• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• Journal of the Korean earth science society
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• v.28 no.3
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• pp.311-323
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• 2007

The Yellow and East China seas received a vast amount of sediment $(>10^9ton/yr)$, which comes mainly from the Changjiang and Huanghe rivers of China and the Korean rivers. However, there are still no direct sedimentological-geochemical indicators, which can distinguish these two end-members (Korean and Chinese river sources) in these seas. The purpose of this study is to provide the potential geochemical-tracers enabling these river materials to be identified within the sediment load of the Yellow and East China seas. The compositions of major elements (Al, Fe, Mg, K, Ca, Na, and Ti) of Chinese and Korean river sediments were analyzed. To minimize the grain-size effect, furthermore, bulk sediments were separated into two groups, silt $(60-20{\mu}m)$ and clay $(<20{\mu}m)$ fractions, and samples of each fraction were analyzed for major and strontium isotope $(^{87}Sr/^{86}Sr)$ compositions. In this study, Fe/Al and Mg/Al ratios in bulk sediment samples, using a new Al-normalization procedure, are suggested as an excellent tool for distinguishing the source of sediments in the Yellow and East China seas. This result is clearly supported by the concentrations of these elements in silt and clay fraction samples. In silt fraction samples, Korean river sediments have much higher $^{87}Sr/^{86}Sr$ ratio $(0.7229{\sim}0.7253)$ than Chinese river sediments $(0.7169{\sim}0.7189)$, which suggests the distribution pattern of $^{87}Sr/^{86}Sr$ ratios as a new tracer to discriminate the provenance of shelf sediments in the Yellow and East China seas. On the basis of these geochemical tracers, clay fractions of southeastern Yellow Sea mud (SEYSM) patch may be a mixture of two sediments originated from Korea and China. In contrast, the geochemical compositions of silt fractions are very close to that of Korea river sediments, which indicates that the silty sediments of SEYSM are mainly originated from Korean rivers.

• Economic and Environmental Geology
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• v.43 no.5
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• pp.491-503
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• 2010

Geochemical characteristics of the Moisan epithermal gold-silver deposit with total 140 samples in Haenam area, Jeollanamdo were studied by using multivariate statistical analysis (correlation analysis, factor analysis and cluster analysis). The correlation analysis reveals that Ag, Cu, Bi, Te are highly correlated with Au in the both non-mineralized and mineralized zone. It is resulted from the presence of Au-Ag bearing minerals (electrum, sylvanite, calaverite and stuezite) and non Au-Ag containing minerals (chalcopyrite, tellurobismuthite and bismuthinite). Mo shows relatively much higher correlation at the mineralized zone (0.615) than non-mineralized zone (0.269) which implies Mo content is strongly affected by Au-mineralization. While Mn, Cs, Fe, Se correlated with Au at the nonmineralized zone, they have negative correlation at the mineralized zone. Therefore, they seem to be eluviated elements from the host rock during gold mineralization. Sb is enriched during the gold mineralization showing high correlation at the mineralized zone and negative correlation at the non-mineralized zone. According to the factor analysis, Se, Ag, Cs, Te are the indicators of gold mineralization presence due to the strong affection of gold content in the non-mineralized zone. In the mineralized zone, on the other hand, Mo, Te and Sb, Cu are the indicators of gold and silver mineralization, respectively. While the cluster analysis reveals that Cd-Zn-Pb-S, Bi-Fe-Cu-Mn, Se-Te-Au-Cs-Ag, As-Sb-Ba are the similar behavior elements groups in the non-mineralized zone, Cd-Zn-Mn-Pb, Fe-S-Se, As-Bi-Cs, Ag-Sb-Cu, Au-Te-Mo are the similar behavior elements groups in the mineralized zone. Using multivariate statistical analysis as mentioned above makes it possible to compare the behavior of presented minerals and difference of geochemical characteristics between mineralized and non-mineralized zone. Therefore, it will be expected a useful tool on the similar type of mining exploration.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.152-155
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• 2009

Purpose: The most widely accepted tool for follow up management of thyroid cancer patients is serum thyroglobulin (Tg) measurement, but its value is limited by the interference of anti-thyroglobulin antibodies (anti-Tg Ab). Recently thyroglobulin measurement in the wash out of fine-needle aspiration biopsy specimens (Tg-FNAB) is frequently used for differential diagnosis of recurrences/metastases. The aim of this study was the investigation of the diagnostic utility of Tg-FNAB compared with serum Tg. Materials and Methods: We enrolled 41 consecutive patients with thyroid cancer who were evaluated for Tg-FNAB between January 2007 and February 2008 retrospectively. We ruled out 6 patients who anti-Tg Ab positive (${\geq}$100 U/mL) in the RIA (BRAHMS anti-Tgn RIA 100Det; BRAHMS Aktiengesell schaft, Berlin, Germany). Serum Tg and Tg-FNAB were measured by immunoradiometric assay (BRAHMS Tg pluS RIA 100 Det; BRAHMS Aktienge sellschaft, Berlin, Germany). We evaluated for Tg-FNAB compared with serum Tg and corresponding cytological smear. To compare the values of the two the t-test was used. Results: Tg-FNAB values were significantly higher (median 1,060 ng/mL, range 0.2~434,000 ng/mL) than serum Tg (median 2.5 ng/mL, range 0.9~131 ng/mL) (p=0.0394). The rate of correspondence with Tg-FNAB between cytological result was 87.9% and 65.9% in the case of serum Tg. Tg-FNAB was positive in 28 (24 with positive and 4 with suspicious cytology). Of the remaining 13 patients with negative Tg-FNAB, 1 had suspicious and 12 had unsuspicious cytology. serum Tg was positive in 26 (17 with positive and 3 with suspicious and 6 with unsuspicious cytology), Of the remaining 15 patients with negative serum Tg, 8 was positive in cytological result and 1 had suspicious and 6 had unsuspicious cytology. Conclusions: Tg-FNAB measurement is more accurate with high sensitivity (87.9%) than serum Tg (65.9%). The Tg-FNAB was a useful predictor for detecting recurrences/metastases with serum Tg.

• Progress in Medical Physics
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• v.19 no.4
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• pp.231-240
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• 2008

We developed a user-friendly program to independently verify monitor units (MUs) calculated by radiation treatment planning systems (RTPS), as well as to manage beam database in clinic. The off-axis factor, beam hardening effect, inhomogeneity correction, and the different depth correction were incorporated into the program algorithm to improve the accuracy in calculated MUs. A beam database in the program was supposed to use measured data from routine quality assurance (QA) processes for timely update. To enhance user's convenience, a graphic user interface (GUI) was developed by using Visual Basic for Application. In order to evaluate the accuracy of the program for various treatment conditions, the MU comparisons were made for 213 cases of phantom and for 108 cases of 17 patients treated by 3D conformal radiation therapy. The MUs calculated by the program and calculated by the RTPS showed a fair agreement within ${\pm}3%$ for the phantom and ${\pm}5%$ for the patient, except for the cases of extreme inhomogeneity. By using Visual Basic for Application and Microsoft Excel worksheet interface, the program can automatically generate beam data book for clinical reference and the comparison template for the beam data management. The program developed in this study can be used to verify the accuracy of RTPS for various treatment conditions and thus can be used as a tool of routine RTPS QA, as well as independent MU checks. In addition, its beam database management interface can update beam data periodically and thus can be used to monitor multiple beam databases efficiently.

• Asian-Australasian Journal of Animal Sciences
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• v.13 no.11
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• pp.1619-1637
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• 2000

A review was undertaken to obtain information on the range of beak-trimming methods available or under development. Beak-trimming of commercial layer replacement pullets is a common yet critical management tool that can affect the performance for the life of the flock. The most obvious advantage of beak-trimming is a reduction in cannibalism although the extent of the reduction in cannibalism depends on the strain, season, and type of housing, flock health and other factors. Beak-trimming also improves feed conversion by reducing food wastage. A further advantage of beak-trimming is a reduction in the chronic stress associated with dominance interactions in the flock. Beak-trimming of birds at 7-10 days is favoured by Industry but research over last 10 years has shown that beak-trimming at day-old causes the least stress on birds and efforts are needed to encourage Industry to adopt the practice of beak-trimming birds at day-old. Proper beak-trimming can result in greatly improved layer performance but improper beak-trimming can ruin an other wise good flock of hens. Re-trimming is practiced in most flocks, although there are some flocks that only need one trimming. Given the continuing welfare scrutiny of using a hot blade to cut the beak, attempts have been made to develop more welfare friendly methods of beak-trimming. Despite the developments in design of hot blade beak-trimmers the process has remained largely unchanged. That is, a red-hot blade cuts and cauterises the beak. The variables in the process are blade temperature, cauterisation time, operator ability, severity of trimming, age of trimming, strain of bird and beak length. This method of beak-trimming is still overwhelmingly favoured in Industry and there appears to be no other alternative procedures that are more effective. Sharp secateurs have been used trim the upper beak of both layers and turkeys. Bleeding from the upper mandible ceases shortly after the operation, and despite the regrowth of the beak a reduction of cannibalism has been reported. Very few differences have been noted between behaviour and production of the hot blade and cold blade cut chickens. This method has not been used on a large scale in Industry. There are anecdotal reports of cannibalism outbreaks in birds with regrown beaks. A robotic beak-trimming machine was developed in France, which permitted simultaneous, automated beak-trimming and vaccination of day-old chicks of up to 4,500 chickens per hour. Use of the machine was not successful because if the chicks were not loaded correctly they could drop off the line, receive excessive beak-trimming or very light trimming. Robotic beak-trimming was not effective if there was a variation in the weight or size of chickens. Capsaicin can cause degeneration of sensory nerves in mammals and decreases the rate of beak regrowth by its action on the sensory nerves. Capsaicin is a cheap, non-toxic substance that can be readily applied at the time of less severe beak-trimming. It suffers the disadvantage of causing an extreme burning sensation in operators who come in contact with the substance during its application to the bird. Methods of applying the substance to minimise the risk to operators of coming in contact with capsaicin need to be explored. A method was reported which cuts the beaks with a laser beam in day-old chickens. No details were provided on the type of laser used, or the severity of beak-trimming, but by 16 weeks the beaks of laser trimmed birds resembled the untrimmed beaks, but without the bill tip. Feather pecking and cannibalism during the laying period were highest among the laser trimmed hens. Currently laser machines are available that are transportable and research to investigate the effectiveness of beak-trimming using ablasive and coagulative lasers used in human medicine should be explored. Liquid nitrogen was used to declaw emu toes but was not effective. There was regrowth of the claws and the time and cost involved in the procedure limit the potential of using this process to beak-trim birds.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.1
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• pp.247-275
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• 1998

The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

• Geophysics and Geophysical Exploration
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• v.11 no.1
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• pp.52-59
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• 2008

We have developed a new deep-towed marine DC resistivity survey system. It was designed to detect the top boundary of the methane hydrate zone, which is not imaged well by seismic reflection surveys. Our system, with a transmitter and a 160-m-long tail with eight source electrodes and a receiver dipole, is towed from a research vessel near the seafloor. Numerical calculations show that our marine DC resistivity survey system can effectively image the top surface of the methane hydrate layer. A survey was carried out off Joetsu, in the Japan Sea, where outcrops of methane hydrate are observed. We successfully obtained DC resistivity data along a profile ${\sim}3.5\;km$ long, and detected relatively high apparent resistivity values. Particularly in areas with methane hydrate exposure, anomalously high apparent resistivity was observed, and we interpret these high apparent resistivities to be due to the methane hydrate zone below the seafloor. Marine DC resistivity surveys will be a new tool to image sub-seafloor structures within methane hydrate zones.

• Proceedings of the Korean Society of Crop Science Conference
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• 2017.06a
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• pp.240-240
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• 2017

Quinoa (Chenopodium quinoa Willd.) is one of the ancient crops cultivated in the Andes region at an altitude of 3,500-4000m in Chile and Bolivia from 5000 BC. It contains a large amount of protein, minerals and vitamins in comparison with other crops. The cultivation area has been increasing worldwide because of its excellent resistance to various abiotic stress such as salinity, drought and low temperature. ${\gamma}$-Ray radiation of high dose is often used as a tool to induce mutations in plant breeding, but it has a deleterious effect on organisms. However, the radiation may have a positive stimulatory effect of 'hormesis' in the low dose range. This experiment was carried out to investigate the optimum dose range for creating the quinoa genetic resources and to investigate the hormesis effect at low dose on the quinoa. This experiment was performed for 120 days from November, 2016 to February, 2017 in the greenhouse of Gyeongsang National University. ${\gamma}$-Ray radiation was irradiated to seeds at 0 Gy, 50 Gy, 100 Gy, 200 Gy, 300 Gy, 400 Gy, 600 Gy, 800 Gy and 1000 Gy for 8 hours. (50 Gy) using the low level radiation facility ($Co^{60}$) of Cooperative Research Institute of Radiation Research Institute, KAERI. Fifty seeds were placed on each petri dish lined with wet filter paper and germination rate was measured at a time interval of 2 hours for 40 hrs. The length of the root length was measured one week after germination. Each treatment was carried out in 3 replicates. The growth of seedlings were investigated for 10 days after transplanting of 30 day-old seedlings. The plant height, NDVI, SPAD, Fv/Fm, and panicle weight were measured. The germination rate was highest at 50Gy and 0Gy and the rate of seeds treated with 400Gy or higher rate decreased to 25% of the seeds treated with 50Gy. The emergence rate of seedling in pot experiment was higher at the dose of 200 Gy, 300 Gy and 400 Gy than at 0 and 50Gy. However, the rate was lower at strong radiation higher than 600Gy at which $1^{st}$ leaf was not expanded fully and dead due to extreme overgrowth at 44 days after treatment (DAT). The highest value of panicle weight was observed at 50Gy (6.15g) and 100Gy (5.57g). On the other hand, the weight at high irradiated dose of 300Gy and 400Gy was decreased by about 55% compared to low dose (50 Gy). NDVI measurement also showed the highest value at 50 Gy as the growth progressed. SPAD was the highest at 400 Gy and showed positive correlation with irradiation dose except 0 Gy. Fv/Fm was high at 50 Gy up to 30 DAT and no difference between treatments was observed except for 400 Gy from 44 DAT. The plant height was the highest in 50Gy during the growing period and was higher in the order of 50Dy, 100Gy, 0Gy, 200Gy, 300Gy and 400Gy in 88 DAT. In this experiment, the optimal radiation dose for hormesis was 50Gy and 100Gy, and the optimal radiation dose for mutagenesis seems to be 400 Gy.

• Korean Journal of Heritage: History & Science
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• v.53 no.3
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• pp.24-41
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• 2020

The engraved line expression in metal crafts is a detailed technique of carving or decorating metal surfaces. This technique engraves a line using a tool on the surface of a metal craft. This technique was used extensively in articles made of various metal materials during the Goryeo Dynasty, and the range of patterns that could be expressed and the width of users was wide. In this paper, based on relics and literature, the concept of line representation of this engraving technique used in the metal crafts of the Goryeo Dynasty and the perceptions and terms of the Goryeo Dynasty were examined. In addition, the users engaged in this craft and the specific patterns and patterns of decoration were reviewed. Through these means, it was possible to confirm various aspects of a technique that was thought previously to involve just simple expression of lines using tools. In addition, through the literature, Geumseokmun Gate, and relics currently being transmitted, it was possible to confirm the utilization patterns of techniques used in various types of objects. Various uses have led to the combination with other metal craft techniques that were popular at the time, and while utilizing unique characteristics of the techniques, this maximized the molding of various patterns. In the meantime, it is true that the intaglio technique in metal crafts has not received much attention compared to the decoration techniques of other metal crafts, such as inlay, embossing, and openwork techniques in which decorative effects are maximized due to the recognition that the technique was used so widely in relics. However, the universality of the technique is premised on its wide use across all eras. As such, it was used in metal craft relics that reflect the various cultural characteristics of Korea and various cultural aspects that are currently passed down. On the one hand, technology has been passed down as a form of intangible heritage that embodies a longstanding craft culture which continues to the present in the fields of sculpture and intangible cultural properties. As such, the universality of Seongak contains many cultural meanings. In addition, the uniqueness of the technique is distinct, and it is deeply related to Goryeo, who was in charge of the use of technology and craftsmanship of the Joseon Dynasty and the metal craft technology that is currently handed down. I think research on future techniques should be continued in depth.