• Quality Improvement in Health Care
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• v.30 no.1
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• pp.120-131
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• 2024

Purpose: This study aimed to evaluate the impact of implementing a clinical pathways (CPs) on the clinical outcomes and costs of patients undergoing breast cancer surgery. Methods: This retrospective cohort study included patients who were newly diagnosed with primary breast cancer at the Samsung Medical Center between 2014 and 2019 (N=8482; 2931 patients in the pre-path and 5551 patients in the post-path). Clinical outcomes included reoperation during hospitalization, readmission, and emergency room visits within 30 days of discharge. The cost data for each unit were obtained from an activity-based management accounting system. We performed an interrupted time series analysis. Results: The post-path period showed a significantly shorter hospital length of stay (LOS) than the pre-path period (6.3 days in pre-path vs. 5.0 days in post-path; -1.3 days' difference; p=.001), and fewer reoperations during hospitalization and within 30 days after discharge than the pre-path period. After adjusting for inflation rates and relative value scores, the model demonstrated savings of $146 per patient in the post-path for total costs, and $537 per patient for patient out-of-pocket costs (p=.001). Conclusion: CPs can help reduce costs without compromising the quality of care by reducing the number of reoperations, readmissions, and complications.

• Journal of Industrial Convergence
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• v.22 no.3
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• pp.67-78
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• 2024

The purpose of this study is to identify the factors affecting job satisfaction by examining the positive psychological capital, job crafting, and nursing work environment of clinical nurses, and to provide foundational data necessary to devise strategies for enhancing job satisfaction. Data were collected online from 208 clinical nurses working in three comprehensive hospitals located in J city from March 15 to March 30, 2023. Data were analyzed using the SPSS/WIN 26.0 program. The influencing factors on subjects' job satisfaction were marital status, education level, salary satisfaction, workload, clinical experience, positive psychological capital, job crafting, and nursing work environment. A hierarchical regression analysis following the order of general characteristics, positive psychological capital, nursing work environment, and job crafting identified nursing work environment (𝛽=.37, p<.001), job crafting (𝛽=.35, p<.001), positive psychological capital (𝛽=.33, p<.001), education level (𝛽=.09, p=.014) and salary satisfaction (𝛽=.09, p=.015) as the influencing factors of job satisfaction, in which the explanatory power for the final model was 78%. Based on the results of this study, it is suggested to develop and verify the effectiveness of programs to improve the positive psychological capital and job crafting of clinical nurses.

• Journal of Nutrition and Health
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• v.57 no.1
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• pp.16-26
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• 2024

Purpose: Type 2 diabetes mellitus is a metabolic condition marked by persistent elevated blood sugar levels resulting from insulin resistance. The effective management of diabetes mellitus involves strict regulation of the blood glucose levels. This study examined the effects of Autumn olive (Elaeagnus umbellata Thunb.) berry (AOB) on insulin resistance and hyperglycemia using a type 2 diabetes mellitus animal model. Methods: Eight-week-old C57BL/6J mice were divided into four groups. The control group received a basal diet, while the high-fat, high-sucrose (HFHS) group was fed a HFHS diet containing 27% sucrose and 33% lard for 12 weeks. The low AOB (LAOB) and high AOB (HAOB) groups were offered a HFHS diet with a 0.5% and 1.0% AOB extract, respectively. Results: The HAOB group showed significantly lower epididymal fat pad weight than the HFHS group. The LAOB and HAOB groups showed lower serum glucose levels and homeostasis model assessment for insulin resistance values than the HFHS group, and the HAOB group has lower serum insulin levels than the HFHS group. Supplementation with HAOB decreased serum cholesterol levels significantly compared with the HFHS group. The consumption of LAOB and HAOB reduced the serum triglyceride and hepatic total lipids and triglyceride levels compared to the HFHS group. In addition, LAOB and HAOB consumption in mice fed a HFHS diet increased adenosine monophosphate-activated protein kinase protein expression. Insulin receptor substrate-2 protein expression in the HAOB group was significantly higher than the HFHS group. Conclusion: AOB can alleviate hyperglycemia in type 2 diabetes mellitus partly by mitigating insulin resistance.

• The Journal of Korean Medicine
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• v.44 no.4
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• pp.41-58
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• 2023

Objectives: This retrospective observational study aimed to investigate the efficacy and safety of Cheongpebaedok-tang, a traditional Korean herbal medicine, provided via telemedicine to patients with asymptomatic to mild COVID-19 in Korea. Methods: From February to April 2020, a retrospective analysis investigated COVID-19 patients treated via Korean telemedicine. The study involved asymptomatic to mild cases receiving Cheongpebaedok-tang more than three times, along with continuous Korean medicine care in convalescence. Diagnoses and treatment adhered to the telemedicine guidelines of the Association of Korean Medicine, with varied Cheongpebaedok-tang prescriptions based on symptom severity. Symptom evaluation involved a detailed assessment using a 15-item tool at initial and final sessions. Results: The study included 27 patients, with a mean age of 48.7 ± 2.3 years (mean ± standard error). Patients began self-administering oral Cheongpebaedok-tang for an average of 19.4 ± 1.8 days after the date of COVID-19 diagnosis confirmation and continued the medication for 15.8 ± 1.2 days. The reported side effects of the Cheongpebaedok-tang included palpitations (11.1%), insomnia (7.4%), dizziness (3.7%), and diarrhea (3.7%). All side effects disappeared after adjusting the prescription according to standard treatment guidelines. The occurrence of all COVID-19-related adverse symptoms, except fatigue and myalgia, decreased. Fatigue was the most common chronic symptom persisting after 6 months (51.9%), followed by ocular symptoms (37.0%) and sore throat (22.2%). Conclusions: This study implies Cheongpebaedok-tang may offer a potentially safe, symptom-alleviating approach for managing mild COVID-19 cases via telemedicine, although further comprehensive research is warranted.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.3
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• pp.224-233
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• 2024

The patient was a 69-year-old male who had decreased VDO and overbite of the anterior teeth due to severe teeth wear. Complete mouth rehabilitation was planned to restore esthetics and function. Due to the presence of a subgingival finish line, poor fit of the margin of the temporary crown, and insufficient oral hygiene management, gingival overgrowth and bleeding occurred in many teeth, and inaccurate impressions were taken. After dividing each arch and taking partial impressions, a transfer coping was made using pattern resin on each working model die, and after being placed on the abutment teeth, a master cast was made through pick-up impression taking to produce prosthesis. In this case, the final prosthesis produced on the second master cast were fitted in terms of proximal contact, marginal fit, vertical occlusal dimension, facial appearance, esthetics, and occlusion. After complete mouth rehabilitation, the patient was satisfied with function and esthetic appearance.

• The Journal of the Convergence on Culture Technology
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• v.10 no.4
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• pp.121-132
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• 2024

This study attempted to determine the effects of job stress, nursing problem-solving ability, nursing work performance, and job stress and nursing problem-solving ability on nursing work performance according to the MBTI type of nurses. The study subjects were 141 nurses working at a medical institution in G Province, and data collection was conducted from March 01 to March 31, 2024. The collected data were analyzed using correlation and multiple regression analysis. Among the psychological function types of MBTI, the SF type (sympathetic and friendly type) was the most common, and among the psychological temperament types, the SP type (sensuous and open type) was the most common. Nursing work performance had a negative correlation with job resource stress, a positive correlation with nursing problem-solving ability, and a positive correlation with problem recognition, information collection, planning ability, and evaluation. The variable that had a significant impact on nursing work performance was job resources, and problem recognition, a subfactor of nursing problem-solving ability, was found to be the best predictor of nursing work performance, followed by planning ability. The explanatory power was 17.8%. The results of this study are expected to be used as basic data to develop efficient nursing management guidelines by not only improving understanding of the personality of nurses but also investigating factors related to nurses' work performance. Through the development of programs and measures to improve nursing performance, it is necessary to revitalize programs, provide educational opportunities, and provide institutional support from hospital organizations to enable high-quality nursing care through skilled nursing work.

• Journal of the Korean Society of Radiology
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• v.18 no.4
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• pp.373-381
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• 2024

This study aimed to identify and assess the influence of risk factors on the frequency of thyroid nodules diagnosed through ultrasonography among adults visiting for health screenings. The study analyzed 210 adult men and women who underwent thyroid ultrasound at J Hospital in Busan. The differences in variables were analyzed using Chi-square and independent t-tests, and risk ratios were calculated using binary logistic regression. The results showed significant differences in gender, age, T3, Free T4, Uric acid, T-chol, HDL-C and LDL-C. The risk ratios for risk factors indicated that women had a 2.42 times higher risk compared to men, and the age groups 41-50 and over 61 had risks 2.32 and 2.22 times higher, respectively compared to those under 40. Conversely, and increase in T3 and Free T4 levels was associated with a decreased risk of 0.12 and 0.86 times, respectively, while lipid levels had negligible influence. Based on these findings, it is concluded that regular ultrasonography monitoring, rather than solely relying on biochemical markers, is crucial for the early detection and management of thyroid nodules.

• The Journal of Information Systems
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• v.24 no.2
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• pp.23-52
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• 2015

Purpose This study aims to understand the role of digital knowledge in accepting the green technology. This study combined digital option theory with the second version of the Unified Theory of Acceptance and Use of Technology (UTAUT2). Contrary to other studies in which the UTAUT2 is used to explain IT adoption behavior, we look at the relationship between IT and the UTAUT2 from a new angle, incorporating an important aspect of IT, that is, digitized knowledge richness, as a determinant of the UTAUT2. Design/methodology/approach Grounded in the UTAUT2, a content analysis was conducted to investigate novel constructs dedicated to explaining green technology adoption. In this study, an amended version of the UTAUT2 specific to green technology is offered that better explains the green technology adoption behavior of consumers. Using the items identified by content analysis, we developed a questionnaire with 36 survey items. We measured all the items on a seven-point Likert-type scale. We randomly selected 402 survey respondents from a set of panel data. After a pilot study, we analyzed the main survey data by using PLS 2.0M3 and SPSS 20.0, and employed structural equation modeling to test the hypotheses. Findings The results suggest that the UTAUT2 was found to be extendable to technologies other than conventional IT. Social influence is more significant than conventional utilitarian and hedonic-based constructs such as those utilized in the UTAUT and UTAUT2 in explaining adoption behavior in the context of green technologies. The hypothesized connection between digitized knowledge richness and adoption intention was supported by the results of studies on the role of IT in formation of attitudes toward eco-friendly production. The results also indicate that digital knowledge can also encourage people to try green technology when they learn that their peers are already using the technology successfully.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.9-18
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• 1995

Purpose : A retrospective analysis was performed to investigate the proper management of maxillary sinus carcinoma. Materials and Methods : Authors analysed 33 patients of squamous cell carcinoma of maxillary sinus treated at Chonnam University Hospital from January 1986 to December 1992. There were 24 men and 9 women with median age of 55 years. According to AJCC TNM system of 1988, a patient of T2, 10 patients of T3 and 22 patients of T4 were availalbe, respectively. Cervical lymph node metastases was observed in 5 patients(N 1;4/33, N2b; 1/33). Patients were classified as 3 groups according to management method. The first group, named as 'FAR' (16 patients), was consisted or preoperative intra-arterial chemotherapy with 5-fluorouracil(5-FU;mean of total dosage;3078mg) through the superficial temporal artery with concurrent radiation(mean dose delivered:3433cGy, daily 180-200cGy) and vitamin A(50,000 IU daily), and followed by total maxillectomy and postoperative radiation therapy(mean dose;2351cGy). The second group, named as 'SR'(7 patients), was consisted of total maxillectomy followed by postoperative radiation therapy(mean dose 5920 cGy). The third group, named as 'R'(6 patients), was treated with radiation alone(mean dose;7164cGy). Kaplan-Meier product limit method was used for survival analysis and Mantel-Cox test was performed for significance of survival difference between two groups. Results : Local recurrence free survival rate in the end of 2 year was $100\%$, $50\%$ and $0\%$ in FAR, SR and R group, respectively. Disease free survival rate in 2 years was $88.9\%$, $28.0\%$ and $0\%$ in FAR, SR and R group, respectively. Overall survival rate in 2 years was $88.9\%$, $40\%$ and $50\%$ in FAR, SR and R group, respectively. There were statistically significant difference between FAR and SR or FAR and R group in their local recurrence free, disease free and overall survial rates. But difference of each survival rate between SR and R group was not significant. Conclusion : In this study FAR group revealed better results than SR or R group. In the future prospective randomized study is in need.

• Journal of radiological science and technology
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• v.29 no.3
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• pp.185-195
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• 2006

Purpose: This study investigated the status of radiation exposure doses since the establishment of the "Regulations on Safety Management of Diagnostic Radiation Generation Device" in January 6, 1995. Method: The level of radiation exposure in people engaged or having been engaged in radiation-related industries of inspection organizations, educational organizations, military units, hospitals, public health centers, businesses, research organizations or clinics over a 5 year period from Jan. 1, 2000 to Dec. 31, 2004 was measured. The 149,205 measurement data of 57,136 workers registered in a measurement organization were analysed in this study. Frequency analysis, a Chi-square test, Chi-square trend test, and ANOVA was used for data analysis. Results: Among 57,136, men were 40,870(71.5%). 50.3% of them were radiologic technologists, otherwise medical doctors(22.7%), nurse(2.9%) and others(24.1%). The average of depth radiation and surface radiation during the 5-year period were found to decrease each year. Both the depth radiation and surface radiation exposure were significantly higher in males, in older age groups, in radiological technologists of occupation. The departments of nuclear medicine had the highest exposure of both depth and surface radiation of the divisions of labor. There were 1.98 and 2.57 per 1,000 person-year were exposed more than 20 mSv(limit recommended by International Commission on Radiological Protection) in depth and surface radiation consequently. Conclusion: The total exposure per worker was siginifcantly decreased by year. But Careful awareness is needed for the workers who exposed over 20 mSv per year. In order to minimize exposure to radiation, each person engaged in a radiation-related industry must adhere to the individual safety management guidelines more thoroughly. In addition, systematic education and continuous guidance aimed at increasing the awareness of safety must be provided.