits, fruit juices, and nuts. The correlation coefficient between the content of total phenolics of each food and the in vitro antioxidant capacity was relatively high at 0.851. The intake of total phenolics per capita per day in the Republic of Korea was estimated to be 127 mg. The total dietary antioxidant capacity (TDAC) values, which were obtained from the total antioxidant capacity of each food, taking into account the intake of each food, were 20,763, 54,335, and $876.4{\mu}mol$ of Trolox equivalents using the DPPH, ORAC, and TEAC methods, respectively. The food group that contributed the most to the Korean TDAC was cereals at 39.7%, followed by fruits and vegetables at 27.8% and 13.9%, respectively. The contribution of legumes, nuts, fruit juices, and mushrooms was quite minimal at less than 2% each. CONCLUSIONS: The content of total phenolics and the antioxidant capacity of the Korean diet are significantly correlated and the high contributing food groups are cereals, fruits, and vegetables.

• Nutrition Research and Practice
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• v.7 no.2
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• pp.96-102
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• 2013

Obesity, an intractable metabolic disease, currently has no medical treatment without side effects, so studies have been actively carried out to find natural compounds that have anti-obesity activity with minimum side effects. In this study, the anti-obesity effects of water extracts of seven Capsicum annuum L. varieties being Putgochu (Pca), Oyee gochu (Oca), Kwari putgochu (Kca), Green pepper (Gca), Yellow paprika (Yca), Red paprika (Rca) and Cheongyang gochu (Cca), were examined through the evaluation of lipoprotein lipase (LPL) mRNA expression level in 3T3-L1 cells (mouse pre-adipocytes). After capsaicin elimination by chloroform defatting, freeze-dried powder of Cca was treated to 3T3-L1 cells and anti-obesity effects were examined by determining the LPL mRNA level using the RT-PCR method. Of the primary fractions, only proven fractions underwent secondary and tertiary refractionating to determine anti-obesity effects. From seven different Capsicum annuum L., there was a significant decrease of the LPL mRNA expression level of 50.9% in Cca treatment compared to the control group. A significant decrease of the LPL mRNA expression level was shown in primary fractions (Fr) 5 (36.2% decrease) and 6 (30.5% decrease) of the Cca water extracts. Due to the impurities checked by UPLC chromatography, Fr 5 and 6 were refractionated to determine the LPL mRNA expression level. Treatment of Fr 6-6 (35.8% decrease) and Fr 5-6 (35.3% decrease) showed a significant decrease in the LPL mRNA expression level. When analyzed using UPLC, major compounds of Fr 6-6 and Fr 5-6 were very similar. Subsequently, we refractionated Fr 6-6 and Fr 5-6 to isolate the major peak for structure elucidation. Treatment of Fr 5-6-1 (26.6% decrease) and Fr 6-6-1 (29.7% decrease) showed a significant decrease in the LPL mRNA expression level. Consequently, the fractions may have a possibility to ameliorate obesity through the decrease of the LPL mRNA expression level.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.28-40
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• 2014

Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

• Nutrition Research and Practice
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• v.6 no.2
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• pp.97-105
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• 2012

$Schizandra$ $chinensis$ Baillon is a traditional folk medicine plant that is used to treat and prevent several inflammatory diseases and cancer in Korea, but the underlying mechanisms involved in its anti-allergic activity are not fully understood. This study was designed to investigate mechanisms of anti-allergic activity of a $Schizandra$ $chinensis$ Baillon water extract (SCWE) in immunoglobulin E (IgE)-antigen complex-stimulated RBL2H3 cells and to assess whether gastric and intestinal digestion affects the anti-allergic properties of SCWE. Oxidative stress is an important consequence of the allergic inflammatory response. The antioxidant activities of SCWE increased in a concentration-dependent manner. RBL-2H3 cells were sensitized with monoclonal anti-dinitrophenol (DNP) specific IgE, treated with SCWE, and challenged with the antigen DNP-human serum albumin. SCWE inhibited ${\beta}$-hexosaminidase release and expression of interleukin (IL)-4, IL-13, and tumor necrosis factor-alpha (TNF-${\alpha}$) mRNA and protein in IgE-antigen complex-stimulated RBL2H3 cells. We found that digested SCWE fully maintained its antioxidant activity and anti-allergic activity against the IgE-antigen complex-induced activation of RBL-2H3 cells. SCWE may be useful for preventing allergic diseases, such as asthma. Thus, SCWE could be used as a natural functional ingredient for allergic diseases in the food and/or pharmaceutical industries.

• Nutrition Research and Practice
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• v.5 no.6
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• pp.511-519
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• 2011

Dietary intake of whole grains reduces the incidence of chronic diseases such as obesity, diabetes, cardiovascular disease, and cancer. In an earlier study, we showed that Panicum miliaceum L. extract (PME) exhibited the highest anti-lipogenic activity in 3T3-L1 cells among extracts of nine different cereal grains tested. In this study, we hypothesized that PME in the diet would lead to weight loss and augmentation of hyperlipidemia by regulating fatty acid metabolism. PME was fed to ob/ob mice at 0%, 0.5%, or 1% (w/w) for 4 weeks. After the experimental period, body weight changes, blood serum and lipid profiles, hepatic fatty acid metabolism-related gene expression, and white adipose tissue (WAT) fatty acid composition were determined. We found that the 1% PME diet, but not the 0.5%, effectively decreased body weight, liver weight, and blood triglyceride and total cholesterol levels (P < 0.05) compared to obese ob/ob mice on a normal diet. Hepatic lipogenic-related gene ($PPAR{\alpha}$, L-FABP, FAS, and SCD1) expression decreased, whereas lipolysis-related gene (CPT1) expression increased in animals fed the 1% PME diet (P < 0.05). Long chain fatty acid content and the ratio of C18:1/C18:0 fatty acids decreased significantly in adipose tissue of animals fed the 1% PME diet (P < 0.05). Serum inflammatory mediators also decreased significantly in animals fed the 1% PME diet compared to those of the ob/ob control group (P < 0.05). These results suggest that PME is useful in the chemoprevention or treatment of obesity and obesity-related disorders.