• Radiation Oncology Journal
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• v.28 no.1
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• pp.1-8
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• 2010

Purpose: This retrospective study was performed to evaluate the efficacy of radiation therapy (RT) and to investigate the prognostic factors for thymoma when treated with RT. Materials and Methods: We analyzed 21 patients with thymoma and also received RT from March 2002 to January 2008. The median follow-up time was 37 months (range, 3 to 89 months). The median patient age was 57 years (range, 24 to 77 years) and the gender ratio of males to females was 4：3. Of the 21 patients, complete resections (trans-sternal thymectomy) and R2 resections were performed in 14 and 1 patient, respectively. A biopsy was performed in 6 patients (28.7%). The WHO cell types in the 21 patients were as follows: 1 patient (4.8%) had type A, 10 patients (47.6%) had type B1-3, and 10 patients (47.6%) had type C. Based on Masaoka staging, 10 patients (47.6%) were stage II, 7 patients (33.3%) were stage III, and 4 patients (19.1%) were stage IVa. Three-dimensional RT was adminstered to the tumor volume (planned target volume), including the anterior mediastinum and the residual disease. The total RT dose ranged from 52.0 to 70.2 Gy (median dose, 54 Gy). Consistent with the WHO criteria, the response rate was only analyzed for the 6 patients who received a biopsy only. The prognostic factors analyzed for an estimate of survival included age, gender, tumor size, tumor pathology, Masaoka stage, the possibility of treatment by performing surgery, the presence of myasthenia gravis, and RT dose. Results: The 3-year overall survival rate (OS) and the progression free survival rate (PFS) were 80.7% and 78.2%, respectively. Among the 10 patients with WHO cell type C, 3 of 4 patients (75%) who underwent a complete resection and 3 of 6 patients (50%) who underwent a biopsy survived. Distant metastasis developed in 4 patients (19.1%). The overall response rate in the 6 patients who received biopsy only were as follows: partial remission in 4 patients (66.7%), stable disease in 1 patient (16.6%), and progressive disease in 1 patient (16.6%). Acute RTOG radiation pneumonitis occurred in 1 patient (4.8%), grade 2 occurred in 2 patients (9.5%), grade 3 occurred in 1 patient (4.8%), and grade 4 occurred in 1 patient (4.8%). A univariate analysis revealed that the significant prognostic factors for OS were age (${\geq}60$, 58.3%; <60, 100%; p=0.0194), pathology (WHO cell type A-B3, 100%; C, 58.3%; p=0.0194) and, whether the patient underwent surgery (yes, 93.3%; no, 50%; p=0.0096). Conclusion: For the 15 patients who received surgery, there was no local failure within the radiation field. In patients with WHO cell type C, surgical procedures could have resulted in a more favorable outcome than biopsy alone. We report here our clinical experience in 21 patients with thymoma who were treated by radiation therapy.

• Journal of Intelligence and Information Systems
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• v.24 no.3
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• pp.177-198
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• 2018

Recently, as economic property it has become necessary to acquire and utilize the framework for water resource measurement and performance management as the property of water resources changes to hold "public property". To date, the evaluation of water technology has been carried out by feasibility study analysis or technology assessment based on net present value (NPV) or benefit-to-cost (B/C) effect, however it is not yet systemized in terms of valuation models to objectively assess an economic value of technology-based business to receive diffusion and feedback of research outcomes. Therefore, K-water (known as a government-supported public company in Korea) company feels the necessity to establish a technology valuation framework suitable for technical characteristics of water resources fields in charge and verify an exemplified case applied to the technology. The K-water evaluation technology applied to this study, as a public interest goods, can be used as a tool to measure the value and achievement contributed to society and to manage them. Therefore, by calculating the value in which the subject technology contributed to the entire society as a public resource, we make use of it as a basis information for the advertising medium of performance on the influence effect of the benefits or the necessity of cost input, and then secure the legitimacy for large-scale R&D cost input in terms of the characteristics of public technology. Hence, K-water company, one of the public corporation in Korea which deals with public goods of 'water resources', will be able to establish a commercialization strategy for business operation and prepare for a basis for the performance calculation of input R&D cost. In this study, K-water has developed a web-based technology valuation model for public interest type water resources based on the technology evaluation system that is suitable for the characteristics of a technology in water resources fields. In particular, by utilizing the evaluation methodology of the Institute of Advanced Industrial Science and Technology (AIST) in Japan to match the expense items to the expense accounts based on the related benefit items, we proposed the so-called 'K-water's proprietary model' which involves the 'cost-benefit' approach and the FCF (Free Cash Flow), and ultimately led to build a pipeline on the K-water research performance management system and then verify the practical case of a technology related to "desalination". We analyze the embedded design logic and evaluation process of web-based valuation system that reflects characteristics of water resources technology, reference information and database(D/B)-associated logic for each model to calculate public interest-based and profit-based technology values in technology integrated management system. We review the hybrid evaluation module that reflects the quantitative index of the qualitative evaluation indices reflecting the unique characteristics of water resources and the visualized user-interface (UI) of the actual web-based evaluation, which both are appended for calculating the business value based on financial data to the existing web-based technology valuation systems in other fields. K-water's technology valuation model is evaluated by distinguishing between public-interest type and profitable-type water technology. First, evaluation modules in profit-type technology valuation model are designed based on 'profitability of technology'. For example, the technology inventory K-water holds has a number of profit-oriented technologies such as water treatment membranes. On the other hand, the public interest-type technology valuation is designed to evaluate the public-interest oriented technology such as the dam, which reflects the characteristics of public benefits and costs. In order to examine the appropriateness of the cost-benefit based public utility valuation model (i.e. K-water specific technology valuation model) presented in this study, we applied to practical cases from calculation of benefit-to-cost analysis on water resource technology with 20 years of lifetime. In future we will additionally conduct verifying the K-water public utility-based valuation model by each business model which reflects various business environmental characteristics.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.75-87
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• 1996

Background: Lung cancer is the second most frequent malignancy in man in Korea. Surgery is the best treatment modality for non-small cell lung cancer, but most patients were presented in far advanced stage. So radiation therapy(RT) with or without chemotherapy is the next choice and radiation-induced pneumonitis and pulmonary fibrosis is the major limiting factor for the curative RT. Radiation pneumonitis is manifested with fever, cough and dyspnea, 2~3 months after the termination of radiotherpy. Chest X ray shows infiltration, typically limited to the radiation field, but occasionally bilateral infiltration was reported. Also Gibson et al reported that BAL lymphocytosis was found in both lungs, even though the radiation was confined to one lung. The aim of this study is to investigate the change of adhesion molecules expression on BAL cells and serum soluble ICAM-1(sICAM-1) level after the RT and its relationship to the development of radiation pneumonitis. The second aim is to confirm the bilaterality of change of BAL cell pattern and adhesion molecule expression. Subjects: BAL and the measurement of sICAM level in serum and BALF were done on 29 patients with lung cancer who received RT with curative intention. The BAL was done before the RT in 16 patients and 1~2 month after RT in 18 patients. 5 patients performed BAL before and after RT. Result: Clinically significant radiation pneumonitis developed in 7 patients. After RT, total cell count in BAL was significantly increased from $(20.2{\pm}10.2){\times}10^6\;cells/ml$ to $(35.3{\pm}21.6){\times}10^6\;cells/ml$ (p=0.0344) and %lymphocyte was also increased from $5.3{\pm}4.2%$ to $39.6{\pm}23.4%$ (p=0.0001) in all patient group. There was no difference between ipsilateral and contraleteral side to RT, and between the patients with and without radiation-pneumonitis. In whole patient group, the level of sICAM-1 showed no significant change after RT(in serum: $378{\pm}148$, $411{\pm}150\;ng/ml$, BALF: $20.2{\pm}12.2$, $45.1{\pm}34.8\;ng/ml$, respectively), but there was a significant difference between the patients with pneumonitis and without pneumonitis (serum: $505{\pm}164$ vs $345{\pm}102\;ng/ml$, p=0.0253, BALF: $67.9{\pm}36.3$ vs $25.2{\pm}17.9\;ng/ml$, p=0.0112). The expression of ICAM-1 on alveolar macrophages (AM) tends to increase after RT (RMFI: from $1.28{\pm}0.479$ to $1.63{\pm}0.539$, p=0.0605), but it was significantly high in patients with pneumonitis ($2.10{\pm}0.390$) compared to the patients without pneumonitis ($1.28{\pm}0.31$, p=0.0002). ICAM-1 expression on lymphocytes and CD 18 (${\beta}2$-integrin) expression tended to be high in the patients with pneumonitis but the difference was statiastically not significant. Conclusion: Subclinical alveolitis on the basis of BAL finding developed bilaterally in all patients after RT. But clinically significant pneumonitis occurred in much smaller fraction and the ICAM-1 expression on AM and the sICAM-1 level in serum were good indicator of it.

• The Korean Nurse
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• v.29 no.2
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

• Journal of Radiation Protection and Research
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• v.39 no.2
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• pp.118-126
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• 2014

A survey was conducted on perceptions, knowledge, and attitudes of elementary, middle, and high school students, who will lead public opinion in the future, regarding irradiated food, nuclear power generation, and medical radiation. These topics urgently require general social acceptability among various fields in which radiation is used. Educational methods to enhance social acceptability were partially discovered. First, it is necessary to implement different strategies when designing courses for female and male students. Male students have higher levels of objective knowledge (p<0.039) of irradiated food, necessity (p<0.001) and objective knowledge (p<0.001) of nuclear power generation, approval of building a nuclear power plant in the nation (p<0.001), necessity (p<0.001) and objective knowledge (p<0.001) of medical radiation, and attitudes regarding using medical radiation (p<0.007, p<0.001). Second, the educational effect of explanations to help increase national understanding of the necessity and safety of nuclear power generation will increase if information on the necessity and safety of medical radiation is provided as well. Both male and female students perceived that medical radiation is the most necessary (p<0.001), medical radiation is the safest (p<0.001), and nuclear power generation is the least safe (p<0.013). Moreover, the correlation between medical radiation and nuclear power generation was the highest. Third, there is a need for different lectures between classes, since the patterns of perception vary according to the field of radiation use among elementary, middle, and high school students. Elementary school students had high interest in education on nuclear power generation (p<0.005), perceived that irradiated food is safe (p<0.001), and had the most positive attitude toward consuming irradiated food (p<0.001). Middle school students had high interest in education on nuclear power generation (p<0.018), perceived that nuclear power generation (p<0.001) and medical radiation (p<0.002) are safe, and had the most positive attitude toward using radiation for treatment (p<0.001). High school students had the highest level of objective knowledge on nuclear power generation (p<0.001) and medical radiation (p<0.001), and perceived that medical radiation is the most necessary (p<0.017); however, they perceived that nuclear power generation is the least safe (p<0.001). Attitudes toward irradiated food intake (p<0.001) and approving construction of a nuclear power plant in their neighborhood (p<0.001) were both low. Fourth, it is necessary to provide educational programs to change perceptions and improve attitudes rather than providing education focused on objective knowledge. There was no correlation between objective knowledge and necessity of irradiated food, objective knowledge and safety and interest in education on nuclear power generation, and objective knowledge and interest in education and information acquirement regarding medical radiation. In particular, high school students had the highest level of objective knowledge and yet had the least positive attitudes toward approving construction of nuclear power plants in their neighborhood and intake of irradiated food. Therefore, to increase the social acceptability of using nuclear energy and radiation in Korea, it is desirable to provide strategic educational programs to improve perceptions, knowledge, and attitudes regarding the necessity and safety of their use.

• Korean Journal of Agricultural Science
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• v.2 no.1
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• pp.61-100
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• 1975

This study has been made to find out the possibilty of successfully using the following $K_2O$ recommended equation $K_2O\;kg/10a=(Ko/\sqrt{Ca+Mg}-Ks/\sqrt{Ca+Mg})sqrt{Ca+Mg}.\;47.\;B\;D$. where $Ko/sqrt{Ca+Mg}=0.03518+0.0007658\;Sio_2/O.M$. $K_Ssqrt{Ca+Mg}$=Exchangeable K me/100g/$\sqrt{Total\;soluble(Ca+Mg)me/100g\;in\;Soil}$ B. D. =Bulk density of top soil, when the dose of Nitrogen for rice is estimated from the following equation: $N\;kg/10a=(4.2+0.096\;SiO_2/O.M).F$ where $F=0.907+0.263x-0.013x^2$ $SiO_2/O.M=(available\;SiO_2=ppm)/(organic\;matter\;%)$in soil For this. two field experiments. one in sandy and the other in clay paddy soil. have been conducted using 3 levels of wollastonite (0, 500, 100kg/10a) as main treatments; 3 levels of $K_2O$ application were used as sub-plots. These were as follows : (1) 8kg of $K_2O$/10a regardless of the K activity-$K/\sqrt{Ca+Mg}$; (2) kg of $K_2O$/10a estimated from the above equation. and (3) same as (2) above plus additional 30% of $K_2O$. The dose of N kg/ 10a was determined from the above equation based on the value of $SiO_2$/O.M. ratio in each treatment. There were three replications. The leading variety of rice in Chung Chong Nam Do area. Akibare (introduced from Japan) was used. The data obtained. through soil and plant analysis and growth and yield observations. have been throughly examined to attain the following summarized conclusions. 1. The nitrogen dose. estimated from the above equation. was in excess for optimum growth of the rice variety Akibare; indicating the necessity of modification onthe value of "F" or the constants in the equation. The concept of using $SiO_2$/O.M. in the equation was shown to be applicable. 2. The dose of potash. estimated from the respective equation given above. also was in excess of the rice requirements indicating the necessity of minor change in the estimation of $Ko/\sqrt{Ca+Mg}$ value and some great modification in the calculation of $Ks/\sqrt{Ca+Mg}$ value for the equation; however the concept of using $K/\sqrt{Ca+Mg}$ as a basis of $K_2O$ recommendation was shown to be quite reasonable. 3. It was found. from the correlation study using the data of paddy yield and amount of $K_2O$ absorbed by rice plants that the substitution of the value of $Ks/\sqrt{Ca+Mg}$ in the equation for the vaule $Ks/\sqrt{Ca+Mg}=0.037+0.78K\;me/100g$ soil was much more applicable than using the value calculated from the data of soil and wollastonite analysis.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.485-495
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• 1998

Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

• (The) Research of the performance art and culture
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• no.36
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• pp.441-471
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• 2018

East Coast Gut, Korean shamanism ritual on its east coastal area, is a Gut held in fishing villages alongside Korean east coastal area from Goseong area in Gangwon-Do to Busan area. East Coast Gut is performed in a series mainly by a successor shaman, Korean shaman, who hasn't received any spiritual power from a God, and the implications of this thesis lie in that we look over the learning aspects of Seokchool Kim shaman group among other East Coast Gut successor shaman groups after dividing it into 2 categories, successor shaman and learner shaman and based upon this, we reveal the meaning of the learning aspects of East Coast Gut. For successor shamans, home means the field of education. Since they are little, they chased Gut events performing dance in a series to accumulate onsite experiences. However, in the families of successor shamans that have passed their shaman work down from generation to generation, their descendents didn't inherit shaman work any longer, which changed the way of succession and learning of shaman work. Since 1980's, Gut has been officially acknowledged as a kind of general art embracing songs, dance and music and designated as a cultural asset of the state and each city and province, and at art universities, it was adopted as a required course for its related major, which caused new learner shamans who majored in shamanism to emerge. These learner shamans are taking systematical succession lessons on the performance skills of East Coast Byeolshin Gut at universities, East Coast Byeolshin Gut preservation community, any places where Guts are held and etc.. As changes along time, the successor shamans accepted the learner shamans to pass shaman work down and changes appeared in the notion of towners who accept the performer groups of Gut and Gut itself. Unlike the past, as Gut has been acknowledged as the origin of Korean traditional arts and as the product of compresensive learning on songs, dance and music and it was designated as a national intangible cultural asset, shaman's social status and personal pride and dignity has become very high. As shaman has become positioned as the traditional artist getting both national and international recognition unlike its past image of getting despised, at the site of Gut event or even in the relation with towners, their status and the treatment they get became far different. Even towners, along with shift in shaman groups' generation, take position to acknowledge and accept the addition of new learning elements unlike the past. Even in every town, rather than just insisting on the type or the event purpose of traditional Gut, they think over on the type of festival and the main direction of a variety of Guts with which all of towners can mingle with each other. They are trying to find new meanings in the trend of changing Gut and the adaptation of new generation to this. In our reality of Gut events getting minimalized along with rapid change of times, East Coast Gut is still very actively performed in a series until now compared to Guts in other regions. This is because following the successor shamans who have struggled to preserve the East Coast Gut, the learner shamans are actively inflowing and the series performance groups preserve the origin of Gut and try hard to use Gut as art contents. Besides, the learner shamans systematically organize what they learned on shamanism from the successor shamans and get prepared and try to hand it down to descendents in the closest possible way to preserve its origin. In the future, East Coast Gut will be succeeded by the learner shamans from the last successor shamans to inherit its tradition and develop it to adapt to the times.

• Journal of Korean Academy of Nursing
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• v.3 no.1
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• pp.13-40
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• 1972

Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

• The Korean Journal of Air & Space Law and Policy
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• v.32 no.1
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• pp.83-138
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• 2017

Korea-China FTA entered into force on the 20th of December 2015, and one year elapsed after its effectuation as the FTA with China, our country's largest trading partner. Therefore, this study looks at the trends of air transport trade between Korea and China, and examines the contents of concessions to the air transport services sector in Korea-China FTA, and analyzes the impact on the air transport sector by Korea-China FTA, and proposes our country's aviation policy direction in order to respond to such impact. In 2016 the trends of air transport trade between Korea and China are as follows : The export amount of air transport trade to China was 40.03 billion dollars, down by 9.3% from the last year, and occupied 32.2% of the total export amount to China. The import amount of air transport trade from China was 24.26 billion dollars, down by 9.1% from the last year, and occupied 27.7% of the total import amount from China. The contents of concessions to the air transport services sector in Korea-China FTA are as follows : China made concessions to the aircraft repair and maintenance services and the computer reservation system services with limitations on market access and national treatment in the air transport services sector of the China Schedule of Specific Commitments of Korea-China FTA Chapter 8 Annex. Korea made concessions to the computer reservation system services, selling and marketing of air transport services, and aircraft repair and maintenance without limitations on market access and national treatment in the air transport services sector of the Korea Schedule of Specific Commitments of Korea-China FTA Chapter 8 Annex. The impact on the air transport sector by Korea-China FTA are as follows : As for the impact on the air passenger market, in 2016 the arrival passengers of the international flight from China were 9.96 million, up by 20.6% from the last year, and the departure passengers to China were 9.90 million, up by 34.8% from the last year. As for the impact on the air cargo market, in 2016 the exported goods volumes of air cargo to China were 105,220.2 tons, up by 6.6% from the last year, and imported goods volumes from China were 133,750.9 tons, up by 12.3% from the last year. Among the major items of exported air cargo to China, the exported goods volumes of benefited items in the Tariff Schedule of China of Korea-China FTA were increased, and among the major items of imported air cargo from China, the imported goods volumes of benefited items in the Tariff Schedule of Korea of Korea-China FTA were increased. As for the impact on the logistics market, in 2016 the handling performance of exported air cargo to China by domestic forwarders were 119,618 tons, down by 2.1% from the last year, and the handling performance of imported air cargo from China were 79,430 tons, down by 4.4% from the last year. In 2016 the e-commerce export amount to China were 109.16 million dollars, up by 27.7% from the last year, and the e-commerce import amount from China were 89.43 million dollars, up by 72% from the last year. The author proposes the aviation policy direction of Korea according to Korea-China FTA as follows : First, the open skies between Korea and China shall be pushed ahead. In June 2006 Korea and China concluded the open skies agreement within the scope of the third freedom and fourth freedom of the air for passenger and cargo in Sandong Province and Hainan Province of China, and agreed the full open skies of flights between the two countries from the summer season in 2010. However, China protested against the interpretation of the draft of the memorandum of understanding to the air services agreement, therefore the further open skies did not take place. Through the separate aviation talks with China from Korea-China FTA, the gradual and selective open skies of air passenger market and air cargo market shall be pushed ahead. Second, the competitiveness of air transport industry and airport shall be secured. As for the strengthening methods of the competitiveness of Korea's air transport industry, the support system for the strengthening of national air carriers' competitiveness shall be prepared, and the new basis for competition of national air carriers shall be made, and the strategic network based on national interest shall be built. As for the strengthening methods of the competitiveness of Korea's airports, particularly Incheon Airport, the competitiveness of the network for aviation demand creation shall be strengthened, and the airport facilities and safety infrastructure shall be expanded, and the new added value through the airport shall be created, and the world's No.1 level of services shall be maintained. Third, the competitiveness of aviation logistics enterprises shall be strengthened. As for the strengthening methods of the competitiveness of Korea's aviation logistics enterprises, as the upbringing strategy of higher added value in response to the industry trends changes, the new logistics market shall be developed, and the logistics infrastructure shall be expanded, and the logistics professionals shall be trained. Additionally, as the expanding strategy of global logistics market, the support system for overseas investment of logistics enterprises shall be built, and according to expanding the global transport network, the international cooperation shall be strengthened, and the network infrastructure shall be secured. As for the strengthening methods of aviation logistics competitiveness of Incheon Airport, the enterprises' demand of moving in the logistics complex shall be responded, and the comparative advantage in the field of new growth cargo shall be preoccupied, and the logistics hub's capability shall be strengthened, and the competitiveness of cargo processing speed in the airport shall be advanced. Forth, in the subsequent negotiation of Korea-China FTA, the further opening of air transport services sector shall be secured. In the subsequent negotiation being initiated within two years after entry into force of Korea-China FTA, it is necessary to ask for the further opening of the concessions of computer reservation system services, and aircraft repair and maintenance services in which the concessions level of air transport services sector by China is insufficient compared to the concessions level in the existing FTA concluded by China. In conclusion, in order to respond to the impact on Korea's air passenger market, air cargo market and aviation logistics market by Korea-China FTA, the following policy tasks shall be pushed ahead : Taking into consideration of national air carriers' competitiveness and nation's benefits, the gradual and selective open skies shall be pushed ahead, and the support system to strengthen the competitiveness of air transport industry and airport shall be built, and entry into aviation logistics market by logistics enterprises shall be expanded, and the preparations to ask for the further opening of air transport services sector, low in the concessions level by China shall be made.