• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.239-247
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• 2017

Among the commonly known tools to diagnose diabetes are fasting plasma glucose (FPG), HbA1c., and OGTT known as gold standard. However, there can be many disagreements on the ways to diagnose diabetes. In this study, we examined the differences of the types of diabetes according to the applicability of FPG and HbA1c. Moreover, we evaluated the concordance of diagnosis. We excluded subjects with missing glucose and HbA1c data, as well as those previously diagnosed with diabetes, and those who fasted less than 8 hours. The data of 4,502 subjects (1,956 men and 2,546 women) from the 2015 KNHNES were analyzed. We divided these patients into three categories which are normal, prediabetes, and diabetes, based on the FPG and HbA1c. In men, the number of subjects with FPG ranging from 100 to 125 mg/dL and HbA1c ${\geq}6.5%$ was 23 out of 664, and the number of subjects with FPG < 126 mg/dL and HbA1c ${\geq}6.5%$ was 39 out of 86 newly diagnosed diabetes patients. The concordance rate was as follows: Normal 80.3%, prediabetes 44.9%, and diabetes 54.7%. The coefficient of Cohen's Kappa was 0.322 in men and 0.362 in women; this suggests that both gender showed a low concordance rate. However, when we divided them into two categories (nondiabetes and diabetes), Kappa was 0.582 in men and 0.637 in women, showing a relatively high concordance rate. While all subjects with FPG ${\geq}126mg/dL$ showed a significantly high HOMA IR, all subjects with FPG < 126 mg/dL showed a significantly high QUICKI. Considering the low concordance rate for the diagnosis of diabetes and characteristic of diagnostic tests, it is necessary to combine the related tests for diagnosing diabetes.

• Korean Parent-Child Health Journal
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• v.3 no.1
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• pp.1-14
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• 2000

The Low Birth Weight infant birth rate in this country is a little more than 15 percent and is being increased. The survival rate of Low Birth Weight infant is over 90 percent and recently the rate runs is getting. However, because of the high risk of Low Birth Weight infant for handicap in growth, a preventive nursing intervention program for Low Birth Weight infant and their mother is considered to be necessary. Touch and massage, thus sensory stimulation has been considered to be important ensuring a normal growth of Low Birth Weight infant During the past decades sensory stimulation program has been used for premature and Low Birth Weight infants. Recently a study on the sensory stimulation for Low Birth Weight infants has bee n done in this country. Mother and infant relationship has a great influence on child's development. Especially, mother and infant interaction during one year after birth plays important role in child's social. affective and cognitive developments. But in the study of Low Birth Weight infants, the mother and infant interaction has been rare yet. However, there was no study effectiveness of the sensory stimulation on mother and infant interaction. In this respect, this study based on the importance of the nursing intervention, is intended to measure the effectiveness of the massage therapy in the aspects of weight, daily feeding amount, cortisolurine stress hormone and mother and infant interactions. This study has been conducted on the nonequivalent control group pretestposttest design in quasi experimental basis and Low Birth Weight infants from NICU of two Medical University Hospitals located in Taegu Metropolitan were selected in experimental group of 21 infants and control group of 20 infants. Data has been collected from May 1, 1999 to September 5, 2000. For the experimental group Field's sensory stimulation(tactile and kinesthetic stimulation) was applied 2 times a day for 10 days(10:00 - 11:00 hours in the morning and 19:00 - 20:00 in the afternoon) by nurse and mother. The electronic indicator scale (Cas Co. Korea) was used to measure infant's body weight. To determine urine cortisol concentration level under stress, rad immuno assay method was used. And to determine mother and infant interactions during feeding, tools developed by Kim Mi-Ye (1999) were used. Collected data were analyzed with SAS program using x-test, t-test, paired t-test and repeated measures ANOVA. Findings were as follows : 1. For the daily mean weight gain, the experimental group showed little higher than the control group, even though, there was no Statistically significant differences between two groups. 2. For the amount of daily mean feeding, the experimental group showed little higher than the control group, while there was no Statistically significant differences between two groups. 3. The level of wine cortisol concentration was increased in both groups, while no Statistical significance was shown between the two groups. 4. Mothers in experimental group were more likely to have higher mean scores in mother and infant interaction during feeding than mothers in the control group. Statistical significance was shown between the two groups(t= 5.78, P=.001). In conclusion, the massage therapy in this study showed with regard to even though through there was no statistically significance in the weight gain and urine stress hormone concentration. there was Statistical significantly higher in the mother and infant interaction during feeding. Based on the result of this study, it is considered that the massage therapy should be applied clinical practice and home to help a developmental growth and interaction of Low Birth Weight infants and mothers during the period of recovery.

• Journal of Nutrition and Health
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• v.49 no.5
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• pp.378-394
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• 2016

Purpose: Screening of preschool-age children for nutrition programs to improve dietary intake and behaviors requires cost-effective and easily administered validated assessment tools. The purpose of this study was to develop a parent/caregiver-administered instrument for measuring diet quality and behaviors of preschoolers as a nutrition quotient for preschoolers (NQ-P). Methods: Development of NQ-P was carried out in three steps: item generation, item reduction, and validation. The 24-h dietary record was selected as the gold standard reference tool. The 38 items of the NQ-P checklist were derived from a systematic literature review, expert in-depth interviews, statistical analysis of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Self-administered questionnaires were delivered to parents who recorded 24-h dietary intakes of 100 responders aged 3~5 yr. Pearson's correlation was used to measure the level of agreement between questionnaires. Item reduction was performed, and 20 items were selected based on survey results, expert reviews, and priorities of national nutrition policy and recommendations. The 412 nationwide subjects sampled through daycare centers completed the 20-item checklist questionnaire. The construct validity of the NQ-P was assessed using confirmatory factor analysis, LISREL. Results: After analyses of exploratory factors, NQ-P items identified three dimensions of diet (balance, moderation, and environment). The three-factor structure accounted for 49.28% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-P and three-factor scores of the subjects were calculated by the obtained weights of the questionnaire items. Conclusion: A food behavior checklist for preschoolers' NQ would be a useful and suitable instrument for evaluating nutrition adequacy and dietary quality of Korean preschoolers.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.176-189
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• 2003

Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.

• The Journal of Korean Society for School & Community Health Education
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• v.1 no.1
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• pp.83-93
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• 2000

The purpose of this study were to suggest the method of sex education by designing and implementing multimedia program about sex education, to search the efficiency between a teaching using multimedia program and a teaching of traditional method. To put above aims into practice, these were required : 1. are there any differences in the alteration of sex attitude according to teaching methods. 2. are there any differences in the completion of sex knowledge according to teaching methods. 3. are there any differences in the alteration of sex attitude according to learning level and teaching methods. 4. are there any differences in the completion of sex knowledge according to learning level and teaching methods. 5. are there any differences in the alteration of sex attitude according to sex and teaching methods. 6. are there any differences in the completion of sex knowledge according to sex and teaching methods. To carry out a reseach for this purpose, the subjects for this study were 160 sixth grade students from 2 elementary schools in Pu-Chun, Kyung Ki. The tools for study were two kind of questionnaires: sex knowledge test, sex attitude test. Each test consists of 20 items. Collected data was analysed with t-test by means of SPSS program. The main results of this study are as follow: 1. The Alteration of sex attitude according to teaching methods. There was a significant difference among teaching methods(P<.001). a teaching using multimedia program was more efficient than a teaching of traditional method in the alteration of sex attitude. 2. The Completion of sex knowledge according to teaching methods. There was a significant difference among teaching methods(P<.001). a teaching using multimedia program was more efficient than a teaching of traditional method in the completion of sex knowledge. 3. The Alteration of sex attitude according to learning level and teaching methods. There was a significant difference among teaching methods in the superior class. a teaching using multimedia program was more efficient than a teaching of traditional method in the alteration of sex attitude(P<.001). However, there was not a significant difference among teaching methods in the inferior class(P>.05). 4. The Completion of sex knowledge according to learning level and teaching methods. There was a significant difference among teaching methods in the superior class. a teaching using multimedia program was more efficient than a teaching of traditional method in the completion of sex knowledge(P<.001). Also, there was a significant difference among teaching methods in the inferior class. a teaching using multimedia program was more efficient than a teaching of traditional method in the completion of sex knowledge(P<.001). 5. The Alteration of sex attitude according to sex and teaching methods. There was a significant difference among teaching methods in the man class. a teaching using multimedia program was more efficient than a teaching of traditional method in the alteration of sex attitude(P<.01). However, There was not a significant difference among teaching methods in the woman class(P>.05). 6. The Completion of sex knowledge according to sex and teaching methods. There was a significant difference among teaching methods in the man class. a teaching using multimedia program was more efficient than a teaching of traditional method in the completion of sex knowledge(P<.001). Also, there was a significant difference among teaching methods in the woman class. a teaching using multimedia program was more efficient than a teaching of traditional method in the completion of sex knowledge(P<.05).

• The Journal of Korean Society for School & Community Health Education
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• v.5
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• pp.25-42
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• 2004

This study set out to investigate the relations between middle school students' perception of body image and their allowance for plastic surgery, to understand their perception of body image and desire for plastic surgery, and provide some data needed to warn against reckless plastic surgery and guide the students effectively. For those purposes, an examination was conducted of the relationships between the individual characteristics and perception levels of body image, the individual characteristics and allowance for plastic surgery, and perception levels of body image and allowance for plastic surgery. The subjects were drawn from sour middle schools located in two regions of Gyeonggi Province. Total 922 boys and girls were surveyed on a questionnaire, which was developed based on the pretest of previous literature, reviewed for appropriateness, and tested for reliability and reasonableness. The body image on the five scale was greater as the perception level was higher. The allowance for plastic surgery was also greater as the scores were more. The findings were as follows: First, the relationships between individual characteristics and perception levels of body image were examined. The third graders showed the highest perception level, being followed by the first and second graders. The girls were more perceptive than the boys, and those who were extrovert were more perceptive than those who were introvert. Those students whose parents earned 2 million won or more a month and who adapted themselves to the environmental changes had a higher perception level. In a word, the girls from the middle class that were well adapted, felt happy, and were extrovert had a higher perception level of body image. Second, the connections between individual characteristics and allowance for plastic surgery were investigated. The third graders were the most admissive of plastic surgery, followed by the second and first graders. That is, the upper graders were more admissive of plastic surgery. In addition, the girls were more admissive than the boys, and those who were extrovert were more than those who were introvert. There were no significant differences according to the monthly income of the parents, grades, adaptability to surroundings, and happiness, which results almost resembled the findings of a study conducted on adults. Third, there were negative correlations found between the perception levels of body image and the allowance for plastic surgery. To elaborate, the higher the perception levels were, the lower the allowance was, and vice versa. As for the items, the subjects showed more allowance for plastic surgery when they scored less in the item of caring about appearance, importance of looking pretty to others, and efforts to improve appearance. When they had a low value of body and easily felt tired, they were highly acceptive of plastic surgery. The allowance for plastic surgery was also great when their perception was much of how healthy they felt, how important they felt about their bodies, how they were satisfied with their current appearances, how they evaluated the appearance of others, how much they were satisfied physically, and how much demanding they were for physical changes. Meanwhile, there were no correlations between the allowance and physical attraction, the degree for one's activities to be hindered, and sickness. In short, the demand for plastic surgery was 41% for the girls and 20.2% for the boys. Just as the study on adults reported, those who had a low or negative perception of body image were more acceptive of plastic surgery. The middle school students were generally positive about their bodies with the lowest perception level at 2.91 and the highest at 3.21. Their individual allowance for plastic surgery was related to their individual body images, which were in turn affected by the mass communication, surrounding environments, and social values. Thus it's necessary for the entire society to try to improve or change the overall perception. Helping measures should be taken so that the students can form right sense of values about their bodies, avoid the obsession with appearance and appearance-based evaluation, and exercise righteous criteria against humans beings and things. In conclusions, the following suggestions were made: they need to develop such questionnaires or tools as can measure the body image of teens and fit the reality. Moreover, body image improvement programs should be more diverse and more applicable to teens. Despite the consistent reports that prove the correlations between body image and plastic surgery, there has been little effort to apply such factors as experience of the life of the disabled, volunteer activities for the disabled and at the hospitals, and others that can induce changes to body image to the body image improvement programs. In the future, comparative research should be carried out on body image and plastic surgery.

• Journal of agricultural medicine and community health
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• v.16 no.1
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• pp.48-60
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• 1991

In a seroepidemiological study in several areas of Korea, the ELISA technique was performed to determine prevalence of some important helminthic diseases in our nation during March $15^{th}$ to June $30^{th}$. 1991. In this survey the serum antibody positive rates of anisakiasis, toxocariasis, clonorchiasis, paragonimiasis, cysticercosis, and sparganosis were measured. Among, 6,704 cases examined, 19.7% showed positive antibody titer at least one of the six items studied. Overall positive antibody rate was 8.1% in anisakiasis, 5.6% in toxocariasis, 3.6% in clonorchiasis, 1.7% in paragonimiasis, 4.5% in cysticercosis, and 2.6% in sparganosis respectively. In Pusan port southeastern part of Korea, antibody positive rate of anisakiasis was 2.9%, and clonorchiasis was 2.8% among 450 examine. In TaeJ$\check{o}$n city, central part of Korea. toxocariasis(6.7%) and anisakiasis(3.7%) showed high serologic positive rate. Of the 875 persons in Chunche$\check{o}$n gun(=province), northern central rural area of South Korea, anisakiasis was revealed as 3.4% seropositivity. In Tonghae port, eastern coast of South Korea. 9.9% of population examined showed positive antibody titer in anisakiasis. Of the 1,122 persons examined in Southern part of Cholla-Namdo(Southwestern coastal area of Korea), anisakiasis was 16.9%, cysticerocosis was 12.7% and the paragonimiasis was 3.3% respectively. In some localized area of Cholla-Pukdo, anisakiasis was 9.3% and cysticekosis was 4.3% among 702 cases examined. In some localized area of Kyungsang-Pukdo, anisakiasis was 10.6%. and toxocariasis was 16.1% among 900 cases examined. And finally, in Cheju-do, southern island of Korea, anisakiasis showed high positive rate(6.7%). Because cross reactions between related helminth group may disturb the analysis of these data, use of further developed techniques such as EITB(enzyme-linked immunoelectrotransfer blot) was considered as a essential tools for the study. We thought that probably most of the positive cases of cysticerosis were taeniasis cases. We can't rule out taeniasis even though EITB was employed as far as crude worm extract or cystic fluid of cysticercus was used as antigen. It was well Known that toxocariasis and anisakiasis also showed cross reactivity. However, the data presented here focus on seropositive rate of several helminthic diseases in Korea, not true prevalence rate of helminthiases, and to wait for more expensive purified antigen in sufficient amount for epidemiologic use is not necessary because increased immunologic sensitivity had little effect on epidemiologic sensitivity. We, here, suggest that ELISA should be applied as soon as possible to the evaluation of prevalence of tissue invading parasitic diseases, and a review of the antibody positive rate obtained in this study would be a basic data for controlling program of parasitic diseases in Korea.

• Journal of agricultural medicine and community health
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• v.33 no.1
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• pp.27-36
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• 2008

=Objectives: This study was conducted to evaluate the diferences in Farmer's syndrome between greenhouse-melon farmers and rice farmers. Methods: The study included 160 residents, who lived in rural community. Of those subjects, 73 and 87 from June 1 to July 30, 2006. Respondents were interviewed by means of a structured questionnaire. Results: This study showed that greenhouse-melon farmers had a lower average age, shorter experience of farming, more working hours per day than rice farmers (p<0.05). n farmers was 38.4% respectively, the prevalence in rice farmers was 22.6%. There was statistically significant diference in the prevalence of Farmer's syndrome between greenhouse-melon and rice farmers (p<0.05). The most frequent symptoms among eight symptoms that constitute the Farmer's syndrome were lumbago, shoulder pain and nocturnal urination regardless of type of farming. But greenhouse-melon farmers had higher prevalence of muskuloskeletal symptoms, such as lumbago and shoulder pain, than rice farmers (p<0.05).Conclusions: These results showed that prevalence of Farmer's syndrome was more common in the tools which reduce physical burden and take a rest and exercise periodically during work in the greenhouse-melon farmers.

• Journal of Technologic Dentistry
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• v.28 no.1
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• pp.121-142
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• 2006

Collecting materials for study on teaching efficiency and satisfaction of clinical training, it changes. Dental technology's educational procedure to many ways of a prospect. In a circumstance that needed higher level of education, this study is aimed on realizing an importance of clinical training through the various materials that previously carried out and offering basic knowledge to take better clinical training for the students. Study results below 1. This Investigation conducted on 123 of sophomores(70.3%) and 52 of juniors(29.7%) who have been taken clinical training, and men's proportion(51.45%)is a bit higher than girls(48.6%). The 64% of respondents taken largest proportion were 20 to 24 years old. As 67.9% of respondents attended daytime school and 30.3% of them attended nighttime one, their school time shows a little difference. In a question about relation ship, one answered "Harmonious" took largest proportion by 72.6% during training, and about the degree of satisfaction of campus life who answered "normal" were the most with 59.4%. 2. About the reason choosing dental technology as a major, 41.1% taken the most answered "due to the specialized job", "Getting job easily" was second with 26.9%, and third was "recommended from around" with 18.3%. 50.3% of the respondents answered "normal" about the Satisfaction of their major, student marked in grade "B" most with 51.4% 3. In a investigation result about clinical training statues and preference, most(72.6%) choose place less than 10 for clinical training, and 60.6% of them resided own home. About their commuting time from home to training place, 44% was under 30min, 40% took time 30-60min. It shows students prefer shotter distance in terms of choosing training place. 4. Each part manager took large proportion as a clinical trainer with 33.7%, Training curriculum reform and developing method were most answer as a improvement measure after completing training with 30%. 5. The average of total score about clinical training was 3.15 of 5. In the detailed question, 'satisfaction of clinical training' got 3.38 as a highest score, the lowest score was 2.86 that is about satisfaction of clinical training period. The average score about efficiency of study was 2.86 and in detailed question, 'a Role model' got 3.26 as a highest score and participation of student got 3.05 as a lowest score. 6. The result of T-test to see the difference of the satisfaction according to the general character and clinic training condition between teaching efficiency is that the degree of satisfaction of clinical training showed statistical significance only in the degree of satisfaction of campus life(p<0.05), and teaching efficiency has a statistical significance with their age, grade, and satisfaction of campus life (p<0.05). 7. The relation between of teaching efficiency of clinical training and satisfaction of clinical training of dental technologic student has a statistical meaning in significance leveler 0.01. Now, therefore we suggest following based on these result. 1. To elevate satisfaction of clinical training, it agentry needs development of consistent clinical training curriculum. 2. To grasp the satisfaction and requirement, in needs to measure anxiousness and satisfactory degree after completing training 3. To train efficiently and evaluate efficiency over the teaching activities, it needs to develop measuring tools for teaching efficiency in terms of teacher's important rules in a clinical training. 4. Strengthen the relations with the study developing and managing curriculum gathering theoretical knowledge and practice. And make an effort to apply to their students. 5. Let the trainee take a class setting a belief, sense of value, function and obtain behavior by making the students comfort over clinical training as increasing teaching efficiency.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.265-284
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• 2001

The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.