• Korea Journal of Hospital Management
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• v.10 no.1
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• pp.93-114
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• 2005

The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.1
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• pp.135-143
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• 2009

Objectives : Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods : 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results : The amount of fat in the symptomatic side was $7.6{\pm}4.51%$, asymptomatic side was $6.7{\pm}4.29%$. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men $8.5{\pm}5.1%$, women $6.5{\pm}3.6%$). Conclusions : The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.

• Journal of Gifted/Talented Education
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• v.13 no.1
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• pp.65-80
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• 2003

The purpose of this study was to investigate the Asynchronous development of young gifted children by parents' perception. Total 3 groups of 145 subjects from age 30 months to 6 years 10 months old young gifted children's parents participated. The major findings were as follows: (1) The mean developmental characteristics was at a high average level. The developmental subscales tended to be high. The level of verbal understanding/expression tended to be high. It reared as followed; intellectual capacity, emotional maturity, visual-motor coordination, morality, self-behavior control, emotion control, physical development, social development, peer relationship, leadership ability. (2) There were significant differences between intellectual capacity, verbal understanding /expression and physical, social development, self-behavior control, emotion control. There were significant differences between physical development, self-behavior control and emotion control as children got lower. There were significant differences between verbal understanding/expression and visual-motor coordination as children got older. There were significant differences between social development, peer relationship and self-behavior control, emotion control as children got older. Also, there were significant differences between leadership ability and self-behavior control, emotion control as children got older. There were significant differences between morality and self-behavior control as children got older. These findings suggested that young gifted children were in the special needs because of the developmental differences.

• Journal of the Korean Institute of Landscape Architecture
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• v.48 no.2
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• pp.10-19
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• 2020

The park program can adeptly cope with the diversification of leisure needs in accordance with the changing times. The program also makes the relationship between the users and the park itself closer. For this reason, the Seoul Metropolitan Government has operated a variety of programs, beginning with the Botanical Class Program at the Namsan Outdoor Botanical Garden in 1997. The government additionally began to organize park programs by establishing the Park and Leisure Department and three Park Greenery Offices. However, research on park programs is mainly focused on park users. Therefore, this study intends to reveal the structure of the programs by studying the program operation. The specific purposes of this study are '1. Review the institutional characteristics that underlie the operation of the Park Program in Seoul by examining the relevant laws, the operation organizations, and the personnel composition, 2. Analyze the operation methods, such as procurement and the execution of the program, operation costs, and public-private cooperation methods, etc. 3. Analyze the composition and contents of the program from 2015 to 2017, and process and identify the relationship between the structure of the program operation and the program itself.' Summarizing the results obtained from the study, as far as the structure of the first program operation, the support laws were not systematic, but the operating organization was working to establish a system. The second characteristic of the operation is that most of the budget was funded by local governments, but the level of citizen involvement was low. Third, when we looked at the characteristics of the program, the number of programs increased, but they were focused on a specific theme and few programs actively used the park facilities. Based on the results, three tasks can be proposed. The first is that the 'Act on Parks and Green Spaces' should include the concepts and support for park programs. Second, there is a need to change from the ideas of the quantitative increase of programs to qualitative improvements. Lastly, it is necessary to reorganize the Green Seoul Bureau of the Seoul Metropolitan Government into a citizen-led and leisure-oriented organization to promote the park leisure culture. This study has significance, as it was conducted with a service provider, not a program user, unlike many previous park program-related studies. The results of this study will be able to contribute not only to the Seoul Metropolitan Government, but also to other local governments to suggest the direction of the management and the operation of the park for the consumer, and consequently, it will help prepare the long-term vision of parks as the closest leisure location for most citizens.

• Korean Journal of Social Welfare
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• v.67 no.2
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• pp.85-112
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• 2015

This study examined the relationship structure among personal and social cognitive factors contributing to professional help-seeking decisions to relieve distress of those in low-income, then suggested an appropriate model to inform knowledge for better social work practice. Using data of a purposive sampling from 331 low-income people, covariance structural analyses were conducted in two stages of model exploration, one for TPB model and another for its extended model including the level of distress, family support, and willingness. As results, in the path analyses with the observed variables of the basic components of the TPB, subjective norm showed the strongest effect on the intention, following by attitudes towards help-seeking, then behavioral control the least; in turn both the intention, positively, and behavioral control, negatively, contributed to help-seeking decisions. In the second stage of the path analyses with the extended model of the TPB, each of distress and family support demonstrated direct positive effect on each of attitudes, subjective norm, and behavioral control; each of the attitudes, subjective norm, and behavioral control showed positive effect on both intention and willingness; in turn, while intention showed strong positive effect on help-seeking decisions, willingness had no significant effect and behavioral control had negative effect on decisions. There were significant indirect effects of behavioral control on intention through willingness and of willingness on decisions through intention. These results suggested that the TPB model is useful for modeling help-seeking decisions through personal and social cognitions, especially the significance of subjective norm implied the importance of social cognition for the people in low-income with distress. Further, it was implied that the extended model needs to address particularity of those people in low-income and the mechanism shown by behavioral control and willingness implied the importance of practicing respect for the client's autonomy and will for self-support in social work practice.

• Journal of The Korean Association For Science Education
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• v.31 no.2
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• pp.181-197
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• 2011

The purpose of this study was to look into students' understandings of environmental issues, especially issues on global warming in South Korea and Singapore. We surveyed students (n=2,389, from 6 to 10 years) from 12 schools in South Korea and 5 schools in Singapore on how useful students believe various actions might be in reducing global warming, and their willingness to undertake such actions. We employed questionnaires developed by Boyes, Skamp, & Stanisstreet (2009), which consists of 44 questions on 16 pro-environmental actions. We analyzed the degree of students' beliefs, willingness to act, and the relationship between the believed usefulness of action and willingness to act. Differences between the two countries were determined by Analysis of Covariance (ANCOVA) using the ordinal data and the potential effectiveness of education was explored by plotting the measures of the degree of willingness to act for a particular action against the value of the believed usefulness of action and fitting the regression line. The degree of willingness to act and their beliefs in the usefulness of action was different from question to question between the two countries, however, the overall relationship between willingness to take action and beliefs in the action has shown to be stronger among Singaporean students than those of South Korean students. Based on the findings, we attempted to discuss about how environmental education needs to take into account the complexity of beliefs, willingness to act, and action taking.

• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.480-489
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• 2005

Background : Dysregulation of apoptosis plays an important role in carcinogenesis, tumor progression, and resistance to chemotherapy. X-linked inhibitor of apoptosis (XIAP) is considered to be the most potent caspase inhibitor of all known IAP (inhibitor of apoptosis) family members. This study was designed to assess the pattern of expression and the prognostic value of XIAP in radically resected non-small cell lung carcinoma (NSCLC) patients. Method : The expression of XIAP and its relationship with clinicopathologic parameters (patient age, TNM stage, TNM-pT, TNM-pN, histologic type, VEGF expression, microvessel density, PCNA index) and overall survival were analysed with formalin-fixed, paraffin-embedded blocks from eighty cases of NSCLC. In addition, the apoptotic index (AI) was also assessed. Results : In a regard to histologic type, squamous cell carcinoma (SCC) showed XIAP expression in 91.3%(42/46) and adenocarcinoma (AC) in 61.8%(21/34). The difference was significant(p=0.001). There was no correlation between XIAP expression and other parameters. In the group of AC, XIAP expression showed the signifcant correlation with older age group ${\geq}58years$ and VEGF expression(p=0.028, p=0.014, respectively). The AI in the group with or without XIAP expression were $2.5{\pm}4.9%$ and $18.5{\pm}28.9%$, respectively(p=0.001). Both groups just aforementioned showed no significant difference in median survival time (42.5 months, 29.8 months, respectively). Conclusion : This study suggests that the XIAP expression in NSCLCs could have relation to inhibition of apoptosis, and show differential expression according to histologic type. However, its prognostic role during the progression of NSCLC needs to be further defined.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.155-190
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• 2015

The court sentenced meaningful decisions related to the medical service in 2014. The court assumed the negligence of medical staff in the accident if being broken while using the medical equipment for not an original purpose at the time of surgery and ruled that the compensation for damage can be recognized in recognition of the causal relationship between the explanation duty violation and side effect's happening when unproven surgery on safety is implemented regarding the duty of explanation, that in the case of cosmetic surgery, the subject on the duty of explanation needs to be expanded compared to the general medical practice and that the duty of explanation cannot be accepted for the range that cannot be expectable. Also, the court has provided the requirement and limitation of self-determination exercise in case of the crash between patient's self-determination and doctor's duty of care and has ruled that as automobile insurance contract is a contract with the insurance company to pay regarding liability for car accidents, treating patients and taking the insurance money is not illegal activity even for the unlicensed hospital violating the medical law while established. The judgment stating the opinion that medical practitioners cannot be punished according to the medical law prohibiting the receiving of rebate in case that medical practitioners did not receive benefit while the medical institution itself gained an unfair economic benefit also stands out. And the court has ruled that even if the medical institution who received a business suspension is closed, the suspension is still effective in case that the same operator opens a new medical institution in the same place, ruled on the requirement to conduct a medical service outside of the medical institution that the doctor opened and ruled that the administrative penalty cannot be conducted prior to the conviction on charge of violating the medical law.

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.495-501
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• 2000

Background : Cardiopulmonary exercise test is a useful test for the evaluation of the cardiovascular and respiratory systems. Obese subjects have an increased resting metabolic rate ($VO_2$) compared to non~obese subjects and the increase is more marked during dynamic exercise, which results in the limitation of maximal exercise in obese subjects. In this study, the influence of the obesity and fat distribution on the maximal exercise capacity were evaluated. Methods : Maximal exercise capacity was represented by maximam maximum oxygen uptake and $VO_2$ max in the cardiopulmonary test. Obesity, total fat content and abdomina1 obesity(waist to hip ratio, WHR) were measured by bioelectrical impedence method. Total of 42 volunteers (male 22, fema1e 20) were evaluated. Results : 1) Weight to height ratio (mean$\pm$SD) was 110$\pm$14.9% in men and 100$\pm$11.1% in women. 2) Fat ratio (mean$\pm$SD) was 23.3$\pm$5.2% in men and 27.55$\pm$3.9% in woman. 3) Waist to hip ratio (mean$\pm$SD) was 0.85$\pm$0.04 in men and 0.8$\pm$0.03 in woman. 4) In men, $VO_2$ max/min/Kg was negatively correlated with obesity, fat ratio, and abdominal fat distribution. 5) In woman, $VO_2$ max/Kg was negatively correlated with obesity and fat ratio, but did not show significant relationship with abdominal fat distribution. Conclusion : Obesity was a limiting factor for maximal exercise in both men and women. Abdominal obesity was a limiting factor for maximal exercise in men but its implication to women needs further evaluation.

• Journal of Home Health Care Nursing
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• v.10 no.1
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• pp.58-72
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• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,