• The Journal of the Convergence on Culture Technology
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• v.8 no.3
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• pp.405-413
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• 2022

Since the COVID-19 outbreak, the active utilization of new health care service utilizing the ICT technology and data science such as telemedicine, smart hospital, AI dignosis has been increasingly found. In this study we examined the business model of Amazon healthcare which leads disruptive innovation in U.S. health care industry with the introduction of hybrid model of telemedicin, in-person care and customer-centric online drug delivery, home-use diagnostic kit, characterized by the integrated model combining medical care, drug delivery and the use of diagnostic kit. We showed using the multiproduct competition model that the synergy effect between the Amazon's original business areas and the healthcare business area causes the active market penetration and the increase in the customer value from utilization of the Amazon care. Using Hotelling's spatial competition model, we also showed that the competition in the health care market can be greater when consumer's choice of health care providers are available in telemedicine platform. In the long, run the issue of competition being weakened due to the exit of less competent healthcare providers may arise, to which the policymakers in the charge of fair competition in health care industry should pay attention.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.1
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• pp.52-64
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• 2023

This study aimed to examine the types and characteristics of otorhinolaryngology examinations performed by clinical laboratory technologists and to investigate the working environment and scope of work of otorhinolaryngology laboratory personnel using online questionnaires. Based on the research results, constructive policy measures for the University-Association-Society were also presented. Most of the survey respondents were in their 40s (34.1%). Females accounted for 80.2% of respondents and 30.8% of them had a career spanning 15 years or more. We found that laboratory personnel had a wide scope of work, high work stress and frequently suffered occupational diseases. We observed that, to reduce stress and increase satisfaction, an expansion of the workforce was necessary. Compared to other occupations, 72% of clinical laboratory technologists occupied more senior positions, occupational distribution depended on senior positions (P<0.001). Clinical laboratory technologists performed about 26 types of otorhinolaryngology examinations. The most frequent test performed daily was pure tone audiometry, and polysomnography took the longest test time, with an average of 8 hours. In conclusion, clinical laboratory technologists were in charge of various specialized otorhinolaryngology examinations. Considering the importance of clinical laboratory technologists in otorhinolaryngology, the University-Association-Society should put in additional effort into nurturing otorhinolaryngology examination experts.

• Trans-
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• v.14
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• pp.35-63
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• 2023

Parkinson's disease is a degenerative neurological disease that affects even basic daily life movements due to impairment of body function caused by a lack of dopamine, which is charge of the body movement. Presently, it is hard to cure Parkinson's disease entirely with medical technology, so movement therapy as a solution to delay and prevent disease is getting more attention. Therefore, this study aims at desiging and disseminating a body movement program that concentrates on individual self-care and balacing the state of body and mind by applying the Feldenkrais Method® to patients with Parkinson's disease. The Feldenkrais Method® is a mind-body perceptual learning method using body movements. It is a methodology that re-educates the nervous system by connecting the brain and behavior as a function of neuroplasticity. In this study, the body movement program developed and verified by the researcher was modified and supplemented with a focus on the self-awareness of the Feldenkrais Method®. A 24-session physical exercise program was composed of 5 stages to improve the self-management ability of patients with Parkinson's disease. The stages include self-awareness, self-observation, self-organization, self-control, and self-care. The overall changes recognize one's condition and improve one's ability to detect modifications in the internal sense and external environment. In conclusion, the body movement program improves the body movement program improves mental and physical functions and self-care for Parkinson's disease patients through the Feldenkrais method. The availability of the program's on-site applicability remains a follow-up task. Furthermore, it is necessary to establish a systematic structure to spread it more widely through convergent cooperation with the scientific field applied with metaverse as a reference for the wellness of the elderly.

• Progress in Medical Physics
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• v.25 no.1
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• pp.46-52
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• 2014

Liquid ionization chamber is filled with liquid equivalent material unlike air filled ionization chamber. The high density material allow very small-volume chamber to be constructed that still have a sufficiently high sensitivity. However liquid ionization chamber should be considered for both initial recombination and general recombination. We, therefore, studied using the Co-60 beam as the continuous beam and the microLion chamber (PTW) for comparing the ion collection efficiency by Greening theory, two-dose rate method and our experiment method. The measurements were carried out using Theratron 780 as the cobalt machine and water phantom and 0.6 cc Farmer type ionization chamber was used with microLion chamber in same condition for measuring the charge of microLion chamber according to the dose rates. Dose rate was in 0.125~0.746 Gy/min and voltages applied to the microLion chamber were +400, +600 and +800 V. As the result, the collection efficiency by three method was generally less than 1%. In particular, our experimental collection efficiency was in good agreement within 0.3% with Greening theory except the lowest two dose rates. The collection efficiency by two-dose rate method also agreed with Greening theory generally less than 1%, but the difference was about 4% when the difference of two dose rates were lower. The ion recombination correction factors by Greening theory, two-dose rate method and our experiment were 1.0233, 1.0239 and 1.0316, respectively, in SSD 80 cm, depth 5 cm recommended by TRS-398 protocol. Therefore we confirmed that the loss by ion recombination was about 3% in this condition. We think that our experiment method for ion recombination correction will be useful tool for radiation dosimetry in continuous beam.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.365-368
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• 2002

Background: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. Material and Method: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. Result: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups, Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p<0.01) and ventilator, support time(14.9 vs 56.2 hours, p<0.01) were significantly shorter in the OPCAB group. Total hospital coats were 17,220,000 add 21,250,000(Korean Won) in group I and II, respectively(p<0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II. Conclusion: OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.

• Korean Journal of Adult Nursing
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• v.12 no.2
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• pp.184-195
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• 2000

It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was $185.55{\pm}23.39$ points(96 min. and 234 max.) 2. Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were $38.32{\pm}7.21$(13 min, and 50 max.) and $52.97{\pm}8.49$points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found $35.95{\pm}6.05$(18 min, and 40 max) and $27.02{\pm}4.99$ points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4. The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

• Child Health Nursing Research
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• v.2 no.2
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• pp.45-57
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• 1996

A serious disease in a family influences the entire family member given the fact that the members closely interact with each other. Especially in terms of pediatric nursing, study on family gains importance as the need to care of families whose children with developmental disabilities and chronic disease This study was done based on The Resiliency Model of Family Adjustment and Adaptation(McCubbin, 1991) is intended to examine the stress of parents whose children suffer from cleft lip or /and cleft palate. It also helps them to cope with the stress and analyze the relationship between the stress and coping This study used Family Inventory of Life Events and Changes (FILE) and Coping Health Inventory for Parents(CHIP) for measuring family stress and coping. The two instruments are revised to fit the social and cultural environment of Korean culture. Data collection was done from April 18, 1996 to May 18, 1996 at 8 University medical centers located in Seoul. Those who answered questionnaires were 84 parents whose children have cleft lip or /and cleft palate. SPSS PC+ was used to analyze the data collotted. Programs used for data analysis were t-test, ANOVA, Pearson correlation coefficient. The study is summarized as follows .1. The average score of family stress is 10.46(percentage of the full score 24.90) and 'finance and business strains'(3.25), and 'intrafamily strains'(2.65) ranked the highest. The average score of family's coping is 1.93, which is close to the answer of' moderately helpful' and they are measured to put their utmost efforts to' intergration and cooperation of family and optimistic definition on the situation'. 2. There is no significant statistical correlation between the family stress and coping. 3. Mothers show more stress than fathers in the parts of 'illness and family care strains' and 'losses'(t〓-2.34, t〓-2.32, p<.05). 4. Fathers show more willingness to cope with the stress than mothers do in the parts of' seeking social support','self-esteem','emotional comfort' 5. Mothers are more stress than fathers in the parts of family stress and its coping with it by usual traits(t〓-2.78, p<.05). Parents with religion are measured to cope more willingly than those who are not 6. Income of a family shows positive correlationship with family coping (r〓.28, p<.05). The study shows that gender difference is significant variable in studying on family stress and coping. Mothers get more stress than fathers, which has much to do with the fact that they are in charge of raising children and keeping houseworks. Accordingly, managing family crisis and its survival can be induced by giving support for the mothers, studying fathers including the rest of the family members and giving nursing care and arbitration ; religious background is also considered to be one of the important factors in family stress , judging from the relationship between family income and family's coping, caring given to suffering children is needed on societal levels. The above considerations bring up the need to have a longitudinal study of children with congenital anomaly including cleft lip or /and cleft palate and their families about family stress and coping. Resiliency programs on family system and their effectiveness and the relationship between the enlarged families with social and cultural values reflecting Korean tradition are also needed to be studied.

• 한국호스피스완화의료학회:학술대회논문집
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• 2004.07a
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• pp.100-102
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• 2004

Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

• Journal of dental hygiene science
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• v.5 no.4
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• pp.211-220
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• 2005

The purpose of this study was to examine the job performance of dental coordinators and their perception of their job to lay the groundwork for utilizing dental personnels more efficiently. The subjects in this study were dental coordinators who worked at selected dental hospitals and clinics in Seoul, Gyeonggi province and Incheon. A survey was conducted to gather data from May 1 to August 8, 2005 and answer sheets from 108 respondents were analyzed. The findings of the study were as follows: 1. As for the length of service, 43.5 percent of the dental coordinators investigated had worked at dental institutes for five years or more, which was followed by less than two years(19.5%) and three years to less than five years(19.4%). Concerning the length of service as dental coordinators, 39.8 percent had served for less than two years, and 19.4 percent had worked for two years to less than three years and for five years or more respectively. Regarding the name of position, 38 percent were called team leaders, and 30.6 percent were called coordinators. As to duties, the largest group of them that stood at 30.6 percent were in charge of receiving, and in regard to department, the largest group, 57.4 percent, belonged to the treatment backup department. 2. Concerning education, the greatest number of them, 45.4 percent, had received education at private institutes, and 73.1 percent found it necessary for dental coordinators to take an authorized qualification test. 43.5 percent, the largest group, looked upon the central government as the best organization to authorize their qualifications and 70.8 percent believed that what they learned enabled them to perform their job successfully. As to the necessity of follow-up education as a means to improve job performance, 96.3 percent consented to it. As for the reason, 63.9 percent considered that necessary to enhance their own ability and 22.2 percent were in want of systematic education. Regarding educational expenses, 29.6 percent were subsidized by the dental institutes where they had worked and 25.9 percent had totally been responsible for that. Regarding a required course, medical service and marketing was most widely pointed out(66.7%), followed by theory and practice(65.7%) and introduction to dentistry(57.4%). As to what sort of education they wanted to receive more, dental service and marketing was selected the most, followed by practical health insurance(35.2%). 3. In regard to what type of job they performed as dental coordinators, 88.9 percent were in charge of appointment in the field of customer service, and 87.9 percent paid attention to having good manners as service providers in the area of self-management. In the field of hospital affairs, 81.3 percent were in charge of receiving. 4. As to their awareness of dental coordinator job, the largest group took pride in the job they performed ($3.99{\pm}0.76$), and the second largest group believed that dental coordinators made a great contribution to hospital management ($3.92{\pm}0.70$). The third largest group gave a great weight to their own job ($3.91{\pm}0.84$) in light of overall dental duties and the fourth largest group found themselves to get along with other employees regardless of position ($3.86{\pm}0.74$). The fifth largest group believed their job was of great use for promoting the oral health of patients ($3.76{\pm}0.75$), and the sixth largest group thought the future of dental coordinators was promising($3.74{\pm}0.86$). 5. In regard to their perception by age group, those who were older had a better opinion on every item of their job in general. Their age made a statistically significant difference to their view of the weight of dental coordinator job(P < 0.001) in light of overall dental duties, of being approved and trusted by managers(P < 0.01), of social awareness of dental coordinator, and of being understood and approved by other employees and dentists. Their pride in current job and their satisfaction with the name of their position were statistically significantly different according to their age as well. Besides, their age made a statistically significant difference to their opinion about whether or not there was an age limit to their occupation and about their contribution to hospital management (P < 0.05). 6. As for their perception by type of job, the dental hygienists were generally most satisfied with their job, followed by nursing aids and others. There was a statistically significant gap among their opinions about whether to make a job-related decision on their own(P < 0.001). the weight of their job in terms of overall dental duties, whether their job improved their ability, whether their job made a great contribution to enhancing the oral health of patients, whether their job was understood and approved by other employees(P < 0.01), social awareness of their job, whether they conflicted with other employees during job performance, and whether dental hospitals or clinics offered a self-development opportunity for them to take their ability to another level(P < 0.05). And their satisfaction with current pay was statistically significantly different as well.

• Korean Journal of Childcare and Education
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• v.10 no.3
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• pp.5-29
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• 2014

The purpose of this study was to find out various problem behaviors of children who were not diagnosed with any disability, but instead, engaged in problem behaviors. This study also intended to review the difficulties of children with problem behaviors, their teachers' difficulties and needs, to suggest support for child care and education teachers. This study conducted semi-structured qualitative interviews with eight child care and education teachers. The interviews were transcribed into text and analyzed by contents. The results of this study are as follows. Problem behaviors of children described by teachers were classified into external and internal types. In addition, children with problem behaviors had experienced difficulties in maintaining relationships with their teachers, peers and parents. Many teachers were not successful to provide appropriate support for preschoolers who demonstrated problem behaviors in classrooms or some teachers provided individualized support. Teachers adapted the behavioral and the psychological approaches to problem behaviors of preschoolers. However, teachers reported difficulties with children with problem behavior and brought up the following issues on teaching children with problem behaviors; managing troubled matters happening in the class, difficulty in controlling teacher's emotions on problem behaviors, the lack of time, the integrated child care time without teacher in charge of child, the interruption in activity progress, the lack of a special way to deal with problem behaviors, and difficulty in cooperation with families through parents-teacher counseling sessions. Teachers counseled with parents who had a child with problem behaviors and revealed that parents reacted to problem behaviors in various ways such as embarrassment, acceptance, ignorance, or avoidance. Most teachers received assistance and support for teaching children with problem behaviors, from families, local communities and in-service training. Lastly, teachers with preschoolers with problem behaviors needed the support of experts on managing behavior problems, assistant teaching personnel, education for parents and teachers, respects for teachers, psychological counseling or play therapy from professional service agencies, diagnosis service at child care and education centers which children attended, and support networking with agencies. Teachers also required the family support of medical diagnosis and psychological counseling and financial support from the government.