Background: Primary goal of anticoagulation treatment in patients with mechanical heart valve is the effective prevention of thromboembolism and safe avoidance of bleeding as well. Material and Method: Two-hundred and nine patients with the St. Jude Medical prosthesis operated on between 1984 and 1995, for mitral(MVR 122), aortic(AVR 39) and double mitral and aortic valve replacement(DVR 48) respectively, were studied on the practically achieved levels of anticoagulation and the clinical outcomes. Patients were on Coumadin and followed up by monthly visit to outpatient clinic for examination and prothrombin time measurement to adjust the International Normalized Ratios(INRs) within the low-intensity target range between 1.5 and 2.5. Result: A total anticoagulation follow-up period was 1082.0 patient- years(mean 62.1 months) and INRs of 10,205 measurements were available for evaluation. The accomplished INRs among the replacement groups were not significantly different and only 65% of INRs were within the target range. And, in individual patients, only 37% of patients had INRs included within the target range in more than 70% of tests during follow-up period. The levels of INRs in patients with atrial fibrillation, which was found in 57% of patients, were definitely higher than the ones measured in patients with regular rhythm(p<0.001). Thromboembolisms were experienced by 15 patients with the incidence of 1.265%/patient- year(MVR 1.412%, AVR 0.462% and DVR 1.531%/patient-year) and major bleeding by 4 patients with the incidence of 0.337%/patient-year(MVR 0.424%, AVR none and DVR 0.383%/patient-year). Frequent as well as prolonged missing of prothrombin time tests was the main risk factor strongly associated with the thromboembolic complications(odds ratio 1.99). The proportion of INRs within target range of less than 60% in individual patient was the highly significant risk factor of both thromboembolic and overall embolic and bleeding complications(p<0.004 and p<0.002 respectively). Conclusion: In conclusion, the low-intensity therapeutic target range of INRs was adequate in patients with AVR and in sinus rhythm. However, the patients with replacement of the mitral valve were more likely to require higher target range of INRs, especially in the presence of atrial fibrillation, to achieve the practical levels of anticoagulation enough to prevent thromboembolic complications effectively. For the higher therapeutic target range of INRs between 2.0∼3.0, further accumulation of clinical evidences are required. It is highly desirable to improve the patients' compliance under continuous instructions in visiting outpatient clinic and in taking daily Coumadin without omission and to keep INRs consistently within optimal range with tight control for minimization of chances and of periods of exposure to the risk of complications. And, particularly, patients with high risk of complications and with wide fluctuation of INRs should be better managed with frequent monitoring anticoagulation levels.
The objective of this study is to suggest the utilization of educated dental hygienist as the solution to the problem of supply and demand in dental clinics that has been brought up recently. Through document research and National Health Personnel Licensing Examination Board homepage, we estimated the number of dental hygienist and the condition of employment as well as gotten a grasp of the current activities carried out by dental hygienists. Furthermore, through discussion of researchers, suggested reform bills to guarantee and extend the work of dental hygienists as well as to train dental assistant. The findings were as follows: As the result of the estimation of dental hygienist, in the year 2009, two dental hygienists structure will be formed in each dental clinic. Currently the practice ratio of non-law activities of dental hygienists is high and in order to increase the practical use of dental hygienists, there is a need to reform bills that guarantee and extend the work of dental hygienists. In order to train new labors, there is a need for cautious consideration to distinguish the activities of existing trained labors, reforming of bills, and considering from various other sectors. From present point of view, solving the problem of existing trained dental hygienists, researching for the plan of utilizing dental hygienists and carrying it into practice must be the priority.
Journal of the korean academy of Pediatric Dentistry
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v.28
no.1
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pp.16-24
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2001
The purpose of this study was to evaluate the specificity, sensitivity, and diagnostic power of caries activity test using laser fluorescence. The subjects of this study were 50 children of $7\sim9$ years old. Fluorescence from initial carious lesion of teeth illuminated by an argon laser(480nm) was observed and photographed with barrier filter. Visual examination for the dDfFtT rate and Streptococcus mutans colony counting was done to evaluate correlation with caries activity test using laser fluorescence. Data analysis was accomplished by Axelsson's method. The results from the present study can be summarized as follows: 1. There was positive correlation $(\gamma=0.48)$ between laser fluorescence test and Streptococcus mutans count. And also positive correlation $(\gamma=0.39)$ exists between laser fluorescence test and dDfFtT rate (P<0.01). 2. Positive correlation $(\gamma=0.27)$ between Streptococcus mutans colony count and dDfFtT rate was found(P<0.05). 3. When dDfFtT rate was defined to standard testing method, the specificity, senstivity, and diagnostic power of laser fluorescence test were 44.4%, 85.7%, and 87.8%. 4. When dDfFtT rate was defined to standard testing method, the specificity, senstivity, and diagnostic power of S. mutans colony counting were 77.8%, 92.9%, 84.8%. 5. When S. mutans colony counting was defined to standard testing method, sensitivity, specificity and diagnostic power of laser fluorescence test were 40.0%, 84.8%, 95.1%. In regard to above results, laser fluorescence test considered to be accurate and reliable method for determining caries activity because of it's close relationship with caries susceptibility test and caries experience measurements. And it was also considered to be practical because it would be simple, inexpensive, and time saving method.
Asia-Pacific Journal of Business Venturing and Entrepreneurship
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v.7
no.3
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pp.1-16
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2012
Under the international business circumstance, global supply chain management is considered a vital strategic challenge to small and medium-sized enterprises(SMEs) suffering from deficient resources and capabilities to exploit overseas markets comparing with large corporations. That is because they can expand their business domains into overseas markets by establishing strategic alliances with global supply chain partners. Although a wide range of previous researches have emphasized the cooperative networks in the chain, most are ignoring the importance of developing relational characteristics such as trust and reciprocity with the partners. Besides, verifying the relational factors influencing firms' export performances, some studies proposed different and inconsistent factors. According to the social capital theory, which is the social quality and networks facilitating close cooperation of inter-individual and inter-organization, provides the integrated view to identify the relational characteristics in the aspects of network, trust and reciprocal norm. Meanwhile, a number of researchers shows that global entrepreneurship is the internal and intangible resource necessary to promote SMEs' internationalization. Upon closer examination, however, they cannot explain clearly its influencing mechanism in the inter-firm cooperative relationships. This study is to verify the effect of social capital accumulated within global supply chain on SMEs' qualitative and quantitative export performance. In addition, we shed new light on global entrepreneurship expected to be concerned with the formation of social capital and the enhancement of export performances. For this purpose, the questionnaires, developed through literature review, were collected from 192 Korean SMEs affiliated in Korean Medium Industries Association and Global Chief Executive Officer's Club focusing on their memberships' international business. As a result of multi-regression analysis, the social capital - network, trust and reciprocal norm shared with global supply chain partner - as well as global entrepreneurship - innovativeness, proactiveness and risk-taking - have positive effect on SMEs' export performances. Also global entrepreneurship affects positively social capital which has mediating effect partially in the relationship between global entrepreneurship and performances. These results means that there is a structural process - global entrepreneurship(input), social capital(output), and export performances(outcome). In other words, a firm should consistently invest in and develop the social capital with global supply chain partners in order to achieve common goals, establish strategic collaborations and obtain long-term export performances. Furthermore, it is required to foster the global entrepreneurship in an organization so as to build up the social capital. More detailed practical issues and discussion are made in the conclusion.
Journal of the Korean Institute of Landscape Architecture
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v.35
no.6
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pp.29-36
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2008
This study examined the de-icing agents' stresses on Pinus strobus and Pinus thunbergii by chlorophyll fluorescence analysis. The assumption of this study was that photosynthetic efficiency was changed by de-icing agents applied onto highways in winter by altering the concentration of the de-icier, types of de-icer and leaf surface coating liquid application. The practical purpose of this study was to investigate the de-icing gents stresses on Pinus strobus by the highway area where de-icing agents were used frequently and to discover out minimizing stratages to prevent further damages. or this simulation study, a sample plot was established in Bogae-myeon, Anseong, Gyeonggi-do and Pinus strobus and Pinus thunbergii were planted for the examination in April, 2005. Five types of de-icing agents - NaCl, $CaCl_2$, T product(NS40:low cWoride de-icer type), NaCl+$CaCl_2$ and T product+$CaCl_2$ - were selected and the their concentration was altered to 0%, 5%, and 9%. Five types of de-icing agents were applied to both trees treated by a leaf surface coating liquid and trees not treated by leaf surface coating liquid. For the fluorescence analysis, the leaf surface coating liquid, which was diluted by 10 times, was sprkinkled onto the two tree species three days prior to gathering samples. Sample leaves from the two tree species were gathered at 10 o'clock in the morning of mid-August, 2006 and brought to the laboratory within three hours to be dipped in different concentrations (0%, 5%, or 9%) of the five de-icing agents for two minutes. Then the eaves were placed on the filter paper dipped in each solution on a petri dish, sealed with polyethylene film and kept in a growth chamber at $22^{\circ}C$ for 72 hours. Out of the growth chamber, the leaves were treated with a chorophyll fluorescence reaction analyzer for 30 minutes to measure the initial light acceptance rate(Fo), maximum light acceptance ate(Fv/Fm), light acceptance usage(F' q/F' m) and optical electron delivery coefficient(qP). As a result, Pinus strobus' initial light acceptance rate(Fo) decreased as T product and NaCl increased in concentration, and $Cal_2$ did not reduce much with the eaf surface coating liquid application. Maximum light acceptance rate(Fv/Fm) and light acceptance usage(F' q/F' m) decreased sharply as T product and NaCl increased in concentration and NaCl+$CaCl_2$ and T product+$CaCl_2$ did not reduce much with leaf surface coating liquid application. Optical electrons delivery coefficient (qP) decreased as T product increased in concentration on trees without the leaf surface coating liquid application and all other de-icing agents did not show much reduction. As for Pinus thunbergii, the initial light acceptance rate(Fo) decreased as T product increased in concentration, but the maximum light acceptance rate(Fv/Fm) was not reduced much by changes in concentration. light acceptance usage(F' q/F' m) decreased as NaCl increased in concentration and optical electron delivery coefficient(qP) decreased as NaCl increased in concentration in both with and without leaf surface coating liquid application. In conclusion, it was possible to plant Pinus strobus if spraying leaf surface coating liquid or cleaning deicing salt to prevent the damage caused by deicing agents was more economical than replacing the trees. If not, it was better to plant Pinus thunbergii. Another way to decrease the deicing gents stresses of landscape plants would be planting the trees further away from the roads even though it might take longer period to display its planting functions.
This study was carried out to investigate the management and support system affecting to the occupational health nursing services(OHNS) provided in group occupational health agencies(GOHA). Questionnaire was developed and distributed to 82 nurses who were working in GOHA and who agreed to participate in the survey. The results were as follow: 1. OH nurses responded were mostly in the age of twenty to thirties(89%), married(73.7%), technical college graduates(88.9%), worked in hospital(85.4%) and participated more than 1 year in group occupational health services (96.3%). 2. Fifty eight point four percent of the OH nurses worked in number of workplace more than 30 to less than 60 in the OHNS form. The figure of workplaces undertaken by nurses was ranged greatly from 9 to more than 100. Number of employees who cared by nurses were mostly under 5,000 peoples in 93.3%. The types of industry was mostly manufacturing and located in the order of factory complex area, suburban, urban and others. 3. Most OH nurses(87.8%) were fully involved in the OHNS for the SSE. Their working days to visit SSE was 5 days per week(77.8%) and one day in the GOHA at 41.3%. 4. The OH documents using by nurses were found in more than 23 different types. However, they were largely summarized in the types of 'Workplace Health Management Card', 'Personal Health Counselling Card', 'Daily Health Management Report', 'Visiting List of Workplace' and 'Sick Employee List'. 5. The items of laboratory test provided by GOHA were mostly achieved in the purpose of basic health examination. They were used to be the blood pressure check(98.8%), blood sugar test (98.8%), urine sugar and protein(91.4%), SGOT and SGPT(85.3% each), cholesterol (82.9%), hepa vaccine immunization(82.9%), r-GPT(81.7%), hemoglobin(79.3%) and triglyceride(75.5%). 6. The OH nurses(92.7%) followed the work pattern to visit the GOHA before and after small-scale enterprises(SSE) visit by car driven by nurses in 74.3%. They were payed by GOHA for transportation fees in certain amounts. However, nurse is the main person(75.0%) who covers up in case of traffic accident. If the GOHA has no transportation regulation for the formal workplace visit, data showed that nurses had been responsible to take charge(31.7%). 7. The personnel manager who takes in charge for nursing services was 'nurse' in 61.7% and 41.2% worked as the final decision maker related to nursing work. The OH nurses' opinions about factors affecting to the management were classified in the four areas such as 'Nature(Quality) of health professional'. 'Content of OHNS', 'Delivery system of the GOHS', and 'Others'. The factors were indicated highly in 'Authority as health professional', 'Level of perception of director on the OH' and 'Physical work condition for OHNS'. The things that this study suggests in the recommendation would be summarized in such as the management and supporting system working for SSE in the OHNS is necessary to reform thoroughly. The reconsidered aspects might be in the matters of number of workplaces undertaken by nurses, development of effectively practical health documents, preparation for guideline of the laboratory test in the workpleces, establishment of convenient and encouraging support system and cooperation between other health professionals with respect and skill.
University dining services have received less attention than commercial food services or other institutional food services. Marketing practitioners and researchers recognize the major impact that perceived value has on consumer behavior. The mediating role of value has not been verified in relation to satisfaction in university dining establishments, including Korea. This study intends to investigate the relationships among value, satisfaction and revisit intention of university dining attributes. This study also examines whether university dining service attributes dimensions influence value. Further, this study verifies the role of value as a mediator in the formation of customer satisfaction and revisit intention. Structural Equation Modeling has been applied to the collected data from students of three universities in Korea. The study resulted in that university dining attributes, such as food, menu and convenience, positively affected value of the university dining services. Further analysis with examination of indirect effects confirmed the positive impact of value on satisfaction in university dining services. This study verified the mediating role of value on satisfaction as student's satisfaction is enhanced through the elevation of value of university food services. Enhanced satisfaction via value also led to improvement in revisit intention. This study contributes to the academia by verifying the mediating role of value in the formation of customer satisfaction in a university dining context. This study also offers practical implications to the industry, such as suggestions on developing strategies for value-added products and services to the university dining establishments. This value research for university dining services is also meaningful by triggering future research on market segmentation, product differentiation and positioning policies. In the long run, improving value and satisfaction with university dining services need to be realized to enhance overall college experiences and other competitive advantages, such as student recruitment and enrollment, student academic evaluations, and university reputation.
To analyze dental hygienists and other manpower at dental care service institutions where a dental coordinator was working among about 200 dental care service institutions in Seoul, Gyeonggi Province, and Incheon as of June 2005 for contents of training for dental coordinators, opinions of qualification of dental coordinators, present and future services provided by dental coordinators, and awareness of dental coordinators and to provide basic data about future services, roles, and cultivation of dental coordinators, a survey was conducted and 216 copies returned were analyzed, obtaining the following results. 1. 83.8 percent needed an educational program for dental coordinators as an educational content; 41.7% had awareness of the educational content; and 83.8 percent insisted that over the intermediate level of curricula should be taken. Dental coordinator cultivation institutions identified included the institution under the control of the Korean Dental Hygienists Association and the education center for the department of dental hygiene; 76.9% insisted that an appropriate qualifying examination should be necessary. They suggested the central government department and the local government as a certification institution; 39.4% insisted that financial support for the education should be provided by financing education alone. Only 28.7% experienced dental coordinator education and 73.1% hoped to serve as a dental coordinator. They were found to expect a rise in payment(64.4%) and in the title(46.8%) after completion of the educational program. 2. 66.2% saw a dental hygienist as the most appropriate for a dental coordinator; clinical career (39.4%) and practical capacity(29.2%) were suggested as requirements for a dental coordinator; and a period of over three years(47.2%) was suggested for appropriate dental career. 3. Dental coordinators' present services included 'reservation management' for customer management, 'staff service training' for organization management, 'understanding of customer reception attitudes and actions' for self-management, 'hospital information management' for hospital marketing, 'acceptance' for hospital affairs management, and 'hospital environment management' for hospital facilities management; their future services included 'acquisition of ability to use a foreign language' for self-management, followed by 'staff service training' for organization management, 'training and counseling' for customer management, 'acquisition of counseling capacity' for self-management, 'complaining customer reception' for customer management, and 'marketing strategy implementation' for hospital marketing. 4. After comparing dental hygienists and other manpower in terms of dental coordinators' future services, dental hygienists showed interest in 'acquisition of ability to use a foreign language,' 'staff service training,' 'complaining customer reception,' and 'acquisition of counseling capacity' while other manpower showed interest in 'acquisition of ability to use a foreign language,' 'document data management,' 'acquisition of basic service manner,' 'acquisition of counseling capacity,' 'manpower management,' 'establishment and evaluation of a marketing strategy,' and 'education and counseling.' 5. As for awareness of dental coordinators, they were thought of as helpful in improving image of a dental clinic; it was found that continuous training should be necessary to develop dental coordinators' capacity; dental coordinators' services should be important and contribute to patients' qualitative satisfaction.
Journal of the Korean Institute of Landscape Architecture
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v.43
no.2
/
pp.1-12
/
2015
This study explores urban gardening and garden culture in residential area as an everydayness that has been overlooked during the modern period urbanization and investigates the meaning and value of urban gardening from the perspective of urban formations and growth in spontaneous urban residential area, Haebangchon. The result identified that urban gardening as a meaning of contemporary culture is a new clue to improving the urban physical environment and changing the lives and community network of residents. Haebangchon is one of the few remaining spontaneous habitations in Seoul, and was created as a temporary unlicensed shantytown in 1940s. It became the representative habitation for common people in downtown Seoul through the revitalization of the 60s and the local reform through self-sustaining redevelopment projects during the 70s through the 90s. This area still contains the image of times during the 50s to the 60s, the 70s to the 80s and present, with the percentage of long-term stay residents high. Within this context, the site is divided into third quarters, and the research undertaken by observation and investigation to determine characteristics of urban gardening as an everydayness. It can be said that urban gardening and garden culture in Haebangchon is a unique location culture that has accumulated in the crevices of the physical condition and culture of life. These places are an expression of resident's desires that seeking out nature and gardening as revealed in densely-populated areas and the grounds of practical acting and participating in care and cultivation. It forms a unique, indigenous local landscape as an accumulation of everyday life of residents. Urban gardens in detached home has retained the original function of the dwelling and the garden, or 'madang', and takes on the characteristic of public space through the sharing of a public nature as well as semi-private spatial characteristic. Also, urban gardens including small kitchen garden and flowerpots that appear in the narrow streets provide pleasure as a part of nature that blossoms in narrow alley and functions as a public garden for exchanging with neighbors by sharing produce. This paper provides the concept of redefining the relationship between the private-public area that occurs between outside spaces that are cut off in a modern city.
This research aims to explore the associated linguistic features and functions of Chinese as used for business trading purposes, and which is based on a discourse analysis through a case in which a Korean buyer and a Chinese supplier have exchanged Internet based e-mails. The research questions include first, the linguistic functions and characteristics of Chinese shown as identified in this trade case through e-mails, second, the use of Chinese trade specific terms, and third, the apparent and dynamic negotiation strategies that are identified as followed by the cultural value systems which are used for resolving interest conflicts and issues between the buyer and supplier in the course of negotiating business contracts between two parties. The participants of this research pertain to a Korean buyer, James and a Chinese supplier, Sonya. The associated data consists of 74 e-mails exchanged between the two parties, initiated in an effort to begin and complete a trade item, in this case namely the product of napkin holders. The research for the study is based on the discourse analysis and empirically analyses models of Chinese linguistic functions and features. The findings are the following. First, as identified, the specific Chinese functions used and sequenced in this trade case are of a procedure, request, informing, negotiation and persuasion. Second, the essential trade terms used in this business interaction involve the relevant issues of 1) ordering and price negotiating, 2) marking the origin of the products, 3) the arrangement of the product examination and customs declaration for the anticipated import items, 4) preparation of the necessary legal documents, and 5) the package and transport of the product in the final instance. Third, the impact of the similarities and differences in the cultural value systems between Korea and China on the negotiations and conflict resolution during a negotiated contract between two parties are speculated in terms of the use of culturally based techniques such as face-saving and the utilization of uncertainty-avoiding strategies as meant to prevent misunderstandings from developing between the parties. The concluding part of the study discusses the implications for a practical Chinese language education utilizing the linguistic functions and features of the Chinese culture and language strategies as useful in business associations for trading purposes, and the importance of intercultural communication styles based on similar of different identified cultural values as noted between two parties.
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