• Tuberculosis and Respiratory Diseases
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• v.82 no.1
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• pp.15-26
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• 2019

The pathogen Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease worldwide. The decision to initiate long-term antibiotic treatment is difficult for the physician due to inconsistent disease progression and adverse effects associated with the antibiotic treatment. The prognostic factors for the progression of MAC pulmonary disease are low body mass index, poor nutritional status, presence of cavitary lesion(s), extensive disease, and a positive acid-fast bacilli smear. A regimen consisting of macrolides (clarithromycin or azithromycin) with rifampin and ethambutol has been recommended; this regimen significantly improves the treatment of MAC pulmonary disease and should be maintained for at least 12 months after negative sputum culture conversion. However, the rates of default and disease recurrence after treatment completion are still high. Moreover, treatment failure or macrolide resistance can occur, although in some refractory cases, surgical lung resection can improve treatment outcomes. However, surgical resection should be carefully performed in a well-equipped center and be based on a rigorous risk-benefit analysis in a multidisciplinary setting. New therapies, including clofazimine, inhaled amikacin, and bedaquiline, have shown promising results for the treatment of MAC pulmonary disease, especially in patients with treatment failure or macrolide-resistant MAC pulmonary disease. However, further evidence of the efficacy and safety of these new treatment regimens is needed. Also, a new consensus is needed for treatment outcome definitions as widespread use of these definitions could increase the quality of evidence for the treatment of MAC pulmonary disease.

• Korea Journal of Hospital Management
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• v.5 no.1
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• pp.40-61
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• 2000

The purpose of this study is to promote the efficiency of the management of the controls organization in the university hospitals and general hospitals by evaluating the factors underlying organizational conflict. The subject population included 351 hospital workers randomly selected from two general hospitals of less than 200 beds and two university hospitals over 500 beds in Seoul area. Data were collected through a survey questionnaire. To define related factors for the level of conflict among departments in each hospitals multivariate regression analysis was conducted. Independent factors were characteristics of subjects, conflicting factors between the departments. The results are as follows: 1. Those in high job position group demonstrated significantly higher level of conflict between departments. Those working in the general hospitals, who were older and had long-term tenure at current working hospital had higher level of conflict between the departments. 2. Concerning the involvement of conflicting factors and the level of conflict in the employees' there was statistically significant positive correlation between reliability and job-related and intradepartmental level of conflict in university hospitals. There was a significant positive correlation between interdepartmental conflicting factors of mutual dependence, difference in goal/orientation and interdepartmental level of conflict. 3. In the university hospitals, among the interdepartmental factors, mutual dependence and difference in goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the general hospitals, job position was a significant factor which showed that those in high position such as section chief or above, compared to those in general position had higher level of conflict. Among the interdepartmental characteristics, factors of mutual dependence and goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the general hospitals setting efforts to reduce conflict in areas among workers with high position, old age, and long tenure and those in medical care department should be made and prudent management and planning for improved manpower and increased budget or efficient allocation and clear definition of job description are necessary to adequately assess. In the university hospitals setting efforts to reexaminitation of the organizational structure and efficiency conveyance of information and efforts to resolve conflict among young workers with lower level of education is need. This study has its own merit in comparing empirically the conflict among hospital workers in the university hospitals and general hospitals. Future study are needed with respect to the relationship between interdepartmental level of conflict and the effectiveness of the hospital organization for improved resolution of conflict in the organization and hospital management.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.163-169
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• 2017

The purpose of this study is to present the basic data needed to improve the arts, music, and physical education provided by local child care centers based on an investigation of the current status of and satisfaction with the education. The subjects of this study were 17 local child care centers in Gyeonggi-do, South Korea, and the situation of the arts, music, and physical education programs operated from 2014 to 2016 were examined. In addition, 419 children who received the education were surveyed to evaluate their level of satisfaction. The results of this study are as follows. As regards the status of the arts education from 2014 to 2016, it was observed that three of the 17 local child care centers did not have any arts, music or physical education at all, while six of them continuously implemented all three of these programs during this period of time. Two and six of the 17 institutes had arts, music, and physical education programs for two years and one year, respectively. All of the teachers who ran the arts and music education programs of the 17 institutes were arts and music majors who were certified teachers of the liberal arts. However, the physical education programs were run as volunteer activities by college students majoring in physical education. The survey on the level of satisfaction of the children who participated in the arts, music, and physical education programs showed that they were helpful for the overall life experience of the children and that they were more helpful for the boys than for the girls. The level of satisfaction with the education was high for most of the students who participated in the programs, however the boys were more satisfied than the girls. When asked whether they would participate in the arts, music, and physical education programs again, most of the respondents answered that they would do so. The boys were more likely to participate again than the girls. Based on this study, in order to enhance the creativity and personality education of the children using the local child care centers, higher quality education is needed. Arts and music education can be used to help children to learn to communicate smoothly with their friends. In addition, it seems to be necessary to enhance the education by setting goals that are suitable for its purpose, in order to provide creative arts and music education that contributes to the physical health and emotional stability of the children.

• Korea Journal of Hospital Management
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• v.5 no.1
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• pp.232-271
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• 2000

The introduction of a team system to any organization is usually to improve that organizations dynamics, by increasing the proper adaptation to rapidly changing environments, by reducing approval procedures, and by promoting power authorization. In this regard, this study was carried out in an attempt to determine (1) whether or not the introduction of a team system can be as effective in hospital organizations as it has been in business organizations, and (2) what behavior factors influence such effectiveness. For the current study, questionnaires were distributed to the employees of a university hospital in Pusan. Four hundred eighty three of them(94.7%) were retrieved and analyzed through statistical processes. The three types of variables that were found to influence team effectiveness were: (1) independent variables of team organization characteristics, such as communication, organizational atmosphere, leadership and team knowledge, (2) intervening variables of team organization characteristics. such as job autonomy, technological variety, task subjectivity, task feedback and task importance, and(3) the dependent variables of team level effectiveness, such as job satisfaction and commitment to team organization. The gathered data were processed by using the 6.12 version of the statistical program SAS(Statistical Analysis System), and the reliance coefficient of those measured variables was then evaluated as an average of 0.78. The influence of team level effectiveness was analyzed by using multiple regression analysis. These differences in effectiveness were then analyzed on the basis of related mean values, while the differences among demo-sociological characteristics were analyzed by using the dispersion analysis(ANOVA) and the t-test. The results of the study can be summarized by the following. First, regarding the relationship between team organization characteristics and team level effectiveness, all of the factors including communication, organizational atmosphere, leadership and team knowledge were found to have a significant influence on effectiveness. Second, the factors of team job characteristics, such as technological variety, task importance and job autonomy, had significant effects on job satisfaction and organizational commitment among the teams members. Team level effectiveness was generally high, while team job satisfaction was higher the teams organizational commitment. Third, regarding the demo-sociological characteristics, team level effectiveness was found to be higher among those who were older, who had more job experience, and who had a higher position. Comparing the differences among job types, the effectiveness was relatively higher in the fields of nursing and administration/management then in other fields. Further study should be done towards the setting of variables for characteristics of hospital organization, developing suitable methods of measurement, and researching individual level effectiveness.

• Women's Health Nursing
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• v.7 no.3
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• pp.271-283
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• 2001

The childbearing process is a sociocultural phenomenon of a woman who gives birth to a child as well as a biological phenomenon. The purpose of this ethnographic research study was to explore the experience of childbearing process of mothers with children from pregnancy to the 3 months postpartum in Korea and to understand deeply the perspectives of childbearing women reflected on Korean sociocultural values. A convenient sample of 10 childbearing women were observed from January to October 2000 through field work in Seoul, Korea. Data analysis was accomplished under ongoing process. The results of this study were as follows : The mothers with children experienced self-reflection, family relation, and physical adaptation during pregnancy. In self-reflection, all mothers experienced universality and diversity in their self-discovering process. The universal experiences were maturation, life with family and priority on maternal value between being a mother and a woman. The diverse experiences were taking a dual role of working mother, emotional drift of a resigned mother, and disheartened life of a mother who has two daughters. In family relation, the foundation of the new marital relationship were attained during childbearing process and sexual life were changed for the benefit of a healthy mother and a healthy baby. All mothers established friendly relations with their mothers, but established friendly or conflicting or constraining relations with their mother-in-laws due to husband based family culture. In physical adaptation, the informants endured well the physical discomfort and recognized general appearance change. Also maternal-fetal interaction occurred and mothers realistically felt motherhood and accepted themselves as mother-to-be. The mothers prepared for the best delivery, look for a safe childbirth center, newborn goods, endorsed family coping during hospitalization and responded labor pain to make it more endurable, less painful, fast passed owing to labor recognition of the natural process to be a mother. After childbirth, they felt emancipation, satisfaction, accomplishment, more easiness, actually feeling as mother-to-be, emptiness, and showed response to the sex of newborn. Their Sanhujori practice was different according to the Sanhujori environment including provider, place, time in postpartum and reflected on Sanhubyung. The mothers felt actually mother-to-be and happiness during lactation regardless of feeding pattern. These mothers had a different maternal image about rearing subjecthood through their child-rearing experience. But all mothers felt need for family support and social support. The universal rearing response were actual feeling of mother-to-be, a strenuous experience, a pride on child-rearing, confusion, reflecting marital relationship, and wondering rivalry among children. In conclusion, mother of all with children went through self-discovery, self-reflection and made connections with the family as a mother and as a woman simultaneously during the childbearing process. Therefore it is suggested when harmony and balance between a mother and a woman is accomplished, the woman will lead a healthy and high quality of life. Also, this study sought to confirm the sociocultural factors affecting the childbearing process from the perspectives of the women with children. Therefore health care providers must understand deeply the childbearing women with children based on this finding of and try a integrative approach with new ideology of maternity with biocultural perspectives in a clinical setting.

• Journal of dental hygiene science
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• v.17 no.2
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• pp.123-133
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• 2017

The aim of this study was to analyze in depth the standardized Clinical dental hygiene curriculum of the Fones School in the United States. We investigated the clinical dental hygiene curriculum in 2015~2016 including title, credit, hours, contents, goals, competencies, and evaluation. We obtained the course syllabus and data related to each subject, for each grade, from the professors and students at the university. The goals and competencies, of the clinical dental hygiene program, which were based on the goals of the Fones School and the mission of the University of Bridgeport, were developed in accordance with the dental hygienist practice standards proposed by the American Dental Hygienists Association. The curriculum consisted of theory to teach proper dental hygiene care procedures and incorporated practical exercises that modeled an actual clinical setting. The students had to document the procedures performed for each client/patient and improve their clinical competency through discussion with the professors. Dental hygiene care should be provided for children, adolescents, adults, elderly, and patients, which includes patients with moderate or severe periodontal status. Students were evaluated by a paper test or case study presentation and their clinical evaluation was based on their clinical competency. In particular, professors evaluated students on a rotational basis, so they could evaluate the level of achievement of clinical competency of all students and find ways to improve any weaknesses. Therefore, the current study suggested that clinical dental hygiene program in Korea could be improved if based on the curriculum of Fones School in the United States.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.154-160
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• 2001

Purpose : This study, as the first year project of setting up a community based management system, was attempted for the cancer patients and their family to improve their quality of life; investigating and managing the cancer patients, educating volunteers and connecting the patients with the volunteers were performed. Method and result : The education of managing cancer patients for the volunteers was done once in lune for 2 days to the 80 volunteers. Questions about education effect, volunteer motivation and so on were made up. The survey showed, generally, education satisfaction level was high and a longer education and an intensive course were needed and was suggested that organizing a volunteer community be needed for the continuous further education and systematic management. As the result, after the public health center and volunteers deliberated, a volunteer community consisting of 4 teams, 28 members was organized, launched in Oct. and operated for the cancer patients and their family. For investigating and enrolling the patients, advertising on a local information paper, recommending of local doctors, publicizing by educating the heads of a subdivision of the city, the heads of a neighborhood association and the people in charge of the related local communities such as women's society, and surveying the community by volunteers were performed and the total, 41 patients were registered. Management of cancer patients was carried out by volunteers in a community and in a nursing school. A regional volunteers' community is composed of 23 members and they have worked 87 times, that is 3.8 times per capita on an average. The content of duties is attending the education (41.1%) the most. A volunteers' community of nursing students composed of 12 members have worked 135 times, that is 11.3 times per capita on an average. The content of duties - consulting with patients and home visiting (37.8 %) were the most and survey for investigating the cancer patients was the second. Conclusion : This study has the meaning that this is the guiding attempt in building a community based management system, and especially the achievement of this study is that a regional society organized a volunteer community for the cancer patients by itself and went into action for the cancer patients and their family. Furthermore, to activate this volunteering, it is necessary to keep managing volunteers and running continuing education or the intensive course of the volunteers. Indeed we should let the patients have good impression on this program through publicity and education for the residents to keep track of more cancer patients. For that, systematic and powerful cooperation of a self-administrative organization is required.

• The Korean Society of Law and Medicine
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• v.25 no.1
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• pp.87-115
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• 2024

In Korea, exposure to stress has been accompanied by mental pain in the process of achieving many growth along with rapid development, various social problems, and the frequency of emergency hospitalization is increasing.. In the case of mentally ill patients, "unwanted hospitalization" is a problem, and police and 119 paramedics try to suppress the body of mentally ill patients, and many problems are exposed This is because the constituent requirements of the provisions of emergency hospitalization under the Mental Health and Welfare Act do not reflect reality, and each institution has a different position on one mentally ill person, and emergency hospitalization does not proceed smoothly or leads to friction between related organizations, and the safety of the mentally ill or others is not secured. Emergency hospitalization is defined as "a person who finds a person who is presumed to be mentally ill and is at high risk of harming his or her health or safety or others," and if the situation is so urgent that he or she cannot afford time to go through the hospitalization procedure to decide on his or her own hospitalization, he or she can request emergency hospitalization with the consent of a doctor and a police officer. In this case, 119 paramedics are escorted to a psychiatric institution. This provision of emergency hospitalization poses many problems in the process of transferring to psychiatric institutions. If a police officer or 119 paramedics in charge of practice use "physical force" during the emergency hospitalization process, side effects will inevitably occur, and professional negligence can be a problem. Specifically, when exercising physical force, the minimum necessary physical restraint based on laws and regulations and proportional principles is required, and the lack of the duty of care of 119 paramedics or police officers under the laws and regulations will eventually be resolved by applying other laws and regulations. Accordingly, it will be an opportunity for mentally ill patients to be transferred to psychiatric institutions in a safe environment by changing the subject of emergency hospitalization provisions under the Mental Health Welfare Act, defining and prescribing the use of physical protection guards as the enforcement regulations of the Mental Health Act, setting the duty of care for 119 paramedics and police officers, and creating an environment for transportation so that mentally ill patients can be treated safely.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.42-55
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• 2008

Purpose: A new health policy, referred to as the National Health Screening Program for Infants and Children, was launched in November 2007 by the Ministry of Health and Welfare and National Health Insurance Corporation in Korea. We have developed a nutrition-counseling program that was incorporated into this project. Methods: We reviewed the nutritional guidelines published by The Korean Pediatric Society and internationally well-known screening programs such as Bright Future in the United States. We also reviewed the recent Korean national surveys on nutritional issues, including the Korea National Health and Nutrition Examination Survey (KNHANES) and the 2005 National Survey of Physical Body and Blood Pressure in Children and Adolescents. The development of questions, pamphlets, computer programs, and manuals for doctors was carried out after several meetings of researchers and governmental officers. Results: We summarized the key nutritional issues according to age, including breastfeeding in infants, healthier complementary feeding, and prevention of iron deficiency anemia, establishment of healthier diets, as well as dietary prevention of overweight children with an emphasis on physical exercise. We have constructed a new Korean nutrition questionnaire and an anticipatory guidance program based on the primary care schedule of visits at 4, 9, 18, 30, and 60 months of age. Five to eight questions were asked at each visit and age-matched pamphlets for parents and guidelines for doctors were provided. Conclusion: We developed a nutrition-counseling program based on recent scientific evidence for Korean infants and children. Further research on this national program for screening the nutritional problems in detail and setting the therapeutic approaches may help identify areas of success as well as those that need further attention.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.510-537
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• 1995

Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.