• Journal of the Korean Dietetic Association
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• v.6 no.2
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• pp.136-147
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• 2000

The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.

• The Korean Nurse
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• v.31 no.5
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• pp.39-52
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• 1992

As society has changed, the demand for improved health care has increased. To keep up with this type of social need, professional nursing care is seeking to efficiently satisfy the care needs of human beings. The goal of clinical nurse is to meet nursing care needs of patients. This study was designed to survey attitudes of nursing profession of clinical nurses. The following specific 5 objectives were investigated and the attitudes of clinical nurses were determined. 1. The social position of nursing as a profession. 2. Factors influencing the development of nursing. 3. The future of nursing. 4. Their work. 5. Job satisfaction. The subjects consisted of 120 nurses who are working at 5 general hospital over 150 beds Ill CHONG NAM. The nurses were surveyed by means of a questionnaire from May 24 to Jun 15, 1992. The tool used for this study was based on earlier work by Lee, Nam Hi(1978) and Kim, Myong Hee(1984). Computer was used for Data Analysis. Frequency and Percentage were used to examine the genera] characteristics of the subjects. ANOV A and t.test were used to test the relation in characteristics of the subjects and attitudes Loward nursing prfession. The finding of this study were as follows; 1. Social position of nursing as a profession; The response with the highest agreement was "The professional nursing organization is less power. ful than the other professional organization" 3.333 points, and the response with the lowest agreement was "Nursing get a big salary" 2.225 points. 2. Factors influencing the development of nursing; the response with the highest agreement was "Hospital environment should be improved" 4.267 points, and the response with the lowest agreement was "Nurses satisfaction with salary"2.175 points. 3. The future of nursing; the response with the highest agreement was "Along the deveiopmem of science technique will be elevated educational state and graduate to needed in nursing" 3.958 points, and showed generally positive response toward the future of nursing. 4. Their work; the response with the highest agreement was "Work loading due to nursing staff insufficient" 4. 308 points, the response with the lowest agreement was "Nurses are unkind to patient" 2.508 points. 5. The subject's view regarding job satisfaction;it showed that "Interpersonal nursing staffs" 3.508 points, showed generally unsatisfactory response toward job satisfaction. 6. The relationship between the subject's attitudes toward professional nursing and general characteristics showed a significant difference statistically in regard to the field of work(P<.05). 7. The relationship between general characteristics and the subject's attitudes toward factors influencing the development of nursing showed a significant difference statistically in regard to the age and the status of position(P<.05). The subject's attitude toward the future of nursing showed a significant difference statistically in regard to the age and the period of nursing career and the field of work(P<.05, P<.005). The subject's attitude toward the job satisfaction showed a significant difference statistically in regard to the age and the period of nursing career and the status of position and the field of work(P<.005).

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.723-730
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• 2018

Objective : The aim of the present study was to identify whether the deformity angular ratio (DAR) influences the occurrence of complications after posterior vertebral column resection (PVCR) and to establish the DAR cut-off value. Methods : Thirty-six consecutive patients undergoing PVCR from December 2010 to October 2016 were reviewed. The relationships between the total, sagittal, and coronal DAR and complications were assessed using receiver operator characteristics curves. The patients were divided into two groups according to a reference value based on the cut-off value of DAR. Demographic, surgical, radiological, and clinical outcomes were compared between the groups. Results : There were no significant differences in the patient demographic and surgical data between the groups. The cut-off values for the total DAR (T-DAR) and the sagittal DAR (S-DAR) were 20.2 and 16.4, respectively (p=0.018 and 0.010). Both values were significantly associated with complications (p=0.016 and 0.005). In the higher T-DAR group, total complications (12 vs. 21, p=0.042) and late-onset complications (3 vs. 9, p=0.036) were significantly correlated with the T-DAR. The number of patients experiencing complications (9 vs. 11, p=0.029) and the total number of complications (13 vs. 20, p=0.015) were significantly correlated with the S-DAR. Worsening intraoperative neurophysiologic monitoring was more frequent in the higher T-DAR group (2 vs. 4) than in the higher S-DAR group (3 vs. 3). There was no difference in neurological deterioration between the groups after surgery. Conclusion : Both the T-DAR and the S-DAR are risk factors for complications after PVCR. Those who had a T-DAR >20.2 or S-DAR >16.4 experienced a higher rate of complications after PVCR.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.13-20
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• 2011

Purpose: The limited FOV(Field of View) of CT (Computed Tomography) can cause truncation artifact at external DFOV (Display Field of View) in PET/CT image. In our study, we measured the difference of SUV and compared the influence affecting to the image reconstructed with the extended DFOV. Materials and Methods: NEMA 1994 PET Phantom was filled with $^{18}F$(FDG) of 5.3 kBq/mL and placed at the center of FOV. Phantom images were acquired through emission scan. Shift the phantom's location to the external edge of DFOV and images were acquired with same method. All of acquired data through each experiment were reconstructed with same method, DFOV was applied 50 cm and 70 cm respectively. Then ROI was set up on the emission image, performed the comparative analysis SUV. In the clinical test, patient group shown truncation artifact was selected. ROI was set up at the liver of patient's image and performed the comparative analysis SUV according to the change of DFOV. Results: The pixel size was increase from 3.91 mm to 5.47 mm according to the DFOV increment in the centered location phantom study. When extended DFOV was applied, $_{max}SUV$ of ROI was decreased from 1.49 to 1.35. In case of shifted the center of phantom location study, $_{max}SUV$ was decreased from 1.30 to 1.20. The $_{max}SUV$ was 1.51 at the truncated region in the extended DFOV. The difference of the $_{max}SUV$ was 25.9% higher at the outside of the truncated region than inside. When the extended DFOV was applied, $_{max}SUV$ was decreased from 3.38 to 3.13. Conclusion: When the extended DFOV was applied, $_{max}SUV$ decreasing phenomenon can cause pixel to pixel noise by increasing of pixel size. In this reason, $_{max}SUV$ was underestimated. Therefore, We should consider the underestimation of quantitative result in the whole image plane in case of patient study applied extended DFOV protocol. Consequently, the result of the quantitative analysis may show more higher than inside at the truncated region.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.95-103
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• 1998

Purpose : To find and solve the common problems of peritoneal dialysis(PD) by analysing the clinical data of pediatric PD performed in Korea. Methods : 264 cases of CAPD and acute PD had been performed from Nov.1987 to Oct. 1997 in 17 institutions of pediatric nephrology in Korea. Results : CAPD was performed in 114 cases. The mean age of the patients was $10.5{\pm}6.6$ years and male to female ratio was 1.4:1. The original renal diseases of ESRD were proven in 92 cases($80\%$). The common renal disease of ESRD were FSGS($17\%$), reflux nephropathy ($11\%$), chronic glomerulonephritis($9.6\%$). Mean duration of CAPD was $20{\pm}16.9$ months. Peritonitis was the most common complication and incidence was one episode/18.2 patient-months. Other complications were exit site infection in 10 cases, obstruction in 7 cases, leakage of dialysate in 6 cases. The most common etiologic organism of peritonitis was staphylococcus aureus and the next was staphylococcus coagulase(-). Acute PD was performed in 150 cases. Most common underlying causes were congenital heart disease, hemolytic uremic syndrome, sepsis and dehydration. The mean duration was $10.3{\pm}11.3$ days. The most common complication was peritonitis($20.6\%$). The most common etiologic organism was staphylococcus aureus and coagulase(-), acinetobactor and pseudomonas. Conclusion : Reflux nephropathy should be emphasized in early diagnosis and treatment to prevent ESRD. Incidence of congenital anomaly($7\%$) as a original disease of ESRD was relatively low in Korea. Growth status was not significantly improved after CAPD. In acute PD, the incidence of peritonitis was rapidly increased at 2weeks after beginning of dialysis.

• Journal of Digital Convergence
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• v.10 no.6
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• pp.303-310
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• 2012

In order to analyze factors that support effective health care delivery system, this study aimed to research general public's perception on the functions of medical institutions(based on the levels of treatment: primary care, secondary care, and tertiary care), choices of medical institution when contracted with an unfamiliar disease, and recognition of diseases based on their severities. We collected data using self-administered survey from 400 general public living in Seoul, S. Korea from April 25 to May 18, 2011. The analysis was conducted using frequency analysis, chi-square test, and t-test; we analyzed the data to see if there are differences based on gender, age, and level of education. The result of both recognition of functional differences of medical institutions and selection of medical institutions when contracted with unfamiliar diseases showed that there were no significant differences based on the gender; however there were significant differences when considering the age and education. Looking at the result of the knowledge of the disease classification based on its severity, there were significant differences in age, gender, and education. In order to provide sustainable and effective health care delivery system, utilization of primary care as well as education and promotion regarding the functional differences of medical institutions and classification of disease based on its severity need to be encouraged.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4591-4597
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• 2016

Purpose: Decisions as to whether to provide adjuvant treatment in older breast cancer patients remains challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty. To aid decision-making, we retrospectively analyzed 110 women with breast cancer treated with a curative intention from 2006 to 2012. Survival data with clinical and pathological parameters were evaluated to address the role of adjuvant chemotherapy in this study population. Method: A total of 110 elderly (>70 years) patients that received mastectomy at two hospitals in Taiwan were observed retrospectively for a medium of 51 months. After mastectomy, patients received conservative treatment or adjuvant chemotherapy, or hormone therapy following clinical guidelines or physician's preference. Data were collected from the cancer registry system. Results: Median age at diagnosis was 75.7 years. Thirty-five percent of patients received adjuvant chemotherapy, these having a significantly younger age ($mean=74.0{\pm}5.3$ vs $77.5{\pm}5.3$, p<0.001) and higher tumor staging (p=0.003) compared with their non-chemotherapy counterparts.Five-year overall survival was non-significantly higher in patients who received adjuvant chemotherapy (with chemotherapy 64.2% vs without chemotherapy 62.6%, p=0.635), while five-year recurrence free survival was non-significantly lower (with chemotherapy 64.1% vs without chemotherapy 90.5%, p=0.80). Conclusions: In this analysis, adjuvant chemotherapy tended to be given to patients with a younger age and higher tumor staging at our institute. It was not associated with any statistically significant improvement in survival and recurrence rate. Until age specific recommendations are available, physicians must use their clinical judgment and assess the tumor biology with the patient's comorbidities to make the best choice. Clinical trials focusing on this critical issue are warranted.

• Health Policy and Management
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• v.10 no.2
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• pp.22-40
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• 2000

The purpose of the study was to discuss amrketing strategy for oriental hospital, by making a comparative analysis of how hospital user satifaction was affected by hospi시 choice motivation between oriental hospital users and western hospital. The data usel in this study was the Korea Isititute of oriental medicine(1999)'s study on utilization of oriental medical care. And and interview was hold with outpatients who visited around march to April, 1999, at each an oriental hospital and a westen hospital in Seoul and in Wonju city, Kongwon province. The collected data were analyzed by SPSS program. The factor analysis of hospital choice motivation was made by figuring out facor's mean value, and T-test and ANOVA were employed to find out what difference was made by sociodmographic charcteristics to the factors. Also, the multiple regression analysis was carried out to examine what gave an impact on hospital user satisfaction. The findings of this study were as follows; First as a result of making a factor analysis against hospital choice motivation to find out what kind of differenc there was between oriental hospital user motivation and western hospital and person factors. Among them, the hospital charcteristics, preception, personal and person factors. Among them, the hospital charcteristics appered to have the biggest effect of hospital choice motivation. Second, as a result of making comparison between oriental oriental hospital user satisfaction and werterm hospital user satisfaction, there was a singificant between their satisfaction at treatment time, kindness and relative kiness aginst the pther hospital. The oriental level combining 6 items. The geneal satisfaction level combining 6itmes tured out to have reliability of chronbach $\alpha$=0.7126. As a result of examining how mech the general satifaction level depended on sociodemographic characteristics, ther was found be significantly affected by age, marital status, educational background or hospital type. Those who a spouse or a lower educational background or the oriental hospital users got better score. Third, the multiple regression analysis was made to find out what factors affected western and oriental hospital user satisfaction, As a result, the waiting time, experience of other medical facilities and hospital characteristic variable were identified as a key factor on which westerm hospital user satisfaction depended. In conclusion, the oriental hhspital user expressed more staisfaction than the weshren hospital users. Then the characteristic factor played a singificant role in user satisfaction, which included hospital facilities, kindness of herb doctor and employees, or hospital reputation of credibility. in order to raise hospital user datisfaction, it seemed necessary to pay more attention to hospital characteristic factor rather than to perception factor.

• Journal of Society of Preventive Korean Medicine
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• v.6 no.1
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• pp.1-14
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• 2002

The proportion and role of public sector in health care industry is very small in Korea. Asymmetric distribution of health care resources is one of the major health care concerns. This issue is so important that it raises a question of accessibility, availability, continuity of care and equity of rural area people's health care utilization. To solve these problems and to satisfy the basic demand of oriental medical service in rural areas, the oriental public health doctors were placed in rural health centers since 1998. The main objectives of this study are twofold: to measure the cognition and attitude of health center directors on the strategies for utilizing oriental public health doctors and to provide basic data for improving the health manpower management program. Data have been collected by way of the self-administrative questionnaires. Developing the questionnaire, the literature review on the previous studies and delphi method were carried out. The response rate was 38.7%. The results of this study are summarized as follows; 1. community people respond positively on the oriental medical service activity in health center. 2. In regard to workloads of oriental public health doctor, 'appropriate' was 81.1% and 'burdensome' was 18.2%, respectively. 3. The 94.0% of respondents thought that the oriental medical service will be continued. 4. To activate oriental medical service in health center, the sufficient budget and provision of aid workers is a necessity. 5. The 75.5% of health center directors respond positively on the allocation of oriental public health doctor to health sub-centers. 6. Health center directors agreed that oriental public health doctor should perform the clinical service as well as prevention and health promotion activity. These results recommend that oriental medical service in health center should be continued gradually, and oriental public health doctors working at health center perform their work efficiently. Undoubtedly, their activity should be more focused on health promotion and disease prevention than daily patient care. For achieving this objective, more support of governmental policy is essential for utilizing oriental public health doctor and better health of the rural area community people.

• Journal of Home Health Care Nursing
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• v.9 no.1
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• pp.14-26
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• 2002

The purpose of the study was to compare both the nursing care satisfaction and the image of nurses as experienced by home health care clients and hospitalized clients. For the descriptive survey study. data were collected from 69 home heath care clients and 342 in-patients in a university hospital. The tools used for the study were modified by Quality Patient Care Scale(Wandelt & Ager. 1974) and Image of Nurses (송인자, 1993). The data were analyzed using Pearson Correlation. Scheffe test. factor analysis. t-test. and ANOVA. The major findings were as follows: Regarding nursing care satisfaction, the mean score of total nursing care satisfaction in home health care clients was 3.28 out of 4.0. Among five domains, the domain with the highest score was the psychosocial domain, followed by the general. the professional. the physical. and the communication domain. The level of nursing care satisfaction was not significantly different according to demographic variables except for age: the age group of 41-60 showed the highest score (p<0.05). The mean score of total nursing care satisfaction in hospitalized clients was 2.95 out of 4.0. Among five domains, the domain with the highest score was the psychosocial domain, followed by the physical and the communication. the professional. and the general domain. The level of nursing care satisfaction was not significantly different according to demographic variables except age: the higher the age the higher the score (p<0.05). The levels of nursing care satisfaction in all five domains were significantly higher in home health care clients than in hospitalized clients(p=0.0005). Regarding image of nurses, the mean score of total image of nurses in home health care clients was 3.32 out of 4.0. Among four domains, the domain with the highest score was the sincerity domain, followed by the kindness. the spirit. and the knowledge and skill domain. The level of image of nurses was not significantly different according to demographic variables. The mean score of total image of nurses in hospitalized clients was 3.05 out of 4.0. Among four domains. the domain with the highest score was the sincerity domain, followed by the kindness, the knowledge and skill, and the spirit domain. The level of image of nurses was not significantly different according to demographic variables. The levels of image of nurses in all four domains were significantly higher in home health care clients than in hospitalized clients (p=0.001). Both the levels of nursing care satisfaction and image of nurses, part of an evaluation for quality of nursing care were significantly higher in home health care clients than in hospitalized clients. In light of the findings, we could consider that home health care nurses provided client-centered comprehensive nursing care. However, nurses need to have methods that more promote the social recognition of the image of nurses and nursing care services as well as professional knowledge and skills.