• Journal of the Korean Dietetic Association
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• v.16 no.4
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• pp.378-396
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• 2010

The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.9
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• pp.3366-3374
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• 2010

By identifying the patterns of diabetes and high blood pressure with elderly people in a certain region, this study was intented to obtain the basic information for the improvement of the elderly health. In this analysis, CART was used for studying the pattern for chronic illness, - with the basis on survival factor by each sex, marital status, occupation, methods of health management and age. Occupation related to agriculture showed the highest cases of diabetes. But in the occupations related to fishing industry and public service, number of diabetics were minimal. With occupations related to trades and others, the cases of diabetes increased as the age increased in 80's and 90's. In recent years, the elderly population is ever increasing. In addition, elderly health situation is surfacing as a significant social issue - this is especially the cases as their allowed activities are becoming even more limited. Therefore it is important to improve the functions for their livelihood and increase their satisfaction of life by considering their quality of life, so they could live the rest of their lives happily and comfortably.

• Journal of the Korean Society of Radiology
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• v.8 no.1
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• pp.43-49
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• 2014

PACS is needed medical imaging with large-capacity storage device. Slower transmission degrades the performance of the PACS. Thus, the image read by the reading of the long-term stored image without compromising the quality of the video, which does not affect future readings in the range will be compressed and stored. Compression and video storage, and video transport Noise generated during storage and transmission of medical images and the resulting loss of information that occurs when the monitor output from many problems. The study estimates server display monitor and client display monitor of philips DSA system, and suggests that the evaluation and improvement about PSNR, process from server display signal obtaining to client display monitor. P company DSA is used in the test. Two monitors that are $1280{\times}1024$ pixel monitor of P company and 1536x2048 pixel monitor of Wide are used displaying angiography picture. MARO-view is taken in PACS program, and Visual $C^{++}$ is taken as accomplishing PSNR measurement program. As a result of experiment, no change in No 1, 3 of PSNR appear that there is no error in telephotograph and display. In terms of compressibility, low compressibility has small change of definition, and there was not remarkable drawback of compressibility which has little change in definition.

• Journal of the Korea Convergence Society
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• v.7 no.4
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• pp.107-121
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• 2016

This study aimed to seek the way of effectively managing job stress of shift work nurses, to improve nursing performance, the influence of job stress of shift work nurses on nursing performance through convergence research. A total of 244 questionnaires obtained by a survey targeting nurses, who were doing shift work in a university hospital located in B city, in the period from March 2 to 15, 2015 were analyzed using the SPSS 21.0 program. As a result, the mean score of job stress was 3.57 points, and the mean score of nursing performance was 3.69 points. Job stress made a significant positive(+) influence on the sub-dimensions of interpersonal duty. Therefore, efforts should be made to more accurately identify shift work nurses' job stress and efficiently manage the nursing personnel. Moreover, if shift work nurses' job stress is effectively managed by preparing practical job stress management intervention programs for continuous improvement of nursing performance, high quality medical services will be provided through high quality nursing practice.

• The Journal of Korean society of community based occupational therapy
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• v.4 no.1
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• pp.47-58
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• 2014

Objective : Commonly experienced as an occupational therapist to reveal the meaning of conflict, development by providing information on the quality of official development plan for therapists were willing to contribute. Method : In this study using Parse's human becoming method to collect and analyze data. Participants to understand purpose of the study's researchers and that can be spoken honestly their experience through dialogue were selected eight people as a clinical occupational therapist. Conversation period January-February 2012 was, at the time of about 30-40 minutes, Every conversation is more than three times for each participant were conducted. Result : Experience of occupational therapists, occupational therapy as a conflict of identity confusion and lack of awareness, feeling that comes from a poor working environment and social life, mental conflict, payroll issues to worry about, but concerns about the treatment of the future with hope and effort in the process was an experience. However, external, internal conflicts despite the uneasy reality academic experience for self-development and growth, and the development towards a positive future was out over it. Conclusion : Away from the internal and external conflicts therapists, occupational therapy and establish the identity of satisfaction and quality of care for the treatment to improve their physical and social environment, continuous improvement is necessary.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.195-206
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• 1988

Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation has gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better.' The shortage itself by no means unnecessitate inventory control. In fact, in spite of shortage, no small amount of blood is outdated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this tudy is to develop formulae forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study informations of $A^+$ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated.48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measures of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of the issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study' were as follows ; 1. The formulae to calculate the standard blood inventory level($S^*$)was $S^*=2.8617X(d)^{0.9342}$ where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performace - outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level - were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First In-First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.10-21
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• 2001

Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.44-55
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• 2001

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

• Journal of the Institute of Electronics and Information Engineers
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• v.49 no.12
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• pp.156-163
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• 2012

Recently, Information Hiding Technology are becoming increasingly demanding in the field of international security, military and medical image This paper proposes data hiding technique utilizing parity checker for gray level image. many researches have been adopted LSB substitution and XOR operation in the field of steganography for the low complexity, high embedding capacity and high image quality. But, LSB substitution methods are not secure through it's naive mechanism even though it achieves high embedding capacity. Proposed method replaces LSB of each pixel with XOR(between the parity check bit of other 7 MSBs and 1 Secret bit) within one pixel. As a result, stego-image(that is, steganogram) doesn't result in high image degradation. Eavesdropper couldn't easily detect the message embedding. This approach is applying the concept of symmetric-key encryption protocol onto steganography. Furthermore, 1bit of symmetric-key is generated by the self-reference of each pixel. Proposed method provide more 25% embedding rate against existing XOR operation-based methods and show the effect of the reversal rate of LSB about 2% improvement.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.776-785
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• 2016

The purpose of this study is to report and demonstrate the effect of Korean medical treatment on a wedge resection of a lung patient with mucinous adenocarcinoma. The patient was an 84-year-old female who was diagnosed with mucinous adenocarcinoma and underwent wedge resection. The patient was treated with acupuncture and herbal medicine (Banhahubak-tang and Gamiondam-tang). The EORTC Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30), EORTC Quality of Life Questionnaire, Lung Cancer 13 (EORTC QLQ-LC13), numeric rating scale (NRS), and the Global Assessment (G/A) were used to assess the changes in symptoms, including operation site pain and dyspnea. After treatment, the patient showed improvement in operation site pain and dyspnea, based on the NRS and G/A. However, dyspnea and pain were aggravated based on the EORTC QLQ-C30 and EORTC QLQ-LC13. Therefore, Korean medicine may have a substantial benefit for patients with mucinous adenocarcinoma after wedge resection of the lung.