• 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.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.8 no.2
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• pp.129-139
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• 2013

This paper is targeted on proposing ameliorating alternative to performance assessment method of GSEM through evaluating the current one, which is initiated by SMBA to induce fair competition among 5 GSEM across the country and accommodate the quality improvement of entrepreneurship education since 2005 after beginning the SMBA support, from the perspective of BSC(Balanced Scorecard) tool. Ultimately, it complements the policy defects of SMBA over GSEM, in particular, in the process of performance assessment and management. This paper carries out two studies as follow. First, throughout reviewing the previous studies relating to BSC applications to non-profit organization, it set out the direction of introducing BSC in assessing performance of GSEM in order to enhance its effectiveness. Second, it evaluate the rationality of performance assessing tools apllied to GSEM by SMBA on the basis of BSC application over non-profit organization, especially in education institution. Research results shows the following implications. First, the current evaluation system over GSEM is just merely assessment itself and not much contributions for the post performance management. Second, The annual evaluation just remains to check up whether the policy goals are met or not. Third, the current evaluation puts much emphasis just on financial inputs and hardware infra, not considering human resources and utilization of government policy and institution. Fourth, the policy goals are unilaterally focused on entrepreneurs. Fifth, the current evaluation systems do not contain any indexes relating to learning and growth perspectives for concerning sustainable and independent growing up. However, lack of empirical testing require this paper to need the further study in the future.

• Korean Journal of Biological Psychiatry
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• v.6 no.2
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• pp.153-160
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• 1999

Animal models can provide a useful tool for the study of some aspects of psychiatric disorders and their treatment. The four criteria for the evaluation of animal models of psychiatric disorders are as following : 1) similarity of inducing conditions 2) similarity of behavioral state 3) common underlying neurobiological mechanisms 4) reversal by clinically effective treatment techniques. Several animal models have been proposed for schizophrenia : phenylethylamine model, L-dopa model, hallucinogen model, cocaine model, amphetamine model, phencyclidine model, noradrenergic reward system lesion model, reticular stimulation model, social isolation model, conditioned avoidance reaction, catalepsy test, paw test, self-stimulation paradigms, latent inhibition paradigms, blocking paradigms, prepulse inhibition of the startle reflex, rodent interaction, social behavior in monkeys, hippocampal damage, high ambient pressure, and models using selective breeding. Among them, animals with bilateral lesion of the hippocampus may provide an adequate animal model for several symptoms of schizophrenia, and ketamine model can reproduce negative symptoms and cognitive deficits as well as positive symptoms of schizophrenia. In conclusion, no model of schizophrenia is entirely representative of the disease, and findings gleaned from model systems must be cautiously interpreted. Furthermore, the process of developing and validating animal models must work in concert with the process to identify reliable measures of human phenomenology.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.77-84
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• 2012

Purpose: To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. Materials and Methods: A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align$^{TM}$ quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. Results: The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. Conclusion: When conducting a geometrical quality control using an electronic portal imaging, it was found that it is efficient as a quality control tool. It not only reduces costs through not using films, but also reduces the measurement and analysis time which enhances user convenience and can improve the execution process by leaving out film developing procedures etc. Also, images done with evaluation from the self-developed geometrical quality control real-time analysis program, data processing is capable which supports the storage of information.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.1
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• pp.76-82
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• 2009

Wheat is the most widely cultivated cereal and an important source of dietary protein worldwide. Wheat allergy, defined as an adverse immunologic reaction to wheat, encompasses a broad spectrum of disorders with different pathomechanisms and clinical manifestation. The Nuruk, a traditional Korean Koji for brewing, was made with wheat flour and fermenting microbes such as bacteria, yeast and mold. The strains grown on Nuruk secrete various enzymes as amylase and protease. By the activation of such enzymes, starch and proteins in Nuruk are hydrolyzed to sugar and amino acid. Therefore, it is supposed to reduce allergic proteins in wheat. To study quality properties and degradation degree of allergenicity in Nuruk by fermentation, we investigated the changes of general ingredients and allergenicity in Nuruk during fermentation. Moisture contents was decreased from 24.2% to 13.6% during fermentation. Crude lipid and protein contents were gradually increased during fermentation. After 15 days of fermentation, reducing sugar and total sugar contents were reached its maximum level, and they were 27.45% and 39.00%, respectively. Acid and neutral protease activity were significantly increased during fermentation, but alkaline protease activity was not detected. ${\alpha}$-amylase activity was gradually increased and showed maximum level about 2,833.00 U/g after 15 days of fermentation. Glucoamylase activity was the highest level about 497.9 U/g after 10 days of fermentation. The increase of these proteolytic and saccharogenic enzyme activities will provide efficient condition for production of rice wine. Also, protein fractions were isolated from Nuruk, and degradation of these proteins during fermentation were confirmed by SDS-PAGE. IgE immunoblotting using patient's sera with wheat allergy was performed to confirm allergenic protein in Nuruk. These results as fermentation of Nuruk will provide a useful tool for developing safer wheat products to prevent wheat allergy.

• Tuberculosis and Respiratory Diseases
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• v.60 no.3
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• pp.290-296
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• 2006

Background : IS6110 DNA fingerprint is a very useful tool for investigating the transmission of tuberculosis. The aim of this study was to identify the epidemiological situations within a given area (one province). Methods : The 681 Mycbobacterium tuberculosis isolates from patients, who were registered at health centers in Gyeonggi Province from May to December in 2004, were subjected to IS6110 DNA fingerprinting. Patients belonging to clusters were interviewed by health-workers to determine their previous contacts or household TB history. Results : The number of IS6110 copies of the 681 isolates showed diverse fingerprint patterns from 0 to 21 of which the most prevalent copy number was 10 from 120 isolates (17.6%). Thirty-three isolates (4.8%) belonged to the K strain, and 128 isolates (18.8%) belonged to the K family. There were 180 (26.4%) isolates belonged belonging to fifty clusters, of which two clusters were within household transmission. Forty-three (23.9%) out of 180 patients resided in an area under the same health center control. The rate of clusters in those aged 60-70 was higher than in any other age group ( 95% CI of RR : 1.072 ~ 1.988). Conclusion : This is the first report of an epidemiological survey based on a whole province using a DNA fingerprinting technique for M. tuberculosis. These results will be helpful in developing a program or policies to prevent the transmission of TB.

• Progress in Medical Physics
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• v.26 no.4
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• pp.250-257
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• 2015

Multi-leaf collimator (MLC) systems are frequently used to deliver photon-based radiation, and allow conformal shaping of treatment beams. Many proton beam centers currently make use of aperture and snout systems, which involve use of a snout to shape and focus the proton beam, a brass aperture to modify field shape, and an acrylic compensator to modulate depth. However, it needs a lot of time and cost of preparing treatment, therefore, we developed the manual MLC for solving this problem. This study was carried out with the intent of designing an MLC system as an alternative to an aperture block system. Radio-activation and dose due to primary proton beam leakage and the presence of secondary neutrons were taken into account during these iterations. Analytical calculations were used to study the effects of leaf material on activation. We have fabricated tray model for adoption with a wobbling snout ($30{\times}40cm^2$) system which used uniform scanning beam. We designed the manual MLC and tray and can reduce the cost and time for treatment. After leakage test of new tray, we upgrade the tray with brass and made the safety tool. First, we have tested the radio-activation with usually brass and new brass for new manual MLC. It shows similar behavior and decay trend. In addition, we have measured the leakage test of a gantry with new tray and MLC tray, while we exposed the high energy with full modulation process on film dosimetry. The radiation leakage is less than 1%. From these results, we have developed the design of the tray and upgrade for safety. Through the radio-activation behavior, we figure out the proton beam leakage level of safety, where there detects the secondary particle, including neutron. After developing new design of the tray, it will be able to reduce the time and cost of proton treatment. Finally, we have applied in clinic test with original brass aperture and manual MLC and calculated the gamma index, 99.74% between them.

• Journal of Life Science
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• v.30 no.8
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• pp.701-707
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• 2020

Gene editing technology using the clustered regularly interspaced short palindromic repeat (CRISPR) and the CRISPR associated protein (Cas)9 has been highly anticipated in developing breeding techniques. In this study, we discuss gene scissors as a tool for silkworm molecular breeding through analysis of Bombyx mori Kynurenine 3-Monooxygenase (BmKMO) gene editing using the CRISPR/Cas9 system and analysis of generational transmission through mutagenesis and selective crossing. The nucleotide sequence of the BmKMO gene was analyzed, and three guide RNAs (gRNAs) were prepared. Each synthesized gRNA was combined with Cas9 protein and then analyzed by T7 endonuclease I after introduction into the BM-N silkworm cell line. To edit the silkworm gene, K1P gRNA and Cas9 complexes were subsequently microinjected into the silkworm embryos; the hatching rate was 18% and the incidence of mutation was 60%. The gene mutation was verified in the heterozygous G0 generation, but no phenotypic change was observed. In homozygotes generated by self-crossing, a mutant phenotype was observed. These results suggest that silkworm molecular breeding using the CRISPR/Cas9 system is possible and could be an effective way of shortening the time required.

• Progress in Medical Physics
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• v.10 no.3
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• pp.133-140
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• 1999

In this paper, as a preliminary study for developing a full 3D electron dose calculation algorithm, We developed 2.5D electron dose calculation algorithm by extending 2D pencil-beam model to consider three dimensional geometry such as air-gap and obliquity appropriately. The dose calculation algorithm was implemented using the IDL5.2(Research Systems Inc., USA), For calculation of the Hogstrom's pencil-beam algorithm, the measured data of the central-axis depth-dose for 12 MeV(Siemens M6740) and the linear stopping power and the linear scattering power of water and air from ICRU report 35 was used. To evaluate the accuracy of the implemented program, we compared the calculated dose distribution with the film measurements in the three situations; the normal incident beam, the 45$^{\circ}$ oblique incident beam, and the beam incident on the pit-shaped phantom. As results, about 120 seconds had been required on the PC (Pentium III 450MHz) to calculate dose distribution of a single beam. It needs some optimizing methods to speed up the dose calculation. For the accuracy of dose calculation, in the case of the normal incident beam of the regular and irregular shaped field, at the rapid dose gradient region of penumbra, the errors were within $\pm$3 mm and the dose profiles were agreed within 5%. However, the discrepancy between the calculation and the measurement were about 10% for the oblique incident beam and the beam incident on the pit-shaped phantom. In conclusions, we expended 2D pencil-beam algorithm to take into account the three dimensional geometry of the patient. And also, as well as the dose calculation of irregular field, the irregular shaped body contour and the air-gap could be considered appropriately in the implemented program. In the near future, the more accurate algorithm will be implemented considering inhomogeneity correction using CT, and at that time, the program can be used as a tool for educational and research purpose. This study was supported by a grant (＃HMP-98-G-1-016) of the HAN(Highly Advanced National) Project, Ministry of Health & Welfare, R.O.K.

• Journal of the Korean association of regional geographers
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• v.6 no.3
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• pp.117-138
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• 2000

This study is, from the view point of constructive social studies which is the foundation of the 7th curriculum, to explore whether there is any viable program and to investigate it by which students, using photo resources in social studies, can organize their knowledge in the way of self-directed thinking. The main results are as follows: If it is a principle of knowledge construction process of constructive social studies that individual construction (cognitive construction) develops into communal construction(social construction) and yet communal construction develops itself, interacting with individual construction, it will be meet the objectives of social studies. In social studies, photos are a powerful communication tool. communicating with photos enables to invoke not only the visual aspects but also invisible aspects of social phenomena from photos. It, therefore, can help develop thinking power through inquiry learning, which is one of the emphasis of the 7th curriculum. Having analyzed photo resources appeared on the regional textbooks in elementary social studies, they have been appeared that even though the importance and amount of space photo resources occupy per page is big with regard to total resources, most of the photos failed to lad to self-directed thinking but just assistant material in stead. Besides, there appeared some problems with the title, variety, size, position, tone of color, visibility of the photos, and further with the combination of the photos. Developing of photo resources for constructive social studies is to overcome some problems inherent in current text books and to reflect the theoretical background of the 7th curriculum. To develop the sort of photo that can realize the point just mentioned, it would be highly preferable to provide photo database to facilitate study with homepage through web-based interaction. To take advantage of constructive photo resources, the instruction is strategized in four stages, intuition, conflict, accommodation, and equilibration stage. With the advancement of the era of image culture, curriculum developers are required to develop dynamic, multidimensional digital photos rather than static photos when develop text books.