• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.300-308
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• 2009

Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

• Journal of agricultural medicine and community health
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• v.37 no.2
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• pp.84-95
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• 2012

Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.111-128
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• 2005

Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

• Journal of Korean Home Economics Education Association
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• v.24 no.3
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• pp.143-173
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• 2012

We investigated environmental problems related to clothing, and attempted their practical solutions using Future Problem Solving Program in order to cultivate the creative character in teenagers. We applied "teaching and learning plans" to seventy-seven the first graders of high school students in 2 classes in Gyeonggi-do, one hour per day for 3 weeks, from August 23 to September 8 2011. Statistical analyses were performed using the SPSS for Windows software(version 17.0). Mean differences in results between pretest and posttest were evaluated using Student's t-test. We selected 'production of fabrics, production of clothing, disposal and recycling of clothing and washing of clothing' as the learning theme in educational content factors of 'clothing culture in consideration of environment'. And we developed thirteenth teaching and learning plans and educational materials including 4 problems, 2 worksheets, 10 team worksheets, 7 video materials and 7 Power Point materials using Future Problem Solving Program(FPSP). The measurements of fluency, flexibility, originality and problem-solving ability are significantly improved. The level of creativity in the items of fluency, flexibility and originality, in particular, exhibited marked improvement, 'below-average' to 'above-average', regardless of academic records and gender. Problem-solving ability in female students was more effective than that of male, but it showed no significant correlation with academic records. The analysis of character-change showed the highest improvement in the awareness on the protection of environment, the character factor in the educational contents. Personalities, confidence, consideration and cooperation in learning method of FPSP also exhibited a significant improvement. But character-change did not correlate with academic records or gender. In the present study, we found that home economics has a positive effect on cultivating creative character. When we selectively and properly apply a course of creative problem-solving of FPSP and a course of creative output to students, we can increase their ability to solve problems, cultivate their creative character and further enhance their interest on home economics.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.443-454
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• 2008

Statement of problem: A clinically successful color match is one of the important factor to get an esthetic dental restoration. Dental shade guides are commonly used to evaluate tooth color in restorative procedure. But numerous reports have indicated that common shade guides do not provide sufficient spectral coverage of the natural tooth colors. To address issues associated with the shade guide, distinct avenues have been pursued objective spectrophotometric / colorimetric assessment. Purpose: This study compared the accuracy of tooth color selection of spectrophotometer with that of human visual determination. Three main factors were investigated, namely, the effect of light, the individual variation and the experience of the observer. Material and methods: At the first experiment, on ten patients, one operator independently selected the best matching shade to the unrestored maxillary central incisor, using a Vita Classical Shade Guide in the morning, at noon and in the afternoon. The same teeth were measured by means of a reflectance spectrophotometer. At the second experiment, on ten patients, ten operators (5 experts, 5 novices) selected and measured by the same method above at noon. At the third experiment, the results of the second experiment were divided into two groups, expert and novice, and analyzed. Results: 1. There was significant difference between visual and spectrophotometric assessment (mean ${\Delta}E$ values) in experiment 1, 2, 3 (P < .05). 2. There was no significant difference between experts and novices group, when comparing with each visual and spectrophotometric assessment (mean ${\Delta}E$ values). Conclusion: Spectrophotometer could be used to analyze the shade of natural tooth objectively. Thereby, this method offers the potential tominimize considerably the need for corrections or even remakesafter intraoral try-in of restoration. Furthermore, to achieve its advantage, both the shade-matching environment and communication between dentist and technician should be optimized with use of visual and instrumental shade-matching systems.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.403-411
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• 2001

The aim of this study was to evaluate the resistance to degradation of four commercial composite resins in an alkaline solution. The brands studied were Unifil(GC, Japan), Palfique(Tokuyama Japan). Definite$Degussa-H\ddot{u}ls$ AG, Germany). Revolution(Kerr, U.S.A.). Preweighed discs of each brand were exposed 0.1N NaOH solution at $60^{\circ}C$. After 14 days they were removed, neutralized with HCl, washed with water and dried. Resistance to degradation was evaluated on the basis of following parameters: (a) mass loss(%) - determined from pre-and post-exposed specimen weights; (b) Si loss(ppm) - obtained from ICP-AE analysis of solution exposed to specimens; and (c) degradation depth$({\mu}m)$ - measured microscopically (SEM) from polished circular sections of exposed specimens. The results were follows: 1. The mass loss of Unifil was 3.21%, it was the highest of materials. But, there was no significant difference among the materials. 2. The degree of degradation layer depth was $107.69\sim47.40{\mu}m$, the sequence of the degree pf degradation layer depth was in descending order by Unifil, Palfique, Revolution, Definite. There was significant difference among the materials except Palfique and Definite. 3. The Si loss of Paltique was 8940.0ppm, it was the highest. There was significant difference among the materials, except Revolution and Definite(p<0.05). 4. The correlation coefficient between mass loss and degradation depth was relatively high(r = 0.06, p<0.05). 5. There was no significant coefficient correlation between Si loss and mass loss, and/or the degree of degradation layer depth and Si loss. 6. When observed with SEM, destruction of bonding is observed between resin matrix and filler. Above results suggested that the hydrolytic degradation is considered as evaluation factor of composite resins.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.2
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• pp.254-262
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• 2003

Dental caries has a multifactorial aetiology in which there is an interplay of three principal factors: the host(saliva and teeth), the microflora(dental plaque) and the substrate(diet), and a fourth factor time. There is no single test that takes into consideration all these factors and can accurately predict an individual's susceptibility to dental caries. The risk of dental caries can be evaluated by analysing and integrating several causative factors. The objective of the study was to clarify the relationship between caries activity and the status of caries of primary teeth and the relationship between the quantity of S. mutans in the dental plaque and the status of dental caries. Forty nine children ages 5 were examined with caries indices, Dentocult-SM and quantity of S. mutans. The results were as follows: All the survey results were similar with national means of 5-6 years Korean preschool children. The deft index of subjects was 5.46 and defs index was 9.81. There was 8.6% of negative, 10.9% of mild, 28.1% of moderate and 52.3% of active results at screening strip test. 8.6% was negative, 17.2% was mild, 33.6% was moderate and 40.6% was active in site strip test. The Spearman correlation coefficient was 0.775, and overall kappa index was 0.496 between screening strip test and site strip test. There also was a high correlation between caries incidence, Dentocult-SM test, and quantity of S. mutans. Dentocult-SM test as a caries activity test is a reliable method for measuring the status of dental caries in primary teeth.

• The Korean Journal of Air & Space Law and Policy
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• v.29 no.2
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• pp.135-161
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• 2014

An unmanned aerial vehicle (UAV), commonly known as a drone and also referred to as an unpiloted aerial vehicle and a remotely piloted aircraft (RPA) by the International Civil Aviation Organization (ICAO), is an aircraft without a human pilot aboard. ICAO classify unmanned aircraft into two types under Circular 328 AN/190. Unmanned aircraft, which is the core of the development of the aviation industry. However, there are also elements of the legal dispute. Unmanned aircraft are manufactured in small size, it is possible to shoot a record peripheral routes stored in high-performance cameras and sensors without the consent of the citizens, there is a risk of invasion of privacy. In addition, the occurrence of the people of invasion of privacy is expected to use of civilian unmanned aircraft. If the exposure of private life that people did not want for unmanned aircraft has occurred, may occur liability to the operator of unmanned aircraft, this is a factor to be taken into account for the development of unmanned aircraft industry. In the United States, which is currently led by the unmanned aircraft industry, policy related to unmanned aircraft, invasion of privacy is under development, is preparing an efficient measures making. Unmanned aircraft special law has not been enforced. So there is a need for legal measures based on infringement of privacy by the unmanned aircraft. US was presented Privacy Protection Act of unmanned aircraft (draft). However Korea has many laws have been enacted, to enact a new law, but will be able to harm the legal stability, there is a need for the enactment of laws for public safety of life. Although in force Personal Information Protection Law, unmanned aerospace, when the invasion of privacy occurs, it is difficult to apply the Personal Information Protection Law. So, it was presented a privacy protection bill with infringement of privacy of unmanned aircraft in the reference US legislation and the Personal Information Protection Act.

• Journal of the Korean Society of Food Science and Nutrition
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• v.42 no.8
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• pp.1325-1334
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• 2013

The purposes of the study were to assess the multicultural competencies and to identify potential barriers toward improving multicultural competencies of food and nutrition majors at the university level. A total of 500 students were surveyed and 457 responses were analyzed for the study. The multicultural competencies, based on a literature review, included food culture knowledge, multicultural attitude, and multicultural skills. Approximately half of the respondents took a food culture class as a college course. The food and nutrition majors showed positive multicultural attitudes; however, food culture knowledge scores for traditional Korean food culture and 11 other food cultures remained low (average score: 63.7 out of 100 points). In addition, familiarity with cultural foods and knowledge of food-related cultures were not necessarily related. As a result of factor analysis, multicultural skills, required for dietitians, were classified into three factors: professional skills, food preparation skills, and communication skills. Overall, students rated their professional skills the highest and communication skills the lowest. Multicultural attitudes and skills increased with school years, and students who took a food culture class showed significantly higher multicultural attitudes and knowledge scores compared to their counterparts. Economical issues, lack of time, and lack of opportunities for learning multicultural competencies in majors and experiencing different cultures were highly rated potential barriers for improving multicultural competencies. Our research indicates that food and nutrition educators should review their curriculums to incorporate content that encourages food and nutrition majors to learn about other food cultures and improve their multicultural competency. These skills will be critical for food and nutrition professionals in the multicultural age.

• Women's Health Nursing
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• v.8 no.2
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• pp.232-243
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• 2002

The purpose of this study was to examine factors influencing the meaning of life for middle-aged women. The subjects for the study were 190 middle-aged women who live in Busan. Data were collected from May 25 to June 20, 1999. The instruments for this study were as follows : the meaning of life scale developed by Jung D. R(1978) ; the self-esteem scale developed by Ro, E. Y, Kwon, J. H.(1997) ; the volunteer activity scale developed by Park G. J.(1999), the marital satisfaction scale developed by Choi G. Y.(1999) ; and the health status scale developed by Kim S. Y. (1991). SPSS PC+ was utilized for data analysis. Data were analysed according to frequency and percentage, mean and standard deviation, t-test, ANOVA, Sheffe' s test and Pearson' s correlation coefficients and stepwise multiple regression. The reliability of the tools was tested by Cronbach's $\alpha$ : and it showed reliability scores of 0.88(for the meaning of life tool), 0.81(for the self-esteem tool), 0.94(for the marital satisfaction tool) and 0.78(for the health status tool). The results were as follows: 1) The scores showed that middle-aged women had a moderate level of meaning of life, with a mean of 30.31 and standard deviation of 6.24 (with values ranging from 12.00 to 48.00). The scores showed that middle-aged women had a moderate levels of self-esteem, with a mean of 28.92 and standard deviation of 4.67 (with values ranging from 10.00 to 40.00). The scores showed that middle-aged women had a very low level of volunteer activity, with a mean of 0.87 and standard deviation of 0.93(with values ranging from 0.00 to 1.00). The scores showed that middle-aged women had a moderate level of satisfaction in their marriages, with a mean of 31.99 and standard deviation of 7.84(with values ranging from 12.00 to 48.00). The scores showed that middle-aged women had a moderate level of health status, with a mean of 6.63 and standard deviation of 1.57(with values ranging from 3.00 to 9.00). 2) There was a statistically significant difference of the meaning of life of middle-aged women according to their religion(F=8.930, p=.000), christian ($31.94{\pm}5.96$) had more meaning th life than buddhists ($28.40{\pm}6.23$). 3) There was a statistically significant correlations between the subject' s self-esteem and the her meaning of life(r=0.477, p=0.000), the subject' s level of volunteer activity and meaning of life(r=.428, p=.000), her level of marital satisfaction and meaning of life(r=.417, p=.000), and her level of health status and meaning of life(r=.261, p=.000) among these middle-aged women. 4) Self- esteem was the highest factor influencing the level of meaning of life in middle-aged women. 40.0% of the total variance of levels of meaning of life by was dependent on self-esteem, volunteer activity, marital satisfaction and health status. In conclusion, the higher the self-esteem and levels of volunteer activity, marital satisfaction, and health status of middle-aged women, the higher the meaning of life for them. Therefore, it is necessary to elevate levels of the self-esteem and volunteer activity, marital satisfaction and health status in order to help middle-aged women have more meaning of life.