• Journal of Gynecologic Oncology
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• v.29 no.6
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• pp.83.1-83.10
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• 2018

Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

• Toxicological Research
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• v.29 no.1
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• pp.69-79
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• 2013

The purpose of this study was to investigate the current status of metal pollution in the sediment from rivers, lakes, and streams in active gold mining districts in Ghana. Two hundred and fifty surface sediment samples from 99 locations were collected and analyzed for concentrations of As, Hg, Cr, Co, Cu, Fe, Zn, Pb, Cd, Ni, and Mn using inductively coupled plasma-mass spectroscopy (ICP-MS). Metal concentrations were then used to assess the human health risks to resident children and adults in central tendency exposure (CTE) and reasonable maximum exposure (RME) scenarios. The concentrations of Pb, Cd, and As were almost twice the threshold values established by the Hong Kong Interim Sediment Quality Guidelines (ISQG). Hg, Cu, and Cr concentrations in sediment were 14, 20, and 26 times higher than the Canadian Freshwater Sediment Guidelines for these elements. Also, the concentrations of Pb, Cu, Cr, and Hg were 3, 11, 12, and 16 times more than the Australian and New Zealand Environment and Conservation Council (ANZECC) sediment guideline values. The results of the human health risk assessment indicate that for ingestion of sediment under the central tendency exposure (CTE) scenario, the cancer risks for child and adult residents from exposure to As were $4.18{\times}10^{-6}$ and $1.84{\times}10^{-7}$, respectively. This suggests that up to 4 children out of one million equally exposed children would contract cancer if exposed continuously to As over 70 years (the assumed lifetime). The hazard index for child residents following exposure to Cr(VI) in the RME scenario was 4.2. This is greater than the United States Environmental Protection Agency (USEPA) threshold of 1, indicating that adverse health effects to children from exposure to Cr(VI) are possible. This study demonstrates the urgent need to control industrial emissions and the severe heavy metal pollution in gold mining environments.

• Journal of the Korean Society of Food Culture
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• v.35 no.2
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• pp.201-214
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• 2020

This study was a qualitative investigation into hemodialysis patients' dietary practices. The purpose of this study was to explore the obstacles and requirements to maintain a recommended diet therapy in hemodialysis patients. Five patients undergoing hemodialysis in the renal chamber of the general hospital were interviewed individually. The interviews were based on an interview guide and analyzed by Giorgi's method of analysis. As a result of this study, five elemental factors and 12 subelemental factors were derived. Derived elements were "difficulty in dietary guidelines", "recognizing necessity of diet therapy", "awareness of importance of diet", "difficulty practicing diet therapy", and "looking for ways to practice diet therapy". Patients not only felt difficulties in practicing dietary guidelines but also recognized the need and importance of diet therapy. Patients seemed to have difficulty practicing meal therapy and eating with their families or others. They were also stressed by the limited selection of dietary components and rapid dietary changes before and after dialysis. However, patients showed a willingness to implement dietary management to improve their quality of life and to practice dietary therapy. In order to improve the practice of dietary management in hemodialysis patients, nutritional education should be focused on long-term dietary habits through continuous education and monitoring, not just one-off education. Moreover, patients should be educated that adherence to dietary control may be less burdensome on their families.

• Tuberculosis and Respiratory Diseases
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• v.63 no.5
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• pp.405-411
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• 2007

Background: The objective of this study was to evaluate the clinical applicability of the repeatability criteria recommended by the American Thoracic Society/European Respiratory Society (ATS/ERS) spirometry guidelines and to determine which factors affect the repeatability of spirometry in Korean adults. Methods: We reviewed the spirometry data of 4,663 Korean adults from the Korean National Health and Nutritional Examination Survey (KNHANES) Chronic Obstructive Pulmonary Disease Cohort (COPD cohort) and the Community-based Cohort Study VI-Fishing village/Islands (community cohort). We measured the anthropometric factors and differences between the highest and second-highest FVC (dFVC) and $FEV_1$ ($dFEV_1$) from prebronchodilator spirometry. Analyses included the distribution of dFVC and $dFEV_1$, comparison of the values meeting the 1994 ATS repeatability criteria with the values meeting the 2005 ATS/ERS repeatability criteria, and the performance of linear regression for evaluating the influence of subject characteristics and the change of criteria on the spiro-metric variability. Results: About 95% of subjects were able to reproduce FVC and $FEV_1$ within 150 ml. The KNHANES based on the 1994 ATS guidelines showed poorer repeatability than the COPD cohort and community cohort based on the 2005 ATS/ERS guidelines. Demographic and anthropometric factors had little effect on repeatability, explaining only 0.5 to 3%. Conclusion: We conclude that the new spirometry repeatability criteria recommended by the 2005 ATS/ERS guidelines is also applicable to Korean adults. The repeatability of spirometry depends little on individual characteristics when an experienced technician performs testing. Therefore, we suggest that sustained efforts for public awareness of new repeatability criteria, quality control of spirograms, and education of personnel are needed for reliable spirometric results.

• Journal of Korean Academy of Nursing
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• v.45 no.3
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• pp.420-428
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• 2015

Purpose: Purpose was to explore associations between sleep duration and metabolic syndrome (MS) risks, and to determine factors associated with self-rated health (SRH) of adults with MS compared to other adults. Methods: This is a secondary data analysis based on the Fifth Korea National Health and Nutrition Examination Survey KNHANES V (N=12662). Study instruments included sleep duration, MS risk factors, SRH and health-related quality of life (HRQoL). Results: Mean age of participants was $43.68{\pm}12.26years$. Fifty-eight percent were women, and 18.3% were identified as having MS. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and SRH were significantly different according to sleep duration (p <.05) among all participants. In the non MS group, male gender, younger age (19~30 and 41~50 age brackets) upper income level, sufficient sleep duration, and high density lipoprotein (HDL) were positively associated with SRH, whereas, lower education levels (${\leq}$ middle school), glucose level, and waist circumference were negatively associated with SRH (p <.05). In the MS group, lower income, lower education levels (${\leq}$ middle school), glucose level, and waist circumference were negatively associated with SRH, whereas, having an occupation was positively associated with SRH (p <.05). Conclusion: Results suggest that tailored approaches are required for prevention and control of MS and sleep duration of each individual should be considered rather than applying standardized guidelines. However, as sleep quality was not included in the analysis, further investigations regarding influence of sleep quality on MS and SRH and controlling for other lifestyle and health behavior factors are required.

• Korean Medical Education Review
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• v.25 no.2
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• pp.102-108
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• 2023

This study shares details on the operating process and results of the cohort of students and graduates that was designed and implemented at Konyang University College of Medicine in Daejeon and discusses future directions for cohort establishment and improvement. First, Konyang University College of Medicine established the necessity and defined the purpose of cohort design and implementation. A task force was formed to establish guidelines for analysis targets, procedures, reports, and data management, and cohort operation was classified as a quality control activity. Data were collected through surveys of current students and graduates, and data generated during the curriculum were collected, analyzed, and reported every 2 years. The cohort data collection and analysis methods are designed by the Department of Medical Education, and data collection is carried out by the administrative team and each committee. Data management and analysis are handled by the Center for Medical Education Support, and analysis and reporting are conducted by the Department of Medical Education. Various members of the medical school are working to collect and analyze data, report findings, provide feedback, and improve. In the future, we plan to advance database computerization and work toward more effective data analysis. Cohort operation should not be another burden for medical schools; instead, it is hoped that operating cohorts will be a meaningful activity to increase the effectiveness of medical education and help in the operation and policy decisions of medical schools.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.5
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• pp.589-597
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• 2008

The purpose of this study is to arrange for the systematic execution of safety control in children's foods through nutrition and hygiene standard suggestions and guidelines for quality certification system in children's preferable food. Aiming to achieve this objective, the study researched the present status of children’s preferable food sold near elementary schools, elicited the hazards and problems of those foods and selected nutritional and hygienic hazard components in those foods. To suggest the standards and guidelines for quality certification in children's preferable food, the study referred to sundry records, surveyed the practical cases of relevant policies and standards at home and abroad. We studied the standard of nutrition for the quality certification in those foods for sugar, fat, sodium, and additives (tar color: red No. 2 in a ban on use, caffeine), microorganism (aflatoxin $B_1$ (${\mu}g$/kg) and pathogenic bacteria (Staphylococcus aureus, Bacillus cereus, Salmonella spp.), which are the nutrients that may hamper health when taken in a large amount, and the standard for a diet restricted to under 200 kcal per one serving size. Results of distribution of processed foods (242 samples) by nutrition standards were as follows. In case of all ‘low’ level in total sugar, total fat and sodium, 0.4% of total samples was possible to be certified, In case of all ‘medium’ level in total sugar, total fat and sodium, maximumly 22.3% of total samples was possible to be certified. In case of all medium level in nutrients and $\leq$200 kcal/serving, 17.8% of total samples was possible to be certified. Certified food types was milk products and beverages.

• KIPS Transactions on Software and Data Engineering
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• v.4 no.12
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• pp.549-560
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• 2015

There is a wide variety of data quality attributes such as the ones proposed by the ISO/IEC organization and also by many other domestic and international institutions. However, it takes considerable time and costs to apply those criteria and guidelines to real environment. Therefore, it needs to define data quality evaluation attributes which are easily applicable and are not influenced by organizational environment limitations. The purpose of this paper is to derive data quality attributes and order of their priorities based on customer requirements for managing the process systematically and evaluating the data quantitatively. This study identifies the customer cognitive constructs of data quality attributes using the RGT(Repertory Grid Technique) based on a Korean quality standard model (DQC-M). Also the correlation analysis on the identified constructs is conducted, and the evaluation attributes is prioritized and ranked using the AHP. As the results of this paper, the consistent system, the accurate data, the efficient environment, the flexible management, and the continuous improvement are derived at the first level of the data quality evaluation attributes. Also, Control Compliance(13%), Regulatory Compliance(10%), Requirement Completeness(9.6%), Accuracy(8.4%), and Traceability(6.8%) are ranked on the top 5 of the 19 attributes in the second level.

• Korean journal of food and cookery science
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• v.30 no.6
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• pp.774-784
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• 2014

The purpose of this study was to present management guidelines for critical control points by analyzing microbiological hazardous elements through screening Potentially Hazardous Foods (PHF) menus in an effort improve the microbiological quality of foods prepared by restaurant operations. Steamed spinach with seasoning left at room temperature presents a range of risk temperatures which microorganisms could flourish, and it exceeded all microbiological safety limits in our study. On the other hand, steamed spinach with seasoning stored in a refrigerator had Aerobic Plate Counts of $2.86{\pm}0.5{\log}\;CFU/g$ and all other microbiological tests showed that their levels were below the limit. The standard plate counts of raw materials of lettuce and tomato were $4.66{\pm}0.4{\log}\;CFU/g$ and $3.08{\pm}0.4{\log}\;CFU/g$, respectively. Upon washing, the standard plate counts were $3.12{\pm}0.6{\log}\;CFU/g$ and $2.10{\pm}0.3{\log}\;CFU/g$, respectively, but upon washing after chlorination, those were $2.23{\pm}0.3{\log}\;CFU/g$ and $0.72{\pm}0.7{\log}\;CFU/g$, respectively. The standard plate counts of baby greens, radicchio and leek were $6.02{\pm}0.5{\log}\;CFU/g$, $5.76{\pm}0.1{\log}\;CFU/g$ and $6.83{\pm}0.5{\log}\;CFU/g$, respectively. After 5 minutes of chlorination, the standard plate counts were $4.10{\pm}0.6{\log}\;CFU/g$, $5.14{\pm}0.1{\log}\;CFU/g$ and $5.30{\pm}0.3{\log}\;CFU/g$, respectively. After 10 minutes of chlorination treatment, the standard plate counts were $2.58{\pm}0.3{\log}\;CFU/g$, $4.27{\pm}0.6{\log}\;CFU/g$, and $4.18{\pm}0.5{\log}\;CFU/g$, respectively. The microbial levels decreased as the time of chlorination increased. This study showed that the microbiological quality of foods was improved with the proper practices of time-temperature control, sanitization control, seasoning control, and personal and surface sanitization control. It also presents management guidelines for the control of potentially hazardous foods at the critical control points in the process of restaurant operations.

• Journal of the Korean Society of Food Science and Nutrition
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• v.32 no.5
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• pp.667-672
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• 2003

Low-fat, precooked high quality Wanjajun was prepared by treating natural antioxidant herbs and hydrocolloids for quantity production of cook/chill system in foodservice. The proposed Wanjajun was formulated under the consideration of flavor and fat level. Wanjajun was prepared with hydrocolloid such as sodium alginate, car-boxymethyl cellulose (CMC), carrageenan and xanthan gum. Cooking yield, fat retention and water holding capacity of Wanjajun containing hydrocolloidal gums were higher than those of control. L-value of raw product was low in comparison with cooked product, but a-value was higher than that of other cooked product. Colors of raw and cooked products were not different among five kinds of products. pH value of cooked product was higher than that of raw product pH range of cooked products revealed to 6.10~6.23. There was no considerable change in pH value during storage. The coliform group and Staphylococus aureus were not detected during storage. Total bacteria1 counts were close to microbial guidelines for safe condition. Hardness, springness, cohesiveness, gumminess and brittleness of low-fat products were generally lower than those of control product. Hardness, gumminess and brittleness of reheated products were higher than those of preheated products. Flavor, tenderness, juiciness and overall quality were not different between precooked and reheated products. Textural characteristics of products were superior in the order of sodium alginate, xanthan gum, CMC, carrageenan and control product.