• Women's Health Nursing
• /
• v.6 no.2
• /
• pp.234-257
• /
• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• Journal of Hospice and Palliative Care
• /
• v.13 no.2
• /
• pp.109-119
• /
• 2010

Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

• Korean Journal of Ecology and Environment
• /
• v.53 no.3
• /
• pp.229-240
• /
• 2020

In this study, the results of fish assemblage survey for 16 reservoirs in the Yeongsan·Seomjin-River watershed were presented with fish assemblage characteristics analysis in relation to reservoir size. The survey method including number of sampling sites was followed the "Biomonitoring survey and assessment manual" of the Ministry of Environment/National Institute of Environmental Research (MOE/NIER), and the reservoirs were categorized as three size groups, small, medium or large reservoirs, based on the MOE/NIER as well. Total 13 family classified into 44 species were collected from 2018 (7 reservoirs) to 2019 (9 reservoirs), and the dominant and subdominant species were Hemiculter eigenmanni (Relative abundance, RA, 32.9%) and Lepomis macrochirus (RA, 31.4%), respectively. As a result of the analysis in relation to the reservoir size, the average (±standard deviation) number of species of the small, medium and large reservoirs were 11±2.9, 14.3±2.1, 22.7±0.6, respectively, which showed positive correlation with the reservoir size. Total 6 fish assemblage characteristics(number of species, number of individuals, richness index, herbivorous fish ratio, carnivorous fish ratio, exotic fish ratio) showed significant differences between the each reservoir size groups (P<0.05). As a result of cluster analysis, 16 reservoirs were clustered into 5 groups with 60% similarity, and the each reservoirs seems to be clustered depends on the distance from each other, watershed and their historical geology rather than size. These results are baseline information for the understanding of fish assemblage in Korean reservoirs, important for establishing management policy of reservoirs in the Yeongsan·Seomjin-River watershed.

• Asia pacific journal of information systems
• /
• v.22 no.4
• /
• pp.7-29
• /
• 2012

Smartphone and its applications (i.e. apps) are increasingly penetrating consumer markets. According to a recent report from Korea Communications Commission, nearly 50% of mobile subscribers in South Korea are smartphone users that accounts for over 25 million people. In particular, the importance of smartphone has risen as a geospatially-aware device that provides various location-based services (LBS) equipped with GPS capability. The popular LBS include map and navigation, traffic and transportation updates, shopping and coupon services, and location-sensitive social network services. Overall, the emerging location-based smartphone apps (LBA) offer significant value by providing greater connectivity, personalization, and information and entertainment in a location-specific context. Conversely, the rapid growth of LBA and their benefits have been accompanied by concerns over the collection and dissemination of individual users' personal information through ongoing tracking of their location, identity, preferences, and social behaviors. The majority of LBA users tend to agree and consent to the LBA provider's terms and privacy policy on use of location data to get the immediate services. This tendency further increases the potential risks of unprotected exposure of personal information and serious invasion and breaches of individual privacy. To address the complex issues surrounding LBA particularly from the user's behavioral perspective, this study applied the privacy calculus model (PCM) to explore the factors that influence the adoption of LBA. According to PCM, consumers are engaged in a dynamic adjustment process in which privacy risks are weighted against benefits of information disclosure. Consistent with the principal notion of PCM, we investigated how individual users make a risk-benefit assessment under which personalized service and locatability act as benefit-side factors and information privacy risks act as a risk-side factor accompanying LBA adoption. In addition, we consider the moderating role of trust on the service providers in the prohibiting effects of privacy risks on user intention to adopt LBA. Further we include perceived ease of use and usefulness as additional constructs to examine whether the technology acceptance model (TAM) can be applied in the context of LBA adoption. The research model with ten (10) hypotheses was tested using data gathered from 98 respondents through a quasi-experimental survey method. During the survey, each participant was asked to navigate the website where the experimental simulation of a LBA allows the participant to purchase time-and-location sensitive discounted tickets for nearby stores. Structural equations modeling using partial least square validated the instrument and the proposed model. The results showed that six (6) out of ten (10) hypotheses were supported. On the subject of the core PCM, H2 (locatability ${\rightarrow}$ intention to use LBA) and H3 (privacy risks ${\rightarrow}$ intention to use LBA) were supported, while H1 (personalization ${\rightarrow}$ intention to use LBA) was not supported. Further, we could not any interaction effects (personalization X privacy risks, H4 & locatability X privacy risks, H5) on the intention to use LBA. In terms of privacy risks and trust, as mentioned above we found the significant negative influence from privacy risks on intention to use (H3), but positive influence from trust, which supported H6 (trust ${\rightarrow}$ intention to use LBA). The moderating effect of trust on the negative relationship between privacy risks and intention to use LBA was tested and confirmed by supporting H7 (privacy risks X trust ${\rightarrow}$ intention to use LBA). The two hypotheses regarding to the TAM, including H8 (perceived ease of use ${\rightarrow}$ perceived usefulness) and H9 (perceived ease of use ${\rightarrow}$ intention to use LBA) were supported; however, H10 (perceived effectiveness ${\rightarrow}$ intention to use LBA) was not supported. Results of this study offer the following key findings and implications. First the application of PCM was found to be a good analysis framework in the context of LBA adoption. Many of the hypotheses in the model were confirmed and the high value of $R^2$ (i.,e., 51%) indicated a good fit of the model. In particular, locatability and privacy risks are found to be the appropriate PCM-based antecedent variables. Second, the existence of moderating effect of trust on service provider suggests that the same marginal change in the level of privacy risks may differentially influence the intention to use LBA. That is, while the privacy risks increasingly become important social issues and will negatively influence the intention to use LBA, it is critical for LBA providers to build consumer trust and confidence to successfully mitigate this negative impact. Lastly, we could not find sufficient evidence that the intention to use LBA is influenced by perceived usefulness, which has been very well supported in most previous TAM research. This may suggest that more future research should examine the validity of applying TAM and further extend or modify it in the context of LBA or other similar smartphone apps.

• Korean Security Journal
• /
• no.26
• /
• pp.29-58
• /
• 2011

Since 11 September 2001, warnings of risk in the nexus of terrorism and nuclear weapons and materials which poses one of the gravest threats to the international community have continued. The purpose of this study is to analyze the aim, principles, characteristics, activities, impediments to progress and developmental recommendation of the Global Initiative to Combat Nuclear Terrorism(GICNT). In addition, it suggests implications of the GICNT for the ROK policy. International community will need a comprehensive strategy with four key elements to accomplish the GICNT: (1) securing and reducing nuclear stockpiles around the world, (2) countering terrorist nuclear plots, (3) preventing and deterring state transfers of nuclear weapons or materials to terrorists, (4) interdicting nuclear smuggling. Moreover, other steps should be taken to build the needed sense of urgency, including: (1) analysis and assessment through joint threat briefing for real nuclear threat possibility, (2) nuclear terrorism exercises, (3) fast-paced nuclear security reviews, (4) realistic testing of nuclear security performance to defeat insider or outsider threats, (5) preparing shared database of threats and incidents. As for the ROK, main concerns are transfer of North Korea's nuclear weapons, materials and technology to international terror groups and attacks on nuclear facilities and uses of nuclear devices. As the 5th nuclear country, the ROK has strengthened systems of physical protection and nuclear counterterrorism based on the international conventions. In order to comprehensive and effective prevention of nuclear terrorism, the ROK has to strengthen nuclear detection instruments and mobile radiation monitoring system in airports, ports, road networks, and national critical infrastructures. Furthermore, it has to draw up effective crisis management manual and prepare nuclear counterterrorism exercises and operational postures. The fundamental key to the prevention, detection and response to nuclear terrorism which leads to catastrophic impacts is to establish not only domestic law, institution and systems, but also strengthen international cooperation.

• Economic and Environmental Geology
• /
• v.51 no.4
• /
• pp.381-392
• /
• 2018

This study examines strategies and implementation plans for commercializing $CO_2$ capture and storage, which is an effective method to achieve the national goal of reducing greenhouse gas. In order to secure cost-efficient business model of $CO_2$ capture and storage, we propose four key strategies, including 1) urgent need to select a large-scale storage site and to estimate realistic storage capacity, 2) minimization of source-to-sink distance, 3) cost-effectiveness through technology innovation, and 4) policy implementation to secure public interest and to encourage private sector participation. Based on these strategies, the implementation plans must be designed for enabling $CO_2$ capture and storage to be commercialized until 2030. It is desirable to make those plans in which large-scale demonstration and subsequent commercial projects share a single storage site. In addition, the plans must be able to deliver step-wised targets and assessment processes to decide if the project will move to the next stage or not. The main target of stage 1 (2019 ~ 2021) is that the large-scale storage site will be selected and post-combustion capture technology will be upgraded and commercialized. The site selection, which is prerequisite to forward to the next stage, will be made through exploratory drilling and investigation for candidate sites. The commercial-scale applicability of the capture technology must be ensured at this stage. Stage 2 (2022 ~ 2025) aims design and construction of facility and infrastructure for successful large-scale demonstration (million tons of $CO_2$ per year), i.e., large-scale $CO_2$ capture, transportation, and storage. Based on the achievement of the demonstration project and the maturity of carbon market at the end of stage 2, it is necessary to decide whether to enter commercialization of $CO_2$ capture and storage. If the commercialization project is decided, it will be possible to capture and storage 4 million tons of $CO_2$ per year by the private sector in stage 3 (2026 ~ 2030). The existing facility, infrastructure, and capture plant will be upgraded and supplemented, which allows the commercialization project to be cost-effective.

• Journal of Hospice and Palliative Care
• /
• v.13 no.3
• /
• pp.153-160
• /
• 2010

Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

• Journal of Food Hygiene and Safety
• /
• v.27 no.3
• /
• pp.277-284
• /
• 2012

The objective of this study was to investigate and evaluate microbial contamination levels of leafy greens (perilla leaf and lettuce) and its distributing conditions at different seasons (Feb, May, Aug, and Nov of the year 2011) in order to provide insight into any potential health hazards associated with consumption of these commodities. Leafy greens were collected from a farm located in Geumsan, Chungnam and wholesale markets (WM) and traditional markets (TM) located in Suwon. At the same time, temperature and relative humidity fluctuations experienced by the leafy greens during distribution from the farm to the distribution center were measured by a data logger. The contamination levels of perilla leaf and lettuce were determined by analyzing total plate count. Coliform groups, Bacillus cereus, Escherichia coli, Escherichia coli O157:H7, Salmonella spp., Listeria monocytogenes and Staphylococcus aureus were determined. The contamination levels of total aerobic bacteria, coliform groups and B. cereus in both vegetables sampled during May and August found to be higher than those sampled during February and November. E. coli O157:H7, Salmonella spp., L. monocytogenes were not detected in the vegetables analyzed in this study. There were no significant trends between samples at WM and TM in the contamination levels. Relative humidity of vegetables distributed from the farm to the distribution center showed over 90% during distribution regardless of measured seasons. In the case of background microflora on leafy greens, the density was significantly increased at 20, 30 and $37^{\circ}C$ during storage of 24h. E. coli O157:H7 and B. cereus inoculated on the leaves also showed similar increases in the storage tests. The microbial contamination levels determined in this study may be used as the fundamental data for microbial risk assessment.

• Korean Journal of Agricultural and Forest Meteorology
• /
• v.14 no.3
• /
• pp.132-141
• /
• 2012

Climate change impact assessment of cereal crop production in South Korea was performed using land attributes and daily weather data at a farm scale as inputs to crop models. Farmlands in South Korea were grouped into 68 crop-simulation zone units (CZU) based on major mountains and rivers as well as existing land use information. Daily weather data at a 1-km grid spacing under the A1B- and RCP8.5 scenarios were generated stochastically to obtain decadal mean of daily data. These data were registered to the farmland grid cells and spatially averaged to represent climate conditions in each CZU. Monthly climate data for each decade in 2001~2100 were transformed to 30 sets of daily weather data for each CZU by using a stochastic weather generator. Soil data and crop management information for 68 CZU were used as inputs to the CERES-rice, CERE-barley and CROPGRO-soybean models calibrated to represent the genetic features of major domestic cultivars in South Korea. Results from the models suggested that the heading or flowering of rice, winter barley and soybean could be accelerated in the future. The grain-fill period of winter barley could be extended, resulting in much higher yield of winter barley in most CZUs than that of rice. Among the three major cereal grain crops in Korea, rice seems most vulnerable to negative impact of climate change, while little impact of climate change is expected on soybeans. Because a positive effect of climate change is projected for winter barley, policy in agricultural production should pay more attention to facilitate winter barley production as an adaptation strategy for the national food security.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.39 no.2
• /
• pp.206-225
• /
• 2012

General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.