Purpose: This study was conducted to examine prerequisite-program performance of the hospital foodservice operation and develop measures for improvement of prerequisite-program performance. Methods: Data were collected through surveys administered to 168 hospital dieticians in the Seoul, Incheon, Gyeonggi-do, Daegu, and North Gyeongsang areas. Out of total questionnaires, 65 questionnaires were usable and the response rate was 38.7%. Statistical analyses were performed using the SPSS program (ver 20.0) for ${\chi}^2-test$ and one-way ANOVA. Results: According to the result of the prerequisite-program evaluation, the percentage of 'appropriate', 'needs to be improved', and 'inappropriate' was 44.6%, 47.7%, and 7.7%, respectively. The score for the 'inappropriate' group was significantly lower than that of the 'appropriate' group or 'needs to be improved' group on the food safety management (p < 0.001), preparation facility management (p < 0.001), water management (p < 0.001), and storage transportation management (p < 0.05) parts. Holding rate of foodservice facility and equipments in the 'appropriate' group were significantly higher than in the others on convection oven (p < 0.01), air conditioner (p < 0.01), three-compartment sink (p < 0.01), hot-holding equipment (p < 0.01), cold-holding equipment (p < 0.05), exclusive thawing refrigerator (p < 0.05), and sterilizer for sanitary shoes (p < 0.05) items. Conclusion: To improve the quality of hospital foodservice, foodservice managers and HACCP specialists should develop and implement a prerequisite-program and a HACCP plan considering the characteristics of the hospital foodservice operation.
Han, Jung-Hee;Kim, Young Ran;Lee, Young Min;Kim, Ae Lee;Kim, Ho Jin;Jeong, Young-Gyun;Ryu, Jeong Ha
Quality Improvement in Health Care
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v.17
no.1
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pp.79-88
/
2011
Background : Evidence-based guidelines are now used for enteral nutrition(EN) in neurosurgical intensive care unit patients who mostly depend on EN. This study compared and analyzed the nutritive conditions of patients before and after they underwent guideline based nutritional interventions in order to determine whether using these guidelines improved their calorie supply. Methods : Data on the patients' nutritional requirements, maximum calorie supply through EN, serum albumin level, and total lymphocyte count were collected and analyzed using SAS version 9.1.3. All the statistical analyses were performed at a significance level of P<0.05. Result : The maximum calorie supply through EN was $923.1{\pm}359.7$ kcal before the intervention and $1254.4{\pm}196.3$ kcal after the intervention; this difference was statistically significant(P<0.05). The ratio of nutritional requirements to maximum calorie supply through EN was $55.5{\pm}22.4%$ and $74.2{\pm}13.9%$ before and after the intervention, respectively; this difference was statistically significant(P<0.05). This indicates a 19% increase in the ratio after the nutritional intervention. The serum albumin level also significantly increased from $2.7{\pm}0.6g/dL$ before the intervention to $3.2{\pm}0.4g/dL$ after the intervention(P<0.05). The total lymphocyte count slightly increased from $1267.7{\pm}728.2cells/mm^3$ before the intervention to $1801.9{\pm}1211.5cells/mm^3$ after the intervention; this difference was not statistically significant. Conclusion : The results showed that using the evidence-based feeding guidelines for interventions increased the calorie supply and improved the patients' nutritive conditions from moderate malnutrition to mild malnutrition.
Purpose: Maximizing human comfort in design of medical environments depends immensely on specialized architects particularly critical care design; the study proposes Evidence-Based Design as an apparent analog to Evidence-Based Medicine. Healthcare facility designs are substantially based on the findings of study in an effort to design environments that augment care by improving patient safety and being therapeutic. On SPSS (Statistical Package for Social Science) t-test is applied to simulate two independent variables of PDR (Pre Design-Research) and POE (Post- Occupancy Evaluation). PDR is conducted on relatively new hospital Hallym University Dongtan Sacred Heart Hospital to analyse visibility from researchers' point of view, here the ICU is arranged in I-Shape. POE is applied on Dongguk University Ilsan Hospital to simulate walking on LogWare where two NS are designed based on L- Shape and Seoul St. Mary's Hospital, The Catholic University of Korea where five NS are functional for ICU Intensive Care Unit, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), Critical Care Unit (CCU), Korean Oriental Medical Care Unit which are mostly arranged in U-Shape, and walking pattern is recognized to be in a zigzag path. Method: T-Test is applied on two dependent communication variables: walkability and visibility, with confidence interval of 95%. This study systematically analyses the Nurse Station (NS) typo-morphology, and simulates nurse horizontal circulation, by computing round route visits to patient's bed, then estimating minimum round route on LogWare stop sequence software. The visual connectivity is measured on depth map graphs. Hence the aim is to reduce staff stress and fatigue for better patients care by minimizing staff horizontal travel time and to facilitate nurse walk path and support space distribution by increasing effectiveness in delivering care. Result: Applying visibility graph and isovist field on space syntax on I- Shape, L- Shape and U- Shape ICU (SICU, MICU and CCU) configuration, I-shape facilitated 20% more patients in linear view as they stir to rise from their beds from nurse station compared to U-shape. In conclusion, it was proved that U-Shape supply minimum walking and maximum visibility; and L shape provides just visibility as the nurse is at pivot. I shape provides panoramic view from the Nurse Station but very rigorous walking.
Morphometric and genetic analyses on six populations of the two subspecies of Cobitis koreensis were performed to investigate the geographic variation and to clarify their taxonomic status. No significant differences between subspecies were found. Puan population of C. k. pumilus tends to be smaller in numbers of cross bars and dorsal spots, than those of C. k. koreensis populations with no statistical significance. Average degree of genic variation among six populations of the two subspecies was A=1.5, P =37.3%, HD=0.053, and HG=0.097. Marginal populations of Samchog (C. k. koreensis) and Puan(C. k. pumilus) were least variable: A= 1.3, P=23.8%, HD=0.0l0, HG=0.043, and A= 1.2, P=19.0%, HD=0.029, HG=0.078 respectively.The difference between HD and HG in all populations may indicate a patchness distribution between demes within each population. Genetic similarities between the two subspecies were, on the average, S=0.894, and this value correspond to the average genetic similarities among five populations of C. k. koreensis (5=0.899). Chongup population of C. k. koreensis and Puan population of C. k. pumilus was most similar genetically (5 =0.931). The results of morphometric and genetic analysis in this study indicate that C. k. pumilus is not a valid subspecies and should be considered as a population of C. koreensis.
Precise and accurate measuring of tooth size is essential procedure in orthodontic diagnosis. The purpose of this study was to evaluate the reproducibility and accuracy of tooth size measurements with regard to tooth and investigator. Five investigators measured the size of one side of teeth, from central incisor to first molar, on 20 sets of casts that show a moderate degree of crowding. Mesio-distal width was measured with digital vernier calipers in each tooth and this procedure was repeated three times at two weeks interval. To obtain a standard measurement for each tooth, dental casts were cut into individual tooth, and its width was measured with micrometer. The difference between the measurement from dental cast and the standard measurement was defined as the measurement error. Through various statistical analyses, following results were obtained. 1. The reproducibility did not show significant differences with regard to tooth or investigator. 2. The measurement error showed some difference with regard to tooth and investigator. 3. The magnitude of the measurement error showed increasing tendency from anterior to posterior teeth with maximum value in the first molar. 4. While the measurements obtained on study casts generally showed smaller number compared to standard measurements, the direction of the difference showed variability according to tooth or investigator. 5. The measurement errors did not show significant correlations with the degree of crowding. The results of the present study indicate that the possibility of tooth size measurement error should be taken into consideration when diagnosing an orthodontic case.
Objective: The aim of this research was to evaluate the mechanical properties (MP) and degree of the phase transformation (PT) of martensitic (M-NiTi), austenitic (A-NiTi) and thermodynamic nickel-titanium wire (T-NiTi). Methods: The samples consisted of $0.016\;{\times}\;0.022$ inch M-NiTi (Nitinol Classic, NC), A-NiTi (Optimalloy, OPTI) and T-NiTi (Neo-Sentalloy, NEO). Differential scanning calorimetry (DSC), three-point bending test, X-ray diffraction (XRD), and microstructure examination were used. Statistical evaluation was undertaken using ANOVA test. Results: In DSC analysis, OPTI and NEO showed two peaks in the heating curves and one peak in the cooling curves. However, NC revealed one single broad and weak peak in the heating and cooling curves. Austenite finishing ($A_f$) temperatures were $19.7^{\circ}C$ for OPTI, $24.6^{\circ}C$ for NEO and $52.4^{\circ}C$ for NC. In the three-point bending test, residual deflection was observed for NC, OPTI and NEO. The load ranges of NC and OPTI were broader and higher than NEO. XRD and microstructure analyses showed that OPTI and NEO had a mixture of martensite and austenite at temperatures below Martensite finishing ($M_f$). NEO and OPTI showed improved MP and PT behavior than NC. Conclusions: The mechanical and thermal behaviors of NiTi wire cannot be completely explained by the expected degree of PT because of complicated martensite variants and independent PT induced by heat and stress.
Objective: To investigate the effects of frontal facial type (FFT) and sex on preferred chin projection (CP) in three-dimensional (3D) facial images. Methods: Six 3D facial images were acquired using a 3D facial scanner (euryprosopic [Eury-FFT], mesoprosopic [Meso-FFT], and leptoprosopic [Lepto-FFT] for each sex). After normal CP in each 3D facial image was set to $10^{\circ}$ of the facial profile angle (glabella-subnasale-pogonion), CPs were morphed by gradations of $2^{\circ}$ from normal (moderately protrusive [$6^{\circ}$], slightly protrusive [$8^{\circ}$], slightly retrusive [$12^{\circ}$], and moderately retrusive [$14^{\circ}$]). Seventy-five dental students (48 men and 27 women) were asked to rate the CPs ($6^{\circ}$, $8^{\circ}$, $10^{\circ}$, $12^{\circ}$, and $14^{\circ}$) from the most to least preferred in each 3D image. Statistical analyses included the Kolmogorov-Smirnov test, Kruskal-Wallis test, and Bonferroni correction. Results: No significant difference was observed in the distribution of preferred CP in the same FFT between male and female evaluators. In Meso-FFT, the normal CP was the most preferred without any sex difference. However, in Eury-FFT, the slightly protrusive CP was favored in male 3D images, but the normal CP was preferred in female 3D images. In Lepto-FFT, the normal CP was favored in male 3D images, whereas the slightly retrusive CP was favored in female 3D images. The mean preferred CP angle differed significantly according to FFT (Eury-FFT: male, $8.7^{\circ}$, female, $9.9^{\circ}$; Meso-FFT: male, $9.8^{\circ}$, female, $10.7^{\circ}$; Lepto-FFT: male, $10.8^{\circ}$, female, $11.4^{\circ}$; p < 0.001). Conclusions: Our findings might serve as guidelines for setting the preferred CP according to FFT and sex.
Magaji, Bello Arkilla;Moy, Foong Ming;Roslani, April Camilla;Law, Chee Wei;Raduan, Farhana;Sagap, Ismail
Asian Pacific Journal of Cancer Prevention
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v.16
no.18
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pp.8101-8105
/
2016
Background: This study examined the psychometric properties of the Bahasa Malaysia (BM) version of the European Organization for Research and Treatment of Cancer (EORTC) Colorectal Cancer-specific Quality Of Life Questionnaire (QLQ-CR29). Materials and Methods: We studied 93 patients recruited from University Malaya and Universiti Kebangsaan Medical Centers, Kuala Lumpur, Malaysia using a self-administered method. Tools included QLQ-C30, QLQ-CR29 and Karnofsky Performance Scales (KPS). Statistical analyses included Cronbach's alpha, test-retest correlations, multi-traits scaling and known-groups comparisons. A p vaue ${\leq}0.05$ was considered significant. Results: The internal consistency coefficients for body image, urinary frequency, blood and mucus and stool frequency scales were acceptable (Cronbach's alpha ${\alpha}{\geq}0.65$). However, the coefficients were low for the blood and mucus and stool frequency scales in patients with a stoma bag (${\alpha}=0.46$). Test-retest correlation coefficients were moderate to high (range: r = 0.51 to 1.00) for most of the scales except anxiety, urinary frequency, buttock pain, hair loss, stoma care related problems, and dyspareunia (r ${\leq}0.49$). Convergent and discriminant validities were achieved in all scales. Patients with a stoma reported significantly higher symptoms of blood and mucus in the stool, flatulence, faecal incontinence, sore skin, and embarrassment due to the frequent need to change the stoma bag (p < 0.05) compared to patients without stoma. None of the scales distinguished between patients based on the KPS scores. There were no overlaps between scales in the QLQ-C30 and QLQ-CR29 (r < 0.40). Conclusions: the BM version of the QLQ-CR29 indicated acceptable psychometric properties in most of the scales similar to original validation study. This questionnaire could be used to complement the QLQ-C30 in assessing HRQOL among BM speaking population with colorectal cancer.
Turan, A. Taner;Keskin, H. Levent;Dundar, Betul;Gundogdu, Burcu;Ozgul, Nejat;Boran, Nurettin;Tulunay, Gokhan;Kose, M. Faruk
Asian Pacific Journal of Cancer Prevention
/
v.14
no.1
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pp.133-137
/
2013
Background: To investigate the impact of ovarian transposition (OT) on survival rates of the patients with stage Ib squamous cell cervical cancer. Materials and Methods: Ninety-two subjects who underwent a radical hysterectomy including oophorectomy were evaluated. For nineteen (20.7%), OT was performed. Patients were divided into two groups, OT versus oophorectomy alone. The primary end-point of this study was to investigate the impact of OT on tumor recurrence rate and time, 5-year disease-free survival (DFS) and overall survival (OS). These comparisons were performed for subgroups including patients who received radiotherapy versus who did not. Statistical analyses were conducted using the Chi-square test, T-test and Mann-Whitney test. OS was examined using the Kaplan-Meier method. $P{\leq}0.05$ was considered to be statistically significant. Results: The median follow-up period was 89 months for OT and 81 months for the oophorectomy group (p>0.05). Both groups experienced similar recurrence rates (31.6% vs. 26.4%, p=0.181). The median duration from surgery to recurrence, and surgery to death were also similar between the groups (p>0.05). The 5-year DFS and OS rates were both 68.4% for the OT group, and 73.6% and 77.8% for the oophorectomy group (p=0.457 and p=0.307, respectively). While the 5-year DFS rate was not statistically significant between the OT and oophorectomy groups who did not receive radiotherapy (p=0.148), the 5-year OS rate was significantly higher in the oophorectomy group (95.4% vs 66.7%, respectively) without radiotherapy (p=0.05). The 5-year DFS and OS rates were statistically similar between the groups who received adjuvant radiotherapy (p>0.05). Conclusions: Ovarian transposition has not significantly negative effect on the survival rates when adjuvant radiotherapy will be applied, while 5-year OS may be less in OT group if radiotherapy is not mandatory.
Kang, Moon Hae;Park, Eun-Cheol;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Cho, Eun
Asian Pacific Journal of Cancer Prevention
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v.14
no.3
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pp.2059-2065
/
2013
This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.
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